Cardiorespiratory Responses to 10 Weeks of Exoskeleton-Assisted Overground Walking Training in Chronic Nonambulatory Patients with Spinal Cord Injury

Sensors, 2021 · DOI: https://doi.org/10.3390/s21155022 · Published: July 24, 2021

Spinal Cord Injury Assistive Technology Rehabilitation

Simple Explanation

This study investigated the impact of long-term exoskeleton-assisted walking on the cardiorespiratory systems of patients with spinal cord injury (SCI). Patients underwent a 10-week walking training program using an exoskeleton, with researchers measuring oxygen consumption and heart rate during a 6-minute walking test at the beginning, middle, and end of the training. The study found that the intensity of the exercise, as measured by metabolic rate, remained moderate throughout the training period. However, the average heart rate relative to heart rate reserve significantly decreased after the training, and walking efficiency improved. The results suggest that regular exoskeleton-assisted walking can lead to improved cardiovascular efficiency in individuals with SCI, without necessarily increasing the intensity of the exercise.

Study Duration

10 Weeks

Participants

10 chronic non-ambulatory patients with SCI

Evidence Level

Not specified

Key Findings

1
Exercise intensity, measured by metabolic equivalents (METs), remained at a moderate level throughout the 10-week exoskeleton-assisted walking training.
2
The average heart rate relative to heart rate reserve (%HRRavg) significantly decreased after the training, indicating improved cardiovascular efficiency.
3
Walking efficiency, calculated as oxygen consumption divided by walking speed, progressively improved with the exoskeleton walking training.

Research Summary

This study assessed the cardiorespiratory effects of a 10-week exoskeleton-assisted walking program in chronic SCI patients. The primary outcome measures were oxygen consumption (VO2) and heart rate (HR) during a 6-minute walking test (6MWT). The results indicated that while exercise intensity remained moderate based on METs, the average heart rate decreased significantly post-training, and walking efficiency improved. These findings suggest that regular exoskeleton use can enhance cardiovascular efficiency in SCI patients. The study concludes that exoskeleton-assisted walking is a feasible moderate-intensity exercise for chronic SCI patients, leading to improved walking efficiency and potentially beneficial cardiorespiratory adaptations over time.

Practical Implications

Rehabilitation Strategy

Exoskeleton-assisted walking can be incorporated into rehabilitation programs for SCI patients to improve cardiovascular health and walking efficiency.

Exercise Prescription

The moderate intensity level of exoskeleton walking makes it a safe and tolerable exercise option for individuals with SCI.

Technology Improvement

Further development of exoskeletons should focus on maximizing walking efficiency and promoting long-term cardiorespiratory benefits.

Study Limitations

1
Small sample size and heterogeneity of the study population limits generalizability.
2
Lack of cardiopulmonary exercise tests to evaluate maximal VO2 and HR.
3
Rest time during the 6MWT was not recorded, and cardiorespiratory responses during turn and rest were not assessed separately.

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