Gait training after spinal cord injury: safety, feasibility and gait function following 8 weeks of training with the exoskeletons from Ekso Bionics.

Autor: Bach Baunsgaard C; Clinic for Spinal Cord Injuries, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark. cb.baunsgaard@gmail.com., Vig Nissen U; Clinic for Spinal Cord Injuries, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark., Katrin Brust A; Swiss Paraplegic Centre (SPC), Nottwil, Switzerland., Frotzler A; Swiss Paraplegic Centre (SPC), Nottwil, Switzerland., Ribeill C; SCI Centre Orthopaedic Department Ulm University, Ulm, Germany., Kalke YB; SCI Centre Orthopaedic Department Ulm University, Ulm, Germany., León N; Fundación Lesionado Medular (FLM), Madrid, Spain., Gómez B; Fundación Lesionado Medular (FLM), Madrid, Spain., Samuelsson K; Department of Rehabilitation Medicine and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden., Antepohl W; Department of Rehabilitation Medicine and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden., Holmström U; Spinal Cord Rehabilitation Unit, Uppsala University Hospital, Uppsala, Sweden., Marklund N; Spinal Cord Rehabilitation Unit, Uppsala University Hospital, Uppsala, Sweden., Glott T; Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway., Opheim A; Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway.; Rehabilitation Medicine, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden., Benito J; Institute Guttmann, Neurorehabilitation Hospital, Barcelona, Spain., Murillo N; Institute Guttmann, Neurorehabilitation Hospital, Barcelona, Spain., Nachtegaal J; Heliomare Rehabilitation Center, Wijk aan Zee, The Netherlands., Faber W; Heliomare Rehabilitation Center, Wijk aan Zee, The Netherlands., Biering-Sørensen F; Clinic for Spinal Cord Injuries, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Jazyk: angličtina
Zdroj: Spinal cord [Spinal Cord] 2018 Feb; Vol. 56 (2), pp. 106-116. Date of Electronic Publication: 2017 Nov 06.
DOI: 10.1038/s41393-017-0013-7
Abstrakt: Study Design: Prospective quasi-experimental study, pre- and post-design.
Objectives: Assess safety, feasibility, training characteristics and changes in gait function for persons with spinal cord injury (SCI) using the robotic exoskeletons from Ekso Bionics.
Setting: Nine European rehabilitation centres.
Methods: Robotic exoskeleton gait training, three times weekly over 8 weeks. Time upright, time walking and steps in the device (training characteristics) were recorded longitudinally. Gait and neurological function were measured by 10 Metre Walk Test (10 MWT), Timed Up and Go (TUG), Berg Balance Scale (BBS), Walking Index for Spinal Cord Injury (WISCI) II and Lower Extremity Motor Score (LEMS).
Results: Fifty-two participants completed the training protocol. Median age: 35.8 years (IQR 27.5-52.5), men/women: N = 36/16, neurological level of injury: C1-L2 and severity: AIS A-D (American Spinal Injury Association Impairment Scale). Time since injury (TSI) < 1 year, N = 25; > 1 year, N = 27. No serious adverse events occurred. Three participants dropped out following ankle swelling (overuse injury). Four participants sustained a Category II pressure ulcer at contact points with the device but completed the study and skin normalized. Training characteristics increased significantly for all subgroups. The number of participants with TSI < 1 year and gait function increased from 20 to 56% (P = 0.004) and 10MWT, TUG, BBS and LEMS results improved (P < 0.05). The number of participants with TSI > 1 year and gait function, increased from 41 to 44% and TUG and BBS results improved (P < 0.05).
Conclusions: Exoskeleton training was generally safe and feasible in a heterogeneous sample of persons with SCI. Results indicate potential benefits on gait function and balance.
Databáze: MEDLINE
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