title: Heart rate and oxygen demand of powered exoskeleton-assisted walking in persons with paraplegia.
abstract: Historically, persons with paralysis have limited options for overground ambulation. Recently, powered exoskeletons have become available, which are systems that translate the user's body movements to activate motors to move the lower limbs through a predetermined gait pattern. As part of an ongoing clinical study (NCT01454570), eight nonambulatory persons with paraplegia were trained to ambulate with a powered exoskeleton. Measurements of oxygen uptake (VO2) and heart rate (HR) were recorded for 6 min each during each maneuver while sitting, standing, and walking. The average value of VO2 during walking (11.2 +/- 1.7 mL/kg/min) was significantly higher than those for sitting and standing (3.5 +/- 0.4 and 4.3 +/- 0.9 mL/kg/min, respectively; p < 0.001). The HR response during walking was significantly greater than that of either sitting or standing (118 +/- 21vs 70 +/- 10 and 81 +/- 12 beats per minute, respectively: p < 0.001). Persons with paraplegia were able to ambulate efficiently using the powered exoskeleton for overground ambulation, providing potential for functional gain and improved fitness.
  
  
  BACKGROUND
  ClinicalTrials.gov; NCT01454570; "The ReWalk Exoskeletal Walking System for Persons with Paraplegia (VA_ReWalk)"; https://clinicaltrials.gov/ct2/show/NCT01454570.
authors.affiliation: Department of Veterans Affairs (VA) Rehabilitation Research and Development National Center of Excellence for the Medical Consequences of Spinal Cord Injury.
authors.forename: Pierre
authors.initials: P
authors.lastname: Asselin
authors.forename: Steven
authors.initials: S
authors.lastname: Knezevic
authors.forename: Stephen
authors.initials: S
authors.lastname: Kornfeld
authors.forename: Christopher
authors.initials: C
authors.lastname: Cirnigliaro
authors.forename: Irina
authors.initials: I
authors.lastname: Agranova-Breyter
authors.forename: William A
authors.initials: WA
authors.lastname: Bauman
authors.forename: Ann M
authors.initials: AM
authors.lastname: Spungen
mesh_terms: D000328:Adult; D004734:Energy Metabolism / Q000502:physiology*; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009989:Orthotic Devices; D010101:Oxygen Consumption / Q000502:physiology*; D010264:Paraplegia / Q000503:physiopathology* / Q000534:rehabilitation; D011446:Prospective Studies; D013119:Spinal Cord Injuries / Q000150:complications / Q000503:physiopathology; D013904:Thoracic Vertebrae; D016138:Walking / Q000502:physiology*; D055815:Young Adult
keywords: 6MWT; RGO; ambulatory device; energy expenditure; metabolic; overground walking; oxygen uptake; paraplegia; powered exoskeleton; reciprocating gait orthosis; spinal cord injury