200 Section - Effects of isokinetic and conventional strength training combined with robotic gait training on muscle strength in a person with incomplete spinal cord injury: A case study.

Objective: To compare lower limb muscle strength gains across two phases of a physical training program in an individual with incomplete spinal cord injury. 

Methods: A 28-year-old man with incomplete paraplegia at T12 underwent a two-phase training program. Phase 1 included robot-assisted gait training with an exoskeleton combined with isokinetic strength training for hip and knee flexors and extensors. In Phase 2, conventional lower limb strength training was added. Training sessions lasted 50 minutes, twice weekly, for 24 weeks per phase. Muscle strength was assessed using computerized isokinetic dynamometry. 

Results: After Phase 1, strength increased in hip extensors, hip flexors, and knee extensors, with no changes in knee flexors. Phase 2 produced additional gains in hip extensors, hip flexors, and knee extensors, while knee flexor strength remained unchanged.

Discussions:

Discussion: Gains in hip and knee extensors and hip flexors suggest that combining robot-assisted gait training with strength training promotes neuromuscular adaptations in individuals with incomplete spinal cord injury. Progression between phases indicates an additive effect of conventional strength training. The absence of knee flexor adaptations may be related to the biomechanical demands of exoskeleton-assisted gait and insufficient training specificity.

Conclusions:

Combined training improved and maintained lower limb muscle strength. However, specific protocols targeting knee flexors and studies with larger samples are needed to better understand the effects of this approach on overall lower limb muscle function.