The efficacy of exoskeletal-assisted walking for non-ambulatory patients with a spinal cord injury from T6 to L1 levels: a pre-post observational study

外骨骼辅助行走对T6至L1节段脊髓损伤非行走患者的疗效:一项前后对照观察研究

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Abstract

OBJECTIVES: To verify the efficacy of exoskeletal-assisted walking (EAW) on motor abilities and pulmonary performance of patients with a spinal cord injury (SCI) from T6 to L1 levels. METHODS: An observational pre-post prospective study was done with gait training with robotic exoskeletal devices in 117 patients (with age ≥ 18 years) who had complete or motor complete dorsal/dorso-lumber myelopathy. RESULTS: Compared to walking without the use of a robotic exoskeleton condition, all walking functions were improved 2-weeks and 1-week after the use of a robotic exoskeleton (P < 0.01 for all). Individuals consistently traveled faster in week two (19.1 ± 1.3 m) than they did in week one (almost zero), with a difference of 19.1 m (15.1-21.8 m). Walking, lower extremity motor scores, and the Chinese version of Spinal Cord Independence Measure III were improved from baseline followed by week 1 and week 2 using an exoskeleton for patients with severe injuries (T6-L1; SCI-A; n = 76; I (2) = 99.5; P < 0.001). The post-exoskeleton-intervention stage had better 5 pulmonary function test values (SMD: -0.92; 95% CI: from -1.58 to -0.26, P < 0.05, I (2) = 95.9) and did not show a significant difference for any adverse effects (I (2) = 0 (0-84.7) %) versus the pre-exoskeleton-intervention stage. CONCLUSIONS: EAW is a reliable method for the improvement of walking functions of patients suffering from SCI. The benefits of an EAW are over time connected to the usage of the exoskeleton.

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