Heart disease and diabetes are just two of many conditions that can occur in people after a spinal cord injury (SCI). Exercise can play a significant role in mitigating the risks associated with these conditions, but typical exercise options for people with SCI or other lower limb disabilities are usually limited to seated upper body exercise (for example, wheeling or hand cycling). Physical activity guidelines have been proposed for SCI, and although conventional exercise confers some cardiovascular (CV) benefits, the current options may not be enough to prevent widespread health decline post-injury.
Hybrid exercise, in which passive leg exercise is combined with active arm exercise, represents an under-explored area with significant clinical promise to improve CV outcomes over and above what is possible with arm exercise alone. In parallel, research is emerging about the benefits of upright walking therapy on recovery of neurological function and improvements in the secondary complications that accompany SCI, such as neuropathic pain. However, this type of therapy currently necessitates the use of expensive machines and/or trained personnel at specialized rehabilitation centres.
Dr. Borisoff has developed a new exercise machine, called AAPLE-Walk, that aims to provide arm-driven, walking-like leg movements while standing and exercising. This machine would provide comprehensive benefits to CV fitness and elicit lower limb muscle activity, potentially improving the secondary conditions of multiple diseases.
Dr. Borisoff has developed a proof-of-principle prototype of this machine, and next steps include further refining this prototype so the usability and health impacts can be evaluated.
It is clear that better exercise methods are needed for those with disabilities. These methods should challenge the heart better than simple, arm-only exercise, as well as beneficially impact an array of secondary complications. AAPLE-Walk may be an answer. The ultimate goal for this device is a product suitable for home use—or, with additional features, a device suitable for high-volume use at clinics. If successful, this would be low cost and offer more comprehensive benefits compared to expensive therapy machines currently on the market.