During the stand training sessions, participants may use the custom designed standing apparatus or a less assistive device such as walker or cane. In case of upper limbs and trunk control insufficient for safely using the standing apparatus, participants will be placed on the treadmill, and a body weight support system with a harness will be used to avoid trunk collapse and knee buckling. In this case, the level of body weight support will be continuously reduced over the course of the training sessions as the individuals increase their ability to bear weight on the lower limbs. Participants will be encouraged to stand for as long as possible throughout the training session, with the goal to stand for 60 minutes with the least amount of assistance.Enrolled Research participants will receive approximately 160 sessions training in addition to daily voluntary training with. These sessions can occur once a day or twice daily, 5 days a week for approximately 1 hour. Voluntary training with Vol-scES will occur daily in addition to stand training with stimulation.
Research participants may be placed on the Body Weight Support Treadmill (BWST) in an upright position and suspended in a harness by an overhead cable at the maximum load at which knee buckling and trunk collapse can be avoided (i.e. the BWST). Participants will be encouraged to step for 60 minutes with the least amount of assistance.
Enrolled Research participants will receive approximately 160 sessions training in addition to daily voluntary training with. These sessions can occur once a day or twice daily, 5 days a week for approximately 1 hour. Voluntary training with Vol-scES will occur daily in addition to step training with stimulation. Independence levels and functional gains will be evaluated periodically. Surface electromyography might be used during training sessions to evaluate motor activity during changes in stimulation configurations.
Voluntary Movement Stimulation
Participants will participate in laboratory sessions until all optimal configurations for joint movement and trunk control are found. Participant will demonstrate safe use of the programmer and ability to perform the leg voluntary movement independently or in the presence of a care giver. This will take approximately 3-5 days. Once the participant has demonstrated safe use of programs they will be allowed to conduct the sessions at home. Participants will be asked to train daily (7 days a week). Participants might receive Core voluntary training focusing on trunk exercises and sitting balance for 1 hour. Core voluntary training will be performed in the laboratory under supervision of trained research staff.