Proposed Topic (Most preferred): :
Research and Innovations (new projects / technology / innovations / service models)
Proposed Topic (Second preferred): :
HA Young Investigators Session (Projects to be presented by HA staff who had joined HA for 10 years or less)
Authors (including presenting author) :
Lau ACH, Cheung EYY, Lee JKY, Chow KKT, Leung KKL
Affiliation :
Physiotherapy Department, Kowloon Hospital
Introduction :
Spinal Cord Injury(SCI) can lead to severe neurological deficits and sensorimotor dysfunction. Specialized physiotherapy rehabilitation is known to be crucial in restoring functional independence and improving quality of life in SCI patients. With the emergence of advanced locomotor technology, evidence has suggested that neuroplasticity can be promoted to improve lower limb control and walking function[1]. Overground wearable robotic exoskeleton(WRE) training is implemented in Physiotherapy Department of Kowloon Hospital(KHPT) as a new evidence-based component of comprehensive spinal cord rehabilitation program[2].
Despite the growing knowledge on positive effects of WRE training in adult SCI patients, there is a scarcity of research in paediatric SCI field. Exploration of optimal physiotherapy rehabilitation is indispensable to support the rehabilitation of the juvenile patients to regain functional mobility.
Objectives :
The current study aims to evaluate the feasibility and clinical effectiveness of expanding WRE service beyond adult population
Methodology :
A thirteen-year-old adolescent, with diagnosis of spinal cord infarct, was referred for WRE program in KHPT. Outcome measures, including Spinal Cord Independence Measure Version III(SCIM-III), 10-Meter Walk Test(10MWT), 6-Minute Walk Test(6MWT), Global Rate of Change(GROC) scale and walking performance, were evaluated at first and 20th session.
Result & Outcome :
Upon 20th session, SCIM-III score improved from 72 to 78. It suggests an improvement in his functional independency and ability to perform daily tasks. In terms of gait parameters, 10MWT improved from 0.122m/s to 0.194m/s and 6MWT increased from 10m to 34m. The GROC scale was scored +3. The walking stability was also enhanced from one-person assistance to supervision level. No adverse event is encountered. Both patient and their parents were highly satisfied with WRE training.
The promising result of the current study suggests WRE training in paediatric SCI patient can be safe and effective in improving gait pattern, speed, walking endurance, activities of daily-living and patient-perceived improvement. Effective and timely restoration of posture and gait function is exceptional vital to their natural growth and development. The encouraging outcome can allow expansion of WRE service as integral part of comprehensive physiotherapy SCI rehabilitation to this vulnerable and highly-complex population. This is pivotal in having evidence to inform clinicians, patients and their parents on possible physiotherapeutic intervention with potential physiological and psychosocial effects in specialized paediatric SCI rehabilitation.
