The aim of this prospective, single-group observational study was to investigate energy expenditure and heart rate (HR) during powered exoskeletal-assisted use while participating in seated rest, exoskeleton-assisted standing, and exoskeleton-assisted walking. Oxygen uptake (VO2) while using the powered exoskeleton was compared to other reports that have investigated the use of passive gait orthotics in persons with paraplegia. In this study, 8 non-ambulatory participants with paraplegia were trained to ambulate with a powered exoskeleton. Measurements of oxygen uptake (VO2) and heart rate (HR) were recorded for 6 min while sitting, standing, and walking. The average value of VO2 during walking was significantly higher than for sitting and standing (p < 0.001). The HR response during walking was significantly greater than that of either sitting or standing (p < 0.001). On average, the participants reported RPEs ranging from very light (7) to somewhat hard (13), with an average RPE of very light to fairly light (10 ± 2). Research shows that use of an exoskeletal system that requires increased energy expenditure without requiring excessive effort is desirable. This study demonstrated that persons with paraplegia were able to ambulate efficiently using the powered exoskeleton for over ground ambulation, providing the potential for functional gain and improved fitness.
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