Synergistic effect of epidural electrical stimulation and exoskeleton walk training on dynamic balance for participants with spinal cord injury.

OBJECTIVES

Electrical epidural stimulation (EES) or exoskeleton walking training (EWT) is beneficial to individuals with spinal cord injury (SCI). In this study, we aimed to evaluate the benefits of combining EES and EWT to manage trunk impairment in individuals with SCI.

STUDY

DESIGN

Pre-post study.

SETTING

A medical center.

PARTICIPANTS

Two participants with cervical SCI (C group) and two with thoracolumbar SCI (TL group) were recruited.

INTERVENTION: Each participant underwent personalized EES and EWT rehabilitation for one month.

OUTCOME MEASURES: The modified functional reach test (mFRT) was used for pre- and post-intervention assessments. Movement distance and velocity of the center of pressure (COP), and electromyography data (EMG) from the iliopsoas and erector spinae muscles were collected to assess trunk stability and movement function.

RESULTS

The moving distance and velocity of the COP increased after one month of EES and EWT rehabilitation, with a significant rise in moving distance. In the subsequent stratification analysis, the moving distance of the C group increased significantly with or without EES (P = 0.046), but the increase in velocity was not significant. The TL group showed slight improvements in distance and velocity, both of which were not statistically significant.

CONCLUSIONS

The synergistic effect of EES and EWT may provide effective rehabilitation for individuals with SCI, particularly those with cervical SCI. This treatment helps them regain trunk stability and movement function within one month.Trial Registration: NCT05433064.