{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T07:13:07Z","timestamp":1783581187295,"version":"3.55.0"},"reference-count":75,"publisher":"MJS Publishing, Medical Journals Sweden AB","license":[{"start":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T00:00:00Z","timestamp":1762041600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JRM"],"abstract":"<jats:p>Objective: To evaluate the impact of gait-synchronized functional electrical stimulation during exoskeleton-assisted ambulation on cardiorespiratory demand in individuals with incomplete spinal cord injury. \nDesign: Cross-sectional study employing a randomized crossover arrangement of measurements.\nParticipants: Convenience sample of 11 individuals with chronic incomplete spinal cord injury and partial walking ability.\nMethods: Participants completed 2 x 6-min walking tests (6MWTs) with the EksoNR, 1 with and 1 with-out gait-synchronized functional electrical stimulation targeting gait-related muscles in a randomized order. Cardiorespiratory and metabolic parameters were measured breath-by-breath via ergospirometry. The primary outcome was oxygen consumption (V\u0307O2\/kg). Secondary outcomes included further cardiovascular and metabolic parameters. Data from the final 2 min of each 6MWT were analysed using linear mixed-effect models.\nResults: V\u0307O2\/kg increased by 6% with functional electrical stimulation compared with exoskeleton-assisted ambulation alone (15.07\u2009\u00b1\u20094.11 vs 14.21\u2009\u00b1\u20093.61 mL\u00b7min-\u00b9\u00b7kg-\u00b9, p\u2009=\u20090.02). Heart rate, ventilation, and energy expenditure were also elevated (p\u2009&lt;\u20090.05), while breathing frequency, respiratory exchange ratio, distance, and perceived exertion remained unchanged. Inter-individual differences in V\u0307O2\/kg were not explained by stimulation amplitude (r\u2009=\u20090.36, p\u2009=\u20090.27).\nConclusion: Adding functional electrical stimulation to exoskeleton-assisted gait therapy consistently increased cardiorespiratory demand, potentially enhancing training intensity. Further research assessing long-term clinical impact is required.<\/jats:p>","DOI":"10.2340\/jrm.v57.43423","type":"journal-article","created":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T06:35:31Z","timestamp":1762151731000},"page":"jrm43423","source":"Crossref","is-referenced-by-count":3,"title":["Influence of gait-synchronized functional electrical stimulation during exoskeleton-assisted ambulation on cardiorespiratory outcomes in individuals with incomplete spinal cord injury"],"prefix":"10.2340","volume":"57","author":[{"given":"Robert","family":"Voicu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3255-0966","authenticated-orcid":false,"given":"Daniela B.","family":"Kuchen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3953-589X","authenticated-orcid":false,"given":"Claudio","family":"Perret","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5519-8593","authenticated-orcid":false,"given":"Ines","family":"Bersch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7693-123X","authenticated-orcid":false,"given":"Mario","family":"Widmer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1183","published-online":{"date-parts":[[2025,11,2]]},"reference":[{"key":"131859","unstructured":"Perale G, Rossi F. 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