Robotic Training for Motor Rehabilitation after Complete Spinal Cord Injury

Citation

Liang, Yongqiang (2008) Robotic Training for Motor Rehabilitation after Complete Spinal Cord Injury. Dissertation (Ph.D.), California Institute of Technology. doi:10.7907/T01R-P904. https://resolver.caltech.edu/CaltechETD:etd-09202007-135027

Abstract

The spinal cord circuits have a great degree of automaticity and plasticity. They are able to generate complex locomotor patterns such as stepping and scratching even without input from supraspinal nervous systems. When provided with ensembles of afferent sensory information input associated with a specific motor task, e.g., stepping, the spinal cord can "learn" to perform that task even if it is isolated from the supraspinal nervous systems.

The plasticity of the spinal cord led researchers to study the use of physical locomotor training, e.g., treadmill step training with body weight support, to rehabilitate locomotor function after spinal cord injury (SCI). With intensive training, the spinal-cord-injured subject can recover some level of stepping ability. Explorations were made in this thesis to find an optimal training paradigm. Novel assist-as-needed paradigms were developed to allow variability during training since it is an intrinsic feature of normal stepping. Comparative experiments were conducted against fixed-trajectory training. Results demonstrated that variability is an important factor to induce more improvement in step training.

Standing is another important function in one's daily life, though it received less research attention than stepping. A prototype stand platform with 6 degrees of freedom was developed as an experimental tool for stand and postural study. Analogous to step training, we tested the effect of daily training on extensor responses in the hind limbs of complete spinal rats. The results showed no significant effect of the training. This led to the conclusion that without tonic input, the spinal cord has very limited ability to generate enough extensor muscle tone and to respond to postural disturbance. Further studies in standing rehabilitation should combine other methods to provide tonic inputs to the spinal cord.

Thesis Files