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  4. EXOSKELETON GAIT TRAINING TO IMPROVE LOWER URINARY TRACT FUNCTION IN PEOPLE WITH MOTOR-COMPLETE SPINAL CORD INJURY: A RANDOMIZED PILOT TRIAL

EXOSKELETON GAIT TRAINING TO IMPROVE LOWER URINARY TRACT FUNCTION IN PEOPLE WITH MOTOR-COMPLETE SPINAL CORD INJURY: A RANDOMIZED PILOT TRIAL

Journal of Rehabilitation Medicine, 2021 · DOI: 10.2340/16501977-2864 · Published: August 12, 2021

Spinal Cord InjuryUrologyRehabilitation

Simple Explanation

This study demonstrates that delivering an exoskeleton intervention to people with spinal cord injury for urinary bladder health is feasible. The study showed that the pelvic floor muscles are active while walking in 1 type of exoskeleton, but it remains unclear how exoskeleton-walking may help improve urinary bladder outcomes. Further research is needed to explore how exoskeleton interventions may engage the pelvic floor muscles and improve urinary bladder health outcomes for those with spinal cord injury.

Study Duration
12 weeks
Participants
6 adults with motor-complete spinal cord injury
Evidence Level
Level II, Randomized pilot trial

Key Findings

  • 1
    This pilot study demonstrates the feasibility of delivering an exoskeleton training programme targeting lower urinary tract function.
  • 2
    Ekso-walking elicits pelvic floor muscle activity, but it remains unclear how locomotor training impacts lower urinary tract function.
  • 3
    All participants improved their walking speed and steps/distance from pre- to post-assessment.

Research Summary

This pilot study demonstrates the feasibility of delivering an exoskeleton training programme to people with mcSCI to assess changes in LUT function. More PFM activity was observed in participants who walked in the Ekso than those who walked in the Lokomat. These findings suggest that the Ekso can elicit PFM activity from mcSCI, but it remains unclear how this intervention may impact LUT function and LUT-related QoL.

Practical Implications

Feasibility of Exoskeleton Training

Exoskeletons are viewed positively for rehabilitation, potentially increasing participation in clinical trials.

Pelvic Floor Muscle Activation

Ekso-assisted walking may co-activate pelvic floor muscles due to trunk muscle activation, unlike Lokomat walking.

Further Research Needed

More studies are required to determine the impact of exoskeleton training on lower urinary tract function and related quality of life.

Study Limitations

  • 1
    Small sample size
  • 2
    Lack of stratification by severity of NLUTD symptoms
  • 3
    EMG recordings only taken in assigned exoskeleton

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