Robotic Exoskeleton Gait Training for Inpatient Rehabilitation in a Young Adult with Traumatic Brain Injury

Nolan, Karen J.; Karunakaran, Kiran K.; Ehrenberg, Naphtaly; Kesten, Adam

doi:10.1109/embc.2018.8512745

“…Observational studies ( n = 35 ; 40.2%) represented the most frequent study design among the selected studies, followed by pilot studies ( n = 31 ; 35.6%), experimental validations ( n = 15 ; 17.2%) and experimental studies ( n = 6 ; 6.9%). It should also be pointed out that only 10 out of the 87 studies presented a follow-up evaluation after the intervention with the device [19,47,65,[89][90][91][92][93][94][95].…”

Section: Methodsmentioning

confidence: 99%

Systematic review on wearable lower-limb exoskeletons for gait training in neuromuscular impairments

Rodríguez-Fernández

¹

,

Lobo-Prat

²

,

Font-Llagunes

³

2021

J NeuroEngineering Rehabil

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Gait disorders can reduce the quality of life for people with neuromuscular impairments. Therefore, walking recovery is one of the main priorities for counteracting sedentary lifestyle, reducing secondary health conditions and restoring legged mobility. At present, wearable powered lower-limb exoskeletons are emerging as a revolutionary technology for robotic gait rehabilitation. This systematic review provides a comprehensive overview on wearable lower-limb exoskeletons for people with neuromuscular impairments, addressing the following three questions: (1) what is the current technological status of wearable lower-limb exoskeletons for gait rehabilitation?, (2) what is the methodology used in the clinical validations of wearable lower-limb exoskeletons?, and (3) what are the benefits and current evidence on clinical efficacy of wearable lower-limb exoskeletons? We analyzed 87 clinical studies focusing on both device technology (e.g., actuators, sensors, structure) and clinical aspects (e.g., training protocol, outcome measures, patient impairments), and make available the database with all the compiled information. The results of the literature survey reveal that wearable exoskeletons have potential for a number of applications including early rehabilitation, promoting physical exercise, and carrying out daily living activities both at home and the community. Likewise, wearable exoskeletons may improve mobility and independence in non-ambulatory people, and may reduce secondary health conditions related to sedentariness, with all the advantages that this entails. However, the use of this technology is still limited by heavy and bulky devices, which require supervision and the use of walking aids. In addition, evidence supporting their benefits is still limited to short-intervention trials with few participants and diversity among their clinical protocols. Wearable lower-limb exoskeletons for gait rehabilitation are still in their early stages of development and randomized control trials are needed to demonstrate their clinical efficacy.

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“…Exoskeleton-aided locomotion has several advantages over traditional gait training and rehabilitation, including lower exhaustion rates for patients and physiotherapists [12], improved gait motion [16], and expanded terrain and location options for training [6]. Most, but not all, exoskeletons fully support the body weight of the wearer, allowing patients to walk fully upright using proper body mechanics, which potentially strengthens muscles and neural motor skills that would not otherwise be engaged [11,17].…”

Section: Introductionmentioning

confidence: 99%

Physiotherapists’ Experiences Using the Ekso Bionic Exoskeleton with Patients in a Neurological Rehabilitation Hospital: A Qualitative Study

Read

¹

,

Woolsey

²

,

McGibbon

³

et al. 2020

Rehabilitation Research and Practice

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Use of bionic overground exoskeletons to assist with neurological rehabilitation is becoming increasingly prevalent and has important implications for physiotherapists and their patients. Yet, there is a paucity of research about the impact of integrating this technology on physiotherapists’ work. The purpose of this study was to explore how the training and implementation of using the Ekso robotic exoskeleton with patients affects physiotherapists’ work. An exploratory qualitative study of three physiotherapists working at a neurological rehabilitation centre in Eastern Canada was conducted using one-on-one semistructured interviews in July 2017. Audio recordings were transcribed verbatim, and data was coded and analyzed using thematic analysis. Six themes emerged from the data: developing organizational capacity; ethical use of technology; benefits of the equipment; challenges of the equipment; cognitive workload; and the technological environment. The results suggest that the adoption and integration of bionic exoskeletons into rehabilitation practice is not as simple as training physiotherapists and giving them the device. More research is needed to understand the increased cognitive demands of working with patients using technologically advanced exoskeletons within a dynamic, technology-rich healthcare environment, while managing patient expectations and ethical use.

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“…Observational studies (n=35; 40.2%) represented the most frequent study design among the selected studies, followed by pilot studies (n=31; 35.6%), experimental validations (n=15; 17.2%) and experimental studies (n=6; 6.9%). It should also be pointed out that only 10 out of the 87 studies presented a follow-up evaluation after the intervention with the device [19,47,65,[89][90][91][92][93][94][95]. The average time elapsed between the study and the follow-up evaluation was 2 months, ranging from 1 week [65] to 1 year [19].…”

Section: Methodsmentioning

confidence: 99%

Systematic Review on Wearable Lower-Limb Exoskeletons for Gait Training in Neuromuscular Impairments

Rodríguez-Fernández

¹

,

Lobo-Prat²,

Font-Llagunes

³

2020

Preprint

View full text Add to dashboard Cite

Gait disorders can reduce the quality of life for people with neuromuscular impairments. Therefore, walking recovery is one of the main priorities for counteracting sedentary lifestyle, reducing secondary health conditions and restoring legged mobility. At present, wearable powered lower-limb exoskeletons are emerging as a revolutionary technology for robotic gait rehabilitation. This systematic review provides a comprehensive overview on wearable lower-limb exoskeletons for people with neuromuscular impairments, addressing the following three questions: (1) what is the current technological status of wearable lower-limb exoskeletons for gait rehabilitation?, (2) what is the methodology used in the clinical validations of wearable lower-limb exoskeletons?, and (3) what are the benefits and current evidence on clinical efficacy of wearable lower-limb exoskeletons? We analyzed 87 clinical studies focusing on both device technology (e.g., actuators, sensors, structure) and clinical aspects (e.g., training protocol, outcome measures, patient impairments), and make available the database with all the compiled information. The results of the literature survey reveal that wearable exoskeletons have potential for a number of applications including early rehabilitation, promoting physical exercise, and carrying out daily living activities both at home and the community. Likewise, wearable exoskeletons may improve mobility and independence in non-ambulatory people, and may reduce secondary health conditions related to sedentariness, with all the advantages that this entails. However, the use of this technology is still limited by heavy and bulky devices, which require supervision and the use of walking aids. In addition, evidence supporting their benefits is still limited to short-intervention trials with few participants and diversity among their clinical protocols. Wearable lower-limb exoskeletons for gait rehabilitation are still in their early stages of development and randomized control trials are needed to demonstrate their clinical efficacy.

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Robotic Exoskeleton Gait Training for Inpatient Rehabilitation in a Young Adult with Traumatic Brain Injury

Cited by 16 publications

References 10 publications

Systematic review on wearable lower-limb exoskeletons for gait training in neuromuscular impairments

Systematic review on wearable lower-limb exoskeletons for gait training in neuromuscular impairments

Physiotherapists’ Experiences Using the Ekso Bionic Exoskeleton with Patients in a Neurological Rehabilitation Hospital: A Qualitative Study

Systematic Review on Wearable Lower-Limb Exoskeletons for Gait Training in Neuromuscular Impairments

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