What are exoskeletons used for?

Author: Sharon Jang | Reviewer: Riley Louie | Published: 7 April 2021 | Updated: ~

While there are many purported benefits of using robotic exoskeletons among individuals with SCI, strong research evidence is lacking. Exoskeletons are largely used to enhance mobility in SCI, where they can be used for walk (gait) training during rehabilitation or in the community (at home) to perform simple daily activities. Although further research is required, some research has suggested that walking with an exoskeleton may have additional health benefits:

There are mixed findings regarding the effects of exoskeletal walking on spasticity. Many (weak evidence) studies have found that using exoskeletons can result in decreased spasticity. Despite these noted benefits, one weak evidence study reported mixed findings on spasticity as 26.7% of their study sample saw a decrease in spasticity, while 62.2% of participants saw no change and 11.1% saw an increase in spasticity. The impact of exoskeletal walking on spasticity may be related to the user’s baseline level of spasticity. In a weak evidence study, users who had low levels of spasticity prior to using an exoskeleton experienced an increase in spasticity; however, this increase in spasticity ultimately decreased over 12 weeks back to near zero. Individuals who already had high levels of spasticity prior to walking in an exoskeleton saw no changes in spasticity.

There is some weak research evidence that suggests walking with an exoskeleton can help with various bowel functions, including improved regularity of bowel movements, less time required for bowel management, and decreased enema dose. However, two (weak evidence) studies have found no effects on bowel function.

After SCI, bone mineral density in the legs declines at rapid rates due to inactivity and weight bearing activities have the potential to help restore bone mineral density. One study (weak evidence) found that walking in an exoskeleton may increase bone mineral density up to 14% with 6 weeks of training.

Some research (weak evidence) suggests that walking in an exoskeleton can provide good exercise for the heart and upper and lower limb strength in those with incomplete SCI. More details about the effect of exoskeletons on fitness are discussed below in the section:

A few studies (weak evidence) report a decrease in pain with exoskeleton use, with one n

oting a reduction in pain, but not enough to significantly impact everyday life (i.e., clinical significance). On the other hand, some weak evidence studies have found no effect of exoskeleton walking on pain.

There is some weak research evidence that walking in an exoskeleton may help avoid the negative effects of prolonged standing or sitting  (e.g., pressure ulcers).

Refer to our articles on Pressure Sores, Pain and Spasticity for more information!