Traumatic brain injury (TBI) and cerebrovascular accidents (CVA) are two of the leading causes of disability in the United States. Robotic exoskeletons (RE) have been approved for rehabilitation by the Federal Drug Administration (FDA) for use after a CVA, and recently received approval for use in patients with TBI. The aim of the study was to determine which factors predict the improvement in functional independence measure (FIM) score after using RE rehabilitation in a population of patients with CVA or TBI. We carried out a retrospective chart-review analysis of the use of the RE (Ekso® GT) in the rehabilitation of patients with TBI and CVA using data from a single, private rehabilitation hospital for patients admitted and discharged between 01/01/2017 to 04/30/2020. From the medical records, we collected presentation date, Glasgow Coma Scale score (GCS) on the date of injury, rehabilitation start date, age, diabetes status on presentation (Yes or No), injury category (TBI or CVA), and both admission and discharge FIM scores. Matching algorithms resulted in one TBI patient matched to three CVA patients resulting in a sample size of 36. The diabetic and non-diabetic populations showed significant differences between age and days from injury to the start of rehabilitation. A multivariate linear regression assessed predictors for discharge motor FIM and found admission motor FIM score and total RE steps to be statistically significant predictors. For each point scored higher on the admission motor FIM the discharge FIM was increased by 1.19 FIM points, and for each 1000 steps taken in the RE, the discharge motor FIM increased by 3 points. The type of acquired brain injury (CVA or TBI) was not found to affect functional outcome. The presented results show that key clinic-biologic factors including diabetic status, together with start to rehabilitation play key roles in discharge FIM scores for patients using RE.

中文翻译：

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使用外骨骼康复治疗脑血管意外和脑外伤的西班牙裔患者的功能预后

颅脑外伤（TBI）和脑血管意外（CVA）是美国致残的两个主要原因。机器人外骨骼（RE）已获美国联邦药品管理局（FDA）批准可在CVA后使用，并且最近已获得批准用于TBI患者。该研究的目的是确定在CVA或TBI患者群体中使用RE康复后，哪些因素可预测功能独立性测量（FIM）评分的改善。我们使用回顾性图表回顾分析了RE（Ekso®GT）在TBI和CVA患者康复中的使用，使用了来自一家私人康复医院的数据，该数据是针对2017年1月1日至2020年4月30日。从病历中，我们收集了出诊日期，受伤日期，康复开始日期，年龄，就诊时的糖尿病状况（是或否），损伤类别（TBI或CVA）以及入院和出院FIM分数的格拉斯哥昏迷量表评分（GCS）。匹配算法导致一名TBI患者与三名CVA患者匹配，样本量为36。糖尿病人群和非糖尿病人群从受伤到康复开始的年龄和天数之间存在显着差异。多元线性回归评估了放电运动FIM的预测因子，发现入院运动FIM得分和总RE步长是统计学上显着的预测因子。对于在准入电机FIM上得分更高的每个点，放电FIM将增加1.19 FIM点，而在RE中每执行1000步，放电电机FIM就会增加3点。未发现获得性脑损伤的类型（CVA或TBI）会影响功能预后。提出的结果表明，包括糖尿病状态以及开始康复在内的关键临床生物学因素在使用RE的患者的出院FIM评分中起着关键作用。