Exoskeleton gait training with spinal cord neuromodulation

Neuromodulating the locomotor network through spinal cord electrical stimulation (SCES) is effective for restoring function in individuals with gait deficits. However, SCES alone has limited effectiveness without concurrent locomotor function training that enhances activity-dependent plasticity of spinal neuronal networks by sensory feedback. This mini review discusses recent developments in using combined interventions, such as SCES added to exoskeleton gait training (EGT). To develop personalized therapies, it is crucial to assess the state of spinal circuitry through a physiologically relevant approach that identifies individual characteristics of spinal cord function to develop person-specific SCES and EGT. The existing literature suggests that combining SCES and EGT to activate the locomotor network can have a synergistic rehabilitative effect on restoring walking abilities, somatic sensation, and cardiovascular and bladder function in paralyzed individuals.

Automated summary

Neuromodulation through spinal cord electrical stimulation (SCES) is effective in restoring function, but its effectiveness can be enhanced by combining it with exoskeleton gait training (EGT) that promotes activity-dependent plasticity. Assessing individual characteristics of spinal cord function is important for developing personalized SCES and EGT therapies. Combining SCES and EGT can have a synergistic rehabilitative effect on restoring multiple functions in paralyzed individuals.