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Increased gait variability during robot-assisted walking is accompanied by increased sensorimotor brain activity in healthy people

BACKGROUND: Gait disorders are major symptoms of neurological diseases affecting the quality of life. Interventions that restore walking and allow patients to maintain safe and independent mobility are essential. Robot-assisted gait training (RAGT) proved to be a promising treatment for restoring an...

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Autores principales: Berger, Alisa, Horst, Fabian, Steinberg, Fabian, Thomas, Fabian, Müller-Eising, Claudia, Schöllhorn, Wolfgang I., Doppelmayr, Michael
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6935063/
https://www.ncbi.nlm.nih.gov/pubmed/31882008
http://dx.doi.org/10.1186/s12984-019-0636-3
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author Berger, Alisa
Horst, Fabian
Steinberg, Fabian
Thomas, Fabian
Müller-Eising, Claudia
Schöllhorn, Wolfgang I.
Doppelmayr, Michael
author_facet Berger, Alisa
Horst, Fabian
Steinberg, Fabian
Thomas, Fabian
Müller-Eising, Claudia
Schöllhorn, Wolfgang I.
Doppelmayr, Michael
author_sort Berger, Alisa
collection PubMed
description BACKGROUND: Gait disorders are major symptoms of neurological diseases affecting the quality of life. Interventions that restore walking and allow patients to maintain safe and independent mobility are essential. Robot-assisted gait training (RAGT) proved to be a promising treatment for restoring and improving the ability to walk. Due to heterogenuous study designs and fragmentary knowlegde about the neural correlates associated with RAGT and the relation to motor recovery, guidelines for an individually optimized therapy can hardly be derived. To optimize robotic rehabilitation, it is crucial to understand how robotic assistance affect locomotor control and its underlying brain activity. Thus, this study aimed to investigate the effects of robotic assistance (RA) during treadmill walking (TW) on cortical activity and the relationship between RA-related changes of cortical activity and biomechanical gait characteristics. METHODS: Twelve healthy, right-handed volunteers (9 females; M = 25 ± 4 years) performed unassisted walking (UAW) and robot-assisted walking (RAW) trials on a treadmill, at 2.8 km/h, in a randomized, within-subject design. Ground reaction forces (GRFs) provided information regarding the individual gait patterns, while brain activity was examined by measuring cerebral hemodynamic changes in brain regions associated with the cortical locomotor network, including the sensorimotor cortex (SMC), premotor cortex (PMC) and supplementary motor area (SMA), using functional near-infrared spectroscopy (fNIRS). RESULTS: A statistically significant increase in brain activity was observed in the SMC compared with the PMC and SMA (p < 0.05), and a classical double bump in the vertical GRF was observed during both UAW and RAW throughout the stance phase. However, intraindividual gait variability increased significantly with RA and was correlated with increased brain activity in the SMC (p = 0.05; r = 0.57). CONCLUSIONS: On the one hand, robotic guidance could generate sensory feedback that promotes active participation, leading to increased gait variability and somatosensory brain activity. On the other hand, changes in brain activity and biomechanical gait characteristics may also be due to the sensory feedback of the robot, which disrupts the cortical network of automated walking in healthy individuals. More comprehensive neurophysiological studies both in laboratory and in clinical settings are necessary to investigate the entire brain network associated with RAW.
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spelling pubmed-69350632019-12-30 Increased gait variability during robot-assisted walking is accompanied by increased sensorimotor brain activity in healthy people Berger, Alisa Horst, Fabian Steinberg, Fabian Thomas, Fabian Müller-Eising, Claudia Schöllhorn, Wolfgang I. Doppelmayr, Michael J Neuroeng Rehabil Research BACKGROUND: Gait disorders are major symptoms of neurological diseases affecting the quality of life. Interventions that restore walking and allow patients to maintain safe and independent mobility are essential. Robot-assisted gait training (RAGT) proved to be a promising treatment for restoring and improving the ability to walk. Due to heterogenuous study designs and fragmentary knowlegde about the neural correlates associated with RAGT and the relation to motor recovery, guidelines for an individually optimized therapy can hardly be derived. To optimize robotic rehabilitation, it is crucial to understand how robotic assistance affect locomotor control and its underlying brain activity. Thus, this study aimed to investigate the effects of robotic assistance (RA) during treadmill walking (TW) on cortical activity and the relationship between RA-related changes of cortical activity and biomechanical gait characteristics. METHODS: Twelve healthy, right-handed volunteers (9 females; M = 25 ± 4 years) performed unassisted walking (UAW) and robot-assisted walking (RAW) trials on a treadmill, at 2.8 km/h, in a randomized, within-subject design. Ground reaction forces (GRFs) provided information regarding the individual gait patterns, while brain activity was examined by measuring cerebral hemodynamic changes in brain regions associated with the cortical locomotor network, including the sensorimotor cortex (SMC), premotor cortex (PMC) and supplementary motor area (SMA), using functional near-infrared spectroscopy (fNIRS). RESULTS: A statistically significant increase in brain activity was observed in the SMC compared with the PMC and SMA (p < 0.05), and a classical double bump in the vertical GRF was observed during both UAW and RAW throughout the stance phase. However, intraindividual gait variability increased significantly with RA and was correlated with increased brain activity in the SMC (p = 0.05; r = 0.57). CONCLUSIONS: On the one hand, robotic guidance could generate sensory feedback that promotes active participation, leading to increased gait variability and somatosensory brain activity. On the other hand, changes in brain activity and biomechanical gait characteristics may also be due to the sensory feedback of the robot, which disrupts the cortical network of automated walking in healthy individuals. More comprehensive neurophysiological studies both in laboratory and in clinical settings are necessary to investigate the entire brain network associated with RAW. BioMed Central 2019-12-27 /pmc/articles/PMC6935063/ /pubmed/31882008 http://dx.doi.org/10.1186/s12984-019-0636-3 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Berger, Alisa
Horst, Fabian
Steinberg, Fabian
Thomas, Fabian
Müller-Eising, Claudia
Schöllhorn, Wolfgang I.
Doppelmayr, Michael
Increased gait variability during robot-assisted walking is accompanied by increased sensorimotor brain activity in healthy people
title Increased gait variability during robot-assisted walking is accompanied by increased sensorimotor brain activity in healthy people
title_full Increased gait variability during robot-assisted walking is accompanied by increased sensorimotor brain activity in healthy people
title_fullStr Increased gait variability during robot-assisted walking is accompanied by increased sensorimotor brain activity in healthy people
title_full_unstemmed Increased gait variability during robot-assisted walking is accompanied by increased sensorimotor brain activity in healthy people
title_short Increased gait variability during robot-assisted walking is accompanied by increased sensorimotor brain activity in healthy people
title_sort increased gait variability during robot-assisted walking is accompanied by increased sensorimotor brain activity in healthy people
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6935063/
https://www.ncbi.nlm.nih.gov/pubmed/31882008
http://dx.doi.org/10.1186/s12984-019-0636-3
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