Gait rehabilitation in persons with spinal cord injury using innovative technologies: an observational study

Exoskeleton-based exercises for overground gait and balance rehabilitation in spinal cord injury: a systematic review of dose and dosage parameters

“…Nineteen (n = 19) full text articles were included in the review with a total of 288 participants (214 male) who underwent exoskeleton gait and/or balance training. Five (n = 5) studies had control/comparison groups treated with conventional physical therapy (n = 2) [ 41 , 42 ], Lokomat gait training (n = 1) [ 43 ], BWSTT or no intervention (n = 1) [ 44 ] and BWSTT with overground gait training with functional electrical stimulation (FES) (n = 1) [ 45 ]. One (n = 1) study had a comparison group of individuals with acute SCI/D who underwent the same exoskeleton protocol [ 46 ].…”

“…One (n = 1) study had a comparison group of individuals with acute SCI/D who underwent the same exoskeleton protocol [ 46 ]. As for the geographical distribution of study sites, five (n = 5) were developed in the United States [ 6 , 33 , 44 , 47 , 48 ], four (n = 4) in Italy [ 43 , 45 , 49 , 50 ], two (n = 2) in Canada [ 51 , 52 ], two (n = 2) in China [ 41 , 53 ] and two (n = 2) in Korea [ 54 , 55 ], one (n = 1) in France [ 56 ], one (n = 1) in Japan [ 46 ], one (n = 1) in South Africa [ 42 ], and one (n = 1) from a 7 site (Denmark, Germany, the Netherlands, Norway, Spain, Sweden and Switzerland) multicenter study in Europe [ 28 ], Fig. 2 displays the countries of origin for 18 studies, except for the multicenter study in Europe, which is the most active region investigating overground exoskeletons training for gait and balance rehabilitation among individuals with SCI/D.…”

“…The refined dataset included articles describing participants with subacute (1 to 5 months post-injury) or chronic (> 6- or 12-months post-injury) SCI/D. Thirteen (n = 13) studies investigated chronic SCI/D (> 6 months [ 46 , 51 ], > 12 months [ 6 , 42 – 44 , 48 , 52 , 54 – 57 ], stated it is chronic but did not report time since injury[ 50 ]), one study investigated subacute participants (from 1 to 11 months) [ 41 ] and five studies investigated both subacute and chronic participants [ 28 , 45 , 47 , 49 , 53 ]. The participant’s age ranged from 16 to 78 years, although one study included one participant that was 15 years old, however this paper was not included in our best practice recommendation because the authors did not find significant changes.…”

“…That study, however, had a mean participant age of 41.3 years [ 53 ]. Regarding the etiology of the injury, nine (n = 9) studies included individuals with SCI/D of traumatic and non-traumatic etiology (four chronic [ 6 , 43 , 44 , 51 ], four chronic and subacute [ 28 , 45 , 53 , 57 ], one subacute only [ 41 ]). Five (n = 5) studies only included individuals with traumatic lesions (four chronic [ 42 , 48 , 52 , 56 ] and one subacute and chronic [ 49 ]).…”

“…Four (n = 4) studies did not report the etiology (three chronic [ 50 , 54 , 55 ], one chronic and one subacute [ 47 ]). As for the extent of injury, twelve (n = 12) studies were conducted in individuals with complete or incomplete SCI/D [ 28 , 41 , 43 , 45 , 47 , 48 , 50 – 54 , 57 ], four (n = 4) studies in complete SCI/D only [ 6 , 49 , 55 , 56 ] and two (n = 2) studies in incomplete SCI/D [ 42 , 44 ]. One study did not report the extent of participant injury [ 46 ].…”