Wearable robotic exoskeleton for gait reconstruction in patients with spinal cord injury: A literature review

Journal of Orthopaedic Translation, 2021 · DOI: https://doi.org/10.1016/j.jot.2021.01.001 · Published: January 7, 2021

Spinal Cord Injury Assistive Technology Rehabilitation

Simple Explanation

Wearable robotic exoskeletons (WREs) are being developed to help patients with spinal cord injuries (SCI) regain their ability to walk. This review looks at studies published between 2015 and 2020, focusing on the type of SCI, training provided, and walking performance achieved with different WREs. The review also explores the amount of assistance needed and walking aids used by patients with cervical SCI when using WREs, to inform device selection and development.

Study Duration

Not specified

Participants

228 patients with spinal cord injury

Evidence Level

Review Article

Key Findings

1
T6 was the most frequently reported level of SCI among WRE users.
2
Training procedures varied significantly across studies in terms of session number, duration, and frequency.
3
The average gait speed achieved with WREs was 0.31 m/s, and the average distance covered in a 6-minute walk test was 108.9 m.
4
Among patients with cervical SCI, 59.2% were able to walk with WREs without physical assistance.

Research Summary

This review summarizes clinical trials on wearable robotic exoskeletons (WREs) for gait reconstruction in patients with spinal cord injury (SCI) published from 2015 to 2020. The review identifies the distribution of participants’ neurological level of SCI, amount of training, and gait performance among different WREs. It also explores the number of persons for assistance and the walking aid used among patients with cervical level injury.

Practical Implications

Device Selection

The findings enable evidence-based decision-making in selecting the optimal WRE according to residual motor function of patients with SCI.

Training Standardization

The review highlights the need for standardized training procedures to reduce variability and improve predictability of outcomes.

Further Development

The subgroup exploration provides a new perspective on further development of appropriate WREs for patients with cervical level injury.

Study Limitations

1
The review only included articles published up to 2020, and the field is rapidly advancing.
2
There was a lack of various evaluations except for the 10- and 6-m walk test.
3
There were no reports of subjective perceptions that adequately helped to choose WREs based on the selected studies of the present review.

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