Safety and efficacy of at-home robotic locomotion therapy in individuals with chronic incomplete spinal cord injury: a prospective, pre-post intervention, proof-of-concept study.
<h4>Background</h4>The compact Motorized orthosis for home rehabilitation of Gait (MoreGait) was developed for continuation of locomotion training at home. MoreGait generates afferent stimuli of walking with the user in a semi-supine position and provides feedback about deviations from t...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2015-01-01
|
| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0119167 |
| _version_ | 1819028737524498432 |
|---|---|
| author | Rüdiger Rupp Daniel Schließmann Harry Plewa Christian Schuld Hans Jürgen Gerner Norbert Weidner Eberhard P Hofer Markus Knestel |
| author_facet | Rüdiger Rupp Daniel Schließmann Harry Plewa Christian Schuld Hans Jürgen Gerner Norbert Weidner Eberhard P Hofer Markus Knestel |
| author_sort | Rüdiger Rupp |
| collection | DOAJ |
| description | <h4>Background</h4>The compact Motorized orthosis for home rehabilitation of Gait (MoreGait) was developed for continuation of locomotion training at home. MoreGait generates afferent stimuli of walking with the user in a semi-supine position and provides feedback about deviations from the reference walking pattern.<h4>Objective</h4>Prospective, pre-post intervention, proof-of-concept study to test the feasibility of an unsupervised home-based application of five MoreGait prototypes in subjects with incomplete spinal cord injury (iSCI).<h4>Methods</h4>Twenty-five (5 tetraplegia, 20 paraplegia) participants with chronic (mean time since injury: 5.8 ± 5.4 (standard deviation, SD) years) sensorimotor iSCI (7 ASIA Impairment Scale (AIS) C, 18 AIS D; Walking Index for Spinal Cord Injury (WISCI II): Interquartile range 9 to 16) completed the training (45 minutes / day, at least 4 days / week, 8 weeks). Baseline status was documented 4 and 2 weeks before and at training onset. Training effects were assessed after 4 and 8 weeks of therapy.<h4>Results</h4>After therapy, 9 of 25 study participants improved with respect to the dependency on walking aids assessed by the WISCI II. For all individuals, the short-distance walking velocity measured by the 10-Meter Walk Test showed significant improvements compared to baseline (100%) for both self-selected (Mean 139.4% ± 35.5% (SD)) and maximum (Mean 143.1% ± 40.6% (SD)) speed conditions as well as the endurance estimated with the six-minute walk test (Mean 166.6% ± 72.1% (SD)). One device-related adverse event (pressure sore on the big toe) occurred in over 800 training sessions.<h4>Conclusions</h4>Home-based robotic locomotion training with MoreGait is feasible and safe. The magnitude of functional improvements achieved by MoreGait in individuals with iSCI is well within the range of complex locomotion robots used in hospitals. Thus, unsupervised MoreGait training potentially represents an option to prolong effective training aiming at recovery of locomotor function beyond in-patient rehabilitation.<h4>Trial registration</h4>German Clinical Trials Register (DKRS) DRKS00005587. |
| first_indexed | 2024-12-21T06:03:07Z |
| format | Article |
| id | doaj.art-324bd20b34574a37aa8f594cfdfbb731 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-21T06:03:07Z |
| publishDate | 2015-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-324bd20b34574a37aa8f594cfdfbb7312022-12-21T19:13:42ZengPublic Library of Science (PLoS)PLoS ONE1932-62032015-01-01103e011916710.1371/journal.pone.0119167Safety and efficacy of at-home robotic locomotion therapy in individuals with chronic incomplete spinal cord injury: a prospective, pre-post intervention, proof-of-concept study.Rüdiger RuppDaniel SchließmannHarry PlewaChristian SchuldHans Jürgen GernerNorbert WeidnerEberhard P HoferMarkus Knestel<h4>Background</h4>The compact Motorized orthosis for home rehabilitation of Gait (MoreGait) was developed for continuation of locomotion training at home. MoreGait generates afferent stimuli of walking with the user in a semi-supine position and provides feedback about deviations from the reference walking pattern.<h4>Objective</h4>Prospective, pre-post intervention, proof-of-concept study to test the feasibility of an unsupervised home-based application of five MoreGait prototypes in subjects with incomplete spinal cord injury (iSCI).<h4>Methods</h4>Twenty-five (5 tetraplegia, 20 paraplegia) participants with chronic (mean time since injury: 5.8 ± 5.4 (standard deviation, SD) years) sensorimotor iSCI (7 ASIA Impairment Scale (AIS) C, 18 AIS D; Walking Index for Spinal Cord Injury (WISCI II): Interquartile range 9 to 16) completed the training (45 minutes / day, at least 4 days / week, 8 weeks). Baseline status was documented 4 and 2 weeks before and at training onset. Training effects were assessed after 4 and 8 weeks of therapy.<h4>Results</h4>After therapy, 9 of 25 study participants improved with respect to the dependency on walking aids assessed by the WISCI II. For all individuals, the short-distance walking velocity measured by the 10-Meter Walk Test showed significant improvements compared to baseline (100%) for both self-selected (Mean 139.4% ± 35.5% (SD)) and maximum (Mean 143.1% ± 40.6% (SD)) speed conditions as well as the endurance estimated with the six-minute walk test (Mean 166.6% ± 72.1% (SD)). One device-related adverse event (pressure sore on the big toe) occurred in over 800 training sessions.<h4>Conclusions</h4>Home-based robotic locomotion training with MoreGait is feasible and safe. The magnitude of functional improvements achieved by MoreGait in individuals with iSCI is well within the range of complex locomotion robots used in hospitals. Thus, unsupervised MoreGait training potentially represents an option to prolong effective training aiming at recovery of locomotor function beyond in-patient rehabilitation.<h4>Trial registration</h4>German Clinical Trials Register (DKRS) DRKS00005587.https://doi.org/10.1371/journal.pone.0119167 |
| spellingShingle | Rüdiger Rupp Daniel Schließmann Harry Plewa Christian Schuld Hans Jürgen Gerner Norbert Weidner Eberhard P Hofer Markus Knestel Safety and efficacy of at-home robotic locomotion therapy in individuals with chronic incomplete spinal cord injury: a prospective, pre-post intervention, proof-of-concept study. PLoS ONE |
| title | Safety and efficacy of at-home robotic locomotion therapy in individuals with chronic incomplete spinal cord injury: a prospective, pre-post intervention, proof-of-concept study. |
| title_full | Safety and efficacy of at-home robotic locomotion therapy in individuals with chronic incomplete spinal cord injury: a prospective, pre-post intervention, proof-of-concept study. |
| title_fullStr | Safety and efficacy of at-home robotic locomotion therapy in individuals with chronic incomplete spinal cord injury: a prospective, pre-post intervention, proof-of-concept study. |
| title_full_unstemmed | Safety and efficacy of at-home robotic locomotion therapy in individuals with chronic incomplete spinal cord injury: a prospective, pre-post intervention, proof-of-concept study. |
| title_short | Safety and efficacy of at-home robotic locomotion therapy in individuals with chronic incomplete spinal cord injury: a prospective, pre-post intervention, proof-of-concept study. |
| title_sort | safety and efficacy of at home robotic locomotion therapy in individuals with chronic incomplete spinal cord injury a prospective pre post intervention proof of concept study |
| url | https://doi.org/10.1371/journal.pone.0119167 |
| work_keys_str_mv | AT rudigerrupp safetyandefficacyofathomeroboticlocomotiontherapyinindividualswithchronicincompletespinalcordinjuryaprospectiveprepostinterventionproofofconceptstudy AT danielschließmann safetyandefficacyofathomeroboticlocomotiontherapyinindividualswithchronicincompletespinalcordinjuryaprospectiveprepostinterventionproofofconceptstudy AT harryplewa safetyandefficacyofathomeroboticlocomotiontherapyinindividualswithchronicincompletespinalcordinjuryaprospectiveprepostinterventionproofofconceptstudy AT christianschuld safetyandefficacyofathomeroboticlocomotiontherapyinindividualswithchronicincompletespinalcordinjuryaprospectiveprepostinterventionproofofconceptstudy AT hansjurgengerner safetyandefficacyofathomeroboticlocomotiontherapyinindividualswithchronicincompletespinalcordinjuryaprospectiveprepostinterventionproofofconceptstudy AT norbertweidner safetyandefficacyofathomeroboticlocomotiontherapyinindividualswithchronicincompletespinalcordinjuryaprospectiveprepostinterventionproofofconceptstudy AT eberhardphofer safetyandefficacyofathomeroboticlocomotiontherapyinindividualswithchronicincompletespinalcordinjuryaprospectiveprepostinterventionproofofconceptstudy AT markusknestel safetyandefficacyofathomeroboticlocomotiontherapyinindividualswithchronicincompletespinalcordinjuryaprospectiveprepostinterventionproofofconceptstudy |