Can RYSEN-induced supportive, propelling and impeding forces enhance gait stability, speed and propulsion in individuals with incomplete spinal cord injury?

Abstract

The RYSEN body weight support (BWS) gait training system provides vertical BWS, on top of which mediolateral and anteroposterior forces can be added during overground walking. To assess to what extent these forces can enhance gait stability, speed and propulsion in individuals with an incomplete spinal cord injury (iSCI), this study aimed to investigate the effect of BWS with(out) the addition of mediolateral and anteroposterior forces on step parameters and muscular control. Fifteen individuals with iSCI and fifteen able-bodied individuals completed multiple overground walking conditions: unsupported walking and walking with BWS with(out) mediolateral and anteroposterior forces. Step length, step width (variability), single stance time and walking speed were determined using motion capture data. Muscular control was assessed using electromyography. Linear mixed-effect models were used to analyse the (interaction) effects of condition and group on step parameters. Statistical parametric mapping was used to analyse muscular control. Providing BWS and the addition of mediolateral forces increased single stance time (range: +0.05-0.06 s) and decreased step width (-0.05 m) and ankle muscle activity in individuals with iSCI. Adding anterior forces increased walking speed (range: +0.19-0.25 m/s) in individuals with iSCI. Adding posterior forces did not lead to additional changes. BWS and the addition of mediolateral and anterior forces induced gait adaptations that indicated improved gait stability and speed. Therefore, these forces show promise for targeted gait training in individuals with iSCI. Further research is needed to evaluate the long-term training effects of each of these forces.