Effect of Gait Training Program with Mechanical Exoskeleton on Body Composition of Paraplegics

Abstract

Hyuk-Jae Choi,1 Gyoo-Suk Kim,1 Jung Hoon Chai,2 Chang-Yong Ko3 1Department of Rehabilitation Therapy Training Research, Rehabilitation Engineering Research Institute, Incheon, Republic of Korea; 2Department of Sports Medicine, Soonchunhyang University, Asan, Chungcheongnam-do, Republic of Korea; 3Department of Research & Development, Refind Inc., Wonju, Gangwon-do, Republic of KoreaCorrespondence: Chang-Yong KoRefind Inc, 1, Yeonsedae-gil, Heungeop-myeon, Wonju-si, Gangwon-do 26493, Republic of KoreaTel/Fax [phone]Email [email protected] Hoon ChaiSoonchunhyang University, 22 Soonchunhyangro, Asan 31438 Chungcheongnam-do, Republic of KoreaTel/Fax [phone]Email [email protected]: To identify the effect of a 52-weeks gait training program with an exoskeletal body-powered gait orthosis on the body composition of paraplegics.Patients and Methods: Ten subjects with spinal cord injury at the thoracolumbar spine level for more than 2 years participated and were divided into exercise (n=5) and nonexercise (n=5) groups. A gait training program comprising stages 1– 6 with customized exoskeletal body-powered gait orthosis was conducted for 52-weeks. A six-stage gait training program was conducted to manage the body composition and prevent obesity, and the changes in the body composition before and after the program were determined through bioelectrical impedance analysis.Results: No significant changes in weight, fat-free mass (kg), lean body mass (kg), and percent fat mass (%) are seen in the exercise group before and after the 52-weeks program. However, fat-free mass (pre = 47.3± 6.5, post = 44.3 ± 5.4, kg), lean body mass (pre = 45.2 ± 6.3, post = 42.3± 5.2, kg), and percent fat mass (pre = 30.1 ± 12.1, post = 40.9 ± 9.1, kg) show significant changes (p < 0.05) in the nonexercise group. In the nonexercise group, among lean body mass changes over 52-weeks in the upper limbs (− 31%), trunks (− 9.7%), and lower limbs (− 8.6%), upper limbs exhibit the most significant decrease (p < 0.05).Conclusion: The gait training program with exoskeletal body-powered gait orthosis has a positive effect on fat management in the whole body and lean body mass loss in paraplegics. Furthermore, it is effective in preventing continuous muscle loss and in maintaining health by reducing body fat. Body composition measurements with bioelectrical impedance analysis for paraplegics can be applied in various clinical areas and can be combined with various arbitration methods such as rehabilitation program.Keywords: gait training, exoskeletal orthosis, lean body mass, spinal cord injury, bioelectrical impedance analysis, rehabilitation

Keywords

• gait training
• exoskeletal orthosis
• lean body mass
• spinal cord injury
• bioelectrical impedance analysis
• rehabilitation.