How does walking with an exoskeleton change over time?

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

Using an exoskeleton requires practice. Although walking in an exoskeleton may seem daunting at first, research suggests that walking proficiency improves over time. In both newly injured (i.e., less than 6 months since injury) and chronically injured individuals with SCI, weak evidence shows that walking in the exoskeleton improves over time.

You get faster

Among newly injured individuals, weak evidence from one study suggests that walking speed in an exoskeleton becomes 3.2x faster after 25 1-hour training sessions. Moreover, these individuals were able to walk further in an exoskeleton after their training sessions. Among chronically injured individuals, similar trends are seen with increases in exoskeleton walking speed in two weak evidence studies. In another weak evidence study, it was found that 21 sessions were required to achieve the near-maximal walking speed at the end of a 12-week period, while 62 sessions were required to achieve near-maximal walking distance.

Less effort is Required

There is both weak and moderate evidence suggesting that the amount of effort it takes to walk using an exoskeleton decreases over time. This has been evaluated both subjectively (i.e., people feel like walking in an exoskeleton is not as hard over time) and physiologically (i.e., less demand on your body). This suggests that individuals are able to walk longer distances with lower effort after training to use an exoskeleton.

Is using an exoskeleton different for those with acute injuries versus chronic injuries?

Researchers have noted differences in exoskeleton use among newly injured (e.g., in patients) and chronically injured individuals with respect to adverse effects and benefits received. Among people who have recently sustained an SCI, weak evidence indicates that the most common adverse effect was orthostatic hypotension (a sudden drop in blood pressure). One study found that orthostatic hypotension commonly occurred after the first stand or after pauses (e.g., to take vitals, or to turn). However, the frequency of orthostatic hypotension episodes tapered off after a couple of sessions. Furthermore, another study (weak evidence) suggests that newly injured individuals may see improvements in their independence and quality of life, whereas those with chronic injuries do not. More research is required to determine the significance of differences between acutely injured and chronically injured individuals who use exoskeletons.