Exoskeleton Training May Improve Level of Physical Activity After Spinal Cord Injury: A Case Series

Top Spinal Cord Inj Rehabil, 2017 · DOI: 10.1310/sci16-00025 · Published: May 4, 2017

Spinal Cord Injury Assistive Technology Rehabilitation

Simple Explanation

Spinal cord injuries often lead to reduced mobility and subsequent health issues. Restoring mobility could potentially reduce these comorbidities and associated economic burdens. Exoskeletons offer a unique opportunity for persons with SCI to experience standing and walking at a low metabolic cost. Evidence suggests that exoskeleton-assisted walking can decrease spasticity and improve bowel movement. This study investigates whether using a powered exoskeleton once a week can improve physical activity parameters such as walking time, stand up time, and number of steps in individuals with SCI.

Study Duration

10 to 15 weeks

Participants

Four individuals with SCI (3 complete, 1 incomplete)

Evidence Level

Level 4: Case Series

Key Findings

1
The maximum walking time increased from 12 to 57 minutes, and the number of steps increased from 59 to 2,284 steps over the course of the training program.
2
At the end of the training, the 4 participants were able to exercise for 26 to 59 minutes using the exoskeleton.
3
Oxygen uptake increased from 0.27 L/min during rest to 0.55 L/min during walking in one participant, and delta energy expenditure increased by 1.4 kcal/min during walking.

Research Summary

This case series investigated the effects of exoskeleton training on physical activity in individuals with spinal cord injury (SCI). Results showed improvements in walking time, stand up time, and number of steps after 10 to 15 weeks of weekly exoskeleton training. The study suggests that exoskeleton training may be a beneficial tool to improve physical activity levels and potentially counteract SCI-associated comorbidities.

Practical Implications

Improved Physical Activity

Exoskeleton training can help individuals with SCI increase their walking time, stand-up time, and number of steps, leading to improved physical activity levels.

Potential Comorbidity Reduction

Increased physical activity through exoskeleton training may serve as a countermeasure to several SCI-associated comorbidities.

Rehabilitation Tool

A powered exoskeleton may serve as a rehabilitation tool to restore walking and improve parameters of physical activity.

Study Limitations

1
A major limitation of the current case series is that there is no established protocol. Therefore, these findings should be generalized with caution.
2
Compared to other studies, the frequency selected in this study is unlikely to be sufficient for changes in body composition or metabolic profile
3
The training duration varied from 10 to 15 weeks and was primarily based on the availability of the participants. This may not apply to other settings or other clinical practices.

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