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Aim

Investigation of robotic-assisted tilt-table therapy for early-stage spinal cord injury rehabilitation. Colm T. D. Craven, MEngSc; Henrik Gollee, PhD; Sylvie Coupaud, PhD; Mariel A. Purcell, MRCGP; David B. Allan, FRCS. Aim

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Aim

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  1. Investigation of robotic-assisted tilt-table therapy for early-stage spinal cord injury rehabilitation Colm T. D. Craven, MEngSc; Henrik Gollee, PhD; Sylvie Coupaud, PhD; Mariel A. Purcell, MRCGP; David B. Allan, FRCS

  2. Aim • Investigate physical exertion rate of robotic-assisted tilt-table therapy (RATTT) in patients with spinal cord injury (SCI). • Compare response of patients with motor-complete SCI (cSCI) and motor-incomplete SCI (iSCI). • Relevance • RATTT may provide strong training stimulus to complement conventional physiotherapy. • RATTT may both increase orthostatic tolerance and attenuate decline in aerobic fitness.

  3. Method • Participants • 3 cSCI. • 3 iSCI. • Protocol • 5 discrete phases, 5 min each • Measures • Continuous: pulmonary gas exchange, ventilator, heart rate. • Final 30 s: blood pressure.

  4. Method • Testing phases: • 1. Subject supine; no stepping profile imposed. • 2. Subject tilted to 70 from horizontal at 0.06 rad/s. • 3. Robotic orthoses provided full guidance force. • cSCI: No volitional effort. • 4a. iSCI only. Guidance force reduced, volitional effort increased. • 4b. Functional electrical stimulation (FES) applied. • iSCI subjects instructed to continue volitional participation.

  5. Results • iSCI • O2 uptake, respiratory exchange ratio (RER), minute ventilation, heart rate: • Significantly increased in Phases 4a and 4b only. • cSCI • Minute ventilation: • Small but significant increase. • iSCI vs cSCI • O2 uptake, RER, minute ventilation, heart rate: • No difference in Phases 1-3. • Significantly larger in Phase 4b for iSCI. • Mean arterial pressure significantly larger in all phases for iSCI.

  6. Conclusion • Volitional effort led to increased cardio-pulmonary and ventilatory response during RATTT. • Sustained or improved with addition of FES. • Patients with iSCI: • Period of training with volitional contribution could improve cardiopulmonary and ventilatory fitness. • Patients with cSCI: • FES-assisted RATTT may be sufficient to attenuate fitness losses.

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