Prof. Assoc Faculdade de Medicina da Universidade de Sao Paulo
Objectives The objective of the report the side effect of appetite from the robotic exoskeleton for lower limbs with direct ground weight unloading. Design case report Results A 30-year-old man with a complete SCI (T8, AIS A) and no appetite perception since the injury experienced an unexpected recovery of appetite during exoskeleton-assisted walking therapy. Appetite improvement occurred after two sessions and coincided with the onset of walking in the exoskeleton. Discussion The recovery of appetite during exoskeleton-assisted walking could be linked to autonomic and visceral afferent improvements. However, this observation is exploratory, and other factors, such as mood enhancement from experiencing walking, may have contributed. Further studies are needed to investigate these mechanisms.
Conclusions Loss of appetite in people with spinal cord injury is often associated with trauma, illness, or psychological issues. This work proposes new hypotheses, such as stomach deafferentation leading to loss of appetite. The robotic exoskeleton, as a neuroplastic therapy, restored gastric innervation, returning appetite. This return cannot be attributed to energy expenditure, but to some reconnection between the perceptual centers of appetite and the effector organ. Research Study with Best Paper Award Abstract Introduction Loss of appetite is a neglected condition in individuals with spinal cord injury, often assessed as an emotional issue, without considering the autonomic dysfunctions that decrease gastric afferents, altering hunger perception, to the same extent as it causes autonomic dysreflexia, neurogenic bladder, and neurogenic bowel related to the interruption of information flow between effector organs and the brain. The objective of the report the side effect of appetite from the robotic exoskeleton for lower limbs with direct ground weight unloading.
Case presentation A 30-year-old man with a complete SCI (T8, AIS A) and no appetite perception since the injury experienced an unexpected recovery of appetite during exoskeleton-assisted walking therapy. Appetite improvement occurred after two sessions and coincided with the onset of walking in the exoskeleton.
Discussion The recovery of appetite during exoskeleton-assisted walking could be linked to autonomic and visceral afferent improvements. However, this observation is exploratory, and other factors, such as mood enhancement from experiencing walking, may have contributed. Further studies are needed to investigate these mechanisms.
