Energy Efficiency and Patient Satisfaction of Gait With Knee-Ankle-Foot Orthosis and Robot (ReWalk)-Assisted Gait in Patients With Spinal Cord Injury

Annals of Rehabilitation Medicine, 2020 · DOI: https://doi.org/10.5535/arm.2020.44.2.131 · Published: April 1, 2020

Spinal Cord Injury Assistive Technology Rehabilitation

Simple Explanation

This study compares the energy efficiency of walking with KAFOs and the ReWalk robot for people with spinal cord injuries. Participants trained with each device for 4 weeks, with a break in between to avoid carryover effects. The study also developed a questionnaire to measure how satisfied patients were with each walking device.

Study Duration

March 2017 and March 2019

Participants

13 patients with complete paraplegia (10 completed the evaluation)

Evidence Level

Not specified

Key Findings

1
ReWalk-assisted gait was more energy-efficient than KAFO-gait in both the 6-minute and 30-minute walking tests.
2
There was no significant difference in walking distance or speed during the 30-minute walking test between the two gait methods.
3
The usability questionnaire showed no significant difference in patient satisfaction between ReWalk-gait and KAFO-gait.

Research Summary

The study aimed to compare the energy efficiency and patient satisfaction of KAFO-gait and ReWalk-gait in patients with spinal cord injuries. The results indicated that ReWalk-gait was more energy-efficient, but there were no significant differences in walking distance or speed during longer walking tests. Despite the improved energy efficiency, patients did not report a significant difference in satisfaction between the two gait methods.

Practical Implications

Energy Efficiency

ReWalk can enable paraplegic patients to walk with less energy expenditure compared to KAFO.

Patient Satisfaction

Design improvements are needed for ReWalk to improve patient satisfaction and usability.

Gait Training

ReWalk may be more beneficial for gait training due to its advantages in energy efficiency.

Study Limitations

1
Limited length of ReWalk-gait training to 20 sessions.
2
The reliability and validity of the 30MWT and the usability test conducted in this study were not verified.
3
Energy efficiency differences resulting from the use of different upper limb devices (bilateral forearm crutches and walker) were not considered.

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