Overground Exoskeleton Gait Training During Inpatient Rehabilitation—experience of a Patient with Disorders of Consciousness and Their Family

Research Objectives: Overground exoskeleton gait training (OEGT) allows walking for dependent patients and may increase arousal for patients with disorders of consciousness (DoC) after traumatic brain injury (TBI). This case report describes the experience of a patient with DoC and their family with OEGT during inpatient rehabilitation.

Design: Case Report

Setting: Inpatient Rehabilitation Hospital

Participants: An 18-year-old male with DoC was admitted to inpatient rehabilitation 89 days after severe TBI. At admission, he presented with minimally conscious state [Coma Recovery Scale-Revised (CRS-R) score=6] and required total assistance for mobility. His parents were present throughout as the plan of care focused on family training and equipment evaluation in preparation for discharge, prevention of secondary complications, and increasing arousal.

Interventions: OEGT was scheduled daily during physical therapy sessions.

Main Outcome Measures: Prior to discharge, a simple yes/no questionnaire was completed by the patient to characterize OEGT experience. The family completed a Likert scale survey to describe their perspective of OEGT and the Family Outcome Measure – 40 (FOM-40) to capture family well-being. OEGT session data (session count, up time, walk time and step count) were recorded.

Results: The patient demonstrated emergence from DoC during a 46-day length of stay with CRS-R of 18 at discharge. After 13 OEGT sessions (up time 17.84±4.57 minutes, walk time 11.65±6.57, step count 316.15±192.63), the patient reported he “liked walking”, “would rather walk than lay in bed”, walking made him feel “more awake”, and “not too tired”. His family observed increased arousal during OEGT. Highest FOM-40 scores were in domains of support demands, family member coping, and family resilience with lowest scores in relative adjustment, adequacy of support, and sustainability of family support.

Conclusions: The patient with DoC and their family perceived OEGT to be associated with increased arousal, reporting an overall positive experience with OEGT during inpatient rehabilitation.

Author(s) Disclosures: None