Abstract
Study design:This is a retrospective study.Objectives:The objectives of this study were to categorize unexpected postural changes (UPCs) during gait training in paraplegic patients with wearable gait-assist robots, to reveal the incidence of the UPC and its time-dependent changes during initial gait training period and to investigate neurological level-specific differences.Setting:This study was conducted in Fujita Health University, Aichi, Japan.Methods:We investigated five patients (46.2±14.6 years; lesion level: T6:3, T12:2). All patients had previously achieved gait with wearable robot and walker at supervision level. The UPCs were counted for 2 years and classified according to their type. The time-course data were calculated from the incidence of UPCs for 10 days from initial gait training with the walker. The neurological level-specific differences were investigated between T6 and T12 injuries.Results:Eighty-five UPCs were observed and classified into three categories: anterior breakdown, posterior breakdown (PBD) and mal-timing. The average rate over the entire period was 0.96±0.62 (incidents/h/subject). PBD, which was defined as hyperflexion of both hip joints, occurred with the highest frequency (0.64±0.64 incidents/h/subject). During initial gait training, there was a gradual decrease in the occurrence of UPC. For neurological level-specific differences, UPCs were observed more frequently in T6 injuries (1.36±0.35 incidents/h/subject) compared with T12 injuries (0.36±0.31 incidents/h/subject).Conclusion:PBDs might be the result of near collisions between the trunk of the user and the walker, which make it difficult for the users to move their trunk over an anterior stance limb. Training that is focused upon well-timed forward movements of the walker might be required to avoid the occurrence of this common UPC.
| Original language | English |
|---|---|
| Pages (from-to) | 120-125 |
| Number of pages | 6 |
| Journal | Spinal Cord |
| Volume | 54 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - 01-02-2016 |
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All Science Journal Classification (ASJC) codes
- Neurology
- Clinical Neurology
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Characterization of unexpected postural changes during robot-assisted gait training in paraplegic patients. / Koyama, Soichiro; Tanabe, Shigeo; Saito, Eiichi; Hirano, Satoshi; Shimizu, Y.; Katoh, M.; Uno, A.; Takemitsu, T.
In: Spinal Cord, Vol. 54, No. 2, 01.02.2016, p. 120-125.Research output: Contribution to journal › Article
TY - JOUR
T1 - Characterization of unexpected postural changes during robot-assisted gait training in paraplegic patients
AU - Koyama, Soichiro
AU - Tanabe, Shigeo
AU - Saito, Eiichi
AU - Hirano, Satoshi
AU - Shimizu, Y.
AU - Katoh, M.
AU - Uno, A.
AU - Takemitsu, T.
PY - 2016/2/1
Y1 - 2016/2/1
N2 - Study design:This is a retrospective study.Objectives:The objectives of this study were to categorize unexpected postural changes (UPCs) during gait training in paraplegic patients with wearable gait-assist robots, to reveal the incidence of the UPC and its time-dependent changes during initial gait training period and to investigate neurological level-specific differences.Setting:This study was conducted in Fujita Health University, Aichi, Japan.Methods:We investigated five patients (46.2±14.6 years; lesion level: T6:3, T12:2). All patients had previously achieved gait with wearable robot and walker at supervision level. The UPCs were counted for 2 years and classified according to their type. The time-course data were calculated from the incidence of UPCs for 10 days from initial gait training with the walker. The neurological level-specific differences were investigated between T6 and T12 injuries.Results:Eighty-five UPCs were observed and classified into three categories: anterior breakdown, posterior breakdown (PBD) and mal-timing. The average rate over the entire period was 0.96±0.62 (incidents/h/subject). PBD, which was defined as hyperflexion of both hip joints, occurred with the highest frequency (0.64±0.64 incidents/h/subject). During initial gait training, there was a gradual decrease in the occurrence of UPC. For neurological level-specific differences, UPCs were observed more frequently in T6 injuries (1.36±0.35 incidents/h/subject) compared with T12 injuries (0.36±0.31 incidents/h/subject).Conclusion:PBDs might be the result of near collisions between the trunk of the user and the walker, which make it difficult for the users to move their trunk over an anterior stance limb. Training that is focused upon well-timed forward movements of the walker might be required to avoid the occurrence of this common UPC.
AB - Study design:This is a retrospective study.Objectives:The objectives of this study were to categorize unexpected postural changes (UPCs) during gait training in paraplegic patients with wearable gait-assist robots, to reveal the incidence of the UPC and its time-dependent changes during initial gait training period and to investigate neurological level-specific differences.Setting:This study was conducted in Fujita Health University, Aichi, Japan.Methods:We investigated five patients (46.2±14.6 years; lesion level: T6:3, T12:2). All patients had previously achieved gait with wearable robot and walker at supervision level. The UPCs were counted for 2 years and classified according to their type. The time-course data were calculated from the incidence of UPCs for 10 days from initial gait training with the walker. The neurological level-specific differences were investigated between T6 and T12 injuries.Results:Eighty-five UPCs were observed and classified into three categories: anterior breakdown, posterior breakdown (PBD) and mal-timing. The average rate over the entire period was 0.96±0.62 (incidents/h/subject). PBD, which was defined as hyperflexion of both hip joints, occurred with the highest frequency (0.64±0.64 incidents/h/subject). During initial gait training, there was a gradual decrease in the occurrence of UPC. For neurological level-specific differences, UPCs were observed more frequently in T6 injuries (1.36±0.35 incidents/h/subject) compared with T12 injuries (0.36±0.31 incidents/h/subject).Conclusion:PBDs might be the result of near collisions between the trunk of the user and the walker, which make it difficult for the users to move their trunk over an anterior stance limb. Training that is focused upon well-timed forward movements of the walker might be required to avoid the occurrence of this common UPC.
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U2 - 10.1038/sc.2015.138
DO - 10.1038/sc.2015.138
M3 - Article
VL - 54
SP - 120
EP - 125
JO - Spinal Cord
JF - Spinal Cord
SN - 1362-4393
IS - 2
ER -