Long-Term Performance and User Satisfaction With Implanted Neuroprostheses for Upright Mobility After Paraplegia: 2- to 14-Year Follow-Up.
Ronald J Triolo, Stephanie Nogan Bailey, Kevin M Foglyano and 4 others
PMID 28899825WHAT IT FOUND
After an average of six years at home, 22 people with spinal cord injury reported high satisfaction, most devices survived, and leg strength and transfers were maintained, but standing time and leg weight bearing decreased.
Key findings
01At long-term follow-up, stimulated knee extension strength was unchanged in the 11 participants with paired data, and 28 of 32 tested functional tasks were maintained.
02Maximum standing time fell from 28.1 to 10.8 minutes on average, but all 13 participants with standing data could still stand more than one minute, enough for a standing pivot transfer.
03Seventeen participants rated the device 3.88 of 5 and the service 4.54 of 5, and 13 of 18 participants with usage spent most of their time exercising.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Twenty-two participants were studied, and not all completed every test: knee strength was measured in 16, standing time and leg weight bearing in 13, functional tasks in 15, QUEST satisfaction in 17, the User Questionnaire in 18, and usage logs in 19. The cohort was heterogeneous, with injury levels C5 to T11, time post-injury 6 to 29 years, time at home with the system 2 to 14 years, and frequency of use from 0 to 100% of days. The effects of injury level, time post-injury, time at home, and usage frequency on the results were not formally quantified. Usage logs recorded type and duration of use but not the reason or context for each use. Bone density, muscle atrophy, bowel and bladder function, quality of life, and societal participation were not measured. The authors note limited ability to compare using the neuroprosthesis with standing 30 minutes per day in a passive device.
Declared interests
The authors declare no conflicts of interest. The article is listed as supported by NIH extramural and U.S. Government non-PHS research support.
The easy way to misread this
Do not conclude that these implants restore independent walking or eliminate the need for support. Only 2 participants had systems for walking, most used them mainly for exercise, and standing tests were done with a walker and upper limbs used as needed.