Authors (including presenting author) :
Chan SCN(1), Wong AFY(1), Koljonen PA(2), Liu TWK(2), Wong CCK(1), Wong YW(2)
Affiliation :
(1) Physiotherapy Department, MacLehose Medical Rehabilitation Centre, (2) Department of Orthopaedics and Traumatology, The University of Hong Kong
Introduction :
Since July 2018, with generous donations, the Department of Orthopaedics & Traumatology of The University of Hong Kong has begun a pilot program utilizing a powered wearable robotic exoskeleton (WRE) (EksoGT/NR) for physiotherapy rehabilitation of spinal cord injury (SCI) patients in MMRC.
Objectives :
This presentation aims to report our preliminary experience of using the WRE for physiotherapy rehabilitation in SCI patients, clinical outcomes and patient perceived improvement after a course of training.
Methodology :
Patients were screened and completed baseline assessments before progressing to training. 4 categories of outcome measures were recorded including: (1) Progression outcomes: step initiation mode, swing assist and stance support; (2) Data outcomes: number of steps, on time, upright time and walk time; (3) Rated outcomes: Spinal Cord Independence Measure (Version III) (SCIMIII) score, The Neurogenic Bowel Dysfunction (NBD) score, Global Rating of Change scale (GROC); (4) Mobility outcomes: 10 Meter Walk Test (10MWT), Timed Up and Go Test (TUG), 6-Minute Walk Test (6MWT).
Result & Outcome :
Thirty SCI patients with mean age 52.27, ranged 21-90 (SD ± 16.69) have completed a course with an average of 13.07 sessions of training between July 2018 to Feb 2022. In all three progression outcomes, the incomplete group showed better progression improvements. All groups showed significant improvements in number of steps (p≤0.007) while the acute and incomplete groups showed significant improvements in walk time (p=0.001). For rated outcomes, overall patients reported statistically significant improvements (p=0.027) in total SCIMIII score while the incomplete group reported statistically significant improvements (p=0.019) in NBD score. For mobility outcomes, overall patients showed statistically improvements in 10MWT(p=0.027) and 6MWT (p=0.010) while the acute (p=0.037) and incomplete (p=0.031) groups showed significant improvements in 6MWT. Overall patients reported mean score 5.47 in GROC which corresponded “quite a bit better” to “a great deal better” after the course of WRE training. To date, this is the first WRE introduced as a pilot programme within the Hospital Authority setting. Based on these preliminary data, the use of the EksoGT/NR in selected patients with SCI appears beneficial and effective. Moreover, it seems that there are potentially more benefits for acute and incomplete SCI patients.
