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Cardiorespiratory demand and rate of perceived exertion during overground walking with a robotic exoskeleton in long-term manual wheelchair users with chronic spinal cord injury: A cross-sectional study - 18/06/18

Doi : 10.1016/j.rehab.2017.12.008 
Manuel J. Escalona a, b, Rachel Brosseau a, c, Martin Vermette b, Alain Steve Comtois d, Cyril Duclos a, b, Mylène Aubertin-Leheudre d, Dany H. Gagnon a, b,
a School of rehabilitation, Université de Montréal, Montreal, QC, Canada 
b Pathokinesiology laboratory, Centre for interdisciplinary research in rehabilitation of greater Montreal, Centre intégré universitaire de santé et services sociaux du Centre-Sud-de-l’Île-de-Montréal, 6300, avenue Darlington, Montreal, QC, H3S 2J4 Canada 
c Montreal Heart Institute, QC, Canada 
d Department of exercice sciences , Faculty of sciences, Université du Québec à Montréal ( UQÀM), QC, Canada 

Corresponding author. Pathokinesiology laboratory, Centre for interdisciplinary research in rehabilitation of greater Montreal, Centre intégré universitaire de santé et services sociaux du Centre-Sud-de-l’Île-de-Montréal, 6300, avenue Darlington, Montreal, QC, H3S 2J4 Canada.Pathokinesiology laboratory, Centre for interdisciplinary research in rehabilitation of greater Montreal, Centre intégré universitaire de santé et services sociaux du Centre-Sud-de-l’Île-de-Montréal, 6300, avenue Darlington, Montreal, QC, H3S 2J4 Canada.

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Abstract

Background

Many wheelchair users adopt a sedentary lifestyle, which results in progressive physical deconditioning with increased risk of musculoskeletal, cardiovascular and endocrine/metabolic morbidity and mortality. Engaging in a walking program with an overground robotic exoskeleton may be an effective strategy for mitigating these potential negative health consequences and optimizing fitness in this population. However, additional research is warranted to inform the development of adapted physical activity programs incorporating this technology.

Objectives

To determine cardiorespiratory demands during sitting, standing and overground walking with a robotic exoskeleton and to verify whether such overground walking results in at least moderate-intensity physical exercise.

Methods

We enrolled 13 long-term wheelchair users with complete motor spinal cord injury in a walking program with an overground robotic exoskeleton. Cardiorespiratory measures and rate of perceived exertion (RPE) were recorded by using a portable gas analyzer system during sitting, standing and four 10m walking tasks with the robotic exoskeleton. Each participant also performed an arm crank ergometer test to determine maximal cardiorespiratory ability (i.e., peak heart rate and O2 uptake [HRpeak, VO2peak]).

Results

Cardiorespiratory measures increased by a range of 9%–35% from sitting to standing and further increased by 22%–52% from standing to walking with the robotic exoskeleton. During walking, median oxygen cost (O2Walking), relative HR (%HRpeak), relative O2 consumption (%VO2peak) and respiratory exchange ratio (RER) reached 0.29mL/kg/m, 82.9%, 41.8% and 0.9, respectively, whereas median RPE reached 3.2/10. O2Walking was moderately influenced by total number of sessions and steps taken with the robotic exoskeleton since the start of the walking program.

Conclusion

Overground walking with the robotic exoskeleton over a short distance allowed wheelchair users to achieve a moderate-intensity level of exercise. Hence, an overground locomotor training program with a robotic exoskeleton may have cardiorespiratory health benefits in the population studied.

El texto completo de este artículo está disponible en PDF.

Keywords : Spinal cord injuries, Exercise, Rehabilitation, Technology, Physical fitness, Oxygen consumption


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Vol 61 - N° 4

P. 215-223 - juillet 2018 Regresar al número
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