Engineering Commons^™

The Value Of High Intensity Locomotor Training Applied To Patients With Acute-Onset Neurologic Injury, Meghan Fahey, Gabrielle Brazg, Christopher E. Henderson, Abby Plawecki, Emily H. Lucas, Darcy S. Reisman, Brian D. Schmit, T. George Hornby

Biomedical Engineering Faculty Research and Publications

The purpose of this review is to delineate some of the evidence regarding the effects of exercise intensity during locomotor training in patients with stroke and iSCI. We provide specific definitions of exercise intensity used within the literature, describe methods used to ensure appropriate levels of exertion, and discuss potential adverse events and safety concerns during its application. Further details on the effects of locomotor training intensity on clinical outcomes, and on neuromuscular and cardiovascular function will be addressed as available. Existing literature across multiple studies and meta-analyses reveals that exercise training intensity is likely a major factor that can …

Stepping Responses To Treadmill Perturbations Vary With Severity Of Motor Deficits In Human Sci, Virginia W. T. Chu, T. George Hornby, Brian Schmit

Biomedical Engineering Faculty Research and Publications

In this study, we investigated the responses to tread perturbations during human stepping on a treadmill. Our approach was to test the effects of perturbations to a single leg using a split-belt treadmill in healthy participants and in participants with varying severity of spinal cord injury (SCI). We recruited 11 people with incomplete SCI and 5 noninjured participants. As participants walked on an instrumented treadmill, the belt on one side was stopped or accelerated briefly during mid to late stance. A majority of participants initiated an unnecessary swing when the treadmill was stopped in mid stance, although the likelihood of …

High-Intensity Variable Stepping Training In Patients With Motor Incomplete Spinal Cord Injury: A Case Series, Carey L. Holleran, Patrick W. Hennessey, Abigail L. Leddy, Gordhan B. Mahtani, Gabrielle Brazg, Brian D. Schmit, T. George Hornby

Biomedical Engineering Faculty Research and Publications

Background and Purpose: Previous data suggest that large amounts of high-intensity stepping training in variable contexts (tasks and environments) may improve locomotor function, aerobic capacity, and treadmill gait kinematics in individuals poststroke. Whether similar training strategies are tolerated and efficacious for patients with other acute-onset neurological diagnoses, such as motor incomplete spinal cord injury (iSCI), is unknown. Individuals with iSCI potentially have greater bilateral impairments. This case series evaluated the feasibility and preliminary short- and long-term efficacy of highintensity variable stepping practice in ambulatory participants for more than 1 year post-iSCI.

Case Series Description: Four participants with iSCI (neurological levels …

Robotic Resistance Treadmill Training Improves Locomotor Function In Children With Cerebral Palsy: A Randomized Controlled Pilot Study, Ming Wu, Janis Kim, Deborah J. Gaebler-Spira, Brian D. Schmit, Pooja Arora

Biomedical Engineering Faculty Research and Publications

Objective

To determine whether applying controlled resistance forces to the legs during the swing phase of gait may improve the efficacy of treadmill training as compared with applying controlled assistance forces in children with cerebral palsy (CP).

Design

Randomized controlled study.

Setting

Research unit of a rehabilitation hospital.

Participants

Children with spastic CP (N=23; mean age, 10.6y; range, 6–14y; Gross Motor Function Classification System levels, I–IV).

Interventions

Participants were randomly assigned to receive controlled assistance (n=11) or resistance (n=12) loads applied to the legs at the ankle. Participants underwent robotic treadmill training 3 times a week for 6 weeks (18 …

Repeat Exposure To Leg Swing Perturbations During Treadmill Training Induces Long-Term Retention Of Increased Step Length In Human Sci: A Pilot Randomized Controlled Study, Ming Wu, Jill M. Landry, Janis Kim, Brian D. Schmit, Sheng-Che Yen, Jillian Mcdonald, Yunhui Zhang

Biomedical Engineering Faculty Research and Publications

Objective: To determine whether repeat exposure to force perturbations during treadmill training can induce long-term retention of improved step length and overall improvements in locomotor function in persons with spinal cord injury.

Design: Fourteen patients with spinal cord injury were recruited and randomly assigned to swing resistance or swing assistance training groups. A controlled swing resistance or assistance force, for resistance or assistance training groups, respectively, was applied to both legs through a cable-driven robotic system during treadmill training. Each participant trained 3 times per week for 6 weeks. Step length, walking speed, 6-minute walking distance, and other clinical assessments …

A Novel Fmri Paradigm Suggests That Pedaling-Related Brain Activation Is Altered After Stroke, Nutta-On Promjunyakul, Brian D. Schmit, Sheila M. Schindler-Ivens

Physical Therapy Faculty Research and Publications

The purpose of this study was to examine the feasibility of using functional magnetic resonance imaging (fMRI) to measure pedaling-related brain activation in individuals with stroke and age-matched controls. We also sought to identify stroke-related changes in brain activation associated with pedaling. Fourteen stroke and 12 control subjects were asked to pedal a custom, MRI-compatible device during fMRI. Subjects also performed lower limb tapping to localize brain regions involved in lower limb movement. All stroke and control subjects were able to pedal while positioned for fMRI. Two control subjects were withdrawn due to claustrophobia, and one control data set was …

Changes In Hemodynamic Responses In Chronic Stroke Survivors Do Not Affect Fmri Signal Detection In A Block Experimental Design, Nutta-On Promjunyakul, Brian D. Schmit, Sheila Schindler-Ivens

Physical Therapy Faculty Research and Publications

The use of canonical functions to model BOLD-fMRI data in people post-stroke may lead to inaccurate descriptions of task-related brain activity. The purpose of this study was to determine whether the spatiotemporal profile of hemodynamic responses (HDRs) obtained from stroke survivors during an event-related experiment could be used to develop individualized HDR functions that would enhance BOLD-fMRI signal detection in block experiments. Our long term goal was to use this information to develop individualized HDR functions for stroke survivors that could be used to analyze brain activity associated with locomotor-like movements. We also aimed to examine the reproducibility of HDRs …

Robotic Resistance Treadmill Training Improves Locomotor Function In Human Spinal Cord Injury: A Pilot Study, Ming Wu, Jill M. Landry, Brian Schmit, T. George Hornby, Sheng-Che Yen

Biomedical Engineering Faculty Research and Publications

Objective

To determine whether cable-driven robotic resistance treadmill training can improve locomotor function in humans with incomplete spinal cord injury (SCI).

Design

Repeated assessment of the same patients with crossover design.

Setting

Research units of rehabilitation hospitals in Chicago.

Participants

Patients with chronic incomplete SCI (N=10) were recruited to participate in this study.

Interventions

Subjects were randomly assigned to 1 of 2 groups. One group received 4 weeks of assistance training followed by 4 weeks of resistance training, while the other group received 4 weeks of resistance training followed by 4 weeks of assistance training. Locomotor training was provided by …

Locomotor Adaptation To Resistance During Treadmill Training Transfers To Overground Walking In Human Sci, Sheng-Che Yen, Brian D. Schmit, Jill M. Landry, Heidi Roth, Ming Wu

Biomedical Engineering Faculty Research and Publications

Treadmill training has been used as a promising technique to improve overground walking in patients with spinal cord injury (SCI). Previous findings showed that a gait pattern may adapt to a force perturbation during treadmill training and show aftereffects following removal of the force perturbation. We hypothesized that aftereffects would transfer to overground walking to a greater extent when the force perturbation was resisting rather than assisting leg swing during treadmill training. Ten subjects with incomplete SCI were recruited into this study for two treadmill training sessions: one using swing resistance and the other using swing assistance during treadmill stepping. …

Parallel Facilitatory Reflex Pathways From The Foot And Hip To Flexors And Extensors In The Injured Human Spinal Cord, Maria Knikou, Elizabeth Kay, Brian D. Schmit

Biomedical Engineering Faculty Research and Publications

Spinal integration of sensory signals associated with hip position, muscle loading, and cutaneous sensation of the foot contributes to movement regulation. The exact interactive effects of these sensory signals under controlled dynamic conditions are unknown. The purpose of the present study was to establish the effects of combined plantar cutaneous afferent excitation and hip movement on the Hoffmann (H) and flexion reflexes in people with a spinal cord injury (SCI). The flexion and H-reflexes were elicited through stimulation of the right sural (at non-nociceptive levels) and posterior tibial nerves respectively. Reflex responses were recorded from the ipsilateral tibialis anterior (TA) …