A Comparison of Locomotor Therapy Interventions: Partial‐Body Weight−Supported Treadmill, Lokomat, and G‐EO Training in People With Traumatic Brain Injury

Esquenazi, Alberto; Lee, Stella; Wikoff, Amanda; Packel, Andrew; Toczylowski, Theresa; Feeley, John C.

doi:10.1016/j.pmrj.2016.12.010

Cited by 54 publications

(57 citation statements)

References 21 publications

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“…Devices from both groups have been studied extensively, and attempts also have been made at trying to define whether one class is to be preferred over the other [51‐53]. In 2012, Mehrholz et al [53] conducted a regularly cited systematic review focusing on this topic.…”

Section: Different Considerations For Different Device Typesmentioning

confidence: 99%

“…Nevertheless, they have found their way into guidelines [54]. In the meantime, studies have been conducted that directly compared one device with the other [51,52]. They found that the use of the 2 devices leads to similar results [51] or that there was even an advantage of the exoskeleton device [52].…”

Section: Different Considerations For Different Device Typesmentioning

confidence: 99%

“…Especially with more affected patients, exoskeleton devices are more financially efficient, as patients training in the device need less manual support from the therapist than when they are training with an end‐effector device [52]. As no one‐on‐one supervision is necessary, one therapist can supervise several patients training on these systems at the same time.…”

Section: Different Considerations For Different Device Typesmentioning

confidence: 99%

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Getting the Best Out of Advanced Rehabilitation Technology for the Lower Limbs: Minding Motor Learning Principles

Spiess

Steenbrink²,

Esquenazi

2018

PM&R

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Advanced technology, including gait‐training devices, is increasingly being integrated into neurorehabilitation. However, to use gait‐training devices to their optimal potential, it is important that they are applied in accordance with motor learning and locomotor training principles. In this article, we outline the most important principles and explain how advanced gait‐training devices are best used to improve therapy outcome.

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Section: Different Considerations For Different Device Typesmentioning

confidence: 99%

Section: Different Considerations For Different Device Typesmentioning

confidence: 99%

Section: Different Considerations For Different Device Typesmentioning

confidence: 99%

See 1 more Smart Citation

Getting the Best Out of Advanced Rehabilitation Technology for the Lower Limbs: Minding Motor Learning Principles

Spiess

Steenbrink²,

Esquenazi

2018

PM&R

Self Cite

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“…A systematic review from 2011 reported ten randomized controlled trials for the use of robotic devices in CVA rehabilitation, but none for TBI 27 . However, recent reports indicate increased use of robotic rehabilitation following TBI; for example, to quantify the degree of impairment 28 , improve cognitive function 29 , to support treadmill training 30 , to measure brain activity while having robotic gait training 31 , and to increase gait velocity 32 . While the outcomes of these studies are mixed due to the differences in patient population, training techniques used, and type of equipment, it is promising that the eld is recognizing how robotics present with a novel opportunity to improve quality of life in patients with TBI.…”

Section: Discussionmentioning

confidence: 99%

A Single-center Comparison Using Exoskeleton Rehabilitation for Cerebrovascular Accidents and Traumatic Brain Injury in a Cohort of Hispanic Patients

Treviño

Vatcheva

Auer

et al. 2020

Preprint

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Background Traumatic brain injury (TBI) is one of the leading causes of disability in the United States. The EKSO GT Bionics® (EKSO®) is a robotic exoskeleton approved by the Federal Drug Administration (FDA) for rehabilitation following a cerebrovascular accident (CVA or stroke) and recently received approval for use in patients with TBI. The aim of the study was to examine if the use of exoskeleton rehabilitation in patients with TBI will produce beneficial outcomes. Methods This retrospective chart-review reports the use of the (EKSO®) robotic device in the rehabilitation of patients with TBI compared to patients with CVA. We utilized data from a single, private rehabilitation hospital for patients that received post-CVA or post-TBI robotic exoskeleton intervention. All patients that used the exoskeleton were discharged from the hospital between 01/01/2017 to 04/30/2020. Ninety-four percent of patients in the CVA groups and 100% of patients in the TBI group were of Hispanic or Latino ethnicity. Gains in total Functional Independence Measure (FIM), walking and cognition, and length of stay in the rehabilitation facility were measured. Results Patients in the TBI group (n = 11) were significantly younger than the patients in the CVA group (n = 66; p < 0.05). Both groups spent a similar amount of time active, number of steps taken, and the number of sessions in the exoskeleton. Both groups also started with similar admission FIM scores. The FIM gain in the TBI group was similar to that of the CVA group (37.5 and 32.0 respectively). The length of stay between groups was not different either. Conclusions The use of exoskeleton rehabilitation in patients with TBI appear to produce similar outcomes as for patients with CVA, prompting further attention of this intervention for this type of injury. Trial registration: Retrospectively registered on 07/09/2020 in clinicaltrials.gov number NCT4465019.

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“…Evidence is accumulating that repetitive, task specific practice, such as body weight support treadmill training (BWSTT) and exoskeleton gait training (EGT), should be used in the rehabilitation setting for people with TBI. 5) Repetition is thought to facilitate the integration of remaining and altered sensorimotor systems in persons with brain injury.…”

Section: )mentioning

confidence: 99%

Exoskeleton Gait Training with Traditional Physical Therapy Management of a Patient with Polytrauma Injuries and Diffuse Axonal Injury: A Case Report

soo¹

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Purpose People with polytrauma injuries along with diffuse axonal brain injury (TBI+DAI) present unique challenges to the physical therapist during comprehensive inpatient rehabilitation. The literature available to rehabilitation professionals regarding exoskeleton gait training (EGT) in the traumatic brain injury (TBI) population is limited. The purpose of this case report is to describe the use of EGT and traditional physical therapy management of an adult with polytrauma injuries and TBI+DAI during an inpatient rehabilitation stay. Methods The subject was a 31 year old veteran male diagnosed with polytrauma injuries and TBI+DAI, resulting from a high speed motor vehicle collision. He began to emerge from comatose state 8 days post-injury, was admitted to an inpatient rehabilitation facility and began physical therapy 23 days post-injury. He participated in physical therapy one to two times daily for 60 minute sessions with five additional EGT sessions and two community re-integration outings, for an average of 7 sessions per week throughout episode of care. Results Measures were taken at admission and were reassessed weekly. Functional Independence Measure total score increased from 62 to 117 and the motor subscale increased from 37 to 89. Berg Balance Scale score increased from 0 to 54. Gait distance increased from 20 feet with quad cane and moderate assistance from physical therapist to 5,755 feet with single point cane and modified independence. Conclusion This case reports describes the use of off-label EGT in addition to traditional physical therapy management that was successful in increasing the quality and efficiency of gait in an individual with polytrauma injuries and TBI+DAI.

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A Comparison of Locomotor Therapy Interventions: Partial‐Body Weight−Supported Treadmill, Lokomat, and G‐EO Training in People With Traumatic Brain Injury

Abstract: II.

Cited by 54 publications

References 21 publications

Getting the Best Out of Advanced Rehabilitation Technology for the Lower Limbs: Minding Motor Learning Principles

Getting the Best Out of Advanced Rehabilitation Technology for the Lower Limbs: Minding Motor Learning Principles

A Single-center Comparison Using Exoskeleton Rehabilitation for Cerebrovascular Accidents and Traumatic Brain Injury in a Cohort of Hispanic Patients

Exoskeleton Gait Training with Traditional Physical Therapy Management of a Patient with Polytrauma Injuries and Diffuse Axonal Injury: A Case Report

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