Examinando por Autor "Lozano-Berrio, Vicente"

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A Systematic Methodology to Analyze the Impact of Hand-Rim Wheelchair Propulsion on the Upper Limb
(MDPI, 2019-10-25) Larraga-García, Blanca; Lozano-Berrio, Vicente; Gutiérrez, Álvaro; Gil-Agudo, Ángel; del-Ama, Antonio J.
Objective: To design and test a methodology to compare kinematic and kinetic variables of the upper limb joints when propelling different wheelchairs, and to analyze the differences between paraplegic and tetraplegic patients. Methods: Ten adults with spinal cord injury (five with paraplegia and five with tetraplegia) propelled two different wheelchairs on a treadmill at a constant speed for three minutes, with one minute break between tests. Kinematic and kinetic data of the upper limb and the hand-rim were recorded and processed using a customized software. Results: Significant differences were found between paraplegic and tetraplegic patients in the forces and moments applied on the hand-rim and the upper limb joints, especially on the shoulder. The type of wheelchair also affected the biomechanical load on the upper limb, with a lighter wheelchair reducing the impact on the shoulder of tetraplegic patients. Conclusion: The proposed methodology is suitable for kinematic and kinetic studies on wheelchair propulsion, and can be used to assess the effect of different wheelchair configurations and lesion characteristics on the upper limb biomechanics
Exoskeleton-based training improves walking independence in incomplete spinal cord injury patients: results from a randomized controlled trial Injury Patients
(BMC, 2023-03-24) Gil-Agudo, Ángel; García-Megía, Álvaro; Pons, José L.; Sinovas-Alonso, Isabel; Comino-Suárez, Natalia; Lozano-Berrio, Vicente; del-Ama, Antonio J.
Background: In recent years, ambulatory lower limb exoskeletons are being gradually introduced into the clinical practice to complement walking rehabilitation programs. However, the clinical evidence of the outcomes attained with these devices is still limited and nonconclusive. Furthermore, the user-to-robot adaptation mechanisms responsible for functional improvement are still not adequately unveiled. This study aimed to (1) assess the safety and feasibility of using the HANK exoskeleton for walking rehabilitation, and (2) investigate the effects on walking function after a training program with it. Methods: A randomized controlled trial was conducted including a cohort of 23 patients with less than 1 year since injury, neurological level of injury (C2-L4) and severity (American Spinal Cord Injury Association Impairment Scale [AIS] C or D). The intervention was comprised of 15 one-hour gait training sessions with lower limb exoskeleton HANK. Safety was assessed through monitoring of adverse events, and pain and fatigue through a Visual Analogue Scale. LEMS, WISCI-II, and SCIM-III scales were assessed, along with the 10MWT, 6MWT, and the TUG walking tests (see text for acronyms). Results: No major adverse events were reported. Participants in the intervention group (IG) reported 1.8 cm (SD 1.0) for pain and 3.8 (SD 1.7) for fatigue using the VAS. Statistically significant differences were observed for the WISCI-II for both the "group" factor (F = 16.75, p < 0.001) and "group-time" interactions (F = 8.87; p < 0.01). A post-hoc analysis revealed a statistically significant increase of 3.54 points (SD 2.65, p < 0.0001) after intervention for the IG but not in the CG (0.7 points, SD 1.49, p = 0.285). No statistical differences were observed between groups for the remaining variables. Conclusions: The use of HANK exoskeleton in clinical settings is safe and well-tolerated by the patients. Patients receiving treatment with the exoskeleton improved their walking independence as measured by the WISCI-II after the treatment.