Robotic gait training in patients with impaired consciousness due to severe traumatic brain injury

Lapitskaya, Natallia; Nielsen, Jørgen Feldbæk; Fuglsang-Frederiksen, Anders

doi:10.3109/02699052.2011.607782

Cited by 20 publications

(12 citation statements)

References 45 publications

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“…The effect of robotic gait training on consciousness has not been studied as intensively. Lapitskaya et al [16] were unable to find an effect of a single session of robotic gait training on consciousness of individuals with severe traumatic brain injury and suspected that the reason was the severity of brain dysfunction in their patient sample.…”

Section: Early Therapy Onsetmentioning

confidence: 99%

Getting the Best Out of Advanced Rehabilitation Technology for the Lower Limbs: Minding Motor Learning Principles

Spiess

Steenbrink²,

Esquenazi

2018

PM&R

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Advanced technology, including gait‐training devices, is increasingly being integrated into neurorehabilitation. However, to use gait‐training devices to their optimal potential, it is important that they are applied in accordance with motor learning and locomotor training principles. In this article, we outline the most important principles and explain how advanced gait‐training devices are best used to improve therapy outcome.

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Section: Early Therapy Onsetmentioning

confidence: 99%

Getting the Best Out of Advanced Rehabilitation Technology for the Lower Limbs: Minding Motor Learning Principles

Spiess

Steenbrink²,

Esquenazi

2018

PM&R

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“…A systematic review from 2011 reported 10 randomized controlled trials for the use of robotic devices in CVA rehabilitation, but none for TBI (Tomida et al, 2019 ). However, recent reports indicate increased use of robotic rehabilitation following TBI; for example, to quantify the degree of impairment (Logan et al, 2018 ), improve cognitive function (Maggio et al, 2020 ), to support treadmill training (Esquenazi et al, 2013 ), to measure brain activity while having robotic gait training (Lapitskaya et al, 2011 ), and to increase gait velocity (Esquenazi et al, 2017 ). While the outcomes of these studies are mixed due to the differences in patient population, training techniques used, and type of equipment, it is promising that the field is recognizing how robotics present with a novel opportunity to improve quality of life in patients with TBI.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Functional Outcome in a Cohort of Hispanic Patients Using Exoskeleton Rehabilitation for Cerebrovascular Accidents and Traumatic Brain Injury

et al. 2021

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Traumatic brain injury (TBI) and cerebrovascular accidents (CVA) are two of the leading causes of disability in the United States. Robotic exoskeletons (RE) have been approved for rehabilitation by the Federal Drug Administration (FDA) for use after a CVA, and recently received approval for use in patients with TBI. The aim of the study was to determine which factors predict the improvement in functional independence measure (FIM) score after using RE rehabilitation in a population of patients with CVA or TBI. We carried out a retrospective chart-review analysis of the use of the RE (Ekso® GT) in the rehabilitation of patients with TBI and CVA using data from a single, private rehabilitation hospital for patients admitted and discharged between 01/01/2017 and 04/30/2020. From the medical records, we collected presentation date, Glasgow Coma Scale score (GCS) on the date of injury, rehabilitation start date, age, diabetes status on presentation (Yes or No), injury category (TBI or CVA), and both admission and discharge FIM scores. Matching algorithms resulted in one TBI patient matched to three CVA patients resulting in a sample size of 36. The diabetic and non-diabetic populations showed significant differences between age and days from injury to the start of rehabilitation. A multivariate linear regression assessed predictors for discharge motor FIM and found admission motor FIM score and total RE steps to be statistically significant predictors. For each point scored higher on the admission motor FIM the discharge FIM was increased by 1.19 FIM points, and for each 1,000 steps taken in the RE, the discharge motor FIM increased by three points. The type of acquired brain injury (CVA or TBI) was not found to affect functional outcome. The presented results show that key clinic-biologic factors including diabetic status, together with start to rehabilitation play key roles in discharge FIM scores for patients using RE.Clinical Trial Registration: ClinicalTrials.gov, NCT04465019

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“…A systematic review from 2011 reported ten randomized controlled trials for the use of robotic devices in CVA rehabilitation, but none for TBI 27 . However, recent reports indicate increased use of robotic rehabilitation following TBI; for example, to quantify the degree of impairment 28 , improve cognitive function 29 , to support treadmill training 30 , to measure brain activity while having robotic gait training 31 , and to increase gait velocity 32 . While the outcomes of these studies are mixed due to the differences in patient population, training techniques used, and type of equipment, it is promising that the eld is recognizing how robotics present with a novel opportunity to improve quality of life in patients with TBI.…”

Section: Discussionmentioning

confidence: 99%

A Single-center Comparison Using Exoskeleton Rehabilitation for Cerebrovascular Accidents and Traumatic Brain Injury in a Cohort of Hispanic Patients

Treviño

Vatcheva

Auer

et al. 2020

Preprint

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Background Traumatic brain injury (TBI) is one of the leading causes of disability in the United States. The EKSO GT Bionics® (EKSO®) is a robotic exoskeleton approved by the Federal Drug Administration (FDA) for rehabilitation following a cerebrovascular accident (CVA or stroke) and recently received approval for use in patients with TBI. The aim of the study was to examine if the use of exoskeleton rehabilitation in patients with TBI will produce beneficial outcomes. Methods This retrospective chart-review reports the use of the (EKSO®) robotic device in the rehabilitation of patients with TBI compared to patients with CVA. We utilized data from a single, private rehabilitation hospital for patients that received post-CVA or post-TBI robotic exoskeleton intervention. All patients that used the exoskeleton were discharged from the hospital between 01/01/2017 to 04/30/2020. Ninety-four percent of patients in the CVA groups and 100% of patients in the TBI group were of Hispanic or Latino ethnicity. Gains in total Functional Independence Measure (FIM), walking and cognition, and length of stay in the rehabilitation facility were measured. Results Patients in the TBI group (n = 11) were significantly younger than the patients in the CVA group (n = 66; p < 0.05). Both groups spent a similar amount of time active, number of steps taken, and the number of sessions in the exoskeleton. Both groups also started with similar admission FIM scores. The FIM gain in the TBI group was similar to that of the CVA group (37.5 and 32.0 respectively). The length of stay between groups was not different either. Conclusions The use of exoskeleton rehabilitation in patients with TBI appear to produce similar outcomes as for patients with CVA, prompting further attention of this intervention for this type of injury. Trial registration: Retrospectively registered on 07/09/2020 in clinicaltrials.gov number NCT4465019.

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Robotic gait training in patients with impaired consciousness due to severe traumatic brain injury

Abstract: The study showed that robotic gait training induced measurable changes in the EEG power spectrum in healthy individuals, while no changes were observed in patients with severe TBI. The absence of the EEG changes following training might be an indicator of the severity of brain dysfunction.

Cited by 20 publications

References 45 publications

Getting the Best Out of Advanced Rehabilitation Technology for the Lower Limbs: Minding Motor Learning Principles

Getting the Best Out of Advanced Rehabilitation Technology for the Lower Limbs: Minding Motor Learning Principles

Predictors of Functional Outcome in a Cohort of Hispanic Patients Using Exoskeleton Rehabilitation for Cerebrovascular Accidents and Traumatic Brain Injury

A Single-center Comparison Using Exoskeleton Rehabilitation for Cerebrovascular Accidents and Traumatic Brain Injury in a Cohort of Hispanic Patients

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