What influences walking speed and skill acquisition when using an exoskeleton?

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

Among individuals with SCI who use current exoskeleton devices, the average walking speed is 0.26 meters per second. This speed is fairly slow, and is lower than the average speed required to walk proficiently in the community (0.8 meters per second) and to cross the street safely (1.06 meters per second). However, walking speed in an exoskeleton is subject to improvement, depending on various factors.

Some factors that influence walking speed include age, level and type of injury, and the amount of training one receives. There is some (weak) evidence suggesting that those with incomplete, lower level SCI are more likely to exhibit faster walking speeds. In particular, one (weak evidence) study found that those with lower level paraplegia (i.e., T9-L1) were able to walk at significantly higher speeds. Moreover, there was a weak correlation between older age and faster walking speeds (i.e., older adults walk slightly faster than younger adults), though this could be related to the age-related difference in injury severity (that is, older individuals had lower levels of injury). No correlation was found with a greater time since injury.

What factors influence skill acquisition?

The time it takes to acquire proficient skills to walk in an exoskeleton varies greatly, ranging from 6-23 sessions. A variety of factors influence skill acquisition, including lifestyle, age, age at injury, and body mass index (BMI). Weak evidence suggests that an active lifestyle is the most important predictor of skill performance, although being younger and having a lower BMI are also associated with higher skill level. Additionally, the authors note that while having a lower level of injury was a positive predictor of skill between 2-4 weeks of using an exoskeleton, it did not predict final skill levels.

The type of exoskeleton being used may also influence skill acquisition. For example, weak evidence notes that a device with more support to the torso may facilitate skill acquisition as it provides more stability. Although we have summarized the research on factors influencing skill acquisition, the type of exoskeleton used in each study was not accounted for. As a result, we are unable to tease apart the effects of the aforementioned factors (e.g., lifestyle, age, BMI) and of the exoskeleton type on acquiring skills. The time it takes to acquire proficient skills to walk in an exoskeleton varies greatly, ranging from 6-23 sessions. A variety of factors influence skill acquisition, including lifestyle, age, age at injury, and body mass index (BMI). Weak evidence suggests that an active lifestyle is the most important predictor of skill performance, although being younger and having a lower BMI are also associated with higher skill level. Additionally, the authors note that while having a lower level of injury was a positive predictor of skill between 2-4 weeks of using an exoskeleton, it did not predict final skill levels.