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  • Case Report
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Intensity of overground robotic exoskeleton training in two persons with motor-complete tetraplegia: a case series

Spinal Cord Series and Cases volume 9, Article number: 24 (2023) Cite this article

Subjects

Abstract

Introduction

Participation in moderate-to-vigorous intensity physical activity (MVPA) is recommended to reduce chronic disease risk in individuals with tetraplegia. Assessing exercise intensity using traditional methods, such as heart rate, may be inaccurate in patients with motor-complete tetraplegia due to autonomic and neuromuscular dysfunction. Direct gas analysis may be more accurate. Overground robotic exoskeleton (ORE) training can be physiologically demanding. Yet, its utility as an aerobic exercise modality to facilitate MVPA in patients with chronic and acute motor-complete tetraplegia has not been explored.

Case presentation

We present the results of two male participants with motor-complete tetraplegia who completed one ORE exercise session while intensity was assessed using a portable metabolic system and expressed in metabolic equivalents (METs). METs were calculated using a rolling 30-s average with 1 MET defined as 2.7 mL/kg/min and MVPA defined as MET ≥ 3.0. Participant A (28-year-old) with a chronic (12 yrs) spinal cord injury (C5, AIS A) completed 37.4 min of ORE exercise (28.9 min walking) achieving 1047 steps. Peak METs were 3.4 (average 2.3) with 3% of walk time spent in MVPA. Participant B (21-year-old) with an acute (2 months) spinal cord injury (C4, AIS A) completed 42.3 min of ORE exercise (40.5 min walking) achieving 1023 steps. Peak METs were 3.2 (average 2.6) with 12% of walk time spent in MVPA. Both participants tolerated activity well without observed adverse responses to activity.

Discussion

ORE exercise may be an effective aerobic exercise modality that may increase participation in physical activity in patients with motor-complete tetraplegia.

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Data availability

The data that support the findings of this study are available from the corresponding author, KDB, upon reasonable request.

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Acknowledgements

The authors would like to acknowledge the Baylor Scott & White Foundation for support of this project.

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Authors and Affiliations

  1. Sports Therapy & Research Center, Baylor Scott & White Research Institute, Frisco, TX, USA

    Katelyn D. Bosteder, Jonathan D. Dawkins & Simon Driver

  2. Baylor Scott & White Institute for Rehabilitation, Dallas, TX, USA

    Ashlyn Moore, Ariana Weeks, Molly Trammell, Simon Driver, Rita Hamilton & Chad Swank

  3. Baylor University Medical Center, Dallas, TX, USA

    Jonathan D. Dawkins & Rita Hamilton

  4. Baylor Scott & White Research Institute, Dallas, TX, USA

    Simon Driver & Chad Swank

Authors
  1. Katelyn D. Bosteder
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  2. Ashlyn Moore
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All authors contributed equally and have read and approved the submission of this case series.

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Correspondence to Katelyn D. Bosteder.

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This work was supported by the Baylor Scott & White Research Institute Operations. The authors report there are no competing interests to declare.

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Bosteder, K.D., Moore, A., Weeks, A. et al. Intensity of overground robotic exoskeleton training in two persons with motor-complete tetraplegia: a case series. Spinal Cord Ser Cases 9, 24 (2023). https://doi.org/10.1038/s41394-023-00584-4

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