Exoskeleton-assisted walking improves mobility in individuals with spinal cord injury

November 12, 2020

East Hanover, NJ. November 12, 2020.
Exoskeletal-assisted walking is safe, feasible, and effective in individuals disabled by spinal cord injury, according to the results of a federally funded multi-site randomized clinical trial. The article, "Mobility skills with exoskeletal-assisted walking in persons with SCI: Results from a three-center randomized clinical trial" (doi: 10.3389/frobt.2020.00093), was published August 4, 2020 in Frontiers in Robotics and AI. It is available open access at https://www.frontiersin.org/articles/10.3389/frobt.2020.00093/full

The authors are Eun-Kyoung Hong, Pierre Asselin, MS, Steven Knezevic, Stephen Kornfeld, DO, and Ann M. Spungen, EdD, of the James J. Peters VA Medical Center, Gail Forrest, PhD, of Kessler Foundation, Peter Gorman, MD, and William Scott, PhD, of the University of Maryland School of Medicine, and Sandra Wojciehowski, PT, of Craig Hospital and Kessler Foundation. The study was conducted at three sites: James J. Peters VA Medical Center, Bronx, NY; Kessler Foundation, West Orange, NJ; and the University of Maryland.

Study investigators sought to establish guidelines for clinical exoskeletal-assisted walking programs for individuals with spinal cord injury. Their goal was to determine the number of exoskeleton training sessions needed by individuals with varied mobility deficits to gain adequate exoskeletal assisted walking skills and attain velocity milestones. Two powered exoskeletons were used in the study: the Ekso GT (Ekso Bionics), and ReWalk (ReWalk Robotics).

The 50 participants included individuals with tetraplegia and paraplegia, both motor complete and incomplete. In this randomized control trial, their performance was measured over a total of 36 sessions. Participants were randomized to Group 1 (exo-assisted walking) or Group 2 (usual activity) for 12 weeks; each group crossed over to the other study arm. After 12, 24, and 36 sessions, their progress was measured by the 10-meter walk test seconds (s) (10MWT), 6-min walk test meters (m) (6MWT), and the Timed-Up-and-Go (s) (TUG).

The majority of participants mastered the ability to ambulate effectively with the assistance of the exoskeleton, according to Dr. Forrest, director of the Tim and Caroline Reynolds Center for Spinal Stimulation, and associate director of the Center for Mobility and Rehabilitation Engineering Research at Kessler Foundation. After 12 sessions, 31 (62%), 35 (70%), and 36 (72%) participants achieved the milestones established for the 10MWT, 6MWT, and TUG, respectively. After 36 sessions, the results improved, with 40 (80%), 41 (82%), and 42 (84%) of participants meeting the criteria for the 10MWT, 6MWT, and TUG, respectively.

"Participants showed improvement regardless of level of injury, completeness, or duration of injury," noted Dr. Forrest, "indicating that exoskeletons can be used to improve mobility across a broad spectrum of individuals with neurological deficits caused by spinal cord injury. Our results can be used to guide the application of exoskeletons to spinal cord injury rehabilitation, and the timely acquisition of skills for the safe use of these devices for rehabilitation and community use."
-end-
Funding sources:
US Department of Defense CDMRP SCI Award 30234 (W81XWH-14-2-0170); National Center for the Medical Consequences of SCI (B9212-C, B2020-C); James Lawrence Kernan Endowment Fund; Bronx Veterans Medical Research Foundation

About Kessler Foundation

Kessler Foundation, a major nonprofit organization in the field of disability, is a global leader in rehabilitation research that seeks to improve cognition, mobility and long-term outcomes, including employment, for people with neurological disabilities caused by diseases and injuries of the brain and spinal cord. Kessler Foundation leads the nation in funding innovative programs that expand opportunities for employment for people with disabilities. For more information, visit KesslerFoundation.org.

For more information, or to interview an expert, contact:
Carolann Murphy,
973.324.8382,
CMurphy@KesslerFoundation.org.

Kessler Foundation

Related Spinal Cord Injury Articles from Brightsurf:

Stem cells can help repair spinal cord after injury
Spinal cord injury often leads to permanent functional impairment. In a new study published in the journal Science researchers at Karolinska Institutet in Sweden show that it is possible to stimulate stem cells in the mouse spinal cord to form large amounts of new oligodendrocytes, cells that are essential to the ability of neurons to transmit signals, and thus to help repair the spinal cord after injury.

Spinal cord injury increases risk for mental health disorders
A new study finds adults with traumatic spinal cord injury are at an increased risk of developing mental health disorders and secondary chronic diseases compared to adults without the condition.

Co-delivery of IL-10 and NT-3 to enhance spinal cord injury repair
Spinal cord injury (SCI) creates a complex microenvironment that is not conducive to repair; growth factors are in short supply, whereas factors that inhibit regeneration are plentiful.

IU scientists study link between energy levels, spinal cord injury
A team of researchers from Indiana University School of Medicine, in collaboration with the National Institute of Neurological Disorders and Stroke, have investigated how boosting energy levels within damaged nerve fibers or axons may represent a novel therapeutic direction for axonal regeneration and functional recovery.

UBCO professor simplifies exercise advice for spinal cord injury
Professor Kathleen Martin Ginis says a major barrier to physical activity for people with a spinal cord injury is a lack of knowledge or resources about the amount and type of activity needed to achieve health and fitness benefits.

Robotic trunk support assists those with spinal cord injury
A Columbia Engineering team has invented a robotic device -- the Trunk-Support Trainer (TruST) -- that can be used to assist and train people with spinal cord injuries (SCIs) to sit more stably by improving their trunk control, and thus gain an expanded active sitting workspace without falling over or using their hands to balance.

Does frailty affect outcomes after traumatic spinal cord injury?
A new study has shown that frailty is an important predictor of worse outcome after traumatic spinal cord injury in patients less than 75 years of age.

Sleep and sleepiness 'a huge problem' for people with spinal cord injury
A new study led by a University of Calgary researcher at the Cumming School of Medicine (CSM) finds that fatigue and sleep may need more attention in order to prevent issues like stroke after spinal cord injury.

From spinal cord injury to recovery
Spinal cord injury disconnects communication between the brain and the spinal cord, disrupting control over part of the body.

Transplanting adult spinal cord tissues: A new strategy of repair spinal cord injury
Spinal cord injury repair is one of the most challenging medical problems, and no effective therapeutic methods has been developed.

Read More: Spinal Cord Injury News and Spinal Cord Injury Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.