Lysanne van Silfhout1, Zdenĕk Váňa2, Jakub Pĕtioký3, Michael J R Edwards4, Ronald H M A Bartels5, Henk van de Meent6, Allard J F Hosman7. 1. Department of Surgery, Radboudumc, Nijmegen, the Netherlands. lysannevansilfhout@live.nl. 2. Rehabilitation Centre Kladruby, Kladruby, Czech Republic. 3. Third Faculty of Medicine, Neurosciences, Charles University, Prague, Czech Republic. 4. Department of Trauma Surgery, Radboudumc, Nijmegen, the Netherlands. 5. Department of Neurosurgery, Radboudumc, Nijmegen, the Netherlands. 6. Department of Rehabilitation, Radboudumc, Nijmegen, the Netherlands. 7. Department of Orthopedic Surgery, Radboudumc, Nijmegen, the Netherlands.
Abstract
BACKGROUND: Motor impairment and loss of ambulatory function are major consequences of a spinal cord injury (SCI). Exoskeletons are robotic devices that allow SCI patients with limited ambulatory function to walk. The mean walking speed of SCI patients using an exoskeleton is low: 0.26 m/s. Moreover, literature shows that a minimum speed of 0.59 m/s is required to replace wheelchairs in the community. OBJECTIVE: To investigate the highest ambulatory speed for SCI patients in a Lokomat. METHODS: This clinical pilot study took place in the Rehabilitation Center Kladruby, in Kladruby (Czech Republic). Six persons with motor-complete sub-acute SCI were recruited. Measurements were taken at baseline and directly after a 30 min Lokomat training. The highest achieved walking speed, vital parameters (respiratory frequency, heart rate, and blood pressure), visual analog scale for pain, and modified Ashworth scale for spasticity were recorded for each person. RESULTS: The highest reached walking speed in the Lokomat was on average 0.63 m/s (SD 0.03 m/s). No negative effects on the vital parameters, pain, or spasticity were observed. A significant decrease in pain after the Lokomat training was observed: 95% CI [0.336, 1.664] (p = 0.012). CONCLUSION: This study shows that it is possible for motor-complete SCI individuals to ambulate faster on a Lokomat (on average 0.63 m/s) than what is currently possible with over-ground exoskeletons. No negative effects were observed while ambulating on a Lokomat. Further research investigating walking speed in exoskeletons after SCI is recommended.
BACKGROUND:Motor impairment and loss of ambulatory function are major consequences of a spinal cord injury (SCI). Exoskeletons are robotic devices that allow SCIpatients with limited ambulatory function to walk. The mean walking speed of SCIpatients using an exoskeleton is low: 0.26 m/s. Moreover, literature shows that a minimum speed of 0.59 m/s is required to replace wheelchairs in the community. OBJECTIVE: To investigate the highest ambulatory speed for SCIpatients in a Lokomat. METHODS: This clinical pilot study took place in the Rehabilitation Center Kladruby, in Kladruby (Czech Republic). Six persons with motor-complete sub-acute SCI were recruited. Measurements were taken at baseline and directly after a 30 min Lokomat training. The highest achieved walking speed, vital parameters (respiratory frequency, heart rate, and blood pressure), visual analog scale for pain, and modified Ashworth scale for spasticity were recorded for each person. RESULTS: The highest reached walking speed in the Lokomat was on average 0.63 m/s (SD 0.03 m/s). No negative effects on the vital parameters, pain, or spasticity were observed. A significant decrease in pain after the Lokomat training was observed: 95% CI [0.336, 1.664] (p = 0.012). CONCLUSION: This study shows that it is possible for motor-complete SCI individuals to ambulate faster on a Lokomat (on average 0.63 m/s) than what is currently possible with over-ground exoskeletons. No negative effects were observed while ambulating on a Lokomat. Further research investigating walking speed in exoskeletons after SCI is recommended.
Authors: A Williams Andrews; Susan A Chinworth; Michael Bourassa; Miranda Garvin; Dacia Benton; Scott Tanner Journal: J Geriatr Phys Ther Date: 2010 Jul-Sep Impact factor: 3.381