Rehabilitation of Acute Vs. Chronic Patients With Spinal Cord Injury With a Neurologically Controlled Hybrid Assistive Limb Exoskeleton: Is There a Difference in Outcome?

Frontiers in Neurorobotics, 2021 · DOI: 10.3389/fnbot.2021.728327 · Published: October 27, 2021

Spinal Cord Injury Assistive Technology Rehabilitation

Simple Explanation

This study investigates the effectiveness of using a hybrid assistive limb (HAL) exoskeleton in helping people with spinal cord injuries (SCI) walk better. The study compares how well HAL-assisted treadmill training works for people who have recently had a SCI (acute) versus those who have had a SCI for more than a year (chronic). The researchers measured walking ability using tests like the 10-meter walk test and the 6-minute walk test to see if the exoskeleton helped improve walking speed and endurance in both groups.

Study Duration

12 weeks

Participants

121 participants with spinal cord injury (SCI)

Evidence Level

Not specified

Key Findings

1
Both acute and chronic SCI patients showed significant improvements in walking ability after 12 weeks of HAL-assisted bodyweight supported treadmill training (BWSTT).
2
Acute patients showed significantly greater improvements in 6-minute walk test (6MWT), lower extremity motor score (LEMS), and walking index for spinal cord injury (WISCI II) compared to chronic patients.
3
No significant difference was observed between acute and chronic patients in the 10-meter walk test (10MWT), suggesting both groups benefited similarly in terms of walking speed.

Research Summary

This study assessed the impact of HAL-assisted BWSTT on functional and motor recovery in acute and chronic SCI patients. The study found that both acute and chronic participants benefited from 12 weeks of HAL-assisted BWSTT, showing improvements in treadmill performance and functional assessments. Although chronic participants improved significantly less than acute participants in some measures, they still showed significant improvements compared to their baseline, indicating the effectiveness of HAL-assisted BWSTT for both groups.

Practical Implications

Rehabilitation Strategy

HAL-assisted BWSTT can be considered as a viable rehabilitation strategy for both acute and chronic SCI patients to improve walking ability.

Individualized Treatment Plans

Treatment plans should be tailored to consider the time since injury, as acute patients may experience greater improvements in certain areas.

Further Research

Future research should focus on comparing HAL-assisted BWSTT with conventional training methods through randomized controlled trials to further validate its effectiveness.

Study Limitations

1
The study did not record additional treatments or medication for the participants, which could influence the results.
2
A ceiling effect for higher AIS graded patients (C, D) may cause inaccuracies in measuring the effect of the treatment.
3
The lack of a control group is a limitation.

Your Feedback

Was this summary helpful?

Back to Spinal Cord Injury