TY - JOUR
T1 - Gait training after spinal cord injury
T2 - safety, feasibility and gait function following 8 weeks of training with the exoskeletons from Ekso Bionics
AU - Bach Baunsgaard, Carsten
AU - Vig Nissen, Ulla
AU - Katrin Brust, Anne
AU - Frotzler, Angela
AU - Ribeill, Cornelia
AU - Kalke, Yorck-Bernhard
AU - León, Natacha
AU - Gómez, Belén
AU - Samuelsson, Kersti
AU - Antepohl, Wolfram
AU - Holmström, Ulrika
AU - Marklund, Niklas
AU - Glott, Thomas
AU - Opheim, Arve
AU - Benito, Jesus
AU - Murillo, Narda
AU - Nachtegaal, Janneke
AU - Faber, Willemijn
AU - Biering-Sørensen, Fin
PY - 2018/2/1
Y1 - 2018/2/1
N2 - Study design: Prospective quasi-experimental study, pre- and post-design. Objectives: Assess safety, feasibility, training characteristics and changes in gait function for persons with spinal cord injury (SCI) using the robotic exoskeletons from Ekso Bionics. Setting: Nine European rehabilitation centres. Methods: Robotic exoskeleton gait training, three times weekly over 8 weeks. Time upright, time walking and steps in the device (training characteristics) were recorded longitudinally. Gait and neurological function were measured by 10 Metre Walk Test (10 MWT), Timed Up and Go (TUG), Berg Balance Scale (BBS), Walking Index for Spinal Cord Injury (WISCI) II and Lower Extremity Motor Score (LEMS). Results: Fifty-two participants completed the training protocol. Median age: 35.8 years (IQR 27.5-52.5), men/women: N = 36/16, neurological level of injury: C1-L2 and severity: AIS A-D (American Spinal Injury Association Impairment Scale). Time since injury (TSI) < 1 year, N = 25; > 1 year, N = 27. No serious adverse events occurred. Three participants dropped out following ankle swelling (overuse injury). Four participants sustained a Category II pressure ulcer at contact points with the device but completed the study and skin normalized. Training characteristics increased significantly for all subgroups. The number of participants with TSI < 1 year and gait function increased from 20 to 56% (P = 0.004) and 10MWT, TUG, BBS and LEMS results improved (P < 0.05). The number of participants with TSI > 1 year and gait function, increased from 41 to 44% and TUG and BBS results improved (P < 0.05). Conclusions: Exoskeleton training was generally safe and feasible in a heterogeneous sample of persons with SCI. Results indicate potential benefits on gait function and balance.
AB - Study design: Prospective quasi-experimental study, pre- and post-design. Objectives: Assess safety, feasibility, training characteristics and changes in gait function for persons with spinal cord injury (SCI) using the robotic exoskeletons from Ekso Bionics. Setting: Nine European rehabilitation centres. Methods: Robotic exoskeleton gait training, three times weekly over 8 weeks. Time upright, time walking and steps in the device (training characteristics) were recorded longitudinally. Gait and neurological function were measured by 10 Metre Walk Test (10 MWT), Timed Up and Go (TUG), Berg Balance Scale (BBS), Walking Index for Spinal Cord Injury (WISCI) II and Lower Extremity Motor Score (LEMS). Results: Fifty-two participants completed the training protocol. Median age: 35.8 years (IQR 27.5-52.5), men/women: N = 36/16, neurological level of injury: C1-L2 and severity: AIS A-D (American Spinal Injury Association Impairment Scale). Time since injury (TSI) < 1 year, N = 25; > 1 year, N = 27. No serious adverse events occurred. Three participants dropped out following ankle swelling (overuse injury). Four participants sustained a Category II pressure ulcer at contact points with the device but completed the study and skin normalized. Training characteristics increased significantly for all subgroups. The number of participants with TSI < 1 year and gait function increased from 20 to 56% (P = 0.004) and 10MWT, TUG, BBS and LEMS results improved (P < 0.05). The number of participants with TSI > 1 year and gait function, increased from 41 to 44% and TUG and BBS results improved (P < 0.05). Conclusions: Exoskeleton training was generally safe and feasible in a heterogeneous sample of persons with SCI. Results indicate potential benefits on gait function and balance.
KW - Adolescent
KW - Adult
KW - Aged
KW - Bionics/methods
KW - Exercise Therapy/methods
KW - Exoskeleton Device
KW - Female
KW - Gait/physiology
KW - Humans
KW - Male
KW - Middle Aged
KW - Prospective Studies
KW - Spinal Cord Injuries/physiopathology
KW - Treatment Outcome
KW - Young Adult
U2 - 10.1038/s41393-017-0013-7
DO - 10.1038/s41393-017-0013-7
M3 - Journal article
C2 - 29105657
SN - 1362-4393
VL - 56
SP - 106
EP - 116
JO - Spinal Cord
JF - Spinal Cord
ER -