| Abstract [eng] |
The aim of research work: analyze the effects of exoskeleton use for gait training and mobility in the environment for patients with spinal cord injuries, by analyzing the performed research. Tasks of work: 1. By analyzing the results of the research involved in this systematic literature review, evaluate the effect of using exoskeleton on gait training for people with spinal cord injury. 2. By analyzing the results of the research involved in this systematic literature review, evaluate the effect of using exoskeleton on mobility in the environment for people with spinal cord injury. 3. Based on the findings of the research included in this systematic literature review, analyze the possibility of using an exoskeleton in a home or community setting. Materials and methods: A systematic literature review was performed based on the PRISMA (Preffered Reporting Item for Systematic Review and Meta–Analyses) provisions for systematic reviews. Scientific publications were searched in electronic databases subscribed by Vilnius University: PubMed (MEDLINE) and Web of Science (Clarivate Analytics). An advanced search of the databases found 960 scientific publications. The selected articles were intended to answer the question: is the use of exoskeletons effective for gait function and mobility of patients with spinal cord injuries in the environment? The search was performed from 2021.09.19 to 2022.03.20. Results: After applying the selection criteria, 14 articles were included in this systematic literature review. A total of 269 subjects participated in the selected studies. The ReWalk exoskeleton was used in 7 studies, the Indego exoskeleton in 2, and the EKSO exoskeleton in 6. Training period was very different in all studies included in the review. The number of training sessions ranged from 5 to 55, and the duration of one session ranged from 60 to 90 minutes, ranging from one to five sessions per week. The results of this systematic review showed that individuals with spinal cord injury were able to walk from 0,22 to 0,45 m./s. speed while using an exoskeleton during the 10 meter walk test. The distance walked during the 6 minute walk test ranged from 42 to 148,44 meters. The highest average speed was reached using the Indego exoskeleton and the maximum distance traveled using – ReWalk. The majority of adverse events reported were minor, including skin abrasions, pain, falls, fractures, and other skin problems. Participants' feedback after gait training with the exoskeleton was positive. Conclusion: 1. Exoskeletons can be safely used as a gait training intervention for individuals with spinal cord injuries. After exoskeleton training, subjects improved their six minute and ten meter walking test scores, as well as increased walking speed, distance, and total number of steps. 2. The mobility results reported in the studies indicate that the use of exoskeletons is effective for movement in a clinical setting. Exoskeleton training can be an effective way to increase mobility and independence of a person with spinal cord injury. 3. The results of this systematic literature review demonstrated that exoskeletons can be used to move safely in real conditions. The use of exoskeletons in the community may be limited, but their use in a home environment is possible. |
