Work-rate-guided exercise testing in patients with incomplete spinal cord injury using a robotics-assisted tilt-table

Laubacher, Marco; Perret, Claudio; Hunt, Kenneth James (2014). Work-rate-guided exercise testing in patients with incomplete spinal cord injury using a robotics-assisted tilt-table Disability and Rehabilitation: Assistive Technology, 10(5), pp. 433-438. Taylor & Francis 10.3109/17483107.2014.908246

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Purpose: Robotics-assisted tilt-table (RTT) technology allows neurological rehabilitation therapy to be started early thus alleviating some secondary complications of prolonged bed rest. This study assessed the feasibility of a novel work-rate-guided RTT approach for cardiopulmonary training and assessment in patients with incomplete spinal cord injury (iSCI). Methods: Three representative subjects with iSCI at three distinct stages of primary rehabilitation completed an incremental exercise test (IET) and a constant load test (CLT) on a RTT augmented with integrated leg-force and position measurement and visual work rate feedback. Feasibility assessment focused on: (i) implementation, (ii) limited efficacy testing, (iii) acceptability. Results: (i) All subjects were able follow the work rate target profile by adapting their volitional leg effort. (ii) During the IETs, peak oxygen uptake above rest was 304, 467 and 1378 ml/min and peak heart rate (HR) was 46, 32 and 65 beats/min above rest (subjects A, B and C, respectively). During the CLTs, steady-state oxygen uptake increased by 42%, 38% and 162% and HR by 12%, 20% and 29%. (iii) All exercise tests were tolerated well. Conclusion: The novel work-rate guided RTT intervention is deemed feasible for cardiopulmonary training and assessment in patients with iSCI: substantial cardiopulmonary responses were observed and the approach was found to be tolerable and implementable. Implications for Rehabilitation -Work-rate guided robotics-assisted tilt-table technology is deemed feasible for cardiopulmonary assessment and training in patients with incomplete spinal cord injury. -Robotics-assisted tilt-tables might be a good way to start with an active rehabilitation as early as possible after a spinal cord injury. -During training with robotics-assisted devices the active participation of the patients is crucial to strain the cardiopulmonary system and hence gain from the training.

Item Type:	Journal Article (Original Article)
Division/Institute:	School of Engineering and Computer Science > Institut für Rehabilitation und Leistungstechnologie IRPT School of Engineering and Computer Science School of Engineering and Computer Science > Institute for Human Centered Engineering (HUCE) > Digital Health Lab
Name:	Laubacher, Marco; Perret, Claudio and Hunt, Kenneth James
ISSN:	1748-3115
Publisher:	Taylor & Francis
Language:	English
Submitter:	Service Account
Date Deposited:	22 Jul 2019 13:17
Last Modified:	22 Jul 2019 13:17
Publisher DOI:	10.3109/17483107.2014.908246
Uncontrolled Keywords:	Cardiopulmonary exercise testing, incomplete spinal cord injury, rehabilitation, robotics-assisted tilt-table
URI:	https://arbor.bfh.ch/id/eprint/5471