Facilitatory effects of anti-spastic medication on robotic locomotor training in people with chronic incomplete spinal cord injury
The objective of this study was to investigate whether an anti-spasticity medication can facilitate the effects of robotic locomotor treadmill training (LTT) to improve gait function in people with incomplete spinal cord injury (SCI). Individuals with chronic incomplete SCI were recruited and carrie...
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| Veröffentlicht in: | Journal of neuroengineering and rehabilitation 2015-03, Vol.12 (1), p.29-29, Article 29 |
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| creator | Duffell, Lynsey D Brown, Geoffrey L Mirbagheri, Mehdi M |
| description | The objective of this study was to investigate whether an anti-spasticity medication can facilitate the effects of robotic locomotor treadmill training (LTT) to improve gait function in people with incomplete spinal cord injury (SCI).
Individuals with chronic incomplete SCI were recruited and carried out a 4 week intervention of either locomotor treadmill training (LTT) alone (n = 26) or LTT combined with Tizanidine (TizLTT), an anti-spasticity medication (n = 22). Gait function was evaluated using clinical outcome measures of gait, speed and endurance. To better understand the underlying mechanisms of the therapeutic effects, maximal strength, active range of motion (AROM) and peak velocity (Vp) of ankle dorsi- and planter-flexor muscles were also measured. Differences were assessed using two-way mixed design analysis of variance. The number of subjects that achieved the minimal important difference (MID) for clinical scores was also measured for each group, and the results of those that did attain the MID were compared with those that did not.
Both LTT and TizLTT resulted in significant improvements in walking speed and dorsiflexion maximum strength, with no significant differences between them, using group-averaging analysis. However, using the MID analysis, a higher proportion of subjects in the TizLTT group achieved the MID for walking speed (40%) compared with LTT alone (13%). Those that achieved the MID for walking speed were significantly higher functioning at baseline than those that did not in the TizLTT group, and the change in walking speed was associated with the change in dorsiflexion peak velocity (R(2) = 0.40; P |
| doi_str_mv | 10.1186/s12984-015-0018-4 |
| format | Article |
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Individuals with chronic incomplete SCI were recruited and carried out a 4 week intervention of either locomotor treadmill training (LTT) alone (n = 26) or LTT combined with Tizanidine (TizLTT), an anti-spasticity medication (n = 22). Gait function was evaluated using clinical outcome measures of gait, speed and endurance. To better understand the underlying mechanisms of the therapeutic effects, maximal strength, active range of motion (AROM) and peak velocity (Vp) of ankle dorsi- and planter-flexor muscles were also measured. Differences were assessed using two-way mixed design analysis of variance. The number of subjects that achieved the minimal important difference (MID) for clinical scores was also measured for each group, and the results of those that did attain the MID were compared with those that did not.
Both LTT and TizLTT resulted in significant improvements in walking speed and dorsiflexion maximum strength, with no significant differences between them, using group-averaging analysis. However, using the MID analysis, a higher proportion of subjects in the TizLTT group achieved the MID for walking speed (40%) compared with LTT alone (13%). Those that achieved the MID for walking speed were significantly higher functioning at baseline than those that did not in the TizLTT group, and the change in walking speed was associated with the change in dorsiflexion peak velocity (R(2) = 0.40; P < 0.05).
Tizanidine appears to facilitate the effects of LTT on gait function in individuals with chronic SCI that are higher functioning at baseline. We speculate that this may be due to restoration of inhibitory mechanisms by Tizanidine, resulting in greater stretch in the planterflexor muscles during the LTT.</description><identifier>ISSN: 1743-0003</identifier><identifier>EISSN: 1743-0003</identifier><identifier>DOI: 10.1186/s12984-015-0018-4</identifier><identifier>PMID: 25881322</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject>Adult ; Aged ; Analysis ; Biomechanical Phenomena ; Care and treatment ; Clonidine - analogs & derivatives ; Clonidine - therapeutic use ; Diagnosis ; Exercise equipment ; Female ; Gait ; Health aspects ; Humans ; Isometric Contraction ; Learning - drug effects ; Locomotion ; Male ; Middle Aged ; Muscle Relaxants, Central - therapeutic use ; Muscle Spasticity - drug therapy ; Muscle Spasticity - etiology ; Muscle Strength ; Muscle, Skeletal - physiopathology ; Physiological aspects ; Range of Motion, Articular ; Robotics ; Spinal cord injuries ; Spinal Cord Injuries - complications ; Spinal Cord Injuries - rehabilitation ; Treatment Outcome ; Walking</subject><ispartof>Journal of neuroengineering and rehabilitation, 2015-03, Vol.12 (1), p.29-29, Article 29</ispartof><rights>COPYRIGHT 2015 BioMed Central Ltd.</rights><rights>Duffell et al.; licensee BioMed Central. 2015</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b527t-310065019c26ad5fb20dd4d1ab844f6f7eb0cf84b487d301dce673f8a9e3705c3</citedby><cites>FETCH-LOGICAL-b527t-310065019c26ad5fb20dd4d1ab844f6f7eb0cf84b487d301dce673f8a9e3705c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4376342/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4376342/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25881322$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Duffell, Lynsey D</creatorcontrib><creatorcontrib>Brown, Geoffrey L</creatorcontrib><creatorcontrib>Mirbagheri, Mehdi M</creatorcontrib><title>Facilitatory effects of anti-spastic medication on robotic locomotor training in people with chronic incomplete spinal cord injury</title><title>Journal of neuroengineering and rehabilitation</title><addtitle>J Neuroeng Rehabil</addtitle><description>The objective of this study was to investigate whether an anti-spasticity medication can facilitate the effects of robotic locomotor treadmill training (LTT) to improve gait function in people with incomplete spinal cord injury (SCI).
Individuals with chronic incomplete SCI were recruited and carried out a 4 week intervention of either locomotor treadmill training (LTT) alone (n = 26) or LTT combined with Tizanidine (TizLTT), an anti-spasticity medication (n = 22). Gait function was evaluated using clinical outcome measures of gait, speed and endurance. To better understand the underlying mechanisms of the therapeutic effects, maximal strength, active range of motion (AROM) and peak velocity (Vp) of ankle dorsi- and planter-flexor muscles were also measured. Differences were assessed using two-way mixed design analysis of variance. The number of subjects that achieved the minimal important difference (MID) for clinical scores was also measured for each group, and the results of those that did attain the MID were compared with those that did not.
Both LTT and TizLTT resulted in significant improvements in walking speed and dorsiflexion maximum strength, with no significant differences between them, using group-averaging analysis. However, using the MID analysis, a higher proportion of subjects in the TizLTT group achieved the MID for walking speed (40%) compared with LTT alone (13%). Those that achieved the MID for walking speed were significantly higher functioning at baseline than those that did not in the TizLTT group, and the change in walking speed was associated with the change in dorsiflexion peak velocity (R(2) = 0.40; P < 0.05).
Tizanidine appears to facilitate the effects of LTT on gait function in individuals with chronic SCI that are higher functioning at baseline. We speculate that this may be due to restoration of inhibitory mechanisms by Tizanidine, resulting in greater stretch in the planterflexor muscles during the LTT.</description><subject>Adult</subject><subject>Aged</subject><subject>Analysis</subject><subject>Biomechanical Phenomena</subject><subject>Care and treatment</subject><subject>Clonidine - analogs & derivatives</subject><subject>Clonidine - therapeutic use</subject><subject>Diagnosis</subject><subject>Exercise equipment</subject><subject>Female</subject><subject>Gait</subject><subject>Health aspects</subject><subject>Humans</subject><subject>Isometric Contraction</subject><subject>Learning - drug effects</subject><subject>Locomotion</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Muscle Relaxants, Central - therapeutic use</subject><subject>Muscle Spasticity - drug therapy</subject><subject>Muscle Spasticity - etiology</subject><subject>Muscle Strength</subject><subject>Muscle, Skeletal - physiopathology</subject><subject>Physiological aspects</subject><subject>Range of Motion, Articular</subject><subject>Robotics</subject><subject>Spinal cord injuries</subject><subject>Spinal Cord Injuries - complications</subject><subject>Spinal Cord Injuries - rehabilitation</subject><subject>Treatment Outcome</subject><subject>Walking</subject><issn>1743-0003</issn><issn>1743-0003</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1Uk2LFDEQDaK46-gP8CIBL156zVd3MhdhWV0VFrzoOaTTyUwt3UmbZJS5-stN0-uyAysJpPLy3qMqVQi9puSCUtW9z5RtlWgIbRtCqGrEE3ROpeD1RvjTB_EZepHzbQ0EacVzdMZapShn7Bz9uTYWRiimxHTEzntnS8bRYxMKNHk2uYDFkxvAmgIx4LpT7OOCjtHGKVYhLslAgLDDEPDs4jw6_BvKHtt9iqEyIVRmRYvDeYZgRmxjGip8e0jHl-iZN2N2r-7ODfpx_en71Zfm5tvnr1eXN03fMlkaTgnpWkK3lnVmaH3PyDCIgZpeCeE7L11PrFeiF0oOnNDBuk5yr8zWcUlayzfow-o7H_pakHWhpj3qOcFk0lFHA_r0JcBe7-IvLbjsuGDV4ONq0EP8j8HpSy1arz3StUd66VE126B3d3mk-PPgctETZOvG0QQXD1nTTgpGuZQL9e1K3ZnRaQg-Vl-70PVlK2jLFO1UZV08wqprcBPYGJyHip8I6CqwKeacnL-vgRK9TNajWb95-Hv3in-jxP8CgmDM5A</recordid><startdate>20150320</startdate><enddate>20150320</enddate><creator>Duffell, Lynsey D</creator><creator>Brown, Geoffrey L</creator><creator>Mirbagheri, Mehdi M</creator><general>BioMed Central Ltd</general><general>BioMed Central</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20150320</creationdate><title>Facilitatory effects of anti-spastic medication on robotic locomotor training in people with chronic incomplete spinal cord injury</title><author>Duffell, Lynsey D ; Brown, Geoffrey L ; Mirbagheri, Mehdi M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b527t-310065019c26ad5fb20dd4d1ab844f6f7eb0cf84b487d301dce673f8a9e3705c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Analysis</topic><topic>Biomechanical Phenomena</topic><topic>Care and treatment</topic><topic>Clonidine - analogs & derivatives</topic><topic>Clonidine - therapeutic use</topic><topic>Diagnosis</topic><topic>Exercise equipment</topic><topic>Female</topic><topic>Gait</topic><topic>Health aspects</topic><topic>Humans</topic><topic>Isometric Contraction</topic><topic>Learning - drug effects</topic><topic>Locomotion</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Muscle Relaxants, Central - therapeutic use</topic><topic>Muscle Spasticity - drug therapy</topic><topic>Muscle Spasticity - etiology</topic><topic>Muscle Strength</topic><topic>Muscle, Skeletal - physiopathology</topic><topic>Physiological aspects</topic><topic>Range of Motion, Articular</topic><topic>Robotics</topic><topic>Spinal cord injuries</topic><topic>Spinal Cord Injuries - complications</topic><topic>Spinal Cord Injuries - rehabilitation</topic><topic>Treatment Outcome</topic><topic>Walking</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Duffell, Lynsey D</creatorcontrib><creatorcontrib>Brown, Geoffrey L</creatorcontrib><creatorcontrib>Mirbagheri, Mehdi M</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of neuroengineering and rehabilitation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Duffell, Lynsey D</au><au>Brown, Geoffrey L</au><au>Mirbagheri, Mehdi M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Facilitatory effects of anti-spastic medication on robotic locomotor training in people with chronic incomplete spinal cord injury</atitle><jtitle>Journal of neuroengineering and rehabilitation</jtitle><addtitle>J Neuroeng Rehabil</addtitle><date>2015-03-20</date><risdate>2015</risdate><volume>12</volume><issue>1</issue><spage>29</spage><epage>29</epage><pages>29-29</pages><artnum>29</artnum><issn>1743-0003</issn><eissn>1743-0003</eissn><abstract>The objective of this study was to investigate whether an anti-spasticity medication can facilitate the effects of robotic locomotor treadmill training (LTT) to improve gait function in people with incomplete spinal cord injury (SCI).
Individuals with chronic incomplete SCI were recruited and carried out a 4 week intervention of either locomotor treadmill training (LTT) alone (n = 26) or LTT combined with Tizanidine (TizLTT), an anti-spasticity medication (n = 22). Gait function was evaluated using clinical outcome measures of gait, speed and endurance. To better understand the underlying mechanisms of the therapeutic effects, maximal strength, active range of motion (AROM) and peak velocity (Vp) of ankle dorsi- and planter-flexor muscles were also measured. Differences were assessed using two-way mixed design analysis of variance. The number of subjects that achieved the minimal important difference (MID) for clinical scores was also measured for each group, and the results of those that did attain the MID were compared with those that did not.
Both LTT and TizLTT resulted in significant improvements in walking speed and dorsiflexion maximum strength, with no significant differences between them, using group-averaging analysis. However, using the MID analysis, a higher proportion of subjects in the TizLTT group achieved the MID for walking speed (40%) compared with LTT alone (13%). Those that achieved the MID for walking speed were significantly higher functioning at baseline than those that did not in the TizLTT group, and the change in walking speed was associated with the change in dorsiflexion peak velocity (R(2) = 0.40; P < 0.05).
Tizanidine appears to facilitate the effects of LTT on gait function in individuals with chronic SCI that are higher functioning at baseline. We speculate that this may be due to restoration of inhibitory mechanisms by Tizanidine, resulting in greater stretch in the planterflexor muscles during the LTT.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>25881322</pmid><doi>10.1186/s12984-015-0018-4</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; SpringerNature Journals; PubMed Central Open Access; PubMed Central; Springer Nature OA/Free Journals |
| subjects | Adult Aged Analysis Biomechanical Phenomena Care and treatment Clonidine - analogs & derivatives Clonidine - therapeutic use Diagnosis Exercise equipment Female Gait Health aspects Humans Isometric Contraction Learning - drug effects Locomotion Male Middle Aged Muscle Relaxants, Central - therapeutic use Muscle Spasticity - drug therapy Muscle Spasticity - etiology Muscle Strength Muscle, Skeletal - physiopathology Physiological aspects Range of Motion, Articular Robotics Spinal cord injuries Spinal Cord Injuries - complications Spinal Cord Injuries - rehabilitation Treatment Outcome Walking |
| title | Facilitatory effects of anti-spastic medication on robotic locomotor training in people with chronic incomplete spinal cord injury |
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