Abstract
This study aims to assess the effect of combining virtual walking (VW) therapy with a physical exercise (PE) program compared to PE alone on lower limb strength and muscle activation in people with incomplete spinal cord injury (iSCI). 38 participants performed 3 sessions/week during 6 weeks of Experimental Intervention (EI): VW and PE; or Control intervention (CI): Placebo-VW and PE. Strength and muscle activation of main lower limb muscles were assessed. EI group exhibited a general strength increase after intervention (T2), (16.31-34.72 N), and maintained this improvement up to 1-month-follow-up (T3) for hip abduction and extension movements. The CI group only showed improvements in hip abduction and extension movements (18.34 (7.13) N and 19.98 (9.60) N, respectively). EI group also exhibited an increase of activation in all agonistic muscles in T2 (36.02-20.24 µV), except gastrocnemius. Gastrocnemius and rectus femoris activation as antagonistic decreased during dorsal flexion (- 14.28 (5.61) µV) and hip extension (- 14.78 [6.11] µV), respectively. CI group only showed an activation increase of agonistic muscles of hip abduction and extension (22.16 (9.80) µV and 28.82 (9.14) µV, respectively), without changes in antagonistic activation. VW could enhance the PE effects regarding muscle strength and activation in people with iSCI.Registration number: NCT04809987.