Effect of Exoskeletal-Assisted Walking on Soft Tissue Body Composition in Persons With Spinal Cord Injury

Arch Phys Med Rehabil. 2021 Feb;102(2):196-202. doi: 10.1016/j.apmr.2020.07.018. Epub 2020 Nov 7.

Abstract

Objective: To determine the effect of overground walking using a powered exoskeleton on soft tissue body composition in persons with spinal cord injury (SCI).

Design: A prospective, single group observational pilot study.

Setting: Medical center.

Participants: Persons (N=8) with chronic (>6mo) SCI between 18 and 65 years old who weighed less than 100 kg.

Interventions: Overground ambulation training using a powered exoskeleton (ReWalk) for 40 sessions, with each session lasting up to 2 hours, with participants training 3 times per week.

Main outcome measure(s): Dual-energy x-ray absorptiometry (DXA) was used to measure lean mass (LM) and fat mass (FM) from the whole body, arms, legs and trunk. DXA was also used to assess visceral adipose tissue (VAT). Walking performance was measured by 6-minute walk test.

Results: Participants significantly lost total body FM (-1.8±1.2kg, P=.004) with the loss of adiposity distributed over several regional sites. Six of the 8 participants lost VAT, with the average loss in VAT trending toward significance (-0.141kg, P=.06). LM for the group was not significantly changed.

Conclusions: Sustained and weekly use of powered exoskeletons in persons with SCI has the potential to reduce FM with inferred improvements in health.

Trial registration: ClinicalTrials.gov NCT01454570.

Keywords: Body composition; Exercise therapy; Exoskeleton device; Intra-abdominal fat; Rehabilitation; Spinal cord injuries.

Publication types

  • Observational Study
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Absorptiometry, Photon
  • Adolescent
  • Adult
  • Aged
  • Body Composition*
  • Exoskeleton Device*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pilot Projects
  • Prospective Studies
  • Spinal Cord Injuries / physiopathology*
  • Spinal Cord Injuries / rehabilitation*
  • Walk Test
  • Walking / physiology*

Associated data

  • ClinicalTrials.gov/NCT01454570