Effects of Robotic Use on Gait in People with Spinal Cord Injuries: A Systematic Review

Purpose: The purpose of this study was to describe and analyze current literature over the effects of robotic use on gait in people with SCI. Methods: Fifty-four studies with 988 participants with SCI were included. Electronic databases used were PubMed/MEDLINE, the Physiotherapy Evidence Database (PEDro), Scopus, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL). Key terms used were "Spinal Cord Injury AND Robotic/Exoskeleton AND Gait/Ambulation." Data search included published works to date (March 2019). Altogether, 1659 articles were extracted, 595 articles advanced to title review, 184 articles advanced to abstract review, 109 articles advanced to full article review, and 54 articles met the inclusion criteria. Studies were included if they met the criteria of diagnosis (any type of SCI), population (13-years-old and above), published in peer-reviewed journal, intervention (RGT), time since injury (acute and chronic injuries), and exoskeleton used (all types). Results: Of the 54 articles, ten studies were randomized control trials, five were quasi-experimental, twenty-four were single group design, seven were case series, and eight were case reports. Common outcome measures were 10-meter walk test (10MWT), 6-minute walk test (6MWT), Timed-Up-and-Go (TUG), Walking Index for Spinal Cord Injury - II (WISCI-II), and more. Conclusions: Most studies showed significant improvement in all outcome measures. According to the results of this study, it would be beneficial to incorporate RGT into the rehabilitation of patients with SCI to improve overall gait.