This study examined the pattern of manual forces applied by trainers to the leg of patients with SCI during step-training using BWST. Our goals were to evaluate two hypotheses that are being used to justify the development of robotic gait-training devices: that there is substantial between-trainer variability in assistance patterns and that this variability makes a difference in the quality of the stepping pattern.
Implications for Clinical and Robotic Implementations of Step Training Using BWST
One implication for clinical trials of locomotor training is that between-trainer variability may be a confounding variable for evaluating efficacy of locomotor training with BWST. We note that the trainers who participated in this study were all trained in the same method of step training using BWST (developed by the UCLA Locomotion Laboratory) and worked together in one facility; thus, these differences were not attributable to differences in the taught technique or locale.
Abbreviations: BWS = body-weight support, BWST = BWS on a treadmill, CI = confidence interval, CV = coefficient of variation, RMS = root-mean-square, RMS-SD = RMS of the standard deviation, ROM = range of motion, SCI = spinal cord injury, SD = standard deviation, UCLA = University of California at Los Angeles.