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Year : 2016  |  Volume : 2  |  Issue : 4  |  Page : 163-168

Neurorehabilitation in paraplegic patients with an active powered exoskeleton (Ekso)

1 Prosperius Institute, Neurorehabilitation and Robotic Area, University of Perugia, Umbertide, Italy
2 Elon University, DPTE, Elon North Carolina, USA
3 Prosperius Group, University of Florence, Florence, Italy

Correspondence Address:
Paolo Milia
Neurorehabilitation and Robotic Area, Prosperius Institute, University of Perugia, Umbertide
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/digm.digm_51_16

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Background and Objectives: Spinal cord injury (SCI) is a severe disease where the patients lost the body function below the level of lesion. Neurorehabilitative exercise leads to improvements in physical functions such as strength, range of motion, transfers, wheelchair mobility, and gait. The aim of this study is to evaluate the impact of overground gait training using an active powered exoskeleton. Materials and Methods: Patients affected of SCI admitted to our rehabilitation unit have been studied. We used an active powered exoskeleton (Ekso). Training occurred each day for 5 days a week for a total of 4 weeks. Patients were trained for at least twenty sessions, with a duration of 45–60 min each session. Patients were scored with the 6 min walking test (6MWT) before and after treatment to evaluate the movement and Ashwort scale was used to test spasticity. Psychological tests were also performed to focus on depression (Beck Depression Inventory) and on self-perception (Body Uneasiness Test-A). Results: Thirteen patients were studied (mean age 31 ± 10.4; ten males and three females), who were affected by SCI with motor complete/incomplete lesions (seven complete, six incomplete), according to the American Spinal Injury Association guidelines. All patients completed the overground gait training for all 4 weeks without collateral effects. The motor recovery evaluated with the 6MWT in incomplete motor patients described a statistical significant recovery in terms of meters and absence of rest, especially in thoracic and lumbar level lesions (48/114 m [improvement 137.5%]; 98/214 m [improvement 118.37%], P < 0.05). We did not find any difference in terms of spasticity using the Ashworth Scale. After the treatment, we found in all patients a great improvement in mood disorders and body perception. Conclusions: The overground training with the exoskeleton is a promising therapeutical approach for SCI patients, which can increase both motor and psychological aspects.

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