Abstract
Objective
To assess safety and feasibility for persons with acute spinal cord injury (SCI) using
the robotic exoskeleton.
Design
Case series observational study.
Setting
A level-1 trauma center in Canada with both acute and tertiary inpatient SCI rehabilitation
units.
Participants
Eight male and 3 female (N=11) participants were recruited with a mean age of 41 years
and with neurologic level of injury (C6-L2) and severity (American Spinal Injury Association
Impairment Scale [AIS] A-D). The time since injury is a range of 3-15 weeks at the
onset of training.
Interventions
Up to 25 one-hour sessions of exoskeletal-assisted walking gait training, with participants
less than 6 months from initial SCI.
Main Outcome Measures
Cardiopulmonary outcomes including blood pressure, heart rate, and peripheral oxygen
saturation; and perceived physical exertion using the Borg CR10 Scale were recorded.
Gait parameters were measured by 6-minute walk test (6MWT) and 10-meter walk test
(10MWT). Up Time, walk time, and number of steps were detailed longitudinally. Safety
was assessed with regard to pain, falls, and skin integrity.
Results
No serious adverse events occurred. Blood pressure decreased following initial sit
to stand and increased during walking. Symptoms of hypotension were rare and improved
with increased number of sessions. Perceived exertion was reported on average to be
moderate (mean of 3.1). There was no significant increase in pain scores by Visual
Analog Scale. On 6MWT, participants covered more distance (mean [m] ± SD, 117.1±11.7)
in session 25 compared to session 2 (mean [m] ± SD, 47.6±6.6). On the 10MWT, all participants
showed consistently improved gait speed; with participants traveling an average of
3.2 times faster during their last training session (mean [m/s] ± SD, 0.40±0.04) in
comparison to session 2 (mean [m/s] ± SD, 0.12±0.01).
Conclusions
Exoskeletal-assisted walking in acute rehabilitation (<6mo) following SCI appears
to be both safe and feasible.
Keyword
List of abbreviations:
6MWT (6-Minute Walk Test), 10MWT (10-meter Walk Test), AIS (American Spinal Injury Association Impairment Scale), EAW (exoskeletal-assisted walking), SCI (spinal cord injury)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: September 27, 2019
Footnotes
Current affiliation for McIntosh, Peter Lougheed Hospital, Calgary, Alberta, Canada. Current affiliation for Bensaada, University of Toronto, Toronto, Ontario, Canada. Current affiliation for Bhatiya, St. George's University School of Medicine, Grenada, West Indies. Current affiliation for Ho, University of Alberta, Edmonton, Alberta, Canada.
Supported by the Calgary Health trust, University of Calgary Hotchkiss Brain Institute, and Alberta Paraplegic Foundation.
Disclosures: none.
Identification
Copyright
© 2019 by the American Congress of Rehabilitation Medicine
