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Gait training after spinal cord injury: safety, feasibility and gait function following 8 weeks of training with the exoskeletons from Ekso Bionics.

Journal article
Authors Carsten Bach Baunsgaard
Ulla Vig Nissen
Anne Katrin Brust
Angela Frotzler
Cornelia Ribeill
Yorck-Bernhard Kalke
Natacha León
Belén Gómez
Kersti Samuelsson
Wolfram Antepohl
Ulrika Holmström
Niklas Marklund
Thomas Glott
Arve Opheim
Jesus Benito
Narda Murillo
Janneke Nachtegaal
Willemijn Faber
Fin Biering-Sørensen
Published in Spinal cord
Volume 56
Pages 106-116
ISSN 1476-5624
Publication year 2018
Published at Institute of Neuroscience and Physiology, Department of Clinical Neuroscience
Pages 106-116
Language en
Subject categories Other Medical Engineering, Neurology, Physiotherapy


Prospective quasi-experimental study, pre- and post-design.Assess safety, feasibility, training characteristics and changes in gait function for persons with spinal cord injury (SCI) using the robotic exoskeletons from Ekso Bionics.Nine European rehabilitation centres.Robotic exoskeleton gait training, three times weekly over 8 weeks. Time upright, time walking and steps in the device (training characteristics) were recorded longitudinally. Gait and neurological function were measured by 10 Metre Walk Test (10 MWT), Timed Up and Go (TUG), Berg Balance Scale (BBS), Walking Index for Spinal Cord Injury (WISCI) II and Lower Extremity Motor Score (LEMS).Fifty-two participants completed the training protocol. Median age: 35.8 years (IQR 27.5-52.5), men/women: N = 36/16, neurological level of injury: C1-L2 and severity: AIS A-D (American Spinal Injury Association Impairment Scale). Time since injury (TSI) < 1 year, N = 25; > 1 year, N = 27. No serious adverse events occurred. Three participants dropped out following ankle swelling (overuse injury). Four participants sustained a Category II pressure ulcer at contact points with the device but completed the study and skin normalized. Training characteristics increased significantly for all subgroups. The number of participants with TSI < 1 year and gait function increased from 20 to 56% (P = 0.004) and 10MWT, TUG, BBS and LEMS results improved (P < 0.05). The number of participants with TSI > 1 year and gait function, increased from 41 to 44% and TUG and BBS results improved (P < 0.05).Exoskeleton training was generally safe and feasible in a heterogeneous sample of persons with SCI. Results indicate potential benefits on gait function and balance.

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