Gait speed using powered robotic exoskeletons after spinal cord injury: a systematic review and correlational study

Journal of NeuroEngineering and Rehabilitation, 2015 · DOI: 10.1186/s12984-015-0074-9 · Published: September 4, 2015

Spinal Cord Injury Assistive Technology Rehabilitation

Simple Explanation

Powered robotic exoskeletons are wearable devices that help people with spinal cord injuries (SCI) walk. This study reviews existing research to see how well these exoskeletons restore walking function, focusing on gait speed. The review looks at factors that affect walking speed when using exoskeletons, such as age, injury level, and training time. It also summarizes the screening and training processes involved in using these devices. The study found that exoskeletons can help people with thoracic-level motor-complete SCI walk at modest speeds, and that walking speed is related to the level of injury and the amount of training time.

Study Duration

Not specified

Participants

92 participants (74 males) across 14 studies

Evidence Level

Systematic Review

Key Findings

1
The mean gait speed attained by non-ambulatory participants while wearing a powered exoskeleton was 0.26 m/s, with the majority having a thoracic-level motor-complete injury.
2
A positive correlation was found between gait speed and age, injury level, and number of training sessions.
3
Participants were able to ambulate independently within a reasonable training time, with some subjects doing so within the first training session.

Research Summary

This systematic review examined the use of powered robotic exoskeletons to improve gait speed in individuals with spinal cord injury (SCI). The review found that powered exoskeletons can enable non-ambulatory individuals with thoracic-level motor-complete SCI to walk at modest speeds. Gait speed was positively correlated with age, injury level, and training time. The findings suggest that powered exoskeletons can be a valuable assistive device for individuals with SCI, but further research is needed to optimize training protocols and improve gait speed for community ambulation.

Practical Implications

Assistive Device

Powered exoskeletons can be used as an assistive device for non-ambulatory individuals with SCI, providing them with the ability to walk.

Rehabilitation Tool

Powered exoskeletons can be used as a rehabilitation tool to improve walking ability in ambulatory individuals with SCI.

Personal and Home Use

As exoskeletons are being approved for personal and home use, daily use may help exoskeleton-users attain higher gait speeds quickly.

Study Limitations

1
The level of evidence in the current literature is limited to studies with a small number of participants.
2
There was heterogeneity in the study characteristics (device, control of stepping, training duration, outcome measurement), which made it challenging to compare results and reduces the ability to generalize results.
3
A true control group (without a device to walk) is not relevant as most participants would not have been able to walk without the exoskeleton

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