Effects of Gait Rehabilitation Robot Combined with Electrical Stimulation on Spinal Cord Injury Patients' Blood Pressure.

BACKGROUND

Orthostatic hypotension can occur during acute spinal cord injury (SCI) and subsequently persist. We investigated whether a gait rehabilitation robot combined with functional electrical stimulation (FES) stabilizes hemodynamics during orthostatic stress in SCI.

METHODS

Six intermediate-phase SCI patients (five males and one female; mean age: 49.5 years; four with quadriplegia and two with paraplegia) participated. The participants underwent robotic training (RT), with a gait rehabilitation robot combined with FES, and tilt table training (TT). Hemodynamics were monitored using a laser Doppler flowmeter for the earlobe blood flow (EBF) and non-invasive blood pressure measurements. The EBF over time and the resting and exercise blood pressures were compared between each session. Adverse events were also evaluated.

RESULTS

The EBF change decreased in TT but increased in RT at the 0.5-min slope (p = 0.03). Similarly, the pulse rate change increased in TT but decreased in RT at the 1-min slope (p = 0.03). Systolic and mean blood pressures were slightly higher in RT than in TT but not significantly (p = 0.35; 0.40). No adverse events occurred in RT, but two TT sessions were incomplete due to dizziness.

CONCLUSIONS

RT with FES can reduce symptoms during orthostatic stress in intermediate-phase SCI. Future studies require a larger number of cases to generalize this study.