Energy Efficiency and Patient Satisfaction of Gait With Knee-Ankle-Foot Orthosis and Robot (ReWalk)-Assisted Gait in Patients With Spinal Cord Injury
Objective To compare the energy efficiency of gait with knee-ankle-foot orthosis (KAFO) and robot-assisted gait and to develop a usability questionnaire to evaluate the satisfaction of walking devices in paraplegic patients with spinal cord injuries. Methods Thirteen patients with complete paraplegi...
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Korean Academy of Rehabilitation Medicine
2020-04-01
|
| Series: | Annals of Rehabilitation Medicine |
| Subjects: | |
| Online Access: | http://www.e-arm.org/upload/pdf/arm-2020-44-2-131.pdf |
| _version_ | 1827833394353930240 |
|---|---|
| author | Seung Hyun Kwon Bum Suk Lee Hye Jin Lee Eun Joo Kim Jung Ah Lee Sung Phil Yang Tae Young Kim Han Ram Pak Hyun Ki Kim Hae Young Kim Joo Hwan Jung Sang Wook Oh |
| author_facet | Seung Hyun Kwon Bum Suk Lee Hye Jin Lee Eun Joo Kim Jung Ah Lee Sung Phil Yang Tae Young Kim Han Ram Pak Hyun Ki Kim Hae Young Kim Joo Hwan Jung Sang Wook Oh |
| author_sort | Seung Hyun Kwon |
| collection | DOAJ |
| description | Objective To compare the energy efficiency of gait with knee-ankle-foot orthosis (KAFO) and robot-assisted gait and to develop a usability questionnaire to evaluate the satisfaction of walking devices in paraplegic patients with spinal cord injuries. Methods Thirteen patients with complete paraplegia participated and 10 completed the evaluation. They were trained to walk with KAFO (KAFO-gait) or a ReWalk robot (ReWalk-gait) for 4 weeks (20 sessions). After a 2-week wash-out period, they switched walking devices and underwent 4 additional weeks of training. Two evaluations were performed (after 2 and 4 weeks) following the training periods for each walking device, using the 6-minute walking test (6MWT) and 30-minute walking test (30MWT). The spatiotemporal variables (walking distance, velocity, and cadence) and energy expenditure (heart rate, maximal heart rate, the physiologic cost index, oxygen consumption, metabolic equivalents, and energy efficiency) were evaluated duringthe 6MWT and 30MWT. A usability evaluation questionnaire for walking devices was developed based on the International Organization for Standardization/International Electrotechnical Commission guidelines through expert consultation. Results The ReWalk-gait presented significant advantages in energy efficiency compared to KAFO-gait in the 6MWT and 30MWT; however, there were no differences in walking distance or speed in the 30MWT between ReWalk-gait and KAFO-gait. The usability test demonstrated that ReWalk-gait was not superior to KAFO-gait in terms of safety, efficacy, efficiency, or patient satisfaction. Conclusion The robot (ReWalk) enabled patients with paraplegia to walk with lower energy consumption compared to KAFO, but the ReWalk-gait was not superior to KAFO-gaitin terms of patient satisfaction. |
| first_indexed | 2024-03-12T05:28:31Z |
| format | Article |
| id | doaj.art-4638f25e4c43491797d71b6be091ef33 |
| institution | Directory Open Access Journal |
| issn | 2234-0645 2234-0653 |
| language | English |
| last_indexed | 2024-03-12T05:28:31Z |
| publishDate | 2020-04-01 |
| publisher | Korean Academy of Rehabilitation Medicine |
| record_format | Article |
| series | Annals of Rehabilitation Medicine |
| spelling | doaj.art-4638f25e4c43491797d71b6be091ef332023-09-03T07:00:49ZengKorean Academy of Rehabilitation MedicineAnnals of Rehabilitation Medicine2234-06452234-06532020-04-0144213114110.5535/arm.2020.44.2.1314152Energy Efficiency and Patient Satisfaction of Gait With Knee-Ankle-Foot Orthosis and Robot (ReWalk)-Assisted Gait in Patients With Spinal Cord InjurySeung Hyun Kwon0Bum Suk Lee1Hye Jin Lee2Eun Joo Kim3Jung Ah Lee4Sung Phil Yang5Tae Young Kim6Han Ram Pak7Hyun Ki Kim8Hae Young Kim9Joo Hwan Jung10Sang Wook Oh11 Department of Rehabilitation Medicine, National Rehabilitation Center, Seoul, Korea Department of Rehabilitation Medicine, National Rehabilitation Center, Seoul, Korea Department of Rehabilitation Medicine, National Rehabilitation Center, Seoul, Korea Department of Rehabilitation Medicine, National Rehabilitation Center, Seoul, Korea Department of Clinical Research on Rehabilitation, National Rehabilitation Research Institute, Seoul, Korea Department of Physical Medicine and Rehabilitation, National Rehabilitation Center, Seoul, Korea Department of Physical Medicine and Rehabilitation, National Rehabilitation Center, Seoul, Korea Department of Clinical Research on Rehabilitation, National Rehabilitation Research Institute, Seoul, Korea Department of Clinical Research on Rehabilitation, National Rehabilitation Research Institute, Seoul, Korea Department of Rehabilitation Medicine, National Rehabilitation Center, Seoul, Korea Department of Rehabilitation Medicine, National Rehabilitation Center, Seoul, Korea Department of Rehabilitation Medicine, National Rehabilitation Center, Seoul, KoreaObjective To compare the energy efficiency of gait with knee-ankle-foot orthosis (KAFO) and robot-assisted gait and to develop a usability questionnaire to evaluate the satisfaction of walking devices in paraplegic patients with spinal cord injuries. Methods Thirteen patients with complete paraplegia participated and 10 completed the evaluation. They were trained to walk with KAFO (KAFO-gait) or a ReWalk robot (ReWalk-gait) for 4 weeks (20 sessions). After a 2-week wash-out period, they switched walking devices and underwent 4 additional weeks of training. Two evaluations were performed (after 2 and 4 weeks) following the training periods for each walking device, using the 6-minute walking test (6MWT) and 30-minute walking test (30MWT). The spatiotemporal variables (walking distance, velocity, and cadence) and energy expenditure (heart rate, maximal heart rate, the physiologic cost index, oxygen consumption, metabolic equivalents, and energy efficiency) were evaluated duringthe 6MWT and 30MWT. A usability evaluation questionnaire for walking devices was developed based on the International Organization for Standardization/International Electrotechnical Commission guidelines through expert consultation. Results The ReWalk-gait presented significant advantages in energy efficiency compared to KAFO-gait in the 6MWT and 30MWT; however, there were no differences in walking distance or speed in the 30MWT between ReWalk-gait and KAFO-gait. The usability test demonstrated that ReWalk-gait was not superior to KAFO-gait in terms of safety, efficacy, efficiency, or patient satisfaction. Conclusion The robot (ReWalk) enabled patients with paraplegia to walk with lower energy consumption compared to KAFO, but the ReWalk-gait was not superior to KAFO-gaitin terms of patient satisfaction.http://www.e-arm.org/upload/pdf/arm-2020-44-2-131.pdfexoskeleton deviceorthotic devicespinal cord injuriesmobility limitationpatient satisfaction |
| spellingShingle | Seung Hyun Kwon Bum Suk Lee Hye Jin Lee Eun Joo Kim Jung Ah Lee Sung Phil Yang Tae Young Kim Han Ram Pak Hyun Ki Kim Hae Young Kim Joo Hwan Jung Sang Wook Oh Energy Efficiency and Patient Satisfaction of Gait With Knee-Ankle-Foot Orthosis and Robot (ReWalk)-Assisted Gait in Patients With Spinal Cord Injury Annals of Rehabilitation Medicine exoskeleton device orthotic device spinal cord injuries mobility limitation patient satisfaction |
| title | Energy Efficiency and Patient Satisfaction of Gait With Knee-Ankle-Foot Orthosis and Robot (ReWalk)-Assisted Gait in Patients With Spinal Cord Injury |
| title_full | Energy Efficiency and Patient Satisfaction of Gait With Knee-Ankle-Foot Orthosis and Robot (ReWalk)-Assisted Gait in Patients With Spinal Cord Injury |
| title_fullStr | Energy Efficiency and Patient Satisfaction of Gait With Knee-Ankle-Foot Orthosis and Robot (ReWalk)-Assisted Gait in Patients With Spinal Cord Injury |
| title_full_unstemmed | Energy Efficiency and Patient Satisfaction of Gait With Knee-Ankle-Foot Orthosis and Robot (ReWalk)-Assisted Gait in Patients With Spinal Cord Injury |
| title_short | Energy Efficiency and Patient Satisfaction of Gait With Knee-Ankle-Foot Orthosis and Robot (ReWalk)-Assisted Gait in Patients With Spinal Cord Injury |
| title_sort | energy efficiency and patient satisfaction of gait with knee ankle foot orthosis and robot rewalk assisted gait in patients with spinal cord injury |
| topic | exoskeleton device orthotic device spinal cord injuries mobility limitation patient satisfaction |
| url | http://www.e-arm.org/upload/pdf/arm-2020-44-2-131.pdf |
| work_keys_str_mv | AT seunghyunkwon energyefficiencyandpatientsatisfactionofgaitwithkneeanklefootorthosisandrobotrewalkassistedgaitinpatientswithspinalcordinjury AT bumsuklee energyefficiencyandpatientsatisfactionofgaitwithkneeanklefootorthosisandrobotrewalkassistedgaitinpatientswithspinalcordinjury AT hyejinlee energyefficiencyandpatientsatisfactionofgaitwithkneeanklefootorthosisandrobotrewalkassistedgaitinpatientswithspinalcordinjury AT eunjookim energyefficiencyandpatientsatisfactionofgaitwithkneeanklefootorthosisandrobotrewalkassistedgaitinpatientswithspinalcordinjury AT jungahlee energyefficiencyandpatientsatisfactionofgaitwithkneeanklefootorthosisandrobotrewalkassistedgaitinpatientswithspinalcordinjury AT sungphilyang energyefficiencyandpatientsatisfactionofgaitwithkneeanklefootorthosisandrobotrewalkassistedgaitinpatientswithspinalcordinjury AT taeyoungkim energyefficiencyandpatientsatisfactionofgaitwithkneeanklefootorthosisandrobotrewalkassistedgaitinpatientswithspinalcordinjury AT hanrampak energyefficiencyandpatientsatisfactionofgaitwithkneeanklefootorthosisandrobotrewalkassistedgaitinpatientswithspinalcordinjury AT hyunkikim energyefficiencyandpatientsatisfactionofgaitwithkneeanklefootorthosisandrobotrewalkassistedgaitinpatientswithspinalcordinjury AT haeyoungkim energyefficiencyandpatientsatisfactionofgaitwithkneeanklefootorthosisandrobotrewalkassistedgaitinpatientswithspinalcordinjury AT joohwanjung energyefficiencyandpatientsatisfactionofgaitwithkneeanklefootorthosisandrobotrewalkassistedgaitinpatientswithspinalcordinjury AT sangwookoh energyefficiencyandpatientsatisfactionofgaitwithkneeanklefootorthosisandrobotrewalkassistedgaitinpatientswithspinalcordinjury |