Introduction
For this essay, I plan to discuss the use of exoskeletons as a part of the physiotherapy management for adults with multilevel spinal cord injuries. Fisahn et al (2016) states that “exoskeletons are motorized orthoses placed over a person's limb with joint parts corresponding to those of the human body.” And that “their purpose is to facilitate standing and walking, as well as assist in rehabilitation” (Fisahn et al. 2016). According to the WHO (2017) a spinal cord injury (SCI) is “damage to the spinal cord resulting from trauma (e.g. a car crash) or from disease or degeneration (e.g. cancer)”. Ultimately, physiotherapy plays an integral part in the gait rehabilitation of patients with a SCI but where do exoskeletons fit in to …show more content…
Powered exoskeletons have been shown to have around a 50% lower physiological cost index when compared to conventional orthoses such as HKAFO and RGOs (Arazpour et al. 2012). Moreover, exoskeleton assisted walking has been found to have a metabolic demand of 3.3 METs and a rating of perceived exertion of 10 on the Borg scale. These figures are representative of a peak oxygen uptake of 24%-35% and an exercise intensity that allows for health benefits, without early fatigue, respectively (Miller, Zimmermann and Herbert 2016). Thus, we as physiotherapists could utilise the ability to have extended treatment sessions with SCI patients using powered exoskeletons as it has been shown by Backus et al. (2009) that activity based interventions that are delivered with such an intensity and are for the most part task specific improved both neural and functional outcomes in SCI patients. Unfortunately, specific training protocols with regards to the dosages, frequencies and durations of treatments have yet to be developed (Backus et al. 2009). Similarly, the systematic review by Nam et al. (2017) supports the use of intensive locomotor training to induce plastic changes at the spinal cord level and within the sensory motor cortex in incomplete SCI patients (Nam et al. 2017). I plan to discuss the discrepancies with regards to training protocols later in the
For this essay, I plan to discuss the use of exoskeletons as a part of the physiotherapy management for adults with multilevel spinal cord injuries. Fisahn et al (2016) states that “exoskeletons are motorized orthoses placed over a person's limb with joint parts corresponding to those of the human body.” And that “their purpose is to facilitate standing and walking, as well as assist in rehabilitation” (Fisahn et al. 2016). According to the WHO (2017) a spinal cord injury (SCI) is “damage to the spinal cord resulting from trauma (e.g. a car crash) or from disease or degeneration (e.g. cancer)”. Ultimately, physiotherapy plays an integral part in the gait rehabilitation of patients with a SCI but where do exoskeletons fit in to …show more content…
Powered exoskeletons have been shown to have around a 50% lower physiological cost index when compared to conventional orthoses such as HKAFO and RGOs (Arazpour et al. 2012). Moreover, exoskeleton assisted walking has been found to have a metabolic demand of 3.3 METs and a rating of perceived exertion of 10 on the Borg scale. These figures are representative of a peak oxygen uptake of 24%-35% and an exercise intensity that allows for health benefits, without early fatigue, respectively (Miller, Zimmermann and Herbert 2016). Thus, we as physiotherapists could utilise the ability to have extended treatment sessions with SCI patients using powered exoskeletons as it has been shown by Backus et al. (2009) that activity based interventions that are delivered with such an intensity and are for the most part task specific improved both neural and functional outcomes in SCI patients. Unfortunately, specific training protocols with regards to the dosages, frequencies and durations of treatments have yet to be developed (Backus et al. 2009). Similarly, the systematic review by Nam et al. (2017) supports the use of intensive locomotor training to induce plastic changes at the spinal cord level and within the sensory motor cortex in incomplete SCI patients (Nam et al. 2017). I plan to discuss the discrepancies with regards to training protocols later in the