Application of the Mechanotherapy Devices Simulating Step-Like Movements in Combination with Electrical Stimulation in Spinal Cord Injury Patients

Abstract

Summarizing the results of the world scientific data on this topic, the possibility to evoke step-like movements in the lower limbs of patients with spinal cord injury (SCI) below the level of damage was noted. That was verified during electrical stimulation in combination with mechanotherapy, the electrodes application to the definite areas of spinal cord. In addition, we stated that these measures led to reduction of muscle hypertonus in the lower limbs, improvement of neuromuscular junction and tolerance towards increasing stimulation that were instrumentally confirmed. We stated that it is impossible to achieve the same effect using only one of these methods isolated. The first studies were carried out by implantation of epidural electrodes in the spinal cord, and later by a combination of electrical stimulation and step-like movements with the same frequency setting manually. During further technology development, stimulation became percutaneous, and the movements were carried out using robotic mechanotherapy. The advantage of this method is obvious: the specialist needs to set the initial parameters which are selected individually for the patient,to monitor the progress of the procedure and to fix changes. These devices include robotic systems which perform movements in the lower extremities with full and partial axial load. Currently a study of the device for robotic therapy in horizontal unsupported state is ongoing in rehabilitation clinic of FSBI NMCC n. a. N.I. Pirogov. Its excellence is support absense, the training is held in conditions of complete body weight unloading. Multimodal electrical stimulation is performed simultaneously with robotic therapy: percutaneous electrical stimulation of the spinal cord and functional electrical stimulation (FES) of the legs, back and abdomen muscles. It was stated that parameters of neurological status were improved significantly. This article presents the results of unsupported robotic mechanotherapy`s clinical testing in the SCI patients rehabilitation.