Authors (including presenting author) :
Wong AFY(1), Chan SCN(1), Koljonen PA(2), Tsang RCC(1) Wong CCK(1)
Affiliation :
(1) Physiotherapy Department, MacLehose Medical Rehabilitation Centre, (2) Department of Orthopaedics and Traumatology, The University of Hong Kong
Introduction :
The advancement of medical robotic technology has enabled the evolution of gait training for patients with spinal cord injury (SCI) from stationary assistive systems, to ambulatory wearable robotic exoskeletons (WRE) that facilitate over-ground walking and gait training. However, the widespread clinical use of these new technologies is still hindered by the prohibitive cost and high level of training required for the operator. Since June 2018, The Department of Orthopaedics & Traumatology of The University of Hong Kong has begun utilizing a powered WRE (EksoNR) for rehabilitation of patients with SCI. This pilot program was funded by philanthropy and currently in operation at the Physiotherapy Department of MacLehose Medical Rehabilitation Centre.
Objectives :
This presentation aims to report the preliminary experience of using the WRE for gait training of a patient with Incomplete SCI, with discussion on the feasibility and safety of the WRE, short-term outcomes and patient perceived improvement after a course of training.
Methodology :
A SCI subject with neurological level of injury T10 AIS grade D completed baseline testing before progressing to training. This patient completed a total of 20 one-hour sessions of over-ground gait training. The responsible physiotherapist completed a mandatory four-day certificate training program to operate the EksoNR. Time up and go test, 10 meter walk test and 6 minutes walk test was assessed before and after the course of training. Other outcomes included any adverse events and patient perceived improvement using a global rating scale.
Result & Outcome :
The patient completed 20 sessions of training between June 2021 to September 2021. Over a course of 20 sessions, time up and go test was improved from 29 seconds to 23 seconds, 10 meter walk test was changes from 19 seconds to 11.5 seconds, and distance covered in 6 minutes walk test was changed from 150 meter to 198 meter respectively. And the patient rated his health status as “moderately improved”. No adverse event was reported.
Based on these preliminary data, the use of the EksoNR in this selected patient with incomplete SCI appears safe, feasible and effective.
