Abstract
Exercise intensity of exoskeleton-assisted walking in patients with spinal cord injury (SCI) has been reported as moderate. However, the cardiorespiratory responses to long-term exoskeleton-assisted walking have not been sufficiently investigated. We investigated the cardiorespiratory responses to 10 weeks of exoskeleton-assisted walking training in patients with SCI. Chronic nonambulatory patients with SCI were recruited from an outpatient clinic. Walking training with an exoskeleton was conducted three times per week for 10 weeks. Oxygen consumption and heart rate (HR) were measured during a 6-min walking test at pre-, mid-, and post-training. Exercise intensity was determined according to the metabolic equivalent of tasks (METs) for SCI and HR relative to the HR reserve (%HRR). Walking efficiency was calculated as oxygen consumption divided by walking speed. The exercise intensity according to the METs (both peak and average) corresponded to moderate physical activity and did not change after training. The %HRR demonstrated a moderate (peak %HRR) and light (average %HRR) exercise intensity level, and the average %HRR significantly decreased at post-training compared with mid-training (31.6 ± 8.9% to 24.3 ± 7.3%, p = 0.013). Walking efficiency progressively improved after training. Walking with an exoskeleton for 10 weeks may affect the cardiorespiratory system in chronic patients with SCI.
Highlights
Spinal cord injury (SCI) occurs in 0.93 million persons per year worldwide, and the age-standardized incidence rate is 13 per 100,000 people, causing a significant global injury burden [1]
Eleven participants were enrolled in this study, and one participant withdrew before the initial training session because of scheduling conflicts
Walking efficiency gradually improved after walking training with a robotic exoskeleton
Summary
Spinal cord injury (SCI) occurs in 0.93 million persons per year worldwide, and the age-standardized incidence rate is 13 per 100,000 people, causing a significant global injury burden [1]. Patients with SCI suffer from various health conditions, including pain, pressure ulcers, depression, bladder and bowel dysfunctions, impaired proprioception, and motor weakness [2,3]. Patients with SCI often have difficulty in walking due to motor weakness or impaired proprioception, which can lead to significant reductions in physical activities and a sedentary lifestyle [3,4]. Individuals with SCI have an increased risk of cardiovascular diseases [2,4]. Cardiovascular diseases have become a major cause of mortality in individuals with chronic SCI [5]. Lifestyle interventions have become an important issue in reducing cardiovascular mortality in patients with SCI [6]
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