Best facilitated cortical activation during different stepping, treadmill, and robot-assisted walking training paradigms and speeds: A functional near-infrared spectroscopy neuroimaging study

Article type: Research Article

Authors: Kim, Ha Yeon^{a; b} | Yang, Sung Phil^c | Park, Gyu Lee^a | Kim, Eun Joo^{c; 1; *} | You, Joshua (Sung) Hyun^{b; 1; *}

Affiliations: [a] Translational Research Center for Rehabilitation Robots, National Rehabilitation Center, Seoul, Republic of Korea | [b] Movement Healing Laboratory, Department of Physical Therapy, The Graduate School, Yonsei University, Wonju, Republic of Korea | [c] Department of Rehabilitation Medicine, National Rehabilitation Center, Seoul, Republic of Korea

Correspondence: [*] Address for correspondence: Joshua (Sung) Hyun You, PT, PhD, Professor, Movement Healing Lab, Department of Physical Therapy, Yonsei University, 1 Yonseidae-gil, Wonju, Gangwon-do 220-710, Republic of Korea. Tel.: +82 33 760 2476; Fax: +82 33 760 2496; E-mail: neurorehab@yonsei.ac.kr.

Correspondence: [*] Address for correspondence: Eun Joo Kim, MD, Department of Rehabilitation Medicine, National Rehabilitation Center, 58 Samgaksan-ro, Gangbuk-gu, Seoul 142-884, Republic of Korea. Tel.: +82 2 901 1633; Fax: +82 2 901 1591; E-mail: silverzookim@gmail.com.

Note: [1] Both Joshua (Sung) Hyun You and Eun Joo Kim have equally contributed to the study as corresponding authors.

Abstract: BACKGROUND:Robot-assisted and treadmill-gait training are promising neurorehabilitation techniques, with advantages over conventional gait training, but the neural substrates underpinning locomotor control remain unknown particularly during different gait training modes and speeds. OBJECTIVE:The present optical imaging study compared cortical activities during conventional stepping walking (SW), treadmill walking (TW), and robot-assisted walking (RW) at different speeds. METHODS:Fourteen healthy subjects (6 women, mean age 30.06, years ± 4.53) completed three walking training modes (SW, TW, and RW) at various speeds (self-selected, 1.5, 2.0, 2.5, and 3.0 km/h). A functional near-infrared spectroscopy (fNIRS) system determined cerebral hemodynamic changes associated with cortical locomotor network areas in the primary sensorimotor cortex (SMC), premotor cortex (PMC), supplementary motor area (SMA), prefrontal cortex (PFC), and sensory association cortex (SAC). RESULTS:There was increased cortical activation in the SMC, PMC, and SMA during different walking training modes. More global locomotor network activation was observed during RW than TW or SW. As walking speed increased, multiple locomotor network activations were observed, and increased activation power spectrum. CONCLUSIONS:This is the first empirical evidence highlighting the neural substrates mediating dynamic locomotion for different gait training modes and speeds. Fast, robot-assisted gait training best facilitated cortical activation associated with locomotor control.

Keywords: Cortical activation, functional near-infrared spectroscopy, gait training modes and speeds, neurorehabilitation

DOI: 10.3233/NRE-161307

Journal: NeuroRehabilitation, vol. 38, no. 2, pp. 171-178, 2016