BACKGROUND: Powered exoskeletons have been demonstrated as being safe for persons with spinal cord injury (SCI), but little is known about how users learn to manage these devices. OBJECTIVE: To quantify the time and effort required by persons with SCI to learn to use an exoskeleton for assisted walking. METHODS: A convenience sample was enrolled to learn to use the first-generation Ekso powered exoskeleton to walk. Participants were given up to 24 weekly sessions of instruction. Data were collected on assistance level, walking distance and speed, heart rate, perceived exertion, and adverse events. Time and effort was quantified by the number of sessions required for participants to stand up, walk for 30 minutes, and sit down, initially with minimal and subsequently with contact guard assistance. RESULTS: Of 22 enrolled participants, 9 screen-failed, and 7 had complete data. All of these 7 were men; 2 had tetraplegia and 5 had motor-complete injuries. Of these, 5 participants could stand, walk, and sit with contact guard or close supervision assistance, and 2 required minimal to moderate assistance. Walk times ranged from 28 to 94 minutes with average speeds ranging from 0.11 to 0.21 m/s. For all participants, heart rate changes and reported perceived exertion were consistent with light to moderate exercise. CONCLUSIONS: This study provides preliminary evidence that persons with neurological weakness due to SCI can learn to walk with little or no assistance and light to somewhat hard perceived exertion using a powered exoskeleton. Persons with different severities of injury, including those with motor complete C7 tetraplegia and motor incomplete C4 tetraplegia, may be able to learn to use this device.
BACKGROUND: Powered exoskeletons have been demonstrated as being safe for persons with spinal cord injury (SCI), but little is known about how users learn to manage these devices. OBJECTIVE: To quantify the time and effort required by persons with SCI to learn to use an exoskeleton for assisted walking. METHODS: A convenience sample was enrolled to learn to use the first-generation Ekso powered exoskeleton to walk. Participants were given up to 24 weekly sessions of instruction. Data were collected on assistance level, walking distance and speed, heart rate, perceived exertion, and adverse events. Time and effort was quantified by the number of sessions required for participants to stand up, walk for 30 minutes, and sit down, initially with minimal and subsequently with contact guard assistance. RESULTS: Of 22 enrolled participants, 9 screen-failed, and 7 had complete data. All of these 7 were men; 2 had tetraplegia and 5 had motor-complete injuries. Of these, 5 participants could stand, walk, and sit with contact guard or close supervision assistance, and 2 required minimal to moderate assistance. Walk times ranged from 28 to 94 minutes with average speeds ranging from 0.11 to 0.21 m/s. For all participants, heart rate changes and reported perceived exertion were consistent with light to moderate exercise. CONCLUSIONS: This study provides preliminary evidence that persons with neurological weakness due to SCI can learn to walk with little or no assistance and light to somewhat hard perceived exertion using a powered exoskeleton. Persons with different severities of injury, including those with motor complete C7 tetraplegia and motor incomplete C4 tetraplegia, may be able to learn to use this device.
Authors: Susan J Harkema; Mary Schmidt-Read; Andrea L Behrman; Amy Bratta; Sue Ann Sisto; V Reggie Edgerton Journal: Arch Phys Med Rehabil Date: 2011-07-20 Impact factor: 3.966
Authors: Gabi Zeilig; Harold Weingarden; Manuel Zwecker; Israel Dudkiewicz; Ayala Bloch; Alberto Esquenazi Journal: J Spinal Cord Med Date: 2012-02-07 Impact factor: 1.985
Authors: Susan J Harkema; Mary Schmidt-Read; Douglas J Lorenz; V Reggie Edgerton; Andrea L Behrman Journal: Arch Phys Med Rehabil Date: 2011-07-20 Impact factor: 3.966
Authors: Andrew D Delgado; Miguel X Escalon; Thomas N Bryce; William Weinrauch; Stephanie J Suarez; Allan J Kozlowski Journal: J Spinal Cord Med Date: 2019-10-11 Impact factor: 1.985
Authors: Pierre K Asselin; Manuel Avedissian; Steven Knezevic; Stephen Kornfeld; Ann M Spungen Journal: J Vis Exp Date: 2016-06-16 Impact factor: 1.355