Open AccessInfluence of Locomotion Therapy With the Wearable Cyborg HAL on Bladder and Bowel Function in Acute and Chronic SCI Patients
Author(s) -
Alexis Brinkemper,
Dennis Grasmücke,
Emre Yılmaz,
Felix Reinecke,
Thomas A. Schildhauer,
Mirko Aach
Publication year - 2021
Publication title -
global spine journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.398
H-Index - 26
eISSN - 2192-5690
pISSN - 2192-5682
DOI - 10.1177/21925682211003851
Subject(s) - medicine , bowel function , chronic constipation , constipation , spinal cord injury , physical therapy , fecal incontinence , powered exoskeleton , paraplegia , rehabilitation , surgery , spinal cord , psychiatry
Study Design: Retrospective survey.Objectives: Purpose of this study was to explore whether bowel and bladder management can be influenced by locomotion therapy with HAL Robot Suit.Methods: 35 subjects with acute ( one year since injury, n = 22) incomplete paraplegia (American Spinal Injury Association Impairment Scale (AIS) B, n = 1 / AIS C, n = 22 / AIS D, n = 7) or complete paraplegia (AIS A, n = 5) with zones of partial preservation (ZPP) participated. A retrospective survey was carried out asking for bowel incontinence (Wexner Score), constipation (Cleveland Clinic Constipation Scoring System (CCCS)) and bladder function (self-developed questionnaire) before and after completing a training period of 12 weeks with HAL.Results: Wexner Score over all patients and for group of chronic patients decreased significantly. For group of acute patients Wexner Score decreased insignificantly. Patients from both groups with higher baseline scores could decrease significantly. CCCS was insignificantly reduced for all patients, group of acute and group of chronic patients. For subgroup of chronic patients with higher baseline scores, CCCS decreased at end of training period missing out significance. The self-developed questionnaire showed an improvement in bladder function in 28.24% of all patients, 31.43% of chronic patients, and 23.08% of acute patients.Conclusions: Our findings show trends of enhanced bladder and bowel function following exoskeleton training. Patients with higher baseline scores in Wexner Score and CCCS seem to benefit more than those with mild to moderate scores.