A.C.Y.HO1, S.K.WEE1, C.S.L.TAN1, C.H.ONG1
Tan Tock Seng Hospital1
Powered robotic exoskeleton is a relatively new technology in the field of rehabilitation. The aim of this study is to evaluate the effect of intensive robotic exoskeleton gait training on trunk control, balance, gait speed, endurance and energy expenditure of walking.
Case series report on 23 patients admitted to TTSH Rehabilitation Centre who had undergone training using the EksoGT exoskeleton: fourteen with stroke, five with spinal cord injury, three with traumatic brain injury, and one with multiple sclerosis.
Balance, gait speed, endurance, trunk control and energy expenditure were evaluated using Berg Balance Scale (BBS), ten-metre walk test (10MWT), six-minute walk test (6MWT), Trunk Impairment Scale (TIS) and Physiological Cost Index (PCI) respectively. Wilcoxon signed rank test was used for statistical analysis.
Statistically significant improvements in BBS (p<0.001), TIS (p<0.001), 6MWT (p<0.001) and PCI (p<0.050), but not 10MWT (p=0.126) was observed after EksoGT training. Subgroup analysis of patients ambulating with at least minimal assistance revealed statistically significant improvements in gait speed (p<0.05).
Additionally, nine patients achieved the minimal clinically important difference (MCID) of at least six points for BBS, two achieved the MCID of 0.16 meters per second for 10MWT, seven achieved the MCID of 34.4 meters for 6MWT, and seven achieved the minimal detectable change of PCI of at least 0.52 beats per metre post EksoGT training. Ten patients demonstrated more than 50 percent improvement in energy expenditure.
Exoskeleton training can lead to significant improvements in balance, trunk control, and endurance, resulting in significant reduction in energy expenditure of walking.