Promoting neurological recovery by maximising sensory-motor activation during stepping and walking, development and assessment of robotics-assisted delivery platforms

Spinal cord injury results in severe physical disability and a wide range of progressive medical complications. The main challenge for clinicians and neuroscientists is to develop methods for enhancing recovery after spinal cord injury. New researches have demonstrated that robotic or manual assisted treadmill training can have long lasting positive effects on the recovery of locomotion in incomplete SCI human patients. By moving limbs and progressively modifying body weight support, the patterned sensory information arising from the robotic or manual guidance of movement is considered to increase the potential for the gait recovery. Commonly, deficits in walking in incomplete spinal cord injured patients are often revealed as deficits in ankle control. Accordingly, it is believed that successful recovery of stepping requires a degree of sparing in sensory and motor pathways that subserve ankle control. We therefore have begun experiments that examine ways to facilitate activation in pathways that influence the ankle joint control and that can be used within the context of body weight support rehabilitation programs. The work focused on developing a system for vibratory stimulation of the foot sole that can act as a surrogate stimulus for ground contact and also we studied the physiological effects of vibration in spinal and supraspinal levels. Findings in this thesis demonstrated that short periods of foot vibrotactile stimulation can produce measureable effect at cortical and spinal level in normal subjects. The findings suggest that activation of foot mechanoreceptors using localized vibrotactile stimulation interact with spinal inhibitory control mechanism contributing to the control of locomotion in human. This type of stimulation will most likely can have practical benefits for normalising gait and restoring reflex modulation during gait training. Finding in this study showed that an insole device can make this happen and can be used in gait training of SCI subjects.Spinal cord injury results in severe physical disability and a wide range of progressive medical complications. The main challenge for clinicians and neuroscientists is to develop methods for enhancing recovery after spinal cord injury. New researches have demonstrated that robotic or manual assisted treadmill training can have long lasting positive effects on the recovery of locomotion in incomplete SCI human patients. By moving limbs and progressively modifying body weight support, the patterned sensory information arising from the robotic or manual guidance of movement is considered to increase the potential for the gait recovery. Commonly, deficits in walking in incomplete spinal cord injured patients are often revealed as deficits in ankle control. Accordingly, it is believed that successful recovery of stepping requires a degree of sparing in sensory and motor pathways that subserve ankle control. We therefore have begun experiments that examine ways to facilitate activation in pathways that influence the ankle joint control and that can be used within the context of body weight support rehabilitation programs. The work focused on developing a system for vibratory stimulation of the foot sole that can act as a surrogate stimulus for ground contact and also we studied the physiological effects of vibration in spinal and supraspinal levels. Findings in this thesis demonstrated that short periods of foot vibrotactile stimulation can produce measureable effect at cortical and spinal level in normal subjects. The findings suggest that activation of foot mechanoreceptors using localized vibrotactile stimulation interact with spinal inhibitory control mechanism contributing to the control of locomotion in human. This type of stimulation will most likely can have practical benefits for normalising gait and restoring reflex modulation during gait training. Finding in this study showed that an insole device can make this happen and can be used in gait training of SCI subjects