Novel home-based rehabilitation device to prevent secondary diseases for patients with spinal cord injury

Abstract

The purpose of this study was to develop a rehabilitation device for preventing deterioration of the neuromuscular system in patients with spinal cord injury (SCI). Specifically, motorized footrests that could generate passive motion in paralyzed ankles were devised for use with a wheelchair. We here show the concept and structure of our developed device, and confirmed its effectiveness through physiological evaluation. The proposed device used a pair of linear electric actuators attached to the wheelchair frame at one end and the backside of the foot rest at the other end. The vertical motion of the linear actuator translated into rotational motion about the ankle joint. The developed device had the following features: 1) easy to use at home and 2) easy to install on a variety of manual and electric wheelchairs. To test the effectiveness of the developed device, electromyographic activity, muscle oxygenation and circulation in the paralyzed muscles were evaluated in eight individuals with motor complete SCI. As a result, we found that the passive ankle motion could induce rhythmical muscular activity, alteration in the muscle oxygenation level, and enhancement of the blood flow in the calf muscles. The device developed in this study has a very simple structure and is very effective in generating rhythmic movement in paralyzed ankles. Furthermore, the results obtained from the physiological assessments suggested that passive ankle motion could enhance not only the muscle neuronal activity but also the muscle circulatory conditions. Therefore, the developed device seems to be a useful and effective tool for rehabilitation in individuals with SCI.