Exoskeleton & Gait Speed in Patients with Spinal Cord Injury

Purpose: Robot assisted gait training (RAGT) is an intervention used to improve gait in individuals with lower extremity motor dysfunction. The purpose of this review is to evaluate both prior and recent literature on the effectiveness of exoskeleton use as an intervention for gait speed in individuals with spinal cord injury. Methods: Electronic databases used in the search included PubMed, CINAHL, PEDro, & Scopus. Two reviewers searched all results from the databases and categorically organized relevant articles based on inclusion & exclusion criteria. Studies were included if they involved exoskeleton as an intervention for gait speed and were conducted on adults diagnosed with spinal cord injury. Results: 37 final articles were reviewed. The sample sizes ranged from 1 to 170 participants. Participant ages ranged from 18 to 81 years old. Duration of treatment ranged from a single session to 16 weeks, frequency ranging from 1-2 sessions to 5 per week. Length of sessions ranged from 20 to 90 minutes. The primary outcome measure for gait speed used in most studies was the 10MWT. Others included the 6MWT, 2MWT, TUG, treadmill speed, and motion capture analysis. Conclusion: The evidence suggests that the use of robotic assistance may effectively improve gait speed in individuals with spinal cord injury. However, evidence is inconclusive as to whether RAGT is more effective in improving gait speed when compared to other interventions. Studies report that robotic assisted interventions are safe & feasible interventions without adverse events or exacerbation of symptoms for patients of this population.