Table 3 Physical therapists’ comments specific to clinical decisions for OEGT after neurological injury during inpatient rehabilitation

Initiation

“I use it for patients that would be impossible to get up and walking any other way.”

“To me, Ekso is the most controlled/supportive form of gait training requiring the least amount of stress on both patient and staff. I often have patients ready for this before anything else.”

“The determination for Ekso to be the primary gait training device is dependent on quality of steps, the amount of intensity, and the repetition of steps as compared to other gait training environments.”

Progression

“As soon as I see a decrease in swing assistance or their vitals aren't being challenged I will drive all numbers down in Fixed for less assistance from Ekso as soon as I can because the point of my Ekso treatments is to get them walking over ground.”

“As heart rate decreases in response to workload, I am clued in that they ready for more load. So, I decrease assist or add resistance and observe quality. If they are constantly corrected by the machine, I increase assist levels back to where they are working hard but successful most of the time.”

Termination

“Typically, when a patient gets to Free I move to over ground walking outside of the Ekso so I can incorporate multi-directional walking, stair training, changes in speed, etc.”

“For CVA or TBI, once they understand the concept of midline, gain some trunk control, and learn the general requirements to produce a reciprocal pattern, I will begin incorporating overground training.”

“If the patient progresses to the point where gait overground or within another device provides more repetition, intensity, and variability then I will transition them out of the device.”