A multidimensional evaluation of the Atalante exoskeleton as an assistive locomotion device for individuals with complete paraplegia: a prospective longitudinal study in a controlled environment.
Eric Pantera, Nicolas Reneaud, Claude Bouscavert and 1 others
PMID 42343362WHAT IT FOUND
In 11 adults with complete paraplegia, supervised hands-free Atalante exoskeleton walking became faster to set up and take off, with rare harness-assisted near-falls, but one fracture occurred.
Use needs careful bone screening and supervised indoor setup.
Key findings
01Thirteen adults started the study, eleven completed the full protocol, and one withdrew after a tibial plateau fracture at session 7.
02Four near-fall events occurred across 651 sessions under an overhead rail and harness fall-arrest system.
03During a 6-minute walk, perceived exertion fell from 2.6 to 1.1 on the Borg scale, while oxygen consumption, walking speed and cost of transport did not show significant change.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Thirteen adults started and eleven completed the protocol, so the study was small and single-group, with no control condition. The environment was indoor and supervised, with an overhead rail and harness fall-arrest system, so the findings do not show what happens in home or community mobility. Atalante version 1.0 could not turn autonomously, so a therapist assisted a 180-degree turn between walking bouts. The protocol assessed prerequisite tasks, not unsupervised transfers, household navigation, outdoor walking, or social participation. One serious tibial plateau fracture occurred despite screening, and the proposed bone densitometry threshold requires confirmation in larger cohorts. Two participants discontinued, one after a fracture and one after 22 sessions due to perceived lack of functional benefit.
The easy way to misread this
Do not conclude that the exoskeleton restores walking or is safe for unsupervised community use. It was used indoors with close therapist supervision and an overhead harness, and one participant had a tibial plateau fracture.