To test whether PR with a powered exoskeleton is feasible with COPD patients and whether it improves physical function, and respiratory muscle strength.
Three single cases with COPD visited the outpatient clinic because of progressive dyspnoea. Spirometry revealed obstructive ventilatory dysfunction.The patients were taken on therapy with Fluticasone Furoate (100ug/62.5ug/25ug, 1 puff once daily) and albuterol (100 mg, 2 puffs as needed), however, they still had a recurrent dyspnea after exertion.The exoskeleton is a mobility assist device activated by user movement to synchronize assist. A motor at each knee joint augments leg muscle power and recognizes physical activities, including bending at the knee, sitting, and walking. The patients participated in sessions three times per week for 4 weeks. The PR program comprised prescribed, individualized exercise, strength and Inspiratory muscle training.We assessed their pulmonary function, respiratory muscle strength, and physical function before and after the combination of PR and the powered Exoskeleton. The patients completed the unassisted natural 6-minute walk test (6MWT) and 30-second sit-to-stand (30STST) , fitting to the exoskeleton and practicing 6MWT and 30STST.
The powered exoskeleton training was well tolerated by the patients, while the fitting to the exoskeleton and unassisted natural 6MWD and 30STST showed moderate improvements for all 3 subjects.The respiratory muscle strength results showed an improvement in maximal inspiratory pressure (MIP) and maximal expiratory pressure(MEP). The upper limb strength, abduction and adduction of the upper limb, the handgrip strength were improved.
This study indicates that PR with the powered exoskeleton may be an effective option of treatment for COPD patients.The exoskeleton may reduce the energy expenditure and be beneficial to COPD patients. Moderate improvements were found in all 3 subjects, however, generalization of the results requires further research with more cases.
COPD poses a high burden of morbidity and mortality on patients and health systems globally. It leads to impair individuals’ exercise tolerance and ability to undertake daily activities. Pulmonary rehabilitation with a powered exoskeleton may be an collaborative effect of treatment for COPD patients and enhance patients' confidence in rehabilitation, especially for severe COPD patients who have lost their mobility for a long time, this psychological effect may bring additional rehabilitation motivation.
Chronic Obstructive Pulmonary Disease
Rehabilitation robot
