This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. This project will develop a robotic step trainer that can be used to retrain individuals with spinal cord injury to walk. The device will consist of lightweight leg robots that can control and respond to leg movement, and a body weight support (BWS) system that can control and respond to limb loading and torso movement. The leg robots are called 'ARTHur' (Ambulation-assisting Robotic Tool for Human Rehabilitation). The BWS robotic system is comprised of 'OS' (Overhead Support) and 'PAM' (Pelvis Assist Manipulator). Robotic control algorithms will be designed that provide power assistance for stepping and enhance sensory input into the spinal cord on an as-needed basis in order to facilitate step relearning during locomotor training with body weight support on a treadmill (BWST). The device will be developed at UCI and tested with spinal cord injured subjects at UCLA. the team at UCI is responsible for designing and building the device, and initial testing with unimpaired subjects at UCI. The team at UCLA will test the device with volunteers with spinal cord injury in two small pilot studies. The first study will compare electromyographic patterns in patients during locomotor training on the robotic device and during manual (therapist-based) locomotor training with BWST. The second study will determine whether locomotor trianing using the robotic device can induce changes in a patient's ability to independently step on a treadmill. We hypothesize that robotic training will be at least as effective as manual training in inducing normative EMG pattern, will induce improvements in independent treadmill stepping and will significantly reduce the labor and costs associated with locomotor training. If so, the technology developed in this project will dramatically improve the state-of-the-art in technology and science for gait rehabilitation following spinal cord injury. It will also directly benefit thousands of U.S. citizens with spinal cord injury, and substantially reduce economic costs associated with rehabilitation from spinal cord injury. The scientific rationale for this project is that the spinal cord has a remarkable capacity to learn. The lumbar spinal cord can lear to stand (Pratt et al. 1994; de Leon et al. 1999b) and to step (Lovely et al. 1986; Barbeau and Rossignol 1987; Lovely et al. 1990; Edgerton et al. 1991; Hodgson et al. 1994; Belanger et al. 1996; Edgerton et al. 1997b; de Leon et al. 1998; de Leon et al. 1999a; de Leon et al. 1999c) in the absence of supraspinal input. The ability of the spinal cord to learn, if appropriately trained, is an extremely important finding for tens of thousands of people with spinal cord injury, as it could mean the difference between being confined to a wheelchair or being able to stand and take some steps. Teaching the spinal cord to step has immediate clinical application in itself and can also play a crucial role in enhancing the efficacy of other potential therapeutic interventions for spinal cord injuries, such as cell growth, cell engineering and pharmacological treatments.
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