This article and any supplementary material should be cited as follows: Craven CT, Gollee H, Coupad...

This article and any supplementary material should be cited as follows: Craven CT, Gollee H, Coupad S, Purcell MA, Allan DB. Investigation of robotic-assisted tilt-table therapy for early-stage spinal cord injury rehabilitation. J Rehabil Res Dev. 2013:50(3):367-78. http://dx.doi.org/10.1682/JRRD.2012.02.0027

Slideshow ProjectDOI:10.1682/JRRD.2012.02.0027JSP

Investigation of robotic-assisted tilt-table therapy for early-stage spinal cord injury rehabilitation

Colm T. D. Craven, MEngSc; Henrik Gollee, PhD; Sylvie Coupaud, PhD; Mariel A. Purcell, MRCGP; David B. Allan, FRCS



• Aim– Investigate physical exertion rate of robotic-assisted tilt-

table therapy (RATTT) in patients with spinal cord injury (SCI).

– Compare response of patients with motor-complete SCI (cSCI) and motor-incomplete SCI (iSCI).

• Relevance– RATTT may provide strong training stimulus to

complement conventional physiotherapy.– RATTT may both increase orthostatic tolerance and

attenuate decline in aerobic fitness.



Method• Participants – 3 cSCI.– 3 iSCI.

• Protocol– 5 discrete phases, 5 min each

• Measures– Continuous: pulmonary gas exchange, ventilator,

heart rate.– Final 30 s: blood pressure.



Method• Testing phases:– 1. Subject supine; no stepping profile imposed.– 2. Subject tilted to 70 from horizontal at 0.06 rad/s.– 3. Robotic orthoses provided full guidance force. • cSCI: No volitional effort.

– 4a. iSCI only. Guidance force reduced, volitional effort increased.

– 4b. Functional electrical stimulation (FES) applied.• iSCI subjects instructed to continue volitional participation.



Results• iSCI– O2 uptake, respiratory exchange ratio (RER), minute ventilation,

heart rate:• Significantly increased in Phases 4a and 4b only.

• cSCI– Minute ventilation:

• Small but significant increase.• iSCI vs cSCI– O2 uptake, RER, minute ventilation, heart rate:

• No difference in Phases 1-3.• Significantly larger in Phase 4b for iSCI.

– Mean arterial pressure significantly larger in all phases for iSCI.



Conclusion• Volitional effort led to increased cardio-pulmonary

and ventilatory response during RATTT.– Sustained or improved with addition of FES.

• Patients with iSCI:– Period of training with volitional contribution could

improve cardiopulmonary and ventilatory fitness.

• Patients with cSCI:– FES-assisted RATTT may be sufficient to attenuate

fitness losses.

This article and any supplementary material should be cited as follows: Craven CT, Gollee H, Coupad...

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