TY - JOUR
T1 - Neurorehabilitation using a voluntary driven exoskeletal robot improves trunk function in patients with chronic spinal cord injury
T2 - A single-Arm study
AU - Okawara, Hiroki
AU - Tashiro, Syoichi
AU - Sawada, Tomonori
AU - Sugai, Keiko
AU - Matsubayashi, Kohei
AU - Kawakami, Michiyuki
AU - Nori, Satoshi
AU - Tsuji, Osahiko
AU - Nagoshi, Narihito
AU - Matsumoto, Morio
AU - Nakamura, Masaya
N1 - Funding Information:
Funding: This study was supported by the Uehara Memorial foundation 唀 Japan Science and Technology Agency 唀 No 堀 爃爃唀 and Japan Agency for Medical
Funding Information:
improvement of trunk function (Bjerkefors et al., 2007; ofBWSTT. Bergmann et al., 2019), there has been no report showing a In conclusion, the present study showed that VDE-BWSTT correlation between trunk function and age. In general, the could improve trunk function in patients with chronic SCI. magnitude of functional recovery was lower in older adult Older adult patients, who show a greater increase in trunk patients, with older adult SCI patients having lower degrees function than younger patients 唀 may be more suited for V?E? of neurological recovery, independence in activities of daily BWSTT. These results may contribute to the establishment of life (Scivoletto et al., 2003) and achievement of gait (van a precision rehabilitation strategy utilizing RAGT for patients Middendorp et al., 2011) than younger patients during the with chronic SCI. acute phase of SCI. Moreover, VDE-BWSTT induced a lower level of improvement in gait function in older adult patients Acknowledgments ?We thank Mr. Ikuma Sato (Shonan Robo Care Center, than in younger patients during the chronic phase of SCI Japan) for his excellent technical support in the use of VDE. (Grasmucke et al., 2017). Older adult patients may show Author contributions ?Study design 圀 HO唀 KM 堀 Initiation of the study 圀 HO唀 much stronger adaptation of motion due to their relative ST唀 TS 唀 KM 堀 Determination of analytic strategy and manuscript writing 圀 weakness in muscular power at intact spinal levels, which HO唀 ST唀 TS 唀 MK 唀 SN 唀 OT唀 NN and MM 堀 Monitoring study progress 圀 KS 唀 MK 唀 can lead to more severe disuse of paretic trunk muscles. By SN 唀 OT唀 NN and MM 堀 Manuscript submission 圀 MN 堀 All authors approved contrast, younger SCI patients may be able to utilize their the final version of this manuscript and agreed to be accountable for all impaired trunk muscles because of their stronger residual aspects of this work. muscular function 堀 Medical costs for older adult ??? patientsConflicts of interest 圀Th e authors have no conflict of interest associated have markedly increased, reflecting improvements in acute with this study. treatment and chronic care (Barbara-Bataller et al., 2018; Financial support 圀Th is study was supported by the Uehara Memorial Furusawa, 2019). Our results suggest that trunk function foundation 唀 Japan Science and Technology Agency唀 No 堀 爃? in older adult persons with SCI may be more responsive 19bk0104017h00029 (both to MN). The above funders had no role in 0002, and Japan Agency for Medical Research and Development, No. to RAGT, which may enhance precision patient-centered study design 唀 data collection and analysis 唀 and decision to publish ? neurorehabilitation 唀 or the appropriate selection of advanced Institutional review board statement 圀Th e study was approved by the neurorehabilitation for each patient. Furthermore, we Keio University of Medicine Ethics Committee 縀IRB No 堀 爃缀 on consider that this specific feature of RAGT could be used as September 唀 堀 part of a combination therapy for regenerative treatment, Declaration of patient consent 圀Th e authors certify that they have especially for severe cases (Tashiro et al., 2017). While the obtained all appropriate patient consent forms 堀 In the forms the patients present study was not designed to perform age and AIS grade have given their consent for their images and other clinical information to subgroup analysis 唀 further analysis can provide more specificbe reported in the journal 堀 The patients understand that their names and and precise insights into the effect of RAGT on patients’ initials will not be published and due efforts will be made to conceal their background. identity 唀 but anonymity cannot be guaranteed ?
Publisher Copyright:
© 2022 Wolters Kluwer Medknow Publications. All rights reserved.
PY - 2022/2
Y1 - 2022/2
N2 - Body weight-supported treadmill training with the voluntary driven exoskeleton (VDE-BWSTT) has been shown to improve the gait function of patients with chronic spinal cord injury. However, little is known whether VDE-BWSTT can effectively improve the trunk function of patients with chronic spinal cord injury. In this open-label, single-Arm study, nine patients with chronic spinal cord injury at the cervical or thoracic level (six males and three females, aged 37.8 ± 15.6 years, and time since injury 51.1 ± 31.8 months) who underwent outpatient VDE-BWSTT training program at Keio University Hospital, Japan from September 2017 to March 2019 were included. All patients underwent twenty 60-minute gait training sessions using VDE. Trunk muscular strength, i.e., the maximum force against which patient could maintain a sitting posture without any support, was evaluated in four directions: Anterior, posterior, and lateral (right and left) after 10 and 20 training sessions. After intervention, lateral muscular strength significantly improved. In addition, a significant positive correlation was detected between the change in lateral trunk muscular strength after 20 training sessions relative to baseline and gait speed. The change in trunk muscular strength after 20 training sessions relative to baseline was greatly correlated with patient age. This suggests that older adult patients with chronic spinal cord injury achieved a greater improvement in trunk muscle strength following VDE-BWSTT. All these findings suggest that VDE-BWSTT can improve the trunk function of patients with chronic spinal cord injury and the effect might be greater in older adult patients. The study was approved by the Keio University of Medicine Ethics Committee (IRB No. 20150355-3) on September 26, 2017.
AB - Body weight-supported treadmill training with the voluntary driven exoskeleton (VDE-BWSTT) has been shown to improve the gait function of patients with chronic spinal cord injury. However, little is known whether VDE-BWSTT can effectively improve the trunk function of patients with chronic spinal cord injury. In this open-label, single-Arm study, nine patients with chronic spinal cord injury at the cervical or thoracic level (six males and three females, aged 37.8 ± 15.6 years, and time since injury 51.1 ± 31.8 months) who underwent outpatient VDE-BWSTT training program at Keio University Hospital, Japan from September 2017 to March 2019 were included. All patients underwent twenty 60-minute gait training sessions using VDE. Trunk muscular strength, i.e., the maximum force against which patient could maintain a sitting posture without any support, was evaluated in four directions: Anterior, posterior, and lateral (right and left) after 10 and 20 training sessions. After intervention, lateral muscular strength significantly improved. In addition, a significant positive correlation was detected between the change in lateral trunk muscular strength after 20 training sessions relative to baseline and gait speed. The change in trunk muscular strength after 20 training sessions relative to baseline was greatly correlated with patient age. This suggests that older adult patients with chronic spinal cord injury achieved a greater improvement in trunk muscle strength following VDE-BWSTT. All these findings suggest that VDE-BWSTT can improve the trunk function of patients with chronic spinal cord injury and the effect might be greater in older adult patients. The study was approved by the Keio University of Medicine Ethics Committee (IRB No. 20150355-3) on September 26, 2017.
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U2 - 10.4103/1673-5374.317983
DO - 10.4103/1673-5374.317983
M3 - Article
AN - SCOPUS:85111008538
SN - 1673-5374
VL - 17
SP - 427
EP - 432
JO - Neural Regeneration Research
JF - Neural Regeneration Research
IS - 2
ER -