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Assessment of In-Hospital Walking Velocity and Level of Assistance in a Powered
Exoskeleton in Persons with Spinal Cord Injury
#MMPMID26364279
Yang A
; Asselin P
; Knezevic S
; Kornfeld S
; Spungen AM
Top Spinal Cord Inj Rehabil
2015[Spr]; 21
(2
): 100-9
PMID26364279
show ga
BACKGROUND: Individuals with spinal cord injury (SCI) often use a wheelchair for
mobility due to paralysis. Powered exoskeletal-assisted walking (EAW) provides a
modality for walking overground with crutches. Little is known about the EAW
velocities and level of assistance (LOA) needed for these devices. OBJECTIVE: The
primary aim was to evaluate EAW velocity, number of sessions, and LOA and the
relationships among them. The secondary aims were to report on safety and the
qualitative analysis of gait and posture during EAW in a hospital setting.
METHODS: Twelve individuals with SCI ? 1.5 years who were wheelchair users
participated. They wore a powered exoskeleton (ReWalk; ReWalk Robotics, Inc.,
Marlborough, MA) with Lofstrand crutches to complete 10-meter (10 MWT) and
6-minute (6MWT) walk tests. LOA was defined as modified independence (MI),
supervision (S), minimal assistance (Min), and moderate assistance (Mod). Best
effort EAW velocity, LOA, and observational gait analysis were recorded. RESULTS:
Seven of 12 participants ambulated ? 0.40 m/s. Five participants walked with MI,
3 with S, 3 with Min, and 1 with Mod. Significant inverse relationships were
noted between LOA and EAW velocity for both 6 MWT (Z value = 2.63, Rho = 0.79, P
= .0086) and 10 MWT (Z value = 2.62, Rho = 0.79, P = .0088). There were 13
episodes of mild skin abrasions. MI and S groups ambulated with 2-point
alternating crutch pattern, whereas the Min and Mod groups favored 3-point crutch
gait. CONCLUSIONS: Seven of 12 individuals studied were able to ambulate at EAW
velocities ? 0.40 m/s, which is a velocity that may be conducive to outdoor
activity-related community ambulation. The ReWalk is a safe device for
in-hospital ambulation.
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