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Robot-Aided Gait Training in an Individual With Chronic Spinal Cord Injury: A Case Study

Bishop, Lauri PT, DPT; Stein, Joel MD; Wong, Christopher Kevin PT, PhD

Journal of Neurologic Physical Therapy: September 2012 - Volume 36 - Issue 3 - p 138–143
doi: 10.1097/NPT.0b013e3182624c87
Technology in Rehabilitation

Background and Purpose: Traditional physical therapy is beneficial in restoring mobility in individuals who have sustained spinal cord injury (SCI), but residual limitations often persist. Robotic technologies may offer opportunities for further gains. The purpose of this case study was to document the use and practicality of gait training for an individual with chronic, incomplete SCI with asymmetric lower limb motor deficits using a novel robotic knee orthosis (RKO).

Case Description: The participant was a 22-year-old woman who sustained fractures of the odontoid process and C5-C6 vertebrae from a motor vehicle accident resulting in incomplete SCI with asymmetric tetraparesis, right side more severe than left side. She required supervised assistance with gait and balance tasks, minimal assistance to ascend/descend steps using a handrail, and upper extremity assistance for sit-to-stand tasks.

Intervention: The participant underwent 7 one-hour sessions of mobility training, using a novel RKO. Her primary goal was to increase independence and endurance with mobility.

Outcomes: Functional measures included the 6-Minute Walk Test, the Berg Balance Scale, the Timed Up & Go Test, and the 10-Meter Walk Test. Outcomes were assessed and recorded at baseline and on completion of 7 hours of training with the device over a 2-week period. No adverse events occurred. The RKO was well received by both the participant and the treating therapist. The participant demonstrated improvements in the 6-Minute Walk Test and Berg Balance Scale after RKO-training intervention.

Discussion: Outcomes suggest that the use of this device during a physical therapy program for an individual with incomplete SCI is practical and this device may be a useful adjunct to standard training.

Department of Rehabilitation and Regenerative Medicine, College of Physicians and Surgeons (L.B.,J.S.,C.K.), and Program in Physical Therapy (C.K.), Columbia University, New York.

Correspondence: Lauri Bishop, PT, DPT, Department of Rehabilitation and Regenerative Medicine, College of Physicians and Surgeons, Columbia University, 180 Fort Washington Ave, Room HP 1-165, New York, NY 10032 (

The authors involved in this work have had other research supported by Tibion Bionic Technologies.

This manuscript has not been previously published or presented in any way.

The authors declare no conflict of interest.

© 2012 Neurology Section, APTA