Energy cost and psychological impact of robotic-assisted gait training in people with spinal cord injury: effect of two different types of devices

Corbianco, Silvia; Cavallini, Gabriella; Dini, Marco; Franzoni, Ferdinando; D'Avino, Carla; Gerini, Adriana; Stampacchia, G.

doi:10.1007/s10072-020-04954-w

Cited by 13 publications

(28 citation statements)

References 35 publications

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“…However, this may be attributed to the 1.68 km•h −1 difference in walking speed or differences in the exoskeleton devices. Previous research also demonstrated increased HR data during powered exoskeleton assisted walking, and produced similar results (100 ± 13, 88-134, 72-132, and 115 bpm within a single participant) when compared to the current findings [11,14,15,47,48]. Evans et al [16] recorded HR over two exoskeleton walking bouts within a SCI population.…”

Section: Discussionsupporting

confidence: 85%

The Cardiorespiratory Demands of Treadmill Walking with and without the Use of Ekso GT™ within Able-Bodied Participants: A Feasibility Study

Duddy

Doherty

Connolly

et al. 2022

IJERPH

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Individuals with neurological impairments tend to lead a predominantly sedentary lifestyle due to impaired gait function and mobility. This may be detrimental to health by negatively impacting cardiorespiratory fitness and muscular strength, and increasing the risk of developing secondary health problems. Powered exoskeletons are assistive devices that may aid neurologically impaired individuals in achieving the World Health Organisation’s (WHO) physical activity (PA) guidelines for health. Increased PA should elicit a sufficient cardiorespiratory stimulus to provide health benefits to exoskeleton users. This study examined the cardiorespiratory demands of treadmill walking with and without the Ekso GT™ among able-bodied participants. The Ekso GT™ is a powered exoskeleton that enables individuals with neurological impairments to walk by supporting full body mass with motors attached at the hip and knee joints to generate steps. This feasibility study consisted of one group of healthy able-bodied individuals (n = 8). Participants completed two 12 min treadmill walking assessments, one with and one without the Ekso GT™ at the same fixed speed. Throughout each walking bout, various cardiorespiratory parameters, namely, volume of oxygen per kilogram (kg) of body mass (V˙O2·kg−1), volume of carbon dioxide per kg of body mass (V˙CO2·kg−1), respiratory exchange ratio (RER), ventilation (V˙E), heart rate (HR), and rate of perceived exertion (RPE), were recorded. Treadmill walking with Ekso GT™ elevated all recorded measurements to a significantly greater level (p ≤ 0.05) (except RER at 1 km·h–1; p = 0.230) than treadmill walking without the Ekso GT™ did at the same fixed speed. An increased cardiorespiratory response was recorded during treadmill walking with the exoskeleton. Exoskeleton walking may, therefore, be an effective method to increase PA levels and provide sufficient stimulus in accordance with the PA guidelines to promote cardiorespiratory fitness and subsequently enhance overall health.

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Section: Discussionsupporting

confidence: 85%

The Cardiorespiratory Demands of Treadmill Walking with and without the Use of Ekso GT™ within Able-Bodied Participants: A Feasibility Study

Duddy

Doherty

Connolly

et al. 2022

IJERPH

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“…Question 5 showed the highest score of the questionnaire with 4.86 ± 0.35 out of 5 points, which means that physiotherapists found that the EKSO GT ® had a positive impact in the patients’ gait, in accordance with other studies that showed improvements in gait, balance or better activity of the trunk muscles with EKSO GT ® [ 8 , 43 , 44 ]. In agreement with much of the literature on robotic exoskeletons, the type of the device used could influence walking capacity [ 45 ], since it has been observed that EKSO GT ® allows more work during session than grounded exoskeletons such as Lokomat [ 35 ].…”

Section: Discussionsupporting

confidence: 78%

“…In addition, we investigated the potential correlations between satisfaction and clinical data. While we are aware that some studies have evaluated satisfaction with EKSO GT ® in patients with spinal cord injury [ 35 ], to our best knowledge, this is the first study providing an evaluation of the satisfaction of training with EKSO GT ® in people with MS and the clinical staff involved.…”

Section: Discussionmentioning

confidence: 99%

Wearable Robotic Gait Training in Persons with Multiple Sclerosis: A Satisfaction Study

Fernández-Vázquez

Cano‐de‐la‐Cuerda

Gor‐García‐Fogeda

et al. 2021

Sensors

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Wearable exoskeletons have showed improvements in levels of disability and quality of life in people with neurological disorders. However, it is important to understand users’ perspectives. The aim of this study was to explore the patients’ and physiotherapists’ satisfaction from gait training with the EKSO GT® exoskeleton in people with multiple sclerosis (MS). A cross-sectional study with 54 participants was conducted. Clinical data and self-administered scales data were registered from all patients who performed sessions with EKSO GT®. To evaluate patients’ satisfaction the Quebec User Evaluation with Assistive Technology and Client Satisfaction Questionnaire were used. A high level of satisfaction was reported for patients and for physiotherapists. A moderate correlation was found between the number of sessions and the patients’ satisfaction score (rho = 0.532; p < 0.001), and an excellent correlation between the physiotherapists’ time of experience in neurology rehabilitation and the satisfaction with the possibility of combining the device with other gait trainings approaches (rho = 0.723; p = 0.003). This study demonstrates a good degree of satisfaction for people with MS (31.3 ± 5.70 out of 40) and physiotherapists (38.50 ± 3.67 out of 45 points) with the EKSO GT®. Effectiveness, safety and impact on the patients’ gait were the most highly rated characteristics of EKSO GT®. Features such as comfort or weight of the device should be improved from the patients’ perspectives.

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“…This is a phenomenon that has been captured in the Lemaire et al (2017) research wherein patients with spinal cord injuries used lower extremity-powered exoskeletons. Other studies have found that patients expressed fatigue after rehabilitation that incorporated a treadmill component (Corbianco et al, 2021;Törnbom & Danielsson, 2018).…”

Section: Discussionmentioning

confidence: 99%

The Experiences of Robot-Assisted Gait Training in Patients With Neurological Disorders: A Qualitative Study

Chang

Xiao

et al. 2022

Rehabilitation Nursing

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Purpose: The aim of this study was to explore the rehabilitation experiences and perceptions of patients with neurological disorders who have used the Lokomat Augmented Feedback module, a robot-assisted gait training device. Design: A qualitative descriptive study was conducted. Methods: Purposive sampling was employed to recruit participants with neurological disorders who have used the Lokomat. Semistructured face-to-face interviews were completed in northern Taiwan. Interviews were recorded and transcribed verbatim. Thematic analysis was used. Results: Thirteen interviews were analyzed. Three themes were identified: learning to walk again, inspiring the fighting spirit, and the joys and worries of technological innovation. Conclusions: Strong positive emotions and logistical concerns were associated with the use of the Lokomat. Clinical Relevance: Encouraging patients while also being transparent about the challenges involved in the rehabilitation process and helping set realistic goals is critical. Furthermore, attention directed toward anticipating and mitigating the physical strain associated with the Lokomat is important.

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Energy cost and psychological impact of robotic-assisted gait training in people with spinal cord injury: effect of two different types of devices

Cited by 13 publications

References 35 publications

The Cardiorespiratory Demands of Treadmill Walking with and without the Use of Ekso GT™ within Able-Bodied Participants: A Feasibility Study

The Cardiorespiratory Demands of Treadmill Walking with and without the Use of Ekso GT™ within Able-Bodied Participants: A Feasibility Study

Wearable Robotic Gait Training in Persons with Multiple Sclerosis: A Satisfaction Study

The Experiences of Robot-Assisted Gait Training in Patients With Neurological Disorders: A Qualitative Study

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