Clinical Delivery of Overground Exoskeleton Gait Training in Persons With Spinal Cord Injury Across the Continuum of Care: A Retrospective Analysis

IF 2.4 Q1 REHABILITATION
Dannae Arnold, Jaime Gillespie, Monica Bennett, Librada Callender, Seema Sikka, Rita Hamilton, Simon Driver, Chad Swank
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Abstract

Background After spinal cord injury (SCI), inpatient rehabilitation begins and continues through outpatient therapy. Overground exoskeleton gait training (OEGT) has been shown to be feasible in both settings, yet its use as an intervention across the continuum has not yet been reported. Objectives This study describes OEGT for patients with SCI across the continuum and its effects on clinical outcomes. Methods Medical records of patients with SCI who completed at least one OEGT session during inpatient and outpatient rehabilitation from 2018 to 2021 were retrospectively reviewed. Demographic data, Walking Index for Spinal Cord Injury-II (WISCI-II) scores, and OEGT session details (frequency, “walk” time, “up” time, and step count) were extracted. Results Eighteen patients [male (83%), White (61%), aged 37.4 ± 15 years, with tetraplegia (50%), American Spinal Injury Association Impairment Scale A (28%), B (22%), C (39%), D (11%)] completed OEGT sessions (motor complete, 18.2 ± 10.3; motor incomplete, 16.7 ± 7.7) over approximately 18 weeks (motor complete, 15.1 ± 6.4; motor incomplete, 19.0 ± 8.2). Patients demonstrated improved OEGT session tolerance on device metrics including “walk” time (motor complete, 7:51 ± 4:42 to 24:50 ± 9:35 minutes; motor incomplete, 12:16 ± 6:01 to 20:01 ± 08:05 minutes), “up” time (motor complete, 16:03 ± 7:41 to 29:49 ± 12:44 minutes; motor incomplete, 16:38 ± 4:51 to 23:06 ± 08:50 minutes), and step count (motor complete, 340 ± 295.9 to 840.2 ± 379.4; motor incomplete, 372.3 ± 225.2 to 713.2 ± 272). Across therapy settings, patients with motor complete SCI experienced improvement in WISCI-II scores from 0 ± 0 at inpatient admission to 3 ± 4.6 by outpatient discharge, whereas the motor incomplete group demonstrated a change of 0.2 ± 0.4 to 9.0 ± 6.4. Conclusion: Patients completed OEGT across the therapy continuum. Patients with motor incomplete SCI experienced clinically meaningful improvements in walking function.
脊髓损伤患者的地面外骨骼步态训练的临床交付:回顾性分析
背景脊髓损伤(SCI)后,住院康复开始并通过门诊治疗继续。地面外骨骼步态训练(OEGT)已被证明在这两种情况下都是可行的,但它作为一种连续干预的使用尚未有报道。目的:本研究描述了脊髓损伤患者的连续OEGT及其对临床结果的影响。方法回顾性分析2018年至2021年住院和门诊康复期间至少完成一次OEGT治疗的脊髓损伤患者的病历。提取了人口统计数据、脊髓损伤步行指数- ii (WISCI-II)评分和OEGT会话细节(频率、“步行”时间、“起身”时间和步数)。结果18例患者[男性(83%),白人(61%),年龄37.4±15岁,四肢瘫痪(50%),美国脊髓损伤协会损伤量表A (28%), B (22%), C (39%), D(11%)]完成了OEGT疗程(运动完成,18.2±10.3;电机不完整,16.7±7.7)在大约18周内完成(电机完整,15.1±6.4;电机不完整,19.0±8.2)。患者在设备指标上表现出改善的OEGT会话耐受性,包括“行走”时间(运动完成,7:51±4:42至24:50±9:35分钟;电机未完成,12:16±6:01至20:01±08:05分钟),“启动”时间(电机完成,16:03±7:41至29:49±12:44分钟;电机未完成,16:38±4:51至23:06±08:50分钟),步数(电机完成,340±295.9至840.2±379.4;电机不完整,372.3±225.2至713.2±272)。在整个治疗设置中,运动完全性脊髓损伤患者的WISCI-II评分从住院时的0±0提高到出院时的3±4.6,而运动不完全性脊髓损伤组的评分从0.2±0.4提高到9.0±6.4。结论:患者在整个治疗过程中完成了OEGT。运动不完全性脊髓损伤患者的行走功能有临床意义的改善。
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来源期刊
CiteScore
3.20
自引率
3.40%
发文量
33
期刊介绍: Now in our 22nd year as the leading interdisciplinary journal of SCI rehabilitation techniques and care. TSCIR is peer-reviewed, practical, and features one key topic per issue. Published topics include: mobility, sexuality, genitourinary, functional assessment, skin care, psychosocial, high tetraplegia, physical activity, pediatric, FES, sci/tbi, electronic medicine, orthotics, secondary conditions, research, aging, legal issues, women & sci, pain, environmental effects, life care planning
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