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

J Neuroeng Rehabil

Biomechanical Engineering Lab, Department of Mechanical Engineering and Research Center for Biomedical Engineering, Universitat Politècnica de Catalunya, Diagonal 647, 08028, Barcelona, Spain.

Published: February 2021

AI Article Synopsis

  • Gait disorders significantly impact the quality of life for individuals with neuromuscular impairments, making walking recovery a key focus for improving mobility and reducing health issues.
  • This systematic review evaluates wearable lower-limb exoskeletons, examining their current technology, clinical validation methodologies, and potential benefits for patients with neuromuscular conditions.
  • Despite their promise in enhancing rehabilitation and mobility, challenges such as device bulkiness, the need for supervision, and limited research evidence currently restrict the widespread use of these exoskeletons.

Article Abstract

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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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7852187PMC
http://dx.doi.org/10.1186/s12984-021-00815-5DOI Listing

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