Exoskeleton‑based training improves walking independence in incomplete spinal cord injury patients: results from a randomized controlled trial

Journal of NeuroEngineering and Rehabilitation, 2023 · DOI: https://doi.org/10.1186/s12984-023-01158-z · Published: March 24, 2023

Spinal Cord Injury Assistive Technology Rehabilitation

Simple Explanation

This study investigates whether using a robotic exoskeleton called HANK can help people with incomplete spinal cord injuries walk better. The researchers compared patients who trained with the exoskeleton to those who received traditional walking therapy. The study found that the exoskeleton is safe and can improve walking independence, as measured by a specific walking test.

Study Duration

5 weeks

Participants

23 patients with incomplete SCI (AIS C or D)

Evidence Level

Level 1 Randomized Controlled Trial

Key Findings

1
The use of HANK exoskeleton in clinical settings is safe and well-tolerated by the patients.
2
Patients receiving treatment with the exoskeleton improved their walking independence as measured by the WISCI-II after the treatment.
3
Both groups were able to walk faster and longer after the training programs, yet the IG patients needed less external assistance.

Research Summary

This study assessed the safety and efficacy of the HANK exoskeleton for gait training in individuals with incomplete SCI. Patients who trained with the HANK exoskeleton showed improved walking independence compared to those receiving traditional gait therapy. The findings suggest that exoskeleton-driven interventions improve walking ability and promote balance-related strategies.

Practical Implications

Clinical Practice

The HANK exoskeleton can be safely used in clinical settings to improve walking independence in patients with incomplete SCI.

Rehabilitation Strategies

Exoskeleton training may promote compensatory and balance-related strategies that enhance walking ability.

Future Research

Further studies are needed to confirm these findings in larger, multi-center trials and to optimize exoskeleton-driven therapy protocols.

Study Limitations

1
Guidance force and step initiation detection not set specifically for each patient.
2
The sample size was not adequate since we estimated 24.
3
No follow-up evaluation after 6 months was registered.

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