Gorgey Ashraf S
Spinal Cord Injury and Disorders Center, Hunter Holmes McGuire VAMC, Richmond, VA 23249, United States.
World J Orthop. 2018 Sep 18;9(9):112-119. doi: 10.5312/wjo.v9.i9.112.
Robotic exoskeletons have emerged as rehabilitation tool that may ameliorate several of the existing health-related consequences after spinal cord injury (SCI). However, evidence to support its clinical application is still lacking considering their prohibitive cost. The current mini-review is written to highlight the main limitations and potential benefits of using exoskeletons in the rehabilitation of persons with SCI. We have recognized two main areas relevant to the design of exoskeletons and to their applications on major health consequences after SCI. The design prospective refers to safety concerns, fitting time and speed of exoskeletons. The health prospective refers to factors similar to body weight, physical activity, pressure injuries and bone health. Clinical trials are currently underway to address some of these limitations and to maximize the benefits in rehabilitation settings. Future directions highlight the need to use exoskeletons in conjunction with other existing and emerging technologies similar to functional electrical stimulation and brain-computer interface to address major limitations. Exoskeletons have the potential to revolutionize rehabilitation following SCI; however, it is still premature to make solid recommendations about their clinical use after SCI.
机器人外骨骼已成为一种康复工具，可能会改善脊髓损伤（SCI）后现有的一些与健康相关的后果。然而，考虑到其高昂的成本，支持其临床应用的证据仍然不足。当前的这篇小型综述旨在强调在脊髓损伤患者康复中使用外骨骼的主要局限性和潜在益处。我们认识到与外骨骼设计及其对脊髓损伤后主要健康后果的应用相关的两个主要领域。设计方面涉及外骨骼的安全问题、适配时间和速度。健康方面涉及与体重、身体活动、压疮和骨骼健康等类似的因素。目前正在进行临床试验以解决其中一些局限性，并在康复环境中最大化益处。未来的方向强调需要将外骨骼与其他现有的和新兴的技术（如功能性电刺激和脑机接口）结合使用，以解决主要局限性。外骨骼有潜力彻底改变脊髓损伤后的康复；然而，就其在脊髓损伤后的临床使用做出确凿的推荐仍为时过早。
