Should body weight-supported treadmill training and robotic-assistive steppers for locomotor training trot back to the starting gate?

Neurorehabilitation and Neural Repair

Volumn 26, Issue 4, 2012, Pages 308-317

  Dobkin, Bruce H ^a   Duncan, Pamela W ^b  

^a UNIVERSITY OF CALIFORNIA   (United States)

^b WAKE FOREST UNIVERSITY   (United States)

Author keywords

central pattern generators; clinical trials; exercise therapy; locomotion; motor activity; physical therapy modalities; robotics; spinal cord injury rehabilitation; stroke rehabilitation; walking

Indexed keywords

BODY WEIGHT; BODY WEIGHT SUPPORTED TREADMILL TRAINING; HUMAN; LOCOMOTION; NERVE CELL NETWORK; NERVE CELL PLASTICITY; NONHUMAN; PHYSIOTHERAPY; RETROSPECTIVE STUDY; REVIEW; ROBOTIC ASSISTED STEP TRAINING; THORACIC SPINAL CORD; TREADMILL EXERCISE;

ANIMALS; EXERCISE THERAPY; GAIT DISORDERS, NEUROLOGIC; HUMANS; LOCOMOTION; PHYSICAL THERAPY MODALITIES; RETROSPECTIVE STUDIES; ROBOTICS; WEIGHT-BEARING;

EID: 84860807407     PISSN: 15459683     EISSN: 15526844     Source Type: Journal    
DOI: 10.1177/1545968312439687     Document Type: Review

References (97)

1. Dobkin B. Overview of treadmill locomotor training with partial body weight support: a neurophysiologically sound approach whose time has come for randomized clinical trials. Neurorehabil Neural Repair. 1999 ; 13: 157-165 (Pubitemid 30152169)
2. Dobkin B, Apple D, Barbeau H, et al. Methods for a randomized trial of weight-supported treadmill training versus conventional training for walking during inpatient rehabilitation after incomplete traumatic spinal cord injury. Neurorehabil Neural Repair. 2003 ; 17: 153-167 (Pubitemid 37099592)
3. Duncan PW, Sullivan KJ, Behrman AL, et al. Protocol for the Locomotor Experience Applied Post-stroke (LEAPS) trial: a randomized controlled trial. BMC Neurol. 2007 ; 7: 39
4. Dobkin B, Apple D, Barbeau H, et al. Weight-supported treadmill vs over-ground training for walking after acute incomplete SCI. Neurology. 2006 ; 66: 484-493
5. Duncan P, Sullivan K, Behrman A, et al. Body-weight-supported treadmill rehabilitation program after stroke. N Engl J Med. 2011 ; 364: 2026-2036
6. Behrman A, Harkema S. Locomotor training after human spinal cord injury: a series of case studies. Phys Ther. 2000 ; 80: 688-700 (Pubitemid 30441698)
7. Hesse S, Schmidt H, Werner C, Bardeleben A. Upper and lower extremity robotic devices for rehabilitation and for studying motor control. Curr Opin Neurol. 2003 ; 16: 705-710 (Pubitemid 38429245)
8. Mehrholz J, Kugler J, Pohl M. Locomotor training for walking after spinal cord injury. Cochrane Database Syst Rev. 2008 ; ( 2 ):
9. Mehrholz J, Werner C, Kugler J, Pohl M. Electromechanical-assisted training for walking after stroke. Cochrane Database Syst Rev. 2007 ; ( 4 ):
10. Moseley AM, Stark A, Cameron ID, Pollock A. Treadmill training and body weight support for walking after stroke. Cochrane Database Syst Rev. 2005 ; ( 4 ):
11. Wessels M, Lucas C, Eriks I, de Groot S. Body weight-supported gait training for restoration of walking in people with an incomplete spinal cord injury: a systematic review. J Rehabil Med. 2010 ; 42: 513-519
12. Tefertiller C, Pharo B, Evans N, Winchester P. Efficacy of rehabilitation robotics for walking training in neurological disorders: a review. J Rehabil Res Dev. 2011 ; 48: 387-416
13. Damiano D, DeJong S. A systematic review of the effectiveness of treadmill training and body weight support in pediatric rehabilitation. J Neurol Phys Ther. 2009 ; 33: 27-44
14. Swinnen E, Duerinck S, Baeyens J, Meeusen R, Kerckhofs E. Effectiveness of robot-assisted gait training in persons with spinal cord injury: a systematic review. J Rehabil Med. 2010 ; 42: 520-526
15. Nooijen C, Ter Hoeve N, Field-Fote E. Gait quality is improved by locomotor training in individuals with SCI regardless of training approach. J Neuroeng Rehabil. 2009 ; 6: 36
16. Field-Fote E, Roach K. Influence of a locomotor training approach on walking speed and distance in people with chronic spinal cord injury: a randomized clinical trial. Phys Ther. 2011 ; 91: 48-60
17. Franceschini M, Carda S, Agosti M, Antenucci R, Malgrati D, Cisari C. Walking after stroke: what does treadmill training with body weight support add to overground gait training in patients early after stroke? A single-blind, randomized, controlled trial. Stroke. 2009 ; 40: 3079-3085
18. Ada L, Dean C, Morris M, Simpson J, Katrak P. Randomized trial of treadmill walking with body weight support to establish walking in subacute stroke: the MOBILISE trial. Stroke. 2010 ; 41: 1237-1242
19. Høyer E, Jahnsen R, Stanghelle J, Strand L. Body weight supported treadmill training versus traditional training in patients dependent on walking assistance after stroke: a randomized controlled trial. Disabil Rehabil. 2011 ; 34: 210-219
20. Willoughby K, Dodd K, Shields N, Foley S. Efficacy of partial body weight-supported treadmill training compared with overground walking practice for children with cerebral palsy: a randomized controlled trial. Arch Phys Med Rehabil. 2010 ; 91: 333-339
21. Hidler J, Nichols D, Pelliccio M, et al. Multicenter randomized clinical trial evaluating the effectiveness of the Lokomat in subacute stroke. Neurorehabil Neural Repair. 2009 ; 23: 5-13
22. Picelli A, Melotti C, Origano F, et al. Robot-assisted gait training in patient with Parkinson disease: a randomized controlled trial [published online ahead of print January 18, 2012]. Neurorehabil Neural Repair. :
23. Beer S, Aschbacher B, Manoglou D, Gamper E, Kool J, Kesselring J. Robot-assisted gait training in multiple sclerosis: a pilot randomized trial. Mult Scler. 2008 ; 14: 231-236 (Pubitemid 351639632)
24. Vaney C, Gattlen B, Lugon-Moulin V, et al. Robotic-assisted step training (Lokomat) not superior to equal intensity of over-ground rehabilitation in patients with multiple sclerosis [published online ahead of print December 2, 2012]. Neurorehabil Neural Repair. :
25. Lo AC, Triche EW. Improving gait in multiple sclerosis using robot-assisted, body weight supported treadmill training. Neurorehabil Neural Repair. 2008 ; 22: 661-671
26. Schwartz I, Sajin A, Moreh E, et al. Robot-assisted gait training in multiple sclerosis patients: a randomized trial [published online ahead of print December 6, 2011]. Mult Scler. :
27. Wirz M, Bastiaenen C, de Bie R, Dietz V. Effectiveness of automated locomotor training in patients with acute incomplete spinal cord injury: a randomized controlled multicenter trial. BMC Neurol. 2011 ; 11: 60
28. Grillner S. Neurobiological bases for rhythmic motor acts in vertebrates. Science. 1985 ; 228: 143-149 (Pubitemid 15117269)
29. Barbeau H, Rossignol S. Recovery of locomotion after chronic spinalization in the adult cat. Brain Res. 1987 ; 412: 84-95 (Pubitemid 17096686)
30. Lovely R, Gregor R, Roy R, Edgerton V. Weight-bearing hindlimb stepping in treadmill-exercised adult spinal cats. Brain Res. 1990 ; 514: 206-218 (Pubitemid 20151373)
31. Ichiyama RM, Courtine G, Gerasimenko YP, et al. Step training reinforces specific spinal locomotor circuitry in adult spinal rats. J Neurosci. 2008 ; 28: 7370-7375
32. Lavrov I, Courtine G, Dy C, et al. Facilitation of stepping with epidural stimulation in spinal rats: role of sensory input. J Neurosci. 2008 ; 28: 7774-7780
33. Singh A, Balasubramanian S, Murray M, Lemay M, Houle J. Role of spared pathways in locomotor recovery after body-weight-supported treadmill training in contused rats. J Neurotrauma. 2011 ; 28: 2405-2416
34. Nadeau S, Jacquemin G, Fournier C, Lamarre Y, Rossignol S. Spontaneous motor rhythms of the back and legs in a patient with complete spinal transection. Neurorehabil Neural Repair. 2010 ; 24: 377-383
35. Dobkin B, Harkema S, Requejo P, Edgerton V. Modulation of locomotor-like EMG activity in subjects with complete and incomplete chronic spinal cord injury. J Neurol Rehabil. 1995 ; 9: 183-190
36. Harkema S, Hurley S, Patel U, Dobkin B, Edgerton V. Human lumbosacral spinal cord interprets loading during stepping. J Neurophysiol. 1997 ; 77: 797-811 (Pubitemid 27087781)
37. Harkema S, Gerasimenko Y, Hodes J, et al. Effect of epidural stimulation of the lumbosacral spinal cord on voluntary movement, standing, and assisted stepping after motor complete paraplegia. Lancet. 2011 ; 377: 1938-1947
38. Blicher J, Nielsen J. Cortical and spinal excitability changes after robotic gait training. Neurorehabil Neural Repair. 2009 ; 23: 143-149
39. Levin M, Kleim J, Wolf S. What do motor "recovery" and "compensation" mean in patients following stroke?. Neurorehabil Neural Repair. 2009 ; 23: 313-319
40. Lang C, Macdonald J, Reisman D. Observation of amounts of movement practice provided during stroke rehabilitation. Arch Phys Med Rehabil. 2009 ; 90: 1692-1696
41. van Wijk R, Cumming T, Churilov L, Donnan G, Bernhardt J. An early mobilization protocol successfully delivers more and earlier therapy to acute stroke patients: further results from phase II of AVERT. Neurorehabil Neural Repair. 2012 ; 26: 20-26
42. Birkenmeier R, Prager E, Lang C. Translating animal doses of task-specific training to people with chronic stroke in 1-hour therapy sessions: a proof-of-concept study. Neurorehabil Neural Repair. 2010 ; 24: 620-635
43. Rose D, Paris T, Crews E, et al. Feasibility and effectiveness of circuit training in acute stroke rehabilitation. Neurorehabil Neural Repair. 2011 ; 25: 140-148
44. Veerbeek J, Koolstra M, Ket J, van Wegen E, Kwakkel G. Effects of augmented exercise therapy on outcome of gait and gait-related activities in the first 6 months after stroke: a meta-analysis. Stroke. 2011 ; 42: 3311-3315
45. Dobkin BH. Confounders in rehabilitation trials of task-oriented training: lessons from the designs of the EXCITE and SCILT multicenter trials. Neurorehabil Neural Repair. 2007 ; 21: 3-13 (Pubitemid 44926967)
46. Conklyn D, Stough D, Novak E, Paczak S, Chemali K, Bethoux F. A home-based walking program using rhythmic auditory stimulation improves gait performance in patients with multiple sclerosis. Neurorehabil Neural Repair. 2010 ; 24: 835-842
47. Pelton T, Johannsen L, Chen H, Wing A. Hemiparetic stepping to the beat: asymmetric response to metronome phase shift during treadmill gait. Neurorehabil Neural Repair. 2010 ; 24: 428-434
48. Dobkin B, Plummer-D'Amato P, Elashoff R, Lee J, Group S. International randomized clinical trial, Stroke Inpatient Rehabilitation With Reinforcement of Walking Speed (SIRROWS) improves outcomes. Neurorehabil Neural Repair. 2010 ; 24: 235-242
49. Timmermans A, Spooren A, Kingma H, Seelen H. Influence of task-oriented training content on skilled arm-hand performance in stroke: a systematic review. Neurorehabil Neural Repair. 2010 ; 24: 858-870
50. Kautz S, Bowden M, Clark D, Neptune R. Comparison of motor control deficits during treadmill and overground walking poststroke. Neurorehabil Neural Repair. 2011 ; 25: 756-765
51. Regnaux JP, Saremi K, Marehbian J, Bussel B, Dobkin BH. An accelerometry-based comparison of 2 robotic assistive devices for treadmill training of gait. Neurorehabil Neural Repair. 2008 ; 22: 348-354 (Pubitemid 351852634)
52. Lamontagne A, Fung J, McFadyen B, Faubert J, Paquette C. Stroke affects locomotor steering responses to changing optic flow directions. Neurorehabil Neural Repair. 2010 ; 24: 457-468
53. Krasovsky T, Levin M. Toward a better understanding of coordination in healthy and poststroke gait. Neurorehabil Neural Repair. 2010 ; 24: 213-224
54. Cramer S, Sur M, Dobkin B, et al. Harnessing neuroplasticity for clinical applications. Brain. 2011 ; 134: 1591-1609
55. Buma F, Lindeman E, Ramsey N, Kwakkel G. Functional neuroimaging studies of early upper limb recovery after stroke: a systematic review. Neurorehabil Neural Repair. 2010 ; 24: 589-608
56. Askim T, Indredavik B, Vangberg T, Haberg A. Motor network changes associated with successful motor skill relearning after acute ischemic stroke: a longitudinal fMRI study. Neurorehabil Neural Repair. 2009 ; 23: 295-304
57. de Bode S, Mathern GW, Bookheimer S, Dobkin B. Locomotor training remodels fMRI sensorimotor cortical activations in children after cerebral hemispherectomy. Neurorehabil Neural Repair. 2007 ; 21: 497-508 (Pubitemid 47585205)
58. Dobkin B, Firestine A, West M, Saremi K, Woods R. Ankle dorsiflexion as an fMRI paradigm to assay motor control for walking during rehabilitation. NeuroImage. 2004 ; 23: 370-381 (Pubitemid 39119468)
59. Winchester P, McColl R, Querry R, et al. Changes in supraspinal activation patterns following robotic locomotor therapy in motor-incomplete spinal cord injury. Neurorehabil Neural Repair. 2005 ; 19: 313-324 (Pubitemid 41705659)
60. Luft AR, Macko RF, Forrester LW, et al. Treadmill exercise activates subcortical neural networks and improves walking after stroke. A randomized controlled trial. Stroke. 2008 ; 39: 3341-3350
61. Enzinger C, Dawes H, Johansen-Berg H, et al. Brain activity changes associated with treadmill training after stroke. Stroke. 2009 ; 40: 2460-2467
62. Visintin M, Barbeau H. The effects of body weight support on the locomotor pattern of spastic paretic patients. Can J Neurol Sci. 1989 ; 16: 315-325 (Pubitemid 19213593)
63. Wernig A, Muller S, Nanassy A, Cagol E. Laufband therapy based on "Rules of Spinal Locomotion" is effective in spinal cord injured persons. Eur J Neurosci. 1995 ; 7: 823-829
64. Dietz V, Wirz M, Curt A, Colombo G. Locomotor patterns in paraplegic patients: training effects and recovery of spinal cord function. Spinal Cord. 1998 ; 36: 380-390 (Pubitemid 28276687)
65. Sullivan KJ, Knowlton BJ, Dobkin BH. Step training with body weight support: effect of treadmill speed and practice paradigms on poststroke locomotor recovery. Arch Phys Med Rehabil. 2002 ; 83: 683-691 (Pubitemid 34498887)
66. Dobkin BH. Progressive staging of pilot studies to improve phase III trials for motor interventions. Neurorehabil Neural Repair. 2009 ; 23: 197-206
67. Bowden MG, Balasubramanian CK, Behrman AL, Kautz SA. Validation of a speed-based classification system using quantitative measures of walking performance poststroke. Neurorehabil Neural Repair. 2008 ; 22: 672-675
68. Prassad V, Cifu A, Ioannidis J. Reversals of established medical practices: evidence to abandon ship. JAMA. 2012 ; 307: 37-38
69. Pohl M, Werner C, Holzgraefe M, et al. Repetitive locomotor training and physiotherapy improve walking and basic activities of daily living after stroke: a single-blind, randomized multicentre trial (DEutsche GAngtrainerStudie, DEGAS). Clin Rehabil. 2007 ; 21: 17-27 (Pubitemid 46165302)
70. Morone G, Bragoni M, Iosa M, et al. Who may benefit from robotic-assisted gait training? A randomized clinical trial in patients with subacute stroke. Neurorehabil Neural Repair. 2011 ; 25: 636-644
71. Veerbeek J, Van Wegen E, Harmeling-Van der Wel B, Kwakkel G, Investigators E. Is accurate prediction of gait in nonambulatory stroke patients possible within 72 hours poststroke? The EPOS study. Neurorehabil Neural Repair. 2011 ; 25: 268-274
72. Dobkin B, Barbeau H, Deforge D, et al. The evolution of walking-related outcomes over the first 12 weeks of rehabilitation for incomplete traumatic spinal cord injury: the multicenter randomized Spinal Cord Injury Locomotor Trial. Neurorehabil Neural Repair. 2007 ; 21: 25-35 (Pubitemid 44926969)
73. Sterr A, Shen S, Szameitat A, Herron K. The role of corticospinal tract damage in chronic motor recovery and neurorehabilitation: a pilot study. Neurorehabil Neural Repair. 2010 ; 24: 413-419
74. Qiu M, Darling W, Morecraft R, Ni C, Rajendra J, Butler A. White matter integrity is a stronger predictor of motor function than BOLD response in patients with stroke. Neurorehabil Neural Repair. 2011 ; 25: 275-284
75. Harkema S, Schmidt-Read M, Lorenz D, Edgerton V, Behrman A. Balance and ambulation improvements in individuals with chronic incomplete spinal cord injury using locomotor training-based rehabilitation [published online ahead of print July 19, 2011]. Arch Phys Med Rehabil. :
76. Harkema S, Behrman A, Barbeau H Locomotor Training: Principles and Practice. New York, NY: Oxford University Press ; 2011 :
77. Benito-Penalva J, Edwards D, Opisso E, et al. Gait training in human spinal cord injury using electromechanical systems: effect of device type and patient characteristics [published online ahead of print December 29, 2011]. Arch Phys Med Rehabil. :
78. Koenig A, Omlin X, Bergmann J, et al. Controlling patient participation during robot-assisted gait training. J Neuroeng Rehabil. 2011 ; 8: 14
79. Langhorne P, Bernhardt J, Kwakkel G. Stroke rehabilitation. Lancet. 2011 ; 377: 1693-1702
80. Langhorne P, Coupar F, Pollock A. Motor recovery after stroke: a systematic review. Lancet Neurol. 2009 ; 8: 741-754
81. Bowden M, Embry A, Gregory C. Physical therapy adjuvants to promote optimization of walking recovery after stroke. Stroke Res Treat. 2011 ; 2011: 601416
82. Lima C, Escada P, Pratas-Vital J, et al. Olfactory mucosal autografts and rehabilitation for chronic traumatic spinal cord injury. Neurorehabil Neural Repair. 2010 ; 24: 10-22
83. Dobrossy M, Busse M, Piroth T, Rosser A, Dunnett S, Nikkhah G. Neurorehabilitation with neurotransplantation. Neurorehabil Neural Repair. 2010 ; 24: 692-701
84. Dimyan M, Cohen L. Contribution of transcranial magnetic stimulation to the understanding of functional recovery mechanisms after stroke. Neurorehabil Neural Repair. 2010 ; 24 1: 25-135
85. Tanaka S, Takeda K, Otaka Y, et al. Single session of transcranial direct current stimulation transiently increases knee extensor force in patients with hemiparetic stroke. Neurorehabil Neural Repair. 2011 ; 25: 565-569
86. Tseng H, Liao K, Wang C, Lai K, Yang Y. rTMS combined with task-oriented training to improve symmetry of interhemispheric corticomotor excitability and gait performance after stroke: a randomized trial [published online ahead of print October 5, 2011]. Neurorehabil Neural Repair. :
87. Daly J, Zimbelman J, Roenigk K, et al. Recovery of coordinated gait: randomized controlled stroke trial of functional electrical stimulation (FES) versus no FES, with weight-supported treadmill and over-ground training. Neurorehabil Neural Repair. 2011 ; 25: 588-596
88. Buetefisch C, Heger R, Schicks W, Seitz R, Netz J. Hebbian-type stimulation during robot-assisted training in patients with stroke. Neurorehabil Neural Repair. 2011 ; 25: 645-655
89. Laufer Y, Elboin-Gabyzon M. Does sensory transcutaneous electrical stimulation enhance motor recovery following a stroke? A systematic review. Neurorehabil Neural Repair. 2011 ; 25: 799-809
90. Lam J, Globas C, Cerny J, et al. Predictors of response to treadmill exercise in stroke survivors. Neurorehabil Neural Repair. 2010 ; 24: 567-574
91. Globas C, Becker C, Cerny J, et al. Chronic stroke survivors benefit from high-intensity aerobic treadmill exercise: a randomized controlled trial. Neurorehabil Neural Repair. 2012 ; 26: 85-95
92. Quaney B, Boyd L, McDowd J, et al. Aerobic exercise improves cognition and motor function poststroke. Neurorehabil Neural Repair. 2009 ; 23: 879-885
93. Chang W, Kim M, Huh J, Lee P, Kim Y. Effects of robot-assisted gait training on cardiopulmonary fitness in subacute stroke patients: a randomized controlled study [published online ahead of print November 15, 2011]. Neurorehabil Neural Repair. :
94. Dickstein R. Rehabilitation of gait speed after stroke: a critical review of intervention approaches. Neurorehabil Neural Repair. 2008 ; 22: 649-660
95. Prajapati S, Gage W, Brooks D, Black SE, Mcllroy W. A novel approach to ambulatory monitoring: investigation into the quantity and control of everyday walking in patients with subacute stroke. Neurorehabil Neural Repair. 2011 ; 25: 6-14
96. Dobkin B, Dorsch A. The promise of mHealth: daily activity monitoring and outcome assessments by wearable sensors. Neurorehabil Neural Repair. 2011 ; 25: 788-798
97. Weiss A, Sharifi S, Plotnik M, van Vugt J, Giladi N, Hausdorff J. Towards automated, at-home assessment of mobility among patients with Parkinson's disease using a body-worn accelerometer. Neurorehabil Neural Repair. 2011 ; 25: 810-818