Acute Cardiorespiratory and Metabolic Responses During Exoskeleton-Assisted Walking Overground Among Persons with Chronic Spinal Cord Injury

Evans, Nicholas H.; Hartigan, Clare; Kandilakis, Casey; Pharo, Elizabeth A.; Clesson, Ismari

doi:10.1310/sci2102-122

Cited by 114 publications

(156 citation statements)

References 41 publications

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“…The nerve endings are stimulated through attaching electrodes to the skin, which results in contraction and activation of muscles. Many positive effects have been reported by using of "Erigo" plus FES like improving in the cardiovascular system and metabolism condition, decreasing spasticity, improving the muscle tone, reducing long-term consequences due to the lack of muscle activity, inducing functional movements, increasing cardiovascular stability during upright position, and promoting the orthostatic tolerance by enhancing venous return in individual with SCI [18,22,25,26]. Thrasher et al compared the effects of isometric FES and dynamic FES on cardiovascular parameters on an active tilt-table stepper in 16 young and healthy adults.…”

Section: Early Gait Rehabilitation Interventions After Spinal Cord Inmentioning

confidence: 99%

“…The most outstanding strategy for regaining the walking ability in SCI subjects is body weight-supported treadmill training (BWSTT) [16,26,28]. Traditionally, BWSTT device supported some of the SCI patient's body weight by using a harness, as therapists manually assist their legs via the stepping movement on a treadmill.…”

Section: Body Weight-supported Treadmill Training Approaches After Spmentioning

confidence: 99%

“…Training protocol has been performed different for powered and mechanical orthoses. Based on the time of the training program, five studies had a shorter training period [26,45,[52][53][54][55], while several weeks to months were reported in other studies [32,51]. Training protocol was being done on the different surfaces including sidewalk, grass, or stairs [56][57][58].…”

Section: Orthotic Gait Training Protocolmentioning

confidence: 99%

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Role of Gait Training in Recovery of Standing and Walking in Subjects with Spinal Cord Injury

Arazpour¹,

Sharifi²,

Mousavi³

et al. 2018

Essentials of Spinal Cord Injury Medicine

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Gait training has an important role in rehabilitation of standing and walking in spinal cord injury (SCI) patients. There were different types of gait training in these subjects.Both the body weight support treadmill training and robotic-assisted and robotic exoskeleton are effective and secure methods for gait training and improving the energy demand and metabolic cost in SCI patients in different level of injury. The powered exoskeletons can provide patients with SCI the ability to walk with the lowest energy consumption.The powered exoskeleton's energy consumption and speed of walking depend on the training duration. Based on different types of gait training methods, training time, and other affected parameters, the aim of this chapter was to evaluate the role of gait training in recovery of standing and walking in SCI patients.

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Section: Early Gait Rehabilitation Interventions After Spinal Cord Inmentioning

confidence: 99%

Section: Body Weight-supported Treadmill Training Approaches After Spmentioning

confidence: 99%

Section: Orthotic Gait Training Protocolmentioning

confidence: 99%

See 1 more Smart Citation

Role of Gait Training in Recovery of Standing and Walking in Subjects with Spinal Cord Injury

Arazpour¹,

Sharifi²,

Mousavi³

et al. 2018

Essentials of Spinal Cord Injury Medicine

View full text Add to dashboard Cite

show abstract

“…These powered exoskeleton devices have been studied in persons with stroke 14,15 , persons with complete and incomplete SCI [16][17][18][19][20][21][22][23][24] , and other persons with disabilities causing reduced control of their lower extremities [25][26][27] . Although the devices differ, each one requires training and practice by the user for safe performance.…”

Section: Introductionmentioning

confidence: 99%

“…Other common contraindications may be treated and resolved, such as limited range of motion (ROM) 34 and pressure ulcers 35 . Each of the different powered exoskeleton may require different conditions for eligibility, such as ROM criteria, to be a candidate to use the device, most of which have been described [17][18][19]21,22,36 .…”

Section: Introductionmentioning

confidence: 99%

Training Persons with Spinal Cord Injury to Ambulate Using a Powered Exoskeleton

Asselin

Avedissian

Knezevic

et al. 2016

JoVE

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Powered exoskeletons have become available for overground ambulation in persons with paralyses due to spinal cord injury (SCI) who have intact upper extremity function and are able to maintain upright balance using forearm crutches. To ambulate in an exoskeleton, the user must acquire the ability to maintain balance while standing, sitting and appropriate weight shifting with each step. This can be a challenging task for those with deficits in sensation and proprioception in their lower extremities. This manuscript describes screening criteria and a training program developed at the James J. Peters VA Medical Center, Bronx, NY to teach users the skills needed to utilize these devices in institutional, home or community environments. Before training can begin, potential users are screened for appropriate range of motion of the hip, knee and ankle joints. Persons with SCI are at an increased risk of sustaining lower extremity fractures, even with minimal strain or trauma, therefore a bone mineral density assessment is performed to reduce the risk of fracture. Also, as part of screening, a physical examination is performed in order to identify additional health-related contraindications.Once the person has successfully passed all screening requirements, they are cleared to begin the training program. The device is properly adjusted to fit the user. A series of static and dynamic balance tasks are taught and performed by the user before learning to walk. The person is taught to ambulate in various environments ranging from indoor level surfaces to outdoors over uneven or changing surfaces. Once skilled enough to be a candidate for home use with the exoskeleton, the user is then required to designate a companion-walker who will train alongside them. Together, the pair must demonstrate the ability to perform various advanced tasks in order to be permitted to use the exoskeleton in their home/community environment.

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Intensity of usual care physical therapy during inpatient rehabilitation for people with neurologic diagnoses

DiPasquale

Trammell

Clark

et al. 2021

PM&R

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Background Early, intense rehabilitation is essential to promote recovery after stroke, spinal cord injury (SCI), and traumatic brain injury (TBI). However, intensity of usual care rehabilitation interventions during inpatient rehabilitation are poorly characterized. Objective To describe the intensity of usual care rehabilitation interventions completed during the subacute phase of recovery from neurologic injury. Design Observational. Setting Inpatient rehabilitation facility. Interventions Twenty‐two usual care physical therapy interventions were grouped into six categories: gait (four activities), functional (two), strengthening (four), aerobic (six), balance (four), and wheelchair (two). Patients Patients admitted to inpatient rehabilitation with a primary diagnosis of stroke, SCI or TBI within 6 months of injury. Main Outcome Measure(s) Cardiovascular intensity (physiological and perceived) was recorded during rehabilitation activity sessions. Physiological intensity was assessed by heart rate reserve (HRR) via a Polar A370 Fitness Watch and characterized as very light (<30%), light (30–39%), moderate (40–59%), vigorous (60–89%), and near maximal (≥90%). Perceived intensity was assessed using the Rating of Perceived Exertion scale. Results Patients (stroke n = 16 [number of activity sessions = 338/average session duration = 16.4 min]; SCI n = 15 [299/27.4 min]; TBI n = 15 [340/14.2 min]) participated. For patients with stroke, moderate‐to‐vigorous HRR was attained between 42% (aerobic exercise) to 55% (wheelchair propulsion) of activity sessions. For patients with SCI, moderate‐to‐vigorous HRR was attained between 29% (strength training) to 46% (gait training) of activity sessions. For patients with TBI, moderate‐to‐vigorous HRR was attained between 29% (balance activities) to 47% (gait training) of activity sessions. Associations between HRR and rate of perceived exertion were very weak across stroke (r = 0.12), SCI (r = 0.18), and TBI (r = 0.27). Conclusions Patients with stroke, SCI, and TBI undergoing inpatient rehabilitation achieve moderate‐to‐vigorous intensity during some usual care activities such as gait training. Patient perception of intensity was dissimilar to physiological response.

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Acute Cardiorespiratory and Metabolic Responses During Exoskeleton-Assisted Walking Overground Among Persons with Chronic Spinal Cord Injury

Cited by 114 publications

References 41 publications

Role of Gait Training in Recovery of Standing and Walking in Subjects with Spinal Cord Injury

Role of Gait Training in Recovery of Standing and Walking in Subjects with Spinal Cord Injury

Training Persons with Spinal Cord Injury to Ambulate Using a Powered Exoskeleton

Intensity of usual care physical therapy during inpatient rehabilitation for people with neurologic diagnoses

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