The exoskeleton expansion: improving walking and running economy.

The review included only studies that reported improvement, so studies where exoskeletons did not help were left out. The included studies were laboratory treadmill tests, not clinical use in homes, communities, or rehabilitation settings. The main outcome was energy cost during walking or running, not a patient-centred outcome such as walking distance, function, pain, or falls. Some devices helped only when the task was made harder, such as carrying load, walking on a slope, climbing stairs, or taking long steps, and did not significantly reduce cost during level-ground walking. Tethered and autonomous systems were not compared under common conditions, because devices, speeds, and controllers varied.

Funded by the National Science Foundation, the U.S. Army Natick Soldier Research, Development and Engineering Center, and the National Institute on Aging. No author competing-interests statement is given in the supplied text.

Do not read the 3.3% to 19.8% walking reductions as evidence that exoskeletons improve patient mobility. The review selected only studies that reported improvement, and the studies measured energy cost in laboratory walking or running, not clinical function.