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Training Persons with Spinal Cord Injury to Ambulate Using a Powered Exoskeleton
Published on: June 16, 2016
[A robotic system for gait re-education in patients with an incomplete spinal cord injury]
A Esclarín-De Ruz1, M Alcobendas-Maestro, R Casado-López
1Unidad de Investigación de Reeducación de la Marcha, Hospital Nacional de Paraplejicos, E-45077 Toledo, Espana. anae@sescam.jccm.es
Introduction:
A spinal cord injury involves the loss or alteration of motor patterns in walking, the recovery of which depends partly on the rearrangement of the preserved neural circuits. AIM. To evaluate the changes that take place in the gait of patients with incomplete spinal cord injuries who were treated with a robotic walking system in association with conventional therapy.
Patients And Methods:
The study conducted was an open-label, prospective, descriptive trial with statistical inference in patients with C2-L3 spinal cord injuries that were classified as degrees C and D according to the American Spinal Injury Association (ASIA) scale. The variables that were analysed on the first and the last day of the study were: number of walkers, 10-m gait test, the Walking Index for Spinal Cord Injury scale revision, technical aids, muscle balance in the lower limbs, locomotor subscale of the measure of functional independence, modified Ashworth scale for spasticity and the visual analogue scale for pain. At the end, data were recorded from the impression of change scale. The analysis was conducted by means of Student's t, chi squared and Pearson's correlation; p < or = 0.05.
Results:
Forty-five patients, with a mean age of 44 +/- 14.3 years, finished the study; 76% were males, injury was caused by trauma in 58% of cases, and the time of progression was 139 +/- 70 days. Statistically significant increases were observed in the number of subjects capable of walking, walking speed, less need for technical aids, strength in the lower limbs and independence in activities of daily living.
Conclusions:
Treatment using the robotic system in association with conventional therapy improves walking capacity in patients with incomplete spinal cord injuries.
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