Gait training after spinal cord injury: safety, feasibility and gait function following 8 weeks of training with the exoskeletons from Ekso Bionics

Research output: Contribution to journalArticle


STUDY DESIGN: Prospective quasi-experimental study, pre- and post-design.

OBJECTIVES: Assess safety, feasibility, training characteristics and changes in gait function for persons with spinal cord injury (SCI) using the robotic exoskeletons from Ekso Bionics.

SETTING: Nine European rehabilitation centres.

METHODS: Robotic exoskeleton gait training, three times weekly over 8 weeks. Time upright, time walking and steps in the device (training characteristics) were recorded longitudinally. Gait and neurological function were measured by 10 Metre Walk Test (10 MWT), Timed Up and Go (TUG), Berg Balance Scale (BBS), Walking Index for Spinal Cord Injury (WISCI) II and Lower Extremity Motor Score (LEMS).

RESULTS: Fifty-two participants completed the training protocol. Median age: 35.8 years (IQR 27.5-52.5), men/women: N = 36/16, neurological level of injury: C1-L2 and severity: AIS A-D (American Spinal Injury Association Impairment Scale). Time since injury (TSI) < 1 year, N = 25; > 1 year, N = 27. No serious adverse events occurred. Three participants dropped out following ankle swelling (overuse injury). Four participants sustained a Category II pressure ulcer at contact points with the device but completed the study and skin normalized. Training characteristics increased significantly for all subgroups. The number of participants with TSI < 1 year and gait function increased from 20 to 56% (P = 0.004) and 10MWT, TUG, BBS and LEMS results improved (P < 0.05). The number of participants with TSI > 1 year and gait function, increased from 41 to 44% and TUG and BBS results improved (P < 0.05).

CONCLUSIONS: Exoskeleton training was generally safe and feasible in a heterogeneous sample of persons with SCI. Results indicate potential benefits on gait function and balance.


  • Carsten Bach Baunsgaard
  • Ulla Vig Nissen
  • Anne Katrin Brust
  • Angela Frotzler
  • Cornelia Ribeill
  • Yorck-Bernhard Kalke
  • Natacha León
  • Belén Gómez
  • Kersti Samuelsson
  • Wolfram Antepohl
  • Ulrika Holmström
  • Niklas Marklund
  • Thomas Glott
  • Arve Opheim
  • Jesus Benito
  • Narda Murillo
  • Janneke Nachtegaal
  • Willemijn Faber
  • Fin Biering-Sørensen
External organisations
  • Uppsala University Hospital
Original languageEnglish
Pages (from-to)106-116
JournalSpinal Cord
Issue number2
Publication statusPublished - 2018 Feb
Publication categoryResearch
Externally publishedYes