Silvia Corbianco1,2, Gabriella Cavallini3, Marco Dini3,4, Ferdinando Franzoni5, Carla D'Avino6, Adriana Gerini6, Giulia Stampacchia6. 1. Interdepartmental Research Centre on Biology and Pathology of Aging, University of Pisa, via Roma 55, I-56126, Pisa, Italy. s.corbianco@ao-pisa.toscana.it. 2. Human Movement and Rehabilitation Research Laboratory, Pisa, Italy. s.corbianco@ao-pisa.toscana.it. 3. Interdepartmental Research Centre on Biology and Pathology of Aging, University of Pisa, via Roma 55, I-56126, Pisa, Italy. 4. Human Movement and Rehabilitation Research Laboratory, Pisa, Italy. 5. Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy. 6. Spinal Cord Unit, Pisa University Hospital, Pisa, Italy.
Abstract
BACKGROUND: In the last years, there has been an intense technological development of robotic devices for gait rehabilitation in spinal cord injury (SCI) patients. The aim of the present study was to evaluate energy cost and psychological impact during a rehabilitation program with two different types of robotic rehabilitation systems (stationary system on a treadmill, Lokomat, and overground walking system, Ekso GT). METHODS:Fifteen SCI patients with different injury levels underwentrobot-assisted gait training sessions, divided into 2 phases: in the first phase, all subjects completed 3 sessions both Lokomat and Ekso GT. Afterwards, participants were randomly assigned to Lokomat or the Ekso for 17 sessions. A questionnaire, investigating the subjective psychological impact (SPI) during gait training, was administered. The functional outcome measures were oxygen consumption (VO2), carbon dioxide production (VCO2), metabolic equivalent of task (MET), walking economy, and heart rate (HR). RESULTS: The metabolic responses (7.73 ± 1.02 mL/kg/min) and MET values (3.20 ± 1.01) during robotic overground walking resulted to be higher than those during robotic treadmill walking (3.91 ± 0.93 mL/kg/min and 1.58 ± 0.44; p < 0.01). Both devices showed high scores in emotion and satisfaction. Overground walking resulted in higher scores of fatigue, mental effort, and discomfort while walking with Lokomat showed a higher score in muscle relaxation. All patients showed improvements in walking economy due to a decrease in energy cost with increased speed and workload. CONCLUSIONS:Overground robotic-assisted gait training in rehabilitation program needs higher cognitive and cardiovascular efforts than robot-assisted gait training on a treadmill.
RCT Entities:
BACKGROUND: In the last years, there has been an intense technological development of robotic devices for gait rehabilitation in spinal cord injury (SCI) patients. The aim of the present study was to evaluate energy cost and psychological impact during a rehabilitation program with two different types of robotic rehabilitation systems (stationary system on a treadmill, Lokomat, and overground walking system, Ekso GT). METHODS: Fifteen SCI patients with different injury levels underwent robot-assisted gait training sessions, divided into 2 phases: in the first phase, all subjects completed 3 sessions both Lokomat and Ekso GT. Afterwards, participants were randomly assigned to Lokomat or the Ekso for 17 sessions. A questionnaire, investigating the subjective psychological impact (SPI) during gait training, was administered. The functional outcome measures were oxygen consumption (VO2), carbon dioxide production (VCO2), metabolic equivalent of task (MET), walking economy, and heart rate (HR). RESULTS: The metabolic responses (7.73 ± 1.02 mL/kg/min) and MET values (3.20 ± 1.01) during robotic overground walking resulted to be higher than those during robotic treadmill walking (3.91 ± 0.93 mL/kg/min and 1.58 ± 0.44; p < 0.01). Both devices showed high scores in emotion and satisfaction. Overground walking resulted in higher scores of fatigue, mental effort, and discomfort while walking with Lokomat showed a higher score in muscle relaxation. All patients showed improvements in walking economy due to a decrease in energy cost with increased speed and workload. CONCLUSIONS: Overground robotic-assisted gait training in rehabilitation program needs higher cognitive and cardiovascular efforts than robot-assisted gait training on a treadmill.
Authors: Damien Duddy; Rónán Doherty; James Connolly; Johnny Loughrey; Joan Condell; David Hassan; Maria Faulkner Journal: Int J Environ Res Public Health Date: 2022-05-19 Impact factor: 4.614