Exoskeletal-Assisted Walking for Persons with Motor-Complete Paraplegia

Persons with motor-complete spinal cord injury (SCI) suffer permanent paralysis and loss of mobility. This immobilization limits their ability to access the world as they knew it. Exoskeletal technology has been used in the US and Europe by persons with SCI to perform upright activities of daily living. A single-group, pre/post intervention pilot study was performed to determine the number of sessions and level of assistance needed to execute standing, walking, and stair climbing skills in a powered exoskeleton (ReWalk™). Seven persons with motor-complete paraplegia were studied over an average of 45±20 sessions. Sessions consisted of 1 to 2 hours of standing and overground ambulation for 3 sessions per week. All 7 participants learned to perform sit-to-stand, stand-to-sit, and to walk 50 to 166 m in 6 minutes with none (n=4) to varying levels (n=3) of assistance. Four of 7 participants learned to ascend and descend ≥5 stairs with assistance, and these 4 also achieved some outdoor-specific walking skills. No relationship with achievement of exoskeletal-assisted mobility skills was found with duration or level of SCI; however, the participant with the highest cord lesion (thoracic level 1) did require the most assistance. These preliminary results suggest that exoskeletal-assisted walking and other mobility skills can be performed independently by persons with motor-complete SCI. Future advances in exoskeletal technology and ongoing training may improve overall mobility and independence in the home, work, military, and/or community environments.