Effect on body composition and bone mineral density of walking with a robotic exoskeleton in adults with chronic spinal cord injury

OBJECTIVE: To examine the effect on body composition and bone mineral density of locomotor training using a robotic exoskeleton in individuals with spinal cord injury. STUDY DESIGN: Interventional study. SUBJECTS/METHODS: Five adults with a non-progressive traumatic complete sensorimotor spinal cord injury who were using a wheelchair as a primary mode of mobility. Participants performed a personalized 6-week progressive locomotor training programme using a robotic exoskeleton 3 times/week for up to 60 min. Body composition measures were determined using dual energy X-ray absorptiometry and peripheral quantitative computed tomography. RESULTS: A significant increase in leg and appendicular lean body mass and a decrease in total, leg and appendicular fat mass was observed after the intervention. Furthermore, the calf muscle cross-sectional area increased significantly after the intervention. Finally, although not statistically significant, there was an increase of 14.5% in bone mineral density of the tibia, which may be clinically significant. A decrease of > 5 % was also noted for subcutaneous adipose tissue and intramuscular adipose tissue. CONCLUSION: Locomotor training using a robotic exoskeleton appears to be associated with improvements in body composition and, potentially, bone health.