Exoskeleton-Assisted Walking Improves Mobility in Individuals with Spinal Cord Injury

Multi-center U.S. trial shows exoskeleton training is safe, feasible, and effective across wide spectrum of individuals with mobility deficits caused by traumatic spinal cord injury  

East Hanover, NJ. November 12, 2020. Exoskeletal-assisted walking is safe, feasible, and effective in individuals disabled by spinal cord injury, according to the results of a federally funded multi-site randomized clinical trial. The article, "Mobility skills with exoskeletal-assisted walking in persons with SCI: Results from a three-center randomized clinical trial" (doi: 10.3389/frobt.2020.00093), was published August 4, 2020 in Frontiers in Robotics and AI. It is available open access at https://www.frontiersin.org/articles/10.3389/frobt.2020.00093/full

The authors are Eun-Kyoung Hong, Pierre Asselin, MS, Steven Knezevic, Stephen Kornfeld, DO, and Ann M. Spungen, EdD, of the James J. Peters VA Medical Center, Gail Forrest, PhD, of Kessler Foundation, Peter Gorman, MD, and William Scott, PhD, of the University of Maryland School of Medicine, and Sandra Wojciehowski, PT, of Craig Hospital and Kessler Foundation. The study was conducted at three sites: James J. Peters VA Medical Center, Bronx, NY; Kessler Foundation, West Orange, NJ; and the University of Maryland.

Study investigators sought to establish guidelines for clinical exoskeletal-assisted walking programs for individuals with spinal cord injury. Their goal was to determine the number of exoskeleton training sessions needed by individuals with varied mobility deficits to gain adequate exoskeletal assisted walking skills and attain velocity milestones. Two powered exoskeletons were used in the study: the Ekso GT (Ekso Bionics), and ReWalk (ReWalk Robotics).

The 50 participants included individuals with tetraplegia and paraplegia, both motor complete and incomplete. In this randomized control trial, their performance was measured over a total of 36 sessions. Participants were randomized to Group 1 (exo-assisted walking) or Group 2 (usual activity) for 12 weeks; each group crossed over to the other study arm. After 12, 24, and 36 sessions, their progress was measured by the 10-meter walk test seconds (s) (10MWT), 6-min walk test meters (m) (6MWT), and the Timed-Up-and-Go (s) (TUG).  

The majority of participants mastered the ability to ambulate effectively with the assistance of the exoskeleton, according to Dr. Forrest, director of the Tim and Caroline Reynolds Center for Spinal Stimulation at Kessler Foundation. After 12 sessions, 31 (62%), 35 (70%), and 36 (72%) participants achieved the milestones established for the 10MWT, 6MWT, and TUG, respectively. After 36 sessions, the results improved, with 40 (80%), 41 (82%), and 42 (84%) of participants meeting the criteria for the 10MWT, 6MWT, and TUG, respectively.

“Participants showed improvement regardless of level of injury, completeness, or duration of injury,” noted Dr. Forrest, “indicating that exoskeletons can be used to improve mobility across a broad spectrum of individuals with neurological deficits caused by spinal cord injury. Our results can be used to guide the application of exoskeletons to spinal cord injury rehabilitation, and the timely acquisition of skills for the safe use of these devices for rehabilitation and community use.”

Funding sources: US Department of Defense CDMRP SCI Award 30234 (W81XWH-14-2-0170); National Center for the Medical Consequences of SCI (B9212-C, B2020-C); James Lawrence Kernan Endowment Fund; Bronx Veterans Medical Research Foundation

The views expressed in this article are those of the author and may not reflect the official policy or position of the Department of the Army, Department of Defense, or the U.S. Government.

About Kessler Foundation

Kessler Foundation, a major nonprofit organization in the field of disability, is a global leader in rehabilitation research that seeks to improve cognition, mobility and long-term outcomes, including employment, for people with neurological disabilities caused by diseases and injuries of the brain and spinal cord. Kessler Foundation leads the nation in funding innovative programs that expand opportunities for employment for people with disabilities. For more information, visit KesslerFoundation.org.

For more information, or to interview an expert, contact: Carolann Murphy, 973.324.8382, [email protected].

 

 


About nTIDE Updates
National Trends in Disability Employment (nTIDE) is a joint project of Kessler Foundation and the University of New Hampshire Institute on Disability. The nTIDE team closely monitors the job numbers, issuing semi-monthly reports that track the impact of economic shifts on employment for people with and without disabilities. As the effect of the COVID-19 pandemic continues to wane and inflation persistently rises, the nTIDE team has superseded its mid-month COVID Update to a “Deeper Dive” into the BLS data for people with disabilities. The statistics in the nTIDE are based on BLS numbers but are not identical. They are customized by UNH to combine the statistics for men and women of working age (16- 64). nTIDE is funded by the National Institute on Disability, Independent Living and Rehabilitation Research (NIDILRR; 90RTGE0005) and Kessler Foundation. Each nTIDE release is followed by an nTIDE Lunch & Learn online webinar. This live broadcast, hosted via Zoom Webinar, offers attendees Q&A on the latest nTIDE findings, provides news, updates from the field, and features invited panelists who discuss current disability-related findings and events.

About the Institute on Disability at the University of New Hampshire
The Institute on Disability at the University of New Hampshire was established in 1987 to provide a university-based focus for the improvement of knowledge, policies, and practices related to the lives of persons with disabilities and their families. For information on the Intitute’s NIDILRR-funded Rehabilitation Research and Training Center on Disability Statistics and Demographics (StatsRRTC), visit ResearchOnDisability.org.

About Kessler Foundation
Kessler Foundation, a major nonprofit organization in the field of disability, is a global leader in rehabilitation research. Our scientists seek to improve cognition, mobility, and long-term outcomes, including employment, for adults and children with neurological and developmental disabilities of the brain and spinal cord including traumatic brain injury, spinal cord injury, stroke, multiple sclerosis, and autism. Kessler Foundation also leads the nation in funding innovative programs that expand opportunities for employment for people with disabilities. KesslerFoundation.org.

For more information, contact:
Deb Hauss, [email protected]

Stay Connected with Kessler Foundation
X (formerly known as Twitter) | Facebook | YouTube | Instagram | SoundCloud