Relationship between Timed Up and Go performance and quantitative biomechanical measures of balance.

Traumatic brain injury (TBI) impairs sensory-motor functions, with debilitating consequences on postural control and balance, which persist during the chronic stages of recovery. The Timed Up and Go (TUG) test is a reliable, safe, time-efficient, and one of the most widely used clinical measures to assess gait, balance, and fall risk in TBI patients and is extensively used in inpatient and outpatient settings. Although the TUG test has been used extensively due to its ease of performance and excellent reliability, limited research has been published that investigates the relationship between TUG performance and quantitative biomechanical measures of balance.

Efficacy and safety of using auditory-motor entrainment to improve walking after stroke: a multi-site randomized controlled trial of InTandem.

Walking slowly after stroke reduces health and quality of life. This multi-site, prospective, interventional, 2-arm randomized controlled trial (NCT04121754) evaluated the safety and efficacy of an autonomous neurorehabilitation system (InTandem) designed to use auditory-motor entrainment to improve post-stroke walking. 87 individuals were randomized to 5-week walking interventions with InTandem or Active Control (i.

Motor-Cognitive Virtual Reality Training to Improve Gait and Balance in Young Adults with TBI.

Traumatic Brain Injury (TBI) is one of the leading causes of motor and cognitive deficits in adults, and often results in motor control and balance impairments. Motor deficits include gait dysfunction and decreased postural control & coordination; leading to compromised functional ambulation and reduced quality of life. Research has shown that cognitive (attention and executive) function contributes to motor deficits and recovery.

EEG Based Cortico-Muscular Connectivity During Standing Early Post Stroke.

In this exploratory study we studied brain activation and corticomuscular connectivity during standing in healthy individuals and persons with stroke within 40 days of cerebrovascular accident (CVA). EEG and EMG data were acquired during standing and analysis showed a trend of higher EEG power (hyper activation) in the stroke group. Direct corticomuscular connectivity between sensorimotor cortices and contralateral lower extremity muscles showed lower connectivity between affected motor, premotor, and sensory cortices, and contralateral lower extremity peripheral muscles with moderate effect size.

Intensity Modulated Exoskeleton Gait Training Post Stroke.

Stroke is a leading cause of long-term disability. While major advances have been made in early intervention for the treatment of patients post stroke, the majority of survivors have residual mobility challenges. Recovery of motor function is dependent on the interrelationship between dosing, intensity, and task specific practice applied during rehabilitation.

Enhancing Anticipatory and Compensatory Postural Responses to Improve Balance in Individuals with TBI.

Traumatic Brain Injury (TBI) is one of the leading causes of sensorimotor deficits in adults and often results in balance impairments. Two types of postural mechanisms are employed to achieve balance during perturbations: Anticipatory Postural Adjustments (APA) and Compensatory Postural Adjustments (CPA). People with TBI have reduced APA/CPA responses due to sensory-motor deficits from the injury.

Lower extremity robotic exoskeleton devices for overground ambulation recovery in acquired brain injury-A review.

Acquired brain injury (ABI) is a leading cause of ambulation deficits in the United States every year. ABI (stroke, traumatic brain injury and cerebral palsy) results in ambulation deficits with residual gait and balance deviations persisting even after 1 year. Current research is focused on evaluating the effect of robotic exoskeleton devices (RD) for overground gait and balance training.

Evaluation of Changes in Kinematic Measures of Three Dimensional Reach to Grasp Movements in the Early Subacute Period of Recovery from Stroke.

This study examines longitudinal data of subjects initially examined in the early subacute period of recovery following a stroke with a test of reach to grasp (RTG) kinematics in an attempt to identify changes in movement patterns during the period of heightened neural recovery following a stroke. Subjects (n=8) were a convenience sample of persons with stroke that participated in an intervention trial. Baseline Upper Extremity Fugl Meyer Assessment (UEFMA) scores ranged between 31 and 52 and ages were between 49 and 83.

Changes in Center of Pressure after Robotic Exoskeleton Gait Training in Adults with Acquired Brain Injury.

Acquired brain injury (ABI) resulting in hemiplegia, is one of the leading causes of gait and balance deficits in adults. Gait and balance deficits include reduced momentum for forward progression, reduced step length, increased spatial and temporal asymmetry, and decreased speed; resulting in reduced functional ambulation, activities of daily living, and quality of life. Wearable lower extremity robotic exoskeletons (REs) are becoming an effective method for gait neurorehabilitation in individuals with ABI.

Utilization of Robotic Exoskeleton for Overground Walking in Acute and Chronic Stroke.

Stroke commonly results in gait deficits which impacts functional ambulation and quality of life. Robotic exoskeletons (RE) for overground walking are devices that are programmable to provide high dose and movement-impairment specific assistance thus offering new rehabilitation possibilities for recovery progression in individuals post stroke. The purpose of this investigation is to present preliminary utilization data in individuals with acute and chronic stroke after walking overground with an RE.

Effect of robotic exoskeleton gait training during acute stroke on functional ambulation.

Background: Stroke is a leading cause of disability resulting in long-term functional ambulation deficits. Conventional therapy can improve ambulation, but may not be able to provide consistent, high dose repetition of movement, resulting in variable recovery with residual gait deviations.

Objective: The objective of this preliminary prospective investigation is to evaluate the ability of a robotic exoskeleton (RE) to provide high dose gait training, and measure the resulting therapeutic effect on functional ambulation in adults with acute stroke.

Enhancing sensory acuity and balance function using near-sensory biofeedback-based perturbation intervention for individuals with traumatic brain injury.

Bacground: Interventions addressing balance dysfunction after traumatic brain injury (TBI) only target compensatory aspects and do not investigate perceptual mechanisms such as sensory acuity.

Objective: To evaluate the efficacy of a novel intervention that integrates sensory acuity with a perturbation-based approach for improving the perception and functional balance after TBI.

Methods: A two-group design was implemented to evaluate the effect of a novel, perturbation-based balance intervention.

Augmented-reality guided treadmill training as a modality to improve functional mobility post-stroke: A proof-of-concept case series.

: To provide a proof-of-concept for a novel stroke-gait-specific augmented reality (AR)-guided treadmill intervention by evaluating its effect on temporospatial and functional outcomes of mobility.: Two females with hemiplegia post stroke were recruited for participation in a 4-week intervention, and a single healthy control was recruited for baseline comparisons. The stroke-intervention (SI) participant (aged 54-years), completed 12 sessions of AR-guided treadmill intervention.

Hand Focused Upper Extremity Rehabilitation in the Subacute Phase Post-stroke Using Interactive Virtual Environments.

Innovative motor therapies have attempted to reduce upper extremity impairment after stroke but have not made substantial improvement as over 50% of people post-stroke continue to have sensorimotor deficits affecting their self-care and participation in daily activities. Intervention studies have focused on the role of increased dosing, however recent studies have indicated that timing of rehabilitation interventions may be as important as dosing and importantly, that dosing and timing interact in mediating effectiveness. This study is designed to empirically test dosing and timing.

Kinetic Gait Changes after Robotic Exoskeleton Training in Adolescents and Young Adults with Acquired Brain Injury.

Background: Acquired brain injury (ABI) is one of the leading causes of motor deficits in children and adults and often results in motor control and balance impairments. Motor deficits include abnormal loading and unloading, increased double support time, decreased walking speed, control, and coordination. These deficits lead to diminished functional ambulation and reduced quality of life.

Robotic Exoskeleton Gait Training During Acute Stroke Inpatient Rehabilitation.

Stroke is the leading cause of severe disability in adults resulting in mobility, balance, and coordination deficits. Robotic exoskeletons (REs) for stroke rehabilitation can provide the user with consistent, high dose repetition of movement, as well as balance and stability. The goal of this intervention study is to evaluate the ability of a RE to provide high dose gait therapy and the resulting effect on functional recovery for individuals with acute stroke.

Alterations in Cortical Activity due to Robotic Gait Training in Traumatic Brain Injury.

Traumatic brain injury (TBI), is one of the leading causes of motor deficits in children and adults, affecting motor control, coordination, and acuity. This results in reduced functional ambulation and quality of life. Robotic exoskeletons (REs) are quickly becoming an effective method for gait neurorehabilitation in individuals with TBI.

Evaluating Sensory Acuity as a Marker of Balance Dysfunction After a Traumatic Brain Injury: A Psychophysical Approach.

There is limited research on sensory acuity i.e., ability to perceive external perturbations via body-sway during standing in individuals with a traumatic brain injury (TBI).

The ReWalk ReStore™ soft robotic exosuit: a multi-site clinical trial of the safety, reliability, and feasibility of exosuit-augmented post-stroke gait rehabilitation.

Background: Atypical walking in the months and years after stroke constrain community reintegration and reduce mobility, health, and quality of life. The ReWalk ReStore™ is a soft robotic exosuit designed to assist the propulsion and ground clearance subtasks of post-stroke walking by actively assisting paretic ankle plantarflexion and dorsiflexion. Previous proof-of-concept evaluations of the technology demonstrated improved gait mechanics and energetics and faster and farther walking in users with post-stroke hemiparesis.

Anticipatory and Compensatory Postural Responses during Perturbed Standing in Individuals with Traumatic Brain Injury.

Anticipatory postural adjustments (APA) and compensatory postural adjustments (CPA) are neuromuscular responses generated to stabilize the body and achieve balance during perturbations. The impaired sensory integration after a traumatic brain injury (TBI) can limit the ability to perceive perturbations and potentially affect the ability to generate APA and CPA responses. The main objective of this investigation is to explore the existence of APA and CPA generation in tibialis anterior (TA) and gastrocnemius (GAST) muscles during base of support perturbations in healthy controls (HC) as well as individuals with TBI.

Effects of Robotic Exoskeleton Gait Training on an Adolescent with Brain Injury.

Brain injury is one of the leading causes of motor deficits in children and adults, and it often results in motor control and balance impairments. Motor deficits include decreased walking speed, increased double support time, increased temporal and spatial asymmetry, and decreased control and coordination; leading to compromised functional ambulation and reduced quality of life. Robotic exoskeletons for motor rehabilitation can provide the user with consistent, symmetrical, goal-directed repetition of movement as well as balance and stability.

Kinematic and Functional Gait Changes After the Utilization of a Foot Drop Stimulator in Pediatrics.

Foot drop is one of the most common secondary conditions associated with hemiplegia post stroke and cerebral palsy (CP) in children, and is characterized by the inability to lift the foot (dorsiflexion) about the ankle. This investigation focuses on children and adolescents diagnosed with brain injury and aims to evaluate the orthotic and therapeutic effects due to continuous use of a foot drop stimulator (FDS). Seven children (10 ± 3.

Immediate Effects of Force Feedback and Plantar Somatosensory Stimuli on Inter-limb Coordination During Perturbed Walking.

Single-sided motor weakness, also known as hemiparesis, is the most prevalent gait impairment among stroke survivors, which often results in gait asymmetry. Studies on robot-assisted gait training (RAGT) have shown positive effects of force feedback on spatial symmetry; somatosensory stimulation is thought to facilitate recovery of temporal symmetry. Despite the known importance of sensorimotor integration for motor recovery, interventions that incorporate RAGT and somatosensory stimuli have been largely overlooked so far.

Improving Perception of Perturbations and Balance Using a Novel Dynamic Computerized Biofeedback Based Intervention after Traumatic Brain Injury.

Traumatic Brain Injury (TBI) impairs the integration and organization of the visual, auditory, and somatosensory inputs that permit body position awareness in relation to self and environment resulting in balance dysfunction (BD). The sensitivity levels to which the environmental perturbations are perceived are also critical for attaining the position awareness and the equilibrium. Undetectable perturbations, however small they may be, can result in fatal falls, especially after TBI.

Robotic Exoskeleton Gait Training for Inpatient Rehabilitation in a Young Adult with Traumatic Brain Injury.

Severe and moderate traumatic brain injury (TBI) causes motor deficits leading to impairments in functional ambulation. Motor recovery involves intensive rehabilitation through physical therapy. Current practices in rehabilitation results in variable recovery of motor function and may result in residual gait deviations.