Trunk muscle activity patterns and motion patterns of patients with motor complete spinal cord injury at T8 and T10 walking with different un-powered exoskeletons

Objective: The aim of this study was to explore how neurological injured levels of spinal cord affect the performance of patients walking with different un-powered exoskeletons. Study design: Case series observational study. Setting: Gait and Motion Analysis Laboratory at the National Research Center Rehabilitation Technical Aids. Methods: Electromyography and motion data from two subjects with complete spinal cord injury at T10 and T8 walking with un-powered exoskeletons were collected simultaneously. Outcome measures: Surface electromyography of trunk muscles and motion data including joint angle and center of mass (COM). Results: Compared to T10 subject, T8 subject activated trunk muscles in higher levels walking with all tested un-powered exoskeletons and had greater pelvic obliquity walking with reciprocating gait orthosis (RGO) and energy-stored exoskeleton (ES-EXO). ES-EXO can redistribute muscle forces, recruit trunk muscles evenly, increase walking speed and improve COM trajectory in frontal plane. Conclusion: This study revealed differences in kinematics and muscle activities in walking with three un-powered exoskeletons between two patients with different neurological injured levels. ES-EXO had advantages over conventional un-powered exoskeletons on recruiting muscles evenly and improving walking speed, step length and COM trajectory.