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Nakagawa, Kei; Tomoi, Masahiro; Higashi, Keita; Utsumi, Sho; Kawano, Reo; Tanaka, Eiichiro; Kurisu, Kaoru; Yuge, Louis
Journal of clinical neuroscience, 07/2020, Letnik: 77Journal Article
•A walking assistive device that targets ankle movements has been utilized.•Short-term intervention of the device decreased spinal cord reciprocal inhibition.•The device might be effective for regulating spinal cord excitability. One of the major problems with walking encountered by patients with spastic hemiplegia is diminished toe clearance due to spasticity of their leg muscles. To improve their walking, a specialized robot assist for ankle movements (RE-Gait) has been utilized. The present study examined the neurophysiological effects whether spinal cord reciprocal Ia inhibition (RI) in the leg was altered by using RE-Gait. Sixteen patients with a clinical diagnosis of stroke were divided into the two groups, RE-Gait walking group (Group R) and normal (controlled) walking group (Group C). In each group, they walked on a flat floor for 15 min with or without RE-Gait. The depression of soleus (Sol) H-reflexes conditioned by common peroneal nerve stimuli with the conditioning-test (C-T) intervals of 1, 2, 3, and 4 ms were assessed before and immediately after each walking session. After the intervention, the LSM (SE) of Sol H-reflex amplitude with 1, 2 and 3 ms C-T interval conditions were significantly decreased in group R (1 ms: 88.15 (4.60), 2 ms: 86.37 (4.60), 3 ms: 89.68 (4.62)) compared to group C (1 ms: 105.57 (4.56), 2 ms: 100.89 (4.58), 3 ms: 107.72 (4.58)) 1 ms: p = 0.012, 2 ms: p = 0.035, 3 ms: p = 0.011. Walking assistive robot that targets ankle movements might be a new rehabilitation tool for regulating spinal cord excitability.
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