Therapeutic use of exoskeletons in spinal cord injury gait rehabilitation - a systematic literature review

Abstract

The purpose of this thesis was to research the effectiveness of using exoskeletons in robot-assisted therapy for gait restoration in people with spinal cord injury (SCI). The research for this thesis was carried out in a form of a literature review to address the effectiveness of exoskeletons in improving walking speed and walking distance compared to other physiotherapeutic approaches. The theoretical content of the thesis includes background on spinal cord injuries with anatomy of the spinal cord, modalities used in rehabilitation of gait in population with spinal cord injuries and a presen-tation of different exoskeletons that are used in robot-assisted gait rehabilitation.

The search for full and freely available articles was made using four different data-bases: Medline/Pubmed, Cochrane Library, Ebsco Host and Science Direct. Four dif-ferent articles were found but only three of them were assessed further after applying the PEDro scale. All studies used the same type of exoskeleton (Lokomat) and com-pared it to other approaches.

Robot-assisted gait rehabilitation was found not to be any more effective compared to other modes of physiotherapy, such as treadmill-based training with manual assis-tance, treadmill-based training with stimulation, overground training with stimula-tion, and strength training. It appears that conventional gait training on a treadmill and muscle strength training yield better results in walking speed and distance, and overground locomotor training shows greater improvements in functional walking capacity than treadmill-based training.