PTOTRCTJournal of neuroengineering and rehabilitation2018

The effects of gait training using powered lower limb exoskeleton robot on individuals with complete spinal cord injury.

Cheng-Hua Wu, Hui-Fen Mao, Jwu-Sheng Hu and 3 others

PMID 29506530

WHAT IT FOUND

Two men with complete spinal cord injury walked faster and reported less effort using a new powered exoskeleton than with a traditional knee-ankle-foot orthosis.

They also put the device on and took it off more quickly. No falls or skin injuries occurred.

Key findings

01Both participants completed functional walking tests approximately 1.2 to 3.5 times faster when using the powered exoskeleton compared to the KAFO.

02Perceived exertion was lower during the 6-minute walk test with the exoskeleton (RPE 5–6) than with the KAFO (RPE 8).

03Participants could independently don and doff the exoskeleton within 5 minutes, which was faster than using the KAFO.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTs

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What it does not show

The study included only two participants, making it impossible to generalize the findings to the broader population with spinal cord injury. There was no control group receiving standard care alone; the comparison was within-subject between two devices. The participants were already experienced walkers with KAFOs, so results may not apply to those new to ambulation training. The study was not blinded, and outcomes like perceived exertion are subjective. The training protocol was newly established and has not been validated in a larger sample.

Declared interests

The study was funded by the Industrial Technology Research Institute, the Ministry of Science and Technology in Taiwan, and National Taiwan University. The authors did not declare any specific financial conflicts of interest related to commercial exoskeleton products.

The easy way to misread this

Do not interpret the improved speed and reduced exertion as proof that this exoskeleton is superior to current devices for all patients with spinal cord injury. These results come from only two experienced walkers in a pilot study, so the magnitude of benefit and safety profile are not yet established.

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