Koljonen Paul Aarne, Virk Anna Sternin, Jeong Yoon, McKinley Michael, Latorre Juan, Caballero Amaya, Hu Yong, Wong Yat Wa, Cheung Kenneth, Kazerooni Homayoon
Department of Orthopaedics and Traumatology, Maclehose Medical Rehabilitation Centre, Hong Kong West Cluster, Hospital Authority, Hong Kong, China.
Department of Orthopaedics and Traumatology, The University of Hong Kong Li Ka Shing Faculty of Medicine, Hong Kong, China.
Front Neurol. 2021 Jul 19;12:689751. doi: 10.3389/fneur.2021.689751. eCollection 2021.
To examine the safety and efficacy of ambulation utilizing a semi-passive and lightweight powered exoskeleton by spinal cord injury (SCI) patients. This is a multi-center, open-label, prospective cohort study across three facilities. A cohort of 40 individuals with SCI from T4-L5 was recruited into a 20-session training and assessment protocol, utilizing the SuitX Phoenix. All patients were tested using a 10-m-walk test (10 MWT), 6-min-walk test (6 MWT), and Timed up & Go test (TUG). Patient satisfaction, pain, exertion, changes in affect, as well as overall comfort and confidence were reported using a satisfaction survey, Rated Perceived Exertion (RPE) scale, and Positive and Negative Affect Schedule (PANAS). Safety outcomes, adverse events, and device malfunctions were reported. Forty participants completed the study. There were no serious adverse events. All participants reported moderate to high levels of comfort and confidence using the device. All patients were able to achieve FIM of >4 on transitional movements and walking. The neurological level of injury had a statistically significant association with walking speed, WISCI-II, and FIM. Participants with an incomplete spinal cord injury had a higher FIM, faster speed, and higher WISCI-II in all outcome measures. This is the first study to examine the safety and efficacy of SuitX Phoenix for ambulation by SCI patients. We have shown that Phoenix is efficacious in allowing adults with SCI T4 to L5 perform walking and transitional movements. This study also reports the safety-profile of the device, user satisfaction, and psychological trends during training.
为了研究脊髓损伤(SCI)患者使用半被动且轻便的动力外骨骼进行步行的安全性和有效性。这是一项在三个机构开展的多中心、开放标签、前瞻性队列研究。招募了40名胸4至腰5脊髓损伤患者组成队列,采用SuitX Phoenix进行为期20节的训练和评估方案。所有患者均接受10米步行测试(10 MWT)、6分钟步行测试(6 MWT)和定时起立行走测试(TUG)。通过满意度调查、主观用力程度分级(RPE)量表以及正负性情绪量表(PANAS)报告患者满意度、疼痛、用力程度、情绪变化以及总体舒适度和信心。报告了安全结果、不良事件和设备故障情况。40名参与者完成了研究。未发生严重不良事件。所有参与者报告使用该设备时舒适度和信心处于中高水平。所有患者在转移活动和步行方面的功能独立性测量(FIM)均能达到>4。损伤的神经平面与步行速度、脊髓损伤步行指数-II(WISCI-II)和FIM具有统计学显著关联。在所有结果测量中,不完全性脊髓损伤的参与者FIM更高、速度更快且WISCI-II更高。这是第一项研究SuitX Phoenix对脊髓损伤患者步行安全性和有效性的研究。我们已经表明,Phoenix能有效让胸4至腰5脊髓损伤的成年人进行步行和转移活动。本研究还报告了该设备的安全性概况、用户满意度以及训练期间的心理趋势。