The influence of walking in an exoskeleton on rehabilitation of patients with spinal cord injury consequences

M. A. Gvozdareva, L. A. Shpagina, N. P. Kareva, E. V. Kuropatova, V. Rerikh
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Abstract

Objective: to substantiate the expediency of including training walking in an exoskeleton in the complex rehabilitation of patients with severe motor dysfunctions of the lower limbs due to spinal cord injury (SCI).Methods: 120 patients (84 men and 36 women, age 37.1 ± 8.40 years) with the consequences of SCI at the level of thoracic and lumbar spine who were in the hospital at the second stage of medical rehabilitation were examined. The duration of injury ranged from 1 year to 19 years (77.8 ± 4.05 months). All patients were divided into two groups (80 and 40 patients), comparable by sex, age, duration and severity of injury. Training walking in exoskeleton have been added in the group I rehabilitation program. ASIA, SCIM III scales and SF-36 quality of life questionnaire were used to evaluate the effectiveness of the rehabilitation measures.Results: there was an increase in the total score on SCIM III by 3.20 ± 0.50 (p = 0.05) in group I, which indicates an increase in the level of functioning and daily activity of patients. Positive dynamics was revealed when assessing the quality of life using SF-36 questionnaire: sum index reflecting the psychological component of health increased from 56,0 to 59,5 points (p = 0,05). Group II also showed positive dynamics of the analyzed indicators, but the changes by the end of the rehabilitation course were not statistically significant.Conclusion: the use of exoskeleton training walking at the second stage of medical rehabilitation increases the effectiveness of rehabilitation measures and improves the quality of life of patients with severe motor dysfunctions of the lower limbs due to spinal cord injury (SCI).
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穿戴外骨骼行走对脊髓损伤患者康复后果的影响
目的:证实在脊髓损伤(SCI)导致的下肢严重运动功能障碍患者的综合康复中加入外骨骼行走训练的有效性。方法:研究对象为120名(84名男性,36名女性,年龄(37.1±8.40)岁)胸椎和腰椎水平SCI后遗症患者,他们在医院接受了第二阶段的医疗康复。受伤时间从 1 年到 19 年不等(77.8 ± 4.05 个月)。所有患者按性别、年龄、受伤时间和严重程度分为两组(80 人和 40 人),具有可比性。第一组康复计划中增加了穿着外骨骼行走的训练。结果:第一组患者的 SCIM III 总分增加了 3.20 ± 0.50(P = 0.05),这表明患者的功能和日常活动水平有所提高。使用 SF-36 问卷评估生活质量时也显示出积极的动态:反映健康心理成分的总指数从 56.0 分增加到 59.5 分(p = 0.05)。结论:在医疗康复的第二阶段使用外骨骼训练行走可提高康复措施的有效性,改善脊髓损伤(SCI)导致下肢严重运动功能障碍患者的生活质量。
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