Abstract

Background

Motor impairment and loss of ambulatory function are major consequences of a spinal cord injury (SCI). Exoskeletons are robotic devices that allow SCI patients with limited ambulatory function to walk. The mean walking speed of SCI patients using an exoskeleton is low: 0.26 m/s. Moreover, literature shows that a minimum speed of 0.59 m/s is required to replace wheelchairs in the community.

Objective

To investigate the highest ambulatory speed for SCI patients in a Lokomat.

Methods

This clinical pilot study took place in the Rehabilitation Center Kladruby, in Kladruby (Czech Republic). Six persons with motor-complete sub-acute SCI were recruited. Measurements were taken at baseline and directly after a 30 min Lokomat training. The highest achieved walking speed, vital parameters (respiratory frequency, heart rate, and blood pressure), visual analog scale for pain, and modified Ashworth scale for spasticity were recorded for each person.

Results

The highest reached walking speed in the Lokomat was on average 0.63 m/s (SD 0.03 m/s). No negative effects on the vital parameters, pain, or spasticity were observed. A significant decrease in pain after the Lokomat training was observed: 95% CI [0.336, 1.664] (p = 0.012).

Conclusion

This study shows that it is possible for motor-complete SCI individuals to ambulate faster on a Lokomat (on average 0.63 m/s) than what is currently possible with over-ground exoskeletons. No negative effects were observed while ambulating on a Lokomat. Further research investigating walking speed in exoskeletons after SCI is recommended.

中文翻译：

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使用 Lokomat 步态训练训练运动完全性脊髓损伤患者的最高行走速度：一项临床试验研究。

摘要

背景

运动障碍和行走功能丧失是脊髓损伤 (SCI) 的主要后果。外骨骼是一种机器人设备，可让行走功能有限的 SCI 患者行走。使用外骨骼的 SCI 患者的平均步行速度较低：0.26 m/s。此外，文献表明，在社区中更换轮椅所需的最低速度为 0.59 m/s。

客观的

研究 Lokomat 中 SCI 患者的最高行走速度。

方法

这项临床试验研究在克拉德鲁比（捷克共和国）的克拉德鲁比康复中心进行。招募了 6 名患有运动完全性亚急性 SCI 的人。测量是在基线和 30 分钟 Lokomat 训练后直接进行的。记录每个人的最高步行速度、生命参数（呼吸频率、心率和血压）、疼痛的视觉模拟量表和痉挛的改良 Ashworth 量表。

结果

Lokomat 的最高步行速度平均为 0.63 m/s (SD 0.03 m/s)。没有观察到对生命参数、疼痛或痉挛的负面影响。观察到 Lokomat 训练后疼痛显着减轻：95% CI [0.336, 1.664] ( p  = 0.012)。

结论

这项研究表明，运动完整的 SCI 个体在 Lokomat 上的行走速度（平均 0.63 m/s）可能比目前使用地上外骨骼的速度更快。在 Lokomat 上行走时没有观察到负面影响。建议进一步研究 SCI 后外骨骼的步行速度。