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Review of hybrid exoskeletons to restore gait following spinal cord injury

Review of hybrid exoskeletons to restore gait following spinal cord injury. Antonio J. del-Ama, Eng MSc; Aikaterini D. Koutsou, Eng MSc; Juan C. Moreno, Eng PhD; Ana de-los-Reyes, Eng MSc; Ángel Gil-Agudo, MD, PhD; José L. Pons, Prof Eng PhD. Aim

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Review of hybrid exoskeletons to restore gait following spinal cord injury

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  1. Review of hybrid exoskeletons to restore gait following spinal cord injury Antonio J. del-Ama, Eng MSc; Aikaterini D. Koutsou, Eng MSc; Juan C. Moreno, Eng PhD; Ana de-los-Reyes, Eng MSc; Ángel Gil-Agudo, MD, PhD; José L. Pons, Prof Eng PhD

  2. Aim • Review hybrid lower-limb exoskeletons, related technologies, advances in actuation and control systems, and functional assessment of individuals with spinal cord injury. • Relevance • Combination of functional electrical stimulation (FES) technology and exoskeletons brings together technologies, methods, and rehabilitation principles that can overcome drawbacks of each individual approach.

  3. Methods • Searched Medline, Science Direct, IEEE Xplore digital library, and Google Scholar databases. • Final database contained 34 articles, which became main information source of this article.

  4. Hybrid Exoskeletons Left: Controlled-brake orthosis (CBO) exoskeleton. Right: CBO under clinical trial. WalkTrainer. Variable hip constraint mechanism exoskeleton.

  5. Conclusions • Hybrid technologies can produce feasible systems in which exoskeleton provides FES with adequate control of joint movement, reducing system’s energy requirements. • Assist-as-needed control strategies must also be implemented. • Systems should challenge users to walk in real environments. • Clinical evaluation must address gait performance, user-perception, and physiological cost through clinically validated functional scales and protocols.

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