Legtutor More Successful Than Locomotor Therapy for Spinal Cord Injury Treatment

Writing in the journal NeuroRehabilitation, Published by IOS Press in the 2011 Issue, Dr. Ashraf S. Gorgey et al of the Spinal Cord Injury and Disorders Center, Hunter Holmes McGuire VAMC, Richmond, VA, USA and the Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA, USA conducted a research project to determine if Locomotor training (LT) enhances walking in individuals with spinal cord injuries (SCIs). He states;”We tested the acute effects of 4 days of LT using BWSTT combined with Robotic Locomotor therapy compared to BWSTT twice weekly”. Two non-ambulatory participants were used with an American Spinal Injury Association Impairment Scale (AIS) D. Both received LT for 2 weeks as a portion of their clinical inpatient rehabilitation program and both used wheelchairs as their primary method of mobility. Over a 2 week period, one participant received a total of 8 visits consisting of manual BWSTT (twice weekly) combined with Robotic locomotor therapy (twice weekly). The other participant performed manual BWSTT (twice weekly) for a total of 4 visits. Resting energy expenditure, body composition, muscle strength, submaximal oxygen consumption (VO_{2}) and blood lactate during LT were measured pre and post-training. The results showed that the average maximum voluntary contraction of both knee extensor muscle groups increased by 28–34% with associated reduction in spasticity to the BWSTT participant. Two week interventions resulted in a downward shift of the lactate concentrations for both participants, increase in resting energy expenditure and shift in substrate utilization. The conclusion drawn was that a clinical paradigm of incorporating BWSTT with robotic locomotor therapy for 4 days per week did not provide additional physiological benefits to skeletal muscle strength, spasticity or metabolic profile compared to twice weekly of LT using BWSTT.
On the other hand the LegTutor provides a safe and comfortable leg brace with position and speed sensors that precisely record three dimensional hip and knee extension and flexion. Rehabilitation games allow the patient to exercise Range of Motion (ROM), speed and accuracy of movement. The LegTutor facilitates evaluation and treatment of the lower extremity including isolated and combined hip and knee movements. The LegTutor together with its sister devices (HandTutor, ArmTutor and 3DTutor) aim to optimize motor, sensory and cognitive performance to allow the patient to better perform everyday functional tasks and improve quality of life.
The Tutors are being successfully used in leading U.S. and foreign hospitals and clinics and are suitable for home use through telerehabilitation.