Kanan Yatsuya1,2, Satoshi Hirano1, Eiichi Saitoh1, Shigeo Tanabe3, Hirotaka Tanaka2, Masayuki Eguchi2, Masaki Katoh4, Yasuhiro Shimizu5, Akito Uno6, Hitoshi Kagaya1. 1. a Department of Rehabilitation Medicine I, School of Medicine , Fujita Health University , Toyoake , Aichi , Japan. 2. b Department of Rehabilitation , Japan Organization of Occupational Health and Safety Chubu Rosai Hospital , Nagoya , Aichi , Japan. 3. c Faculty of Rehabilitation, School of Health Sciences , Fujita Health University , Toyoake , Aichi , Japan. 4. d Department of Rehabilitation , Fujita Health University Hospital , Toyoake , Aichi , Japan. 5. e Rehabilitation Center , Kizankai Memorial Hospital , Iida , Nagano , Japan. 6. f Orthopedic Services Division , Tomei Brace Co., Ltd. , Seto , Aichi , Japan.
Abstract
OBJECTIVE: To compare the energy efficiency of Wearable Power-Assist Locomotor (WPAL) with conventional knee-ankle-foot orthoses (MSH-KAFO) such as Hip and Ankle Linked Orthosis (HALO) or Primewalk. STUDY DESIGN: Cross over case-series. SETTING: Chubu Rosai Hospital, Aichi, Japan, which is affiliated with the Japan Organization of Occupational Health and Safety. METHODS: Six patients were trained with MSH-KAFO (either HALO or Primewalk) and WPAL. They underwent 6-minute walk tests with each orthosis. Energy efficiency was estimated using physiological cost index (PCI) as well as heart rate (HR) and modified Borg score. Trial energy efficiency with MSH-KAFO was compared with WPAL to assess if differences in PCI became greater between MSH-KAFO and WPAL as time goes on during the 6-minute walk. Spearman correlation coefficient of time (range: 0.5-6.0 minutes) with the difference was calculated. The same statistical procedures were repeated for HR and modified Borg score. RESULTS: Greater energy efficiency, representing a lower gait demand, was observed in trials with WPAL compared with MSH-KAFO (Spearman correlation coefficients for PCI, HR and modified Borg were 0.93, 0.90 and 0.97, respectively, all P < 0.0001). CONCLUSIONS: WPAL is a practical and energy efficient type of robotics that may be used by patients with paraplegia.
OBJECTIVE: To compare the energy efficiency of Wearable Power-Assist Locomotor (WPAL) with conventional knee-ankle-foot orthoses (MSH-KAFO) such as Hip and Ankle Linked Orthosis (HALO) or Primewalk. STUDY DESIGN: Cross over case-series. SETTING: Chubu Rosai Hospital, Aichi, Japan, which is affiliated with the Japan Organization of Occupational Health and Safety. METHODS: Six patients were trained with MSH-KAFO (either HALO or Primewalk) and WPAL. They underwent 6-minute walk tests with each orthosis. Energy efficiency was estimated using physiological cost index (PCI) as well as heart rate (HR) and modified Borg score. Trial energy efficiency with MSH-KAFO was compared with WPAL to assess if differences in PCI became greater between MSH-KAFO and WPAL as time goes on during the 6-minute walk. Spearman correlation coefficient of time (range: 0.5-6.0 minutes) with the difference was calculated. The same statistical procedures were repeated for HR and modified Borg score. RESULTS: Greater energy efficiency, representing a lower gait demand, was observed in trials with WPAL compared with MSH-KAFO (Spearman correlation coefficients for PCI, HR and modified Borg were 0.93, 0.90 and 0.97, respectively, all P < 0.0001). CONCLUSIONS: WPAL is a practical and energy efficient type of robotics that may be used by patients with paraplegia.
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