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  4. Combining robotic exoskeleton and body weight unweighing technology to promote walking activity in tetraplegia following SCI: A case study

Combining robotic exoskeleton and body weight unweighing technology to promote walking activity in tetraplegia following SCI: A case study

The Journal of Spinal Cord Medicine, 2020 · DOI: 10.1080/10790268.2018.1527078 · Published: January 1, 2020

Spinal Cord InjuryAssistive TechnologyRehabilitation

Simple Explanation

This case study explores whether using a robotic exoskeleton (a wearable robot) along with a body weight support system (which reduces how much weight the person has to carry) can help someone with tetraplegia (paralysis of all four limbs) to walk. A 66-year-old man with a spinal cord injury at the C7 level (complete paralysis) participated in nine sessions of walking with the help of the exoskeleton and body weight support. The results showed that the man was able to tolerate the training and walk short distances with the equipment, suggesting this combination of technologies could potentially help people with tetraplegia to stand and walk, which might improve their physical and mental health.

Study Duration
3 weeks
Participants
1 male with complete (C7 AIS A) non-ambulatory SCI
Evidence Level
Level 4: Case Study

Key Findings

  • 1
    The participant could tolerate the intensity and ambulate with exoskeleton assistance for a short distance with acceptable and appropriate gait kinematics after training.
  • 2
    All four measurements increased as a linear function of the training session index. Compared to the first session, the participant reached 8.5 times of walk distance and almost doubled his walk speed by the end of the training.
  • 3
    The participant’s perception was that the WRE could help him improve his bone density, circulation, and skin integrity.

Research Summary

This case report demonstrated the feasibility of combining WRE and dynamic BWS system to assist a non-ambulatory tetraplegia individual following SCI in walking overground. The increases in up time, walk time and distance during exoskeleton assisted walking indicates that the participant could learn to interact with the devices and trainer to perform the task. In this study, we have demonstrated that a participant with tetraplegia could walk overground in a WRE combined with a dynamic BWS system.

Practical Implications

Rehabilitation Potential

The combination of WRE and BWS can be used in rehabilitation settings to help SCI patients maintain upright posture and exercise.

Psychosocial Benefits

Technology-assisted activity may improve social interaction, self-esteem, and psychological health, leading to improved quality of life.

Therapeutic Benefits

This training may provide therapeutic benefits including preventing/delaying deterioration of musculoskeletal system and promoting psychosocial health.

Study Limitations

  • 1
    Single case study limits generalizability
  • 2
    Long-term therapeutic benefits remain unclear
  • 3
    Slow walking speed in exoskeleton

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