Overground vs. treadmill-based robotic gait training to improve seated balance in people with motor-complete spinal cord injury: a case report.
Amanda E Chisholm, Raed A Alamro, Alison M M Williams and 1 others
PMID 28399877WHAT IT FOUND
Overground robotic gait training (Ekso) engaged trunk muscles and improved seated balance in three people with motor-complete spinal cord injury.
Treadmill-based training (Lokomat) did not engage trunk muscles or improve seated balance.
Key findings
01Overground robotic training (Ekso) produced higher trunk muscle activity than treadmill-based training (Lokomat).
02After Ekso training, participants showed improved static and dynamic seated balance control.
03After Lokomat training, seated balance control generally worsened or showed no change.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
This is a case report with only three participants, so findings cannot be generalized. No washout period between training phases means carry-over effects from Ekso training could have influenced Lokomat phase results. The study did not measure long-term retention of balance improvements. Seated balance changes were not statistically tested due to the small sample size. The specific suspension system used in the Lokomat (four points) may influence trunk muscle activity differently than other systems. EMG data was cross-sectional, not tracking muscle changes over the full training period.
Declared interests
The authors did not report any conflicts of interest or funding sources in the provided text.
The easy way to misread this
Do not conclude that Ekso training is proven to improve seated balance in people with motor-complete SCI. This is a case report of three individuals with no control group or statistical analysis of outcomes, and the lack of a washout period means improvements attributed to Ekso could have persisted into Lokomat phases. The findings are hypothesis-generating, not evidence of efficacy.