Muscle adaptations in acute SCI following overground exoskeleton + FES training: A pilot study

Kristen Hohl; Andrew C. Smith; Rebecca Macaluso; Matthew Giffhorn; Sara Prokup; Denise R. O’Dell; Lina Kleinschmidt; Jim M. Elliott; Arun Jayaraman

doi:10.3389/fresc.2022.963771

Muscle adaptations in acute SCI following overground exoskeleton + FES training: A pilot study

Kristen Hohl
, Andrew C. Smith
, Rebecca Macaluso
, Matthew Giffhorn
, Sara Prokup
, Denise R. O’Dell
, Lina Kleinschmidt
, Jim M. Elliott
, Arun Jayaraman

Physical Therapy

Research output: Contribution to journal › Article › peer-review

4 Scopus citations

Abstract

Objective: To evaluate the combined effects of robotic exoskeleton and functional electrical stimulation (FES) training on muscle composition during over-ground gait training in persons with acute spinal cord injury (SCI). Design: Randomized crossover pilot study. Setting: Inpatient-rehabilitation Hospital. Participants: Six individuals with acute SCI. Intervention: Participants were randomized to either receive training with the Ekso® Bionics exoskeleton combined with FES in addition to standard-of-care or standard-of-care alone. Outcome measures: The main outcome measures for the study were quantified using magnetic resonance imaging (MRI), specifically, lower extremity muscle volume and intramuscular adipose tissue (IMAT). Static balance and fall risk were assessed using the Berg Balance Scale. Results: Significant improvements were observed in muscle volume in the exoskeleton intervention group when compared to only standard-of-care (p < 0.001). There was no significant difference between the groups in IMAT even though the intervention group saw a reduction in IMAT that trended towards statistical significance (p = 0.07). Static balance improved in both groups, with greater improvements seen in the intervention group. Conclusions: Early intervention with robotic exoskeleton may contribute to improved muscle function measured using MRI in individuals with acute SCI.

Original language	English
Article number	963771
Journal	Frontiers in Rehabilitation Sciences
Volume	3
DOIs	https://doi.org/10.3389/fresc.2022.963771
State	Published - 2022

Bibliographical note

Publisher Copyright:
2022 Hohl, Smith, Macaluso, Giffhorn, Prokup, O'Dell, Kleinschmidt, Elliott and Jayaraman.

Funding

AJ and KH were supported by NIDILRR-funded Machines Assisting Recovery from Stroke and Spinal Cord Injury for Reintegration into Society (MARS3) Rehabilitation Engineering Research Center (H133E120010). ACS was supported by NIH Eunice Kennedy Shriver National Institute of Child Health and Human Development \u2013 K01HD106928 and the Boettcher Foundation's Webb-Waring Biomedical Research Program. Acknowledgments

Funders	Funder number
NIDILRR-funded
Boettcher Foundation
Australian National Health and Medical Research Council	106928
Australian National Health and Medical Research Council
Rehabilitation Engineering Research Center	H133E120010
Eunice Kennedy Shriver National Institute of Child Health and Human Development	K01HD106928
Eunice Kennedy Shriver National Institute of Child Health and Human Development

Keywords

MRI
acute-SCI
ekso®
exoskeleton
muscle

ASJC Scopus subject areas

Physical Therapy, Sports Therapy and Rehabilitation
Rehabilitation

Access to Document

10.3389/fresc.2022.963771

Cite this

@article{467859b158a84587b2b0c7e67ae07bf6,

title = "Muscle adaptations in acute SCI following overground exoskeleton + FES training: A pilot study",

abstract = "Objective: To evaluate the combined effects of robotic exoskeleton and functional electrical stimulation (FES) training on muscle composition during over-ground gait training in persons with acute spinal cord injury (SCI). Design: Randomized crossover pilot study. Setting: Inpatient-rehabilitation Hospital. Participants: Six individuals with acute SCI. Intervention: Participants were randomized to either receive training with the Ekso{\textregistered} Bionics exoskeleton combined with FES in addition to standard-of-care or standard-of-care alone. Outcome measures: The main outcome measures for the study were quantified using magnetic resonance imaging (MRI), specifically, lower extremity muscle volume and intramuscular adipose tissue (IMAT). Static balance and fall risk were assessed using the Berg Balance Scale. Results: Significant improvements were observed in muscle volume in the exoskeleton intervention group when compared to only standard-of-care (p < 0.001). There was no significant difference between the groups in IMAT even though the intervention group saw a reduction in IMAT that trended towards statistical significance (p = 0.07). Static balance improved in both groups, with greater improvements seen in the intervention group. Conclusions: Early intervention with robotic exoskeleton may contribute to improved muscle function measured using MRI in individuals with acute SCI.",

keywords = "MRI, acute-SCI, ekso{\textregistered}, exoskeleton, muscle",

author = "Kristen Hohl and Smith, \{Andrew C.\} and Rebecca Macaluso and Matthew Giffhorn and Sara Prokup and O{\textquoteright}Dell, \{Denise R.\} and Lina Kleinschmidt and Elliott, \{Jim M.\} and Arun Jayaraman",

note = "Publisher Copyright: 2022 Hohl, Smith, Macaluso, Giffhorn, Prokup, O'Dell, Kleinschmidt, Elliott and Jayaraman.",

year = "2022",

doi = "10.3389/fresc.2022.963771",

language = "English",

volume = "3",

}

TY - JOUR

T1 - Muscle adaptations in acute SCI following overground exoskeleton + FES training

T2 - A pilot study

AU - Hohl, Kristen

AU - Smith, Andrew C.

AU - Macaluso, Rebecca

AU - Giffhorn, Matthew

AU - Prokup, Sara

AU - O’Dell, Denise R.

AU - Kleinschmidt, Lina

AU - Elliott, Jim M.

AU - Jayaraman, Arun

N1 - Publisher Copyright: 2022 Hohl, Smith, Macaluso, Giffhorn, Prokup, O'Dell, Kleinschmidt, Elliott and Jayaraman.

PY - 2022

Y1 - 2022

N2 - Objective: To evaluate the combined effects of robotic exoskeleton and functional electrical stimulation (FES) training on muscle composition during over-ground gait training in persons with acute spinal cord injury (SCI). Design: Randomized crossover pilot study. Setting: Inpatient-rehabilitation Hospital. Participants: Six individuals with acute SCI. Intervention: Participants were randomized to either receive training with the Ekso® Bionics exoskeleton combined with FES in addition to standard-of-care or standard-of-care alone. Outcome measures: The main outcome measures for the study were quantified using magnetic resonance imaging (MRI), specifically, lower extremity muscle volume and intramuscular adipose tissue (IMAT). Static balance and fall risk were assessed using the Berg Balance Scale. Results: Significant improvements were observed in muscle volume in the exoskeleton intervention group when compared to only standard-of-care (p < 0.001). There was no significant difference between the groups in IMAT even though the intervention group saw a reduction in IMAT that trended towards statistical significance (p = 0.07). Static balance improved in both groups, with greater improvements seen in the intervention group. Conclusions: Early intervention with robotic exoskeleton may contribute to improved muscle function measured using MRI in individuals with acute SCI.

AB - Objective: To evaluate the combined effects of robotic exoskeleton and functional electrical stimulation (FES) training on muscle composition during over-ground gait training in persons with acute spinal cord injury (SCI). Design: Randomized crossover pilot study. Setting: Inpatient-rehabilitation Hospital. Participants: Six individuals with acute SCI. Intervention: Participants were randomized to either receive training with the Ekso® Bionics exoskeleton combined with FES in addition to standard-of-care or standard-of-care alone. Outcome measures: The main outcome measures for the study were quantified using magnetic resonance imaging (MRI), specifically, lower extremity muscle volume and intramuscular adipose tissue (IMAT). Static balance and fall risk were assessed using the Berg Balance Scale. Results: Significant improvements were observed in muscle volume in the exoskeleton intervention group when compared to only standard-of-care (p < 0.001). There was no significant difference between the groups in IMAT even though the intervention group saw a reduction in IMAT that trended towards statistical significance (p = 0.07). Static balance improved in both groups, with greater improvements seen in the intervention group. Conclusions: Early intervention with robotic exoskeleton may contribute to improved muscle function measured using MRI in individuals with acute SCI.

KW - MRI

KW - acute-SCI

KW - ekso®

KW - exoskeleton

KW - muscle

UR - https://www.scopus.com/pages/publications/85174963183

UR - https://www.scopus.com/pages/publications/85174963183#tab=citedBy

U2 - 10.3389/fresc.2022.963771

DO - 10.3389/fresc.2022.963771

M3 - Article

AN - SCOPUS:85174963183

VL - 3

JO - Frontiers in Rehabilitation Sciences

JF - Frontiers in Rehabilitation Sciences

M1 - 963771

ER -

Muscle adaptations in acute SCI following overground exoskeleton + FES training: A pilot study

Abstract

Bibliographical note

Funding

Keywords

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this