Hohl Kristen, Giffhorn Matt, Jackson Steven, Jayaraman Arun
Shirley Ryan AbilityLab, 355 E. Erie St. , 60611, Chicago, IL, USA.
Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, 60611, Chicago, IL, USA.
J Neuroeng Rehabil. 2022 Oct 29;19(1):115. doi: 10.1186/s12984-022-01083-7.
Exoskeletons are externally worn motorized devices that assist with sit-to-stand and walking in individuals with motor and functional impairments. The Food & Drug Administration (FDA) has approved several of these technologies for clinical use however, there is limited evidence to guide optimal utilization in every day clinical practice. With the diversity of technologies & equipment available, it presents a challenge for clinicians to decide which device to use, when to initiate, how to implement these technologies with different patient presentations, and when to wean off the devices. Thus, we present a clinical utilization framework specific to exoskeletons with four aims.These aims are to assist with clinical decision making of when exoskeleton use is clinically indicated, identification of which device is most appropriate based on patient deficits and device characteristics, providing guidance on dosage parameters within a plan of care and guidance for reflection following utilization. This framework streamlines how clinicians can approach implementation through the synthesis of published evidence with appropriate clinical assessment & device selection to reflection for success and understanding of these innovative & complex technologies.
外骨骼是一种可穿戴的电动设备，用于辅助运动和功能受损的个体完成从坐到站以及行走的动作。美国食品药品监督管理局（FDA）已批准其中几种技术用于临床，但在日常临床实践中，指导最佳使用的证据有限。鉴于现有技术和设备的多样性，临床医生在决定使用哪种设备、何时开始使用、如何针对不同患者情况实施这些技术以及何时停用设备方面面临挑战。因此，我们提出了一个针对外骨骼的临床应用框架，该框架有四个目标。这些目标是协助临床决策，确定何时临床上适合使用外骨骼；根据患者缺陷和设备特性确定最合适的设备；在护理计划中提供剂量参数指导；以及在使用后提供反思指导。该框架通过将已发表的证据与适当的临床评估和设备选择相结合，简化了临床医生实施外骨骼的方法，以便反思成功经验并理解这些创新且复杂的技术。
