Initial Outcomes from a Multicenter Study Utilizing the Indego Powered Exoskeleton in Spinal Cord Injury

Abstract

To assess safety and mobility outcomes utilizing the Indego powered exoskeleton in indoor and outdoor walking conditions with individuals previously diagnosed with a spinal cord injury (SCI). We conducted a multicenter prospective observational cohort study in outpatient clinics associated with 5 rehabilitation hospitals. A convenience sample of nonambulatory individuals with SCI ( = 32) completed an 8-week training protocol consisting of walking training 3 times per week utilizing the Indego powered exoskeleton in indoor and outdoor conditions. Participants were also trained in donning/doffing the exoskeleton during each session. Safety measures such as adverse events (AEs) were monitored and reported. Time and independence with donning/doffing the exoskeleton as well as walking outcomes to include the 10-meter walk test (10MWT), 6-minute walk test (6MWT), Timed Up & Go test (TUG), and 600-meter walk test were evaluated from midpoint to final evaluations. All 32 participants completed the training protocol with limited device-related AEs, which resulted in no interruption in training. The majority of participants in this trial were able to don and doff the Indego independently. Final walking speed ranged from 0.19 to 0.55 m/s. Final average indoor and outdoor walking speeds among all participants were 0.37 m/s ( = 0.08, 0.09, respectively), after 8 weeks of training. Significant ( < .05) improvements were noted between midpoint and final gait speeds in both indoor and outdoor conditions. Average walking endurance also improved among participants after training. The Indego was shown to be safe for providing upright mobility to 32 individuals with SCIs who were nonambulatory. Improvements in speed and independence were noted with walking in indoor and outdoor conditions as well as with donning/doffing the exoskeleton.

Robotic Rehabilitation and Spinal Cord Injury: a Narrative Review

“…Several individual studies on specific exoskeletons and feasibility have been conducted. For example, the systems ReWalk [27,29,[39][40][41][42], Ekso [39,43,44], Indego [45,46], Exo-H2 [47], Arke [48], and X1 Mina [49] have been found to be practical for use. In addition to investigations of feasibility, several reviews have explored outcomes that relate to the efficacy of EAW.…”

Systematic Review on Wearable Lower-Limb Exoskeletons for Gait Training in Neuromuscular Impairments

“…On the other hand, wearable exoskeletons need to be easy to don/doff in order to prevent users from carrying out hazardous transitions and requiring assistance from caregivers. Doffing time takes around 10 minutes [40, 64,65] and usually tends to be shorter than donning time, which can reach up to 30 minutes in some cases [66]. In general, patients are unable to don/doff the exoskeleton by themselves [65], often needing to carry out complicated wheelchair-exoskeleton transitions, thus requiring the assistance of caregivers.…”

Muscular Activity Modulation During Post-operative Walking With Hybrid Assistive Limb (HAL) in a Patient With Thoracic Myelopathy Due to Ossification of Posterior Longitudinal Ligament: A Case Report

“…Disorders of the central nervous system sometimes cause severe sensory motor paralysis accompanied by gait impairment. There are several recent reports on gait improvement after clinical intervention using wearable exoskeleton-type robots in patients with gait disturbance after central nervous system disorders; for example, ReWalk (1), Indego (2), Ekso (3), Lopes (4), Lokomat (5,6), MindWalker (7), and HAL (8).…”