Cardiopulmonary function after robotic exoskeleton-assisted over-ground walking training of a patient with an incomplete spinal cord injury

Abstract

Rationale: Spinal cord injury (SCI) patients who experience difficulties with independent walking use gait-assistive devices such as a cane, walker, or wheelchair. Few studies have explored gait patterns or cardiopulmonary function in chronic SCI patients after powered exoskeleton training. We investigated whether the cardiopulmonary function of a patient with an incomplete chronic cervical SCI and a hemiplegic gait pattern could be improved by walking training using a powered exoskeleton (Angelegs).Patient concerns: A 57-year-old male was diagnosed with an SCI at C3-C4. The right upper and lower limb motor functions differed when evaluated before entry into the program. Motor function was good in the right leg but poor in the left one. Before program entry, the patient could walk for about 10 m using a cane. He did not have a history of severe medical or psychological problems and was not cognitively impaired. Diagnosis:The patient was tetraplegia with incomplete SCI at C3-C4. Interventions:The patient was trained for 6 weeks using a powered exoskeleton. The training program consisted of sit-to-stand and stand-to-sit movements, maintenance of balanced standing for 5 minutes, and walking for 15 minutes.Outcomes: After 6 weeks of training, gait speed improved in the timed up-and-go test, and cardiac function was enhanced as measured by the metabolic equivalent and VO 2 tests.Lessions: Walking training using a powered exoskeleton can facilitate the effective rehabilitation and improve the gait speed and cardiopulmonary function of patients with chronic SCIs or strokes.

The Effects of Powered Exoskeleton Gait Training on Cardiovascular Function and Gait Performance: A Systematic Review

“…The design of the selected studies included case series/reports ( n = 7) [ 34 , 35 , 36 , 41 , 42 , 44 , 47 ], pilot studies ( n = 1) [ 28 ], prospective open label ( n = 1) [ 39 ], self-controlled feasibility ( n = 1) [ 31 ], longitudinal cohort ( n = 1) [ 40 ], prospective cohort ( n = 1) [ 38 ], randomised crossover trial ( n = 2) [ 37 , 43 ], open label prospective quasi-experimental ( n = 1) [ 30 ], prospective single group observational ( n = 1) [ 14 ], experimental ( n = 5) [ 22 , 29 , 32 , 33 , 45 ], cross sectional ( n = 1) [ 21 ] and comparative ( n = 1) [ 46 ] studies. The studies were conducted in the USA ( n = 13) [ 14 , 22 , 28 , 32 , 34 , 35 , 37 , 39 , 40 , 41 , 42 , 44 , 45 ], UK ( n = 2) [ 29 , 31 ], Canada ( n = 2) [ 21 , 38 ], Korea ( n = 2) [ 36 , 43 ], Italy ( n = 2) [ 33 , 47 ] and Australia ( n = 1) [ …”

Exoskeleton-assisted walking improves pulmonary function and walking parameters among individuals with spinal cord injury: a randomized controlled pilot study

“…Some previous studies [23][24][25]35] have shown that robotic exoskeletons provide improvement in VO 2 peak Fig. 2 CONSORT diagram of enrollment of participants into the study among the incomplete SCI individuals during gait training.…”

“…Despite the potential walking benefits of EAW, there are few studies manifested that used EAW trainings for PF improving. A quantity of studies has manifested the improvements of metabolic responses, such as heart rate and VO 2 max [23][24][25] during the training program. Nevertheless, none of them has focused on the changes of PF parameters by PFT which contained the vital capacity, forced vital capacity (FVC), forced expiratory volume in 1 second (FEV 1 ), forced expiratory flow (FEF 25/50/75 ), peak expiratory flow (PEF), and maximal voluntary ventilation (MVV).…”

Exoskeleton-assisted walking improves pulmonary function and walking parameters among individuals with spinal cord injury: a randomized controlled pilot study

“…EAW training enhanced the PF parameters among individuals with SCI Some previous studies [22][23][24]33] have shown that robotic exoskeletons provide improvement in VO 2 peak among the incomplete SCI individuals during gait training. We reported changes in PF parameters among complete and incomplete SCI individuals.…”

“…Despite the potential walking bene ts of EAW, there are few studies manifested that used EAW trainings for PF improving. A quantity of studies has manifested the improvements of metabolic responses, such as heart rate and VO 2 max [22][23][24] during the training program. Nevertheless, none of them has focused on the changes of PF parameters by pulmonary function test (PFT) which contained the vital capacity, forced vital capacity (FVC), forced expiratory volume in 1 second (FEV 1 ), forced expiratory ow (FEF 25/50/75 ), peak expiratory ow (PEF), and maximal voluntary ventilation (MVV).…”