Oxygen Uptake During Exoskeletal-Assisted Walking in Persons With Paraplegia

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) [ …”

“…The gender of participants was not disclosed by one study, the remaining studies ( n = 22) were comprised of 151 males and 65 females ( Table 1 ). The participants from n = 19 studies [ 14 , 21 , 22 , 29 , 30 , 31 , 33 , 34 , 35 , 36 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 47 ] were SCI patients, one study involved individuals with MS [ 28 ], another study consisted of stroke patients [ 37 ] and one study involved able-bodied participants [ 32 ]. One study involved patients with MS and stroke as well as healthy individuals [ 46 ].…”

“…The powered exoskeleton devices used throughout the selected studies included the EKSO ( n = 6) [ 28 , 30 , 35 , 40 , 41 , 44 ], Ekso GT ( n = 5) [ 21 , 30 , 33 , 42 , 45 ], ReWalk ( n = 6) [ 14 , 31 , 38 , 39 , 43 , 46 ], Indego ( n = 2) [ 22 , 34 ], Powered Gait Orthosis (PGO) ( n = 1) [ 29 ], Angelegs ( n = 1) [ 36 ], Hybrid Neuro-Prosthesis Exoskeleton ( n = 1) [ 32 ], SMA Exoskeleton ( n = 1) [ 37 ] and REX Bionics ( n = 1) [ 46 ]. Both the EKSO and Ekso GT were included in the intervention of one study [ 30 ].…”

“…Gorgey et al reported O 2 when resting (0.27 L·min −1 ) when standing (0.4 L·min −1 ), and when walking (0.55 L·min −1 ) with powered exoskeleton assistance after a 12-week walking intervention [ 35 ]. Oxygen consumption was recorded at pre-and-post-intervention in four studies, across two of the studies a slight reduction in range was present from pre (8.40–38.90 mL·kg −1 ·min −1 ) to post (9.38–32.9 mL·kg −1 ·min −1 ) intervention [ 39 , 41 ]. Jang et al also indicated a reduction in O 2 results from pre (1208.1 mL) to mid (1077.9 mL) and from mid to post (901.3 mL) intervention [ 36 ], whereas Postol et al highlighted an increase in O 2 from pre (3.7 ± 0.7 mL·kg −1 ·min −1 ) to post (5.3 ± 1.9 mL·kg −1 ·min −1 ) intervention among patients with neurological impairments during a five-minute walking bout [ 46 ]; which was slightly lower than healthy individuals walking with exoskeleton assistance (7.0 ± 2.3 mL·kg −1 ·min −1 ) [ 46 ].…”

“…Escalona et al recorded RPE using a Borg scale which ranged from 1 to 10, the mean score during exoskeleton ambulation was 3.2, which is equal to moderate intensity activity [ 21 ]. Knezevic et al assessed the mean RPE over 60 sessions and found a significant reduction ( p = 0.001) from somewhat hard (13 ± 5.95) to very, very light (7 ± 3.52) [ 39 ].…”