Surface electromyography vs clinical outcome measures after robot-assisted gait training in patients with spinal cord injury after post-acute phase of rehabilitation

Introduction and Objective. Surface electromyography (sEMG) measurements are a valid method for sublesional muscle activity following spinal cord injury (SCI). In the literature there are few reports evaluating the effect of robotic assisted gait training (RAGT) on the sEMG properties change in SCI patients. The aim of this study was to evaluate the influence of RAGT on observed change of sEMG, and in 64 incomplete SCI patients in the sub-acute stage in relation to functional scales. Materials and Method. In the presented single-centre single arm, single-blinded study, the patients were divided into two groups: experimental group with RAGT (exoskeleton EKSO-GT or Locomat-Pro) and the control group with dynamic parapodium training (DPT). The therapy was conducted in two cycles of three weeks for six days a week, with a seven day break between cycles. Obtained measurements were averaged peak muscle amplitude (AMA) in sEMG and maximal torque (MT) on Luna apparatus (muscle strength testing) and functional scales. Results. Statistically significant differences between S0 and S1 were only observed for the change in MT values at the knee joint during extension, and positively correlated with American Spinal Injury Association Impairment Scale, lower limb motor score, and functional scales. A statistically increased value of the Walking Index for Spinal Cord Injury (WISCI-II) and motor score after rehabilitation relative to the initial value, was seen after RAGT in comparison to patients with DPT, but AMA did not differ between patients. Conclusions. sEMG did not provide sufficient information about SCI outcome after RAGT rehabilitation.