Die neuronal gesteuerte Exoskeletttherapie bei Querschnittgelähmten

Eine Querschnittlähmung (QSL) ist eine einschränkende Erkrankung. In Rehabilitationszentren wird gewichtentlastetes Laufbandtraining mit Hilfe von Exoskeletten eingesetzt. In dieser Arbeit wird untersucht, inwiefern sich das Laufen durch ein solches Training mit neurologischer Steuerung verändert und hinsichtlich Läsionshöhe und -zeitpunkt verglichen. Es wurden 121 Patienten mit akuter und chronischer QSL eingeschlossen. Der Trainingsfortschritt ohne Exoskelett wurde bezogen auf das funktionelle Outcome untersucht. Bei chronischen Patienten zeigt sich kein signifikanter Unterschied im Vergleich bezüglich der Läsionshöhe. Zwischen älteren und jüngeren Patienten konnte abgesehen von einem Test kein signifikanter Unterschied gemessen werden. Akute und chronische Patienten verbesserten sich in allen Tests signifikant. In einigen Tests zeigten die akuten Patienten signifikant bessere Fortschritte als die chronischen Patienten, während in anderen Tests kein signifikanter Unterschied bestand

Rehabilitation of Acute Vs. Chronic Patients With Spinal Cord Injury With a Neurologically Controlled Hybrid Assistive Limb Exoskeleton: Is There a Difference in Outcome?

This study aimed to assess the outcome of acute and chronic participants with spinal cord injury (SCI) after 12 weeks of bodyweight supported treadmill training (BWSTT) with a hybrid assistive limb exoskeleton (HAL). Acute participants were defined as ≤12 months between SCI and training, chronic participants \textgreater12 months between SCI and training. We assessed whether HAL-assisted BWSTT is advantageous for acute and chronic participants and if length of time post injury impacts the outcome of HAL-assisted BWSTT. As the primary outcome, we assessed the time needed for the 10 meter walk test (10MWT). Hundred and twenty-one individuals participated in a 12-week HAL-assisted BWSTT five times a week. We regularly conducted a 10MWT, a 6 minute walk test (6MWT), and assessed the walking index for spinal cord injury (WISCI II) and lower extremity motor score (LEMS) to evaluate the gait performance without the exoskeleton. Distance and time were recorded by the treadmill while the participant was walking with the exoskeleton. All participants benefit from the 12-week HAL-assisted BWSTT. A significant difference between acute and chronic participants' outcomes was found in 6MWT, LEMS, and WISCI II, though not in 10MWT. Although chronic participants improved significantly lesser than acute participants, they did improve their outcome significantly compared to the beginning. Hybrid assistive limb-assisted BWSTT in the rehabilitation of patients with SCI is advantageous for both acute and chronic patients. We could not define a time related cut-off threshold following SCI for effectiveness of HAL-assisted BWSTT

Rehabilitation of acute vs. chronic patients with spinal cord injury with a neurologically controlled hybrid assistive limb exoskeleton

This study aimed to assess the outcome of acute and chronic participants with spinal cord injury (SCI) after 12 weeks of bodyweight supported treadmill training (BWSTT) with a hybrid assistive limb exoskeleton (HAL). Acute participants were defined as ≤12 months between SCI and training, chronic participants >12 months between SCI and training. We assessed whether HAL-assisted BWSTT is advantageous for acute and chronic participants and if length of time post injury impacts the outcome of HAL-assisted BWSTT. As the primary outcome, we assessed the time needed for the 10 meter walk test (10MWT). Hundred and twenty-one individuals participated in a 12-week HAL-assisted BWSTT five times a week. We regularly conducted a 10MWT, a 6 minute walk test (6MWT), and assessed the walking index for spinal cord injury (WISCI II) and lower extremity motor score (LEMS) to evaluate the gait performance without the exoskeleton. Distance and time were recorded by the treadmill while the participant was walking with the exoskeleton. All participants benefit from the 12-week HAL-assisted BWSTT. A significant difference between acute and chronic participants' outcomes was found in 6MWT, LEMS, and WISCI II, though not in 10MWT. Although chronic participants improved significantly lesser than acute participants, they did improve their outcome significantly compared to the beginning. Hybrid assistive limb-assisted BWSTT in the rehabilitation of patients with SCI is advantageous for both acute and chronic patients. We could not define a time related cut-off threshold following SCI for effectiveness of HAL-assisted BWSTT