Lajeunesse Veronique, Vincent Claude, Routhier François, Careau Emmanuelle, Michaud François
a Centre for Interdisciplinary Research in Rehabilitation and Social Integration , Quebec , Canada .
b Department of Rehabilitation , Université Laval , Quebec , Canada .
Disabil Rehabil Assist Technol. 2016 Oct;11(7):535-47. doi: 10.3109/17483107.2015.1080766. Epub 2015 Sep 4.
Rehabilitation professionals have little information concerning lower limb exoskeletons for people with paraplegia. This study has four objectives: (1) Outline the characteristics of the exoskeletons' design and their usefulness evidence as assistive mobility devices in the community for the Rewalk™, Mina, Indego®, Ekso™ (previously known as the eLEGS™) and Rex®; (2) document functional mobility outcomes of using these exoskeletons; (3) document secondary skills and benefits achieved with these exoskeletons, safety, user satisfaction and applicability in the community; and (4) establish level of scientific evidence of the selected studies.
A systematic review of the literature (January 2004 to April 2014) was done using the databases PubMed, CINAHL and Embase and groups of keywords associated with "exoskeleton", "lower limb" and "paraplegia".
Seven articles were selected. Exoskeleton use is effective for walking in a laboratory but there are no training protocols to modify identified outcomes over the term usage (ReWalk™: 3 months, Mina: 2 months and Indego®: 1 session). Levels of evidence of selected papers are low.
The applicability and effectiveness of lower limb exoskeletons as assistive devices in the community have not been demonstrated. More research is needed on walking performance with these exoskeletons compared to other mobility devices and other training contexts in the community. Implications for rehabilitation Characteristics of the exoskeletons' design and their usefulness evidence as assistive mobility devices in the community are addressed for the Rewalk™, Mina, Indego®, Ekso™ and Rex® ReWalk™, Indego® and Mina lower limb exoskeletons are effective for walking in a laboratory for individuals with complete lower-level SCI. The ReWalk™ has the best results for walking, with a maximum speed of 0.51 m/s after 45 sessions lasting 60 to 120 min; it is comparable to the average speed per day or per week in a manual wheelchair. The level of scientific evidence is low. Other studies are needed to provide more information about performance over the longer term when walking with an exoskeleton, compared to wheelchair mobility, the user's usual locomotion, the use of different exoskeletons or the training context in which the exoskeleton is used.
康复专业人员对用于截瘫患者的下肢外骨骼了解甚少。本研究有四个目标：（1）概述Rewalk™、Mina、Indego®、Ekso™（前身为eLEGS™）和Rex®等外骨骼的设计特点及其作为社区辅助移动设备的有效性证据；（2）记录使用这些外骨骼后的功能移动结果；（3）记录使用这些外骨骼所获得的次要技能和益处、安全性、用户满意度以及在社区中的适用性；（4）确定所选研究的科学证据水平。
使用PubMed、CINAHL和Embase数据库以及与“外骨骼”、“下肢”和“截瘫”相关的关键词组，对2004年1月至2014年4月的文献进行系统综述。
筛选出7篇文章。外骨骼在实验室中对行走有效，但没有训练方案来改变长期使用后的既定结果（Rewalk™：3个月，Mina：2个月，Indego®：1次训练）。所选论文的证据水平较低。
下肢外骨骼作为社区辅助设备的适用性和有效性尚未得到证实。与其他移动设备以及社区中的其他训练环境相比，需要对这些外骨骼的行走性能进行更多研究。对康复的启示针对Rewalk™、Mina、Indego®、Ekso™和Rex®，阐述了外骨骼的设计特点及其作为社区辅助移动设备的有效性证据。Rewalk™、Indego®和Mina下肢外骨骼对完全性低位脊髓损伤患者在实验室中行走有效。Rewalk™在行走方面效果最佳，在持续60至120分钟的45次训练后，最高速度为0.51米/秒；这与手动轮椅每天或每周的平均速度相当。科学证据水平较低。与轮椅移动、用户通常的移动方式、使用不同外骨骼或使用外骨骼的训练环境相比，需要其他研究来提供更多关于使用外骨骼长期行走性能的信息。
