The Effect of Exoskeletal-Assisted Walking on Soft Tissue Body Composition in Persons with Spinal Cord Injury.

Abstract Objective To determine the effect of overground walking using a powered exoskeleton on soft tissue body composition in persons with spinal cord injury (SCI). Design A prospective, single group observational pilot study. Setting Medical Center Participants Eight persons with chronic (>6 months) SCI between of 18 to 65 years old and weigh less than100 kg. Interventions Overground ambulation training using a powered exoskeleton (ReWalk) for 40 sessions lasting up to two-hours and occurring three times per week. Main Outcome Measure(s) Dual-energy X-ray absorptiometry (DXA) was used to measure lean mass (LM) and fat mass (FM) from the whole body, arms, legs and trunk. DXA was also used to assess visceral adipose tissue (VAT). Walking performance was measured by six-minute walk test (6MWT). Results Participants significantly lost total body FM (-1.8±1.2 kg, p=0.004), with the loss of adiposity distributed over several regional sites. Six of the 8 participants lost VAT, with the average loss in VAT trending toward significance (-0.141 kg, p=0.06). LM was not significantly changed for the group. Conclusions Sustained and weekly use of powered exoskeletons in person with SCI has the potential to reduce fat mass with inferred improvements in health.