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

Area of Science:

• Biomedical Engineering
• Rehabilitation Medicine
• Neuroscience

Background:

• Powered exoskeletons offer overground ambulation for individuals with spinal cord injury (SCI) but require specific user skills.
• Challenges include maintaining balance and weight shifting due to sensory and proprioceptive deficits common in SCI.
• Existing assistive technologies necessitate robust user training protocols.

Purpose of the Study:

• To describe screening criteria and a comprehensive training program for powered exoskeleton use in SCI.
• To enable safe and effective ambulation in institutional, home, and community settings.
• To prepare users and their designated companion-walkers for real-world exoskeleton application.

Main Methods:

• Screening includes joint range of motion, bone mineral density assessment, and physical examination to identify contraindications.
• Training involves static and dynamic balance tasks before gait training.
• Users are trained for ambulation on various surfaces, with a final phase involving companion-walker training and advanced task demonstration.

Main Results:

• A structured screening process identifies suitable candidates for exoskeleton training.
• The training program systematically builds balance and ambulation skills.
• Successful completion requires the user and companion-walker to demonstrate proficiency in diverse environmental conditions and advanced tasks.

Conclusions:

• The developed screening and training program effectively prepares individuals with SCI for powered exoskeleton use.
• This protocol enhances safety and functional independence in community ambulation.
• Involving a companion-walker ensures a supportive and safe transition to home and community environments.