Safety and Efficacy of At-Home Robotic Locomotion Therapy in Individuals with Chronic Incomplete Spinal Cord Injury: A Prospective, Pre-Post Intervention, Proof-of-Concept Study

PLoS ONE, 2015 · DOI: 10.1371/journal.pone.0119167 · Published: March 24, 2015

Spinal Cord Injury Assistive Technology Rehabilitation

Simple Explanation

The study tested a new robotic device called MoreGait for home-based locomotion therapy in people with incomplete spinal cord injury (iSCI). The device helps users practice walking movements in a semi-reclined position. The goal was to see if unsupervised training at home with MoreGait is safe and if it can improve walking ability. Participants trained for 30-45 minutes a day, 4-6 days a week, for 8 weeks. The study found that MoreGait is safe for home use and can lead to improvements in walking speed, endurance, and the ability to walk with less assistance. This suggests it could be a good option for extending rehabilitation after patients leave the hospital.

Study Duration

8 weeks

Participants

25 (5 tetraplegia, 20 paraplegia) participants with chronic sensorimotor iSCI

Evidence Level

Prospective, pre-post intervention, proof-of-concept study

Key Findings

1
Home-based robotic locomotion training with MoreGait is feasible and safe.
2
Nine participants were less dependent on walking aids after therapy than before.
3
The short-distance walking velocity measured by the 10-Meter Walk Test showed significant improvements compared to baseline.

Research Summary

This study evaluated the safety and efficacy of the MoreGait device for home-based robotic locomotion therapy in individuals with chronic incomplete spinal cord injury (iSCI). The results indicated that the MoreGait device is safe and feasible for unsupervised home use, with participants showing improvements in walking speed, endurance, and reduced dependency on walking aids. The study suggests that home-based robotic locomotion therapy with MoreGait could be a valuable option for prolonging effective training and improving locomotor function beyond in-patient rehabilitation.

Practical Implications

Extended Rehabilitation

Home-based robotic therapy can extend rehabilitation beyond the hospital setting, allowing for more intensive and longer-term training.

Improved Locomotor Function

The MoreGait device has the potential to improve walking speed, endurance, and reduce dependency on walking aids in individuals with iSCI.

Accessibility of Therapy

Home-based robotic systems offer increased accessibility to advanced locomotion therapy, particularly for individuals who have difficulty attending outpatient clinics.

Study Limitations

1
The recruitment procedure may have contributed to a selection bias towards exceptionally motivated individuals.
2
The high dropout rate, the criterion for dropping out—less than 4x 30 minutes therapy time per week—was most likely too ambitious.
3
It cannot be excluded that changes in the regimes of these therapies throughout the MoreGait training period contributed to the improvements.

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