Evaluation of the effectiveness and safety of exoskeleton in rehabilitation programs for patients with spinal cord injury

Abstract

Objective. Evaluation of the effectiveness and safety of exoskeleton in rehabilitation programs for patients with spinal cord injury. Material and Methods. A clinical study of the effectiveness of a rehabilitation program based on training in an exoskeleton was carried out on the basis of the Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. L.Ya. Tsivyan in the period from 2017 to 2019. Rehabilitation trainings were conducted using Russian hardware and software complex. The study involved 80 people (57 men and 23 women) with spinal cord damage caused by the thoracic and lumbar spine injury. The duration of the injury ranged from 1 to 15 years, the average duration of the post-traumatic period was 73.4 ± 5.31 months. Results. The rehabilitation program for each participant consisted of 2 sessions of 20 days each held in hospital setting and included training in ExoAtlet exoskeleton (at least 15 trainings, 30 minutes each during each hospital stay), specialized exercise therapy and physiotherapy procedures. The break between sessions was 1 month. The results of the SCIM III assessment showed a change in the level of active functioning towards improvement in half of the patients who underwent rehabilitation in the exoskeleton. Taking into account that patients with complete conduction disturbances (66.3%) and injury duration of more than three years (73.7 %) prevailed among the study participants, such results indicate the effectiveness of rehabilitation measures based on walking in exoskeleton, not only in recovery, but also in the late period of the injury, even with severe neurological deficit. Conclusion. The obtained results allow recommending walking in an exoskeleton for inclusion in the rehabilitation programs for patients with paraplegia and paraparesis in the recovery and late periods of spinal cord injury.