Xiang Xiao-Na, Zhang Li-Ming, Zong Hui-Yan, Ou Yi, Yu Xi, Liu Yan, Jiang Hong-Ying, Cheng Hong, He Hong-Chen, He Cheng-Qi
IEEE Trans Neural Syst Rehabil Eng. 2023;31:39-47. doi: 10.1109/TNSRE.2022.3215652. Epub 2023 Jan 30.
To determine whether exoskeleton-assisted walking (EAW) improves pulmonary ventilation function, motor function and related body structure, and activities equivalently as the conventional exercise program for people with spinal cord injury (SCI).
Forty participants (7 females and 33 males; age 37.1±12.0 years) with thoracic SCI were randomized into two groups and undertook 16 sessions of 50-60 min training (4 days/week). Participants in the EAW group received EAW trainings, such as assisted standing, walking, and climbing the stairs. The control group received a conventional exercise program. Outcomes were measured at baseline and upon completion of treatment.
After trainings, the EAW group improved more than the control group in the forced vital capacity (FVC, 0.53 L [0.01-1.06 L]), predicted FVC% (19.59 [6.63-32.54]) and forced expiratory volume in 1s (0.61 L [0.15-1.07 L]), basic activities of daily living (BADL) (19.75 [10.88-28.62]), and distal femoral cartilage. Participants in the EAW group completed 6-minute walk test with median 17.3 meters while wearing the exoskeleton. There was no difference in trunk and lower extremity motor function, bone mineral density, and adverse events ( P > 0.05).
In people with lower thoracic neurological level of SCI, EAW training has potential benefits to facilitate pulmonary ventilation function, walking, BADL and thickness of cartilage comparing to a conventional excise program.
This study provided more evidence for using EAW in clinic, and partly proved EAW had equivalent effects as conventional exercise program, which may combine with conventional exercise program for reducing burden of therapists in the future.
确定外骨骼辅助行走（EAW）是否能与脊髓损伤（SCI）患者的传统运动方案等效地改善肺通气功能、运动功能及相关身体结构和活动能力。
40名胸段SCI患者（7名女性和33名男性；年龄37.1±12.0岁）被随机分为两组，进行16节时长50 - 60分钟的训练（每周4天）。EAW组的参与者接受EAW训练，如辅助站立、行走和爬楼梯。对照组接受传统运动方案。在基线和治疗结束时测量结果。
训练后，EAW组在用力肺活量（FVC，0.53 L [0.01 - 1.06 L]）、预测FVC%（19.59 [6.63 - 32.54]）和第1秒用力呼气量（0.61 L [0.15 - 1.07 L]）、日常生活基本活动（BADL）（19.75 [10.88 - 28.62]）以及股骨远端软骨方面的改善比对照组更大。EAW组的参与者在穿戴外骨骼时完成6分钟步行测试的中位数为17.3米。在躯干和下肢运动功能、骨密度及不良事件方面无差异（P > 0.05）。
对于胸段神经损伤水平较低的SCI患者，与传统运动方案相比，EAW训练在促进肺通气功能、行走、BADL及软骨厚度方面具有潜在益处。
本研究为EAW在临床中的应用提供了更多证据，部分证明了EAW与传统运动方案具有等效效果，未来可能与传统运动方案相结合以减轻治疗师的负担。
