The future of SCI rehabilitation: Understanding the impact of exoskeletons on gait mechanics

Gorgey, Ashraf S.; Holman, Matthew E.

doi:10.1080/10790268.2018.1474681

Cited by 4 publications

(4 citation statements)

References 4 publications

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“…However, a BMD cutoff value less than 0.6 g/cm 2 of the knee joint has been used in previous SCI studies and may provide a useful absolute cutoff value for future RCTs. 32 No other adverse events or negative side effects were reported. These individualized factors on bone health as well as recognized cutoff values for safety should be considered when implementing rehabilitation interventions in future large-scale studies.…”

Section: Discussionmentioning

confidence: 97%

“…Thus, this study considered the BMD measurements of the hip and spine only. However, based on recent guidelines 32 and because the distal femur and proximal tibia have recently been shown to be the most common sites of fracture after SCI, 2,17 an effort should be made to assess the impact of interventions at these specific sites. In addition, future research should consider caloric intake or dietary outcomes, as this could affect energy balance and result in excess body fat accumulation.…”

Section: Discussionmentioning

confidence: 99%

“…Consequently, it is apparent that a cutoff BMD value to determine eligibility within the trial is challenging, as values are currently based on able-bodied norms. However, a BMD cutoff value less than 0.6 g/cm 2 of the knee joint has been used in previous SCI studies and may provide a useful absolute cutoff value for future RCTs 32 . No other adverse events or negative side effects were reported.…”

Section: Discussionmentioning

confidence: 99%

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Robotic Walking to Mitigate Bone Mineral Density Decline and Adverse Body Composition in Individuals With Incomplete Spinal Cord Injury

Shackleton

Evans

West

et al. 2021

Am J Phys Med Rehabil

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The aim of the study was to determine whether 24 wks of robotic locomotor training or activity-based training was sufficient time to induce bone mineral density and body composition changes in individuals with spinal cord injury. This study reports the secondary analysis of a randomized pilot trial. Design: Participants with chronic motor incomplete tetraplegia (N = 16) were recruited. Interventions involved 60-min sessions, 3Â per week, over 24 wks. Robotic locomotor training involved walking in the Ekso GT suit. Activity-based training involved a combination of resistance, cardiovascular, and weight-bearing exercise. Results: Hip bone mineral density was maintained during robotic locomotor training; however, it was significantly reduced ( P = 0.04, effect size = 0.86) during activity-based training by 0.03 (−0.29 to 0.23) g/cm 2 after intervention. Both interventions improved arm fat-free soft tissue mass, but neither group experienced changes in leg fat-free soft tissue mass. The activity-based training group had a significant decrease in visceral adipose tissue ( P = 0.04, effect size = 0.72) and gynoid fat mass ( P = 0.01, effect size = 0.62). Conclusions: Twenty-four weeks of robotic locomotor training is possibly a sufficient duration to prevent the progressive decline of bone mineral density usually occurring in this population. A longitudinal period of activity-based training serves as an effective rehabilitation strategy to reduce indices of fat mass in individuals with spinal cord injury.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Robotic Walking to Mitigate Bone Mineral Density Decline and Adverse Body Composition in Individuals With Incomplete Spinal Cord Injury

Shackleton

Evans

West

et al. 2021

Am J Phys Med Rehabil

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“…A small number of patients can resume walking after SCI, 1 while the majority of them face great difficulty in this regard. Getting out of bed and standing on the legs can be a good sign indicating the patients' recovery, 2 and smoothly standing is one of the mentalpsychological advantages brought about by walking, along with increasing the patients' self-confidence. There are two main categories of SCI: complete and incomplete.…”

Section: Introductionmentioning

confidence: 99%

Using a saddle-assistive device equipped with mechanical orthosis for walking of the person with incomplete spinal cord injury

Najafabadi

Amini

Farahmand

2021

Proc Inst Mech Eng H

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The majority of the people with incomplete spinal cord injury lose their walking ability, due to the weakness of their muscle motors in providing torque. As a result, developing assistive devices to improve their conditionis of great importance. In this study, a combined application of the saddle-assistive device (S-AD) and mechanical medial linkage or thosis was evaluated to improve the walking ability in patients with spinal cord injury in the gait laboratory. This mobile assistive device is called the saddle-assistive device equipped with medial linkage or thosis (S-ADEM). In this device, a mechanical orthosis was used in a wheeled walker as previously done in the literature. Initially, for evaluation of the proposed assistive device, the experimental results related to the forces and torques exerted on the feet and upper limbs of a person with the incomplete Spinal Cord Injury (SCI) during walking usingthe standard walker were compared with an those obtained from using the S-ADEM on an able-bodied subject. It was found that using this combination of assistive devices decreases the vertical force and torque on the foot at the time of walking by 53% and 48%, respectively compared to a standard walker. Moreover, the hand-reaction force on the upper limb was negligible instanding and walking positions usingthe introduced device. The findings of this study revealed that the walking ability of the patients with incomplete SCI was improved using the proposed device, which is due to the bodyweight support and the motion technology used in it.

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Telerehabilitation for Exercise in Neurological Disability

Gorgey¹,

Goldsmith²,

Anderson³

et al. 2022

Telerehabilitation

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The future of SCI rehabilitation: Understanding the impact of exoskeletons on gait mechanics

Cited by 4 publications

References 4 publications

Robotic Walking to Mitigate Bone Mineral Density Decline and Adverse Body Composition in Individuals With Incomplete Spinal Cord Injury

Robotic Walking to Mitigate Bone Mineral Density Decline and Adverse Body Composition in Individuals With Incomplete Spinal Cord Injury

Using a saddle-assistive device equipped with mechanical orthosis for walking of the person with incomplete spinal cord injury

Telerehabilitation for Exercise in Neurological Disability

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