Robot applied stance loading increases hindlimb muscle mass and stepping kinetics in a rat model of spinal cord injury

Following spinal cord injury (SCI) reduced limb usage typically results in muscle atrophy. While robotic locomotor training has been shown to improve several aspects of stepping ability following SCI, little is known regarding the effects of automated training on the preservation of muscle function. The purpose of this study was to evaluate the effects of two robotic locomotor training algorithms on hindlimb strength and muscle mass in a rat model of SCI. Eighteen Sprague-Dawley rats received a mid-thoracic spinal cord transection at 5 days of age, and were randomly assigned to one of three groups: control (no training), standard robotic training, and robotic training with a downward force applied to the shank during the stance phase of gait. Training occurred 5 days/week for 5 min/day, and animals received 90% body weight support for all sessions. Following 4 weeks of training, vertical and propulsive ground reaction force during stepping and en vitro mass of two plantarflexor muscles were significantly increased for all of the trained animals when compared to the untrained control group. Post hoc analysis revealed that standard robotic training did not appear to increase ground reaction force and muscle mass to the same extent as the loaded condition. These results indicate that automated robotic training helps to preserve hindlimb muscle function in rats following SCI. Further, the addition of a plantarflexion stance load appears to promote greater increases in muscle mass and stepping kinetics.