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Retrospective Analysis of Clinical Practice Data of Robot-Assisted Gait Training in Patients with Spinal Cord Injury

      Research Objectives

      To study training settings and outcomes of robot-assisted gait training in patients with spinal cord injury (SCI).

      Design

      Retrospective cohort.

      Setting

      Rehabilitation hospital (inpatient).

      Participants

      Adults with stable SCI who received robot-assisted gait training between June 2009 and June 2014.

      Interventions

      Robot-assisted gait training.

      Main Outcome Measure(s)

      Demographic and clinical data: type of injury, ASIA Impairment Scale (AIS) level; number of sessions and Lokomat® therapy settings.

      Results

      The data of 84 patients 47.1 [28 - 63.7] years of age (median and interquartile range) were included. 70.2% were male subjects. 84% had acute SCI; 52.4% with traumatic etiology. Only 14% were complete injuries. AIS grade was predominantly D (31%) with 57.7% of the injuries at the cervical level. A median of 14[10.75-17.25] patients per year underwent robot-assisted gait training. The median number of training sessions was 5 [3-8]. 39 patients performed more that 6 sessions. The settings (median and interquartile range) of the first session were: 50 % [36.5-50] Body-Weight Support, 85 % [70-100] guidance force, and treadmill speed 2.0 km/h [1.8-2.1]. We intend to compare our data with data extracted from the ARTIC database, a multi-site initiative aiming to evaluating correlations among the type of injury, therapy plan used, and functional outcomes in patients undergoing Lokomat® therapy.

      Conclusions

      The median number of robot-assisted gait training sessions was lower than we anticipated. However, considering our clinical setting, these results could be related to the short duration of inpatient stay when therapy time has to be allocated for other functional goals besides ambulation. We suggest that it would be advisable to establish standard protocols for robot-assisted gait training in order to assess the effectiveness of robot-assisted training in patients with SCI.

      Key Words

      Spinal Cord Injuries, Robotic Exoskeleton, Biomedical Technology, Rehabilitation

      Disclosures

      None disclosed.