Literature DB >> 26340538

Exoskeletons' design and usefulness evidence according to a systematic review of lower limb exoskeletons used for functional mobility by people with spinal cord injury.

Veronique Lajeunesse1, Claude Vincent1,2, François Routhier1,2, Emmanuelle Careau1,2, François Michaud3,4.   

Abstract

PURPOSE: Rehabilitation professionals have little information concerning lower limb exoskeletons for people with paraplegia. This study has four objectives: (1) Outline the characteristics of the exoskeletons' design and their usefulness evidence as assistive mobility devices in the community for the Rewalk™, Mina, Indego®, Ekso™ (previously known as the eLEGS™) and Rex®; (2) document functional mobility outcomes of using these exoskeletons; (3) document secondary skills and benefits achieved with these exoskeletons, safety, user satisfaction and applicability in the community; and (4) establish level of scientific evidence of the selected studies.
METHOD: A systematic review of the literature (January 2004 to April 2014) was done using the databases PubMed, CINAHL and Embase and groups of keywords associated with "exoskeleton", "lower limb" and "paraplegia".
RESULTS: Seven articles were selected. Exoskeleton use is effective for walking in a laboratory but there are no training protocols to modify identified outcomes over the term usage (ReWalk™: 3 months, Mina: 2 months and Indego®: 1 session). Levels of evidence of selected papers are low.
CONCLUSIONS: The applicability and effectiveness of lower limb exoskeletons as assistive devices in the community have not been demonstrated. More research is needed on walking performance with these exoskeletons compared to other mobility devices and other training contexts in the community. Implications for rehabilitation Characteristics of the exoskeletons' design and their usefulness evidence as assistive mobility devices in the community are addressed for the Rewalk™, Mina, Indego®, Ekso™ and Rex® ReWalk™, Indego® and Mina lower limb exoskeletons are effective for walking in a laboratory for individuals with complete lower-level SCI. The ReWalk™ has the best results for walking, with a maximum speed of 0.51 m/s after 45 sessions lasting 60 to 120 min; it is comparable to the average speed per day or per week in a manual wheelchair. The level of scientific evidence is low. Other studies are needed to provide more information about performance over the longer term when walking with an exoskeleton, compared to wheelchair mobility, the user's usual locomotion, the use of different exoskeletons or the training context in which the exoskeleton is used.

Entities:  

Keywords:  Assistive technology; lower extremities; mobility device; paraplegia; powered exoskeleton; thoracic level injury

Mesh:

Year:  2015        PMID: 26340538     DOI: 10.3109/17483107.2015.1080766

Source DB:  PubMed          Journal:  Disabil Rehabil Assist Technol        ISSN: 1748-3107


  28 in total

Review 1.  Clinician-Focused Overview of Bionic Exoskeleton Use After Spinal Cord Injury.

Authors:  Anne E Palermo; Jennifer L Maher; Carsten Bach Baunsgaard; Mark S Nash
Journal:  Top Spinal Cord Inj Rehabil       Date:  2017

Review 2.  Robotic Rehabilitation and Spinal Cord Injury: a Narrative Review.

Authors:  Marwa Mekki; Andrew D Delgado; Adam Fry; David Putrino; Vincent Huang
Journal:  Neurotherapeutics       Date:  2018-07       Impact factor: 7.620

Review 3.  Wearable powered exoskeletons for gait training in tetraplegia: a systematic review on feasibility, safety and potential health benefits.

Authors:  Gonzalo Rodriguez Tapia; Ioannis Doumas; Thierry Lejeune; Jean-Gabriel Previnaire
Journal:  Acta Neurol Belg       Date:  2022-07-17       Impact factor: 2.471

4.  Accelerometry-enabled measurement of walking performance with a robotic exoskeleton: a pilot study.

Authors:  Luca Lonini; Nicholas Shawen; Kathleen Scanlan; William Z Rymer; Konrad P Kording; Arun Jayaraman
Journal:  J Neuroeng Rehabil       Date:  2016-03-31       Impact factor: 4.262

5.  The Cybathlon promotes the development of assistive technology for people with physical disabilities.

Authors:  Robert Riener
Journal:  J Neuroeng Rehabil       Date:  2016-05-31       Impact factor: 4.262

Review 6.  Mechatronic Wearable Exoskeletons for Bionic Bipedal Standing and Walking: A New Synthetic Approach.

Authors:  Gelu Onose; Vladimir Cârdei; Ştefan T Crăciunoiu; Valeriu Avramescu; Ioan Opriş; Mikhail A Lebedev; Marian Vladimir Constantinescu
Journal:  Front Neurosci       Date:  2016-09-29       Impact factor: 4.677

7.  A Biomechanical Comparison of Proportional Electromyography Control to Biological Torque Control Using a Powered Hip Exoskeleton.

Authors:  Aaron J Young; Hannah Gannon; Daniel P Ferris
Journal:  Front Bioeng Biotechnol       Date:  2017-06-30

Review 8.  Risk management and regulations for lower limb medical exoskeletons: a review.

Authors:  Yongtian He; David Eguren; Trieu Phat Luu; Jose L Contreras-Vidal
Journal:  Med Devices (Auckl)       Date:  2017-05-09

9.  Soft pneumatic elbow exoskeleton reduces the muscle activity, metabolic cost and fatigue during holding and carrying of loads.

Authors:  John Nassour; Martin Grimmer; Guoping Zhao
Journal:  Sci Rep       Date:  2021-06-15       Impact factor: 4.379

Review 10.  Clinical effectiveness and safety of powered exoskeleton-assisted walking in patients with spinal cord injury: systematic review with meta-analysis.

Authors:  Larry E Miller; Angela K Zimmermann; William G Herbert
Journal:  Med Devices (Auckl)       Date:  2016-03-22
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