Overground robotic training effects on walking and secondary health conditions in individuals with spinal cord injury: systematic review.
Federica Tamburella, Matteo Lorusso, Marco Tramontano and 3 others
PMID 35292044WHAT IT FOUND
Overground exoskeleton training in spinal cord injury reported walking-speed improvements in small, low-quality studies, but the evidence was too inconsistent to show it beats usual therapy.
Skin lesions, falls and fractures occurred.
Key findings
01In the group comparisons using the 10-meter walking test, all reported positive walking-speed trends, and three Ekso studies reported significant improvement.
02Thirteen studies reported adverse events, most often skin lesions; falls and bone fractures were less frequent.
03Group comparisons were present in only six studies and were highly heterogeneous; only Ekso studies compared exoskeleton training with conventional physical therapy.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
Most included studies were non-randomised; only one randomised trial was found, and it had a small sample. Study quality was poor or moderate overall, with weak internal validity due to lack of randomisation and blinding. Devices, training doses, participants and outcome measures varied widely, so results could not be combined or compared reliably. Only six studies had group comparisons, and only Ekso studies compared exoskeleton training with conventional physical therapy. Follow-up assessments were rare and inconsistent. Adverse events were not reported in many studies: 13 reported them, 11 said none occurred, and 17 did not address them. Drop-outs occurred in some studies, including adverse events such as ankle swelling, foot fractures and skin breakdown. Many participants' time since injury, lesion level or Asia Impairment Scale score were not specified.
Declared interests
No author conflicts of interest are reported in the supplied text. The paper is labelled as supported by non-U.S. government research.
The easy way to misread this
Do not conclude that overground exoskeleton training is proven better than conventional physical therapy. Only six studies had group comparisons, and the evidence was too heterogeneous to support that claim.