Abstract
Gait training for paraplegic patients is effective in preventing various complications due to prolonged sitting. In these patients, the use of powered exoskeletal-gait-orthosis (EGO) consumes lower energy than traditional training methods using non-powered EGO, such as a reciprocating-gait-orthosis (RGO). Thus, long-term training is possible and effective in increasing the activity level of the trunk muscles. However, more than 60% of paraplegic patients have incomplete injuries with residual function, which is inversely related to the functional role of the orthosis. We hypothesized that the gait ability in incomplete paraplegia could be improved by knee joint activation, and we developed a lightweight knee-actuated EGO (KAEGO). We verified its effectiveness in one patient with an incomplete spinal cord injury by comparing the metabolic cost of transport (COT) measured by a six minute walk test to a traditional non-powered EGO. We found that with increasing assist torque to the knee joint, the COT decreased by up to 24.5%, and the gait performance, including walking speed and travel distance, significantly improved up to 37% compared to that of the non-powered EGO. Future studies should verify the KAEGO system’s effectiveness in a larger number of patients with various injury levels.
Highlights
Due to the loss of sensory and motor functions of the lower extremities, paraplegic patients often suffer from various complications, such as a decrease in various organs’functions, including the bladder, nerve and muscle atrophy, cardiovascular, and musculoskeletal diseases
As a rehabilitation treatment for such patients, muscular contractures are minimized, and secondary medical conditions caused by prolonged sitting such as osteoporosis, bedsores, and organ function decline can be improved through standing or regular gait training using a hip–knee–ankle–foot orthosis (HKAFO) or reciprocating-gaitorthosis (RGO) [1,2,3,4]
We hypothesized that the metabolic cost associated with walking would decrease and walking speed would increase based on the knee joint activation
Summary
Due to the loss of sensory and motor functions of the lower extremities, paraplegic patients often suffer from various complications, such as a decrease in various organs’functions, including the bladder, nerve and muscle atrophy, cardiovascular, and musculoskeletal diseases. Due to the loss of sensory and motor functions of the lower extremities, paraplegic patients often suffer from various complications, such as a decrease in various organs’. As a rehabilitation treatment for such patients, muscular contractures are minimized, and secondary medical conditions caused by prolonged sitting such as osteoporosis, bedsores, and organ function decline can be improved through standing or regular gait training using a hip–knee–ankle–foot orthosis (HKAFO) or reciprocating-gaitorthosis (RGO) [1,2,3,4]. The frequency and duration of training are very important for recovering gait ability in paraplegic patients. Walk training was possible for approximately 20–50 min with the HKAFO or RGO, increasing up to 2 h by wearing the powered exoskeleton system [1]
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