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

Bach Baunsgaard, Carsten; Vig Nissen, Ulla; Katrin Brust, Anne; Frotzler, Angela; Ribeill, Cornelia; Kalke, Yorck-Bernhard; León, Natacha; Gómez, Belén; Samuelsson, Kersti and Antepohl, Wolfram, et al. (2018) In Spinal Cord 56(2). p.106-116
Abstract

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:... (More)

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.

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in
Spinal Cord
volume
56
issue
2
pages
106 - 116
publisher
Nature Publishing Group
external identifiers
  • scopus:85033406013
ISSN
1476-5624
DOI
10.1038/s41393-017-0013-7
language
English
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no
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70eeb037-20ea-48e7-8fae-c908cd7181c3
date added to LUP
2018-03-03 16:53:41
date last changed
2018-05-29 09:25:16
@article{70eeb037-20ea-48e7-8fae-c908cd7181c3,
  abstract     = {<p>STUDY DESIGN: Prospective quasi-experimental study, pre- and post-design.</p><p>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.</p><p>SETTING: Nine European rehabilitation centres.</p><p>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).</p><p>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) &lt; 1 year, N = 25; &gt; 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 &lt; 1 year and gait function increased from 20 to 56% (P = 0.004) and 10MWT, TUG, BBS and LEMS results improved (P &lt; 0.05). The number of participants with TSI &gt; 1 year and gait function, increased from 41 to 44% and TUG and BBS results improved (P &lt; 0.05).</p><p>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.</p>},
  author       = {Bach Baunsgaard, Carsten and Vig Nissen, Ulla and Katrin Brust, Anne and Frotzler, Angela and Ribeill, Cornelia and Kalke, Yorck-Bernhard and León, Natacha and Gómez, Belén and Samuelsson, Kersti and Antepohl, Wolfram and Holmström, Ulrika and Marklund, Niklas and Glott, Thomas and Opheim, Arve and Benito, Jesus and Murillo, Narda and Nachtegaal, Janneke and Faber, Willemijn and Biering-Sørensen, Fin},
  issn         = {1476-5624},
  language     = {eng},
  number       = {2},
  pages        = {106--116},
  publisher    = {Nature Publishing Group},
  series       = {Spinal Cord},
  title        = {Gait training after spinal cord injury : safety, feasibility and gait function following 8 weeks of training with the exoskeletons from Ekso Bionics},
  url          = {http://dx.doi.org/10.1038/s41393-017-0013-7},
  volume       = {56},
  year         = {2018},
}