Rehabilitation of incomplete spinal cord injury using a neuroprosthesis for walking

The purpose of this study was to develop a practical, short-term intervention to improve walking function in incomplete spinal cord injury. Three people with incomplete spinal cord injury who were able to walk without supervision trained for 16 weeks using a neuroprosthesis based on surface stimulation of the lower extremities. Each subject was prescribed a muscle stimulation sequence by an expert. Swing phase was initiated by a pushbutton trigger (open loop control). The sequence was updated between sessions according to qualitative observations. The following outcome measures were recorded throughout the training period: walking speed, stride length, cadence and physiological cost index. Two of the three subjects demonstrated significant improvements in walking speed. The other subject showed no change in walking speed, but experienced a drastic reduction in preferred assistive devices. No subject demonstrated a significant change in physiological cost index. Therefore, the treatment did not result in more efficient gait. A follow-up examination six weeks after treatment found that one subject had experienced a partial loss of benefit in terms of walking speed.