ROBOTIC GAIT REHABILITATION METHODS AFTER INCOMPLETE SPINAL CORD INJURY: A REVIEW OF RESEARCH
DOI:
https://doi.org/10.31891/pcs.2025.2.13Keywords:
robotic rehabilitation methods, incomplete spinal cord injury (iSCI), motor recovery, rehabilitation of the TSM, walking assessmentAbstract
The use of robotic methods to restore walking after spinal cord injury is a promising area of modern rehabilitation that helps to improve patient independence.
This review article discusses the effectiveness of robotic methods of rehabilitation for patients with incomplete spinal cord injuries, their impact on walking recovery, and comparative characteristics of different methods.
The relevance of the article is due to the constant need to improve methods of functional recovery of patients with preserved motor activity. Robotic methods are an innovative approach that combines mechanical support with the potential of neuroplasticity. However, the question of the effectiveness of the intervention and the integration of these techniques into the practice of physical therapy remains open.
The aim of this study is to summarise current scientific data on the use of robotic methods for walking recovery after incomplete spinal cord injury, with a focus on the following impact indicators: speed, endurance and ability to move independently.
The study used a systematic review method that includes peer-reviewed scientific articles, observational studies, and clinical trials.
The results of the analysis showed that the use of robotic methods improves functional performance: speed, endurance and independence, as evidenced by tests: 6MWT, 10MWT and WISCI II.
The scientific novelty of the review is a comparative analysis of autonomous and combined robotic methods.
The practical significance of the work lies in the possibility of using the obtained conclusions by physical therapists to optimise the strategy of walking rehabilitation, as well as to select the most appropriate robotic means for implementation in clinical practice.
References
Ma T.-T. Effects of robotic-assisted gait training on motor function and walking ability in children with thoracolumbar incomplete spinal cord injury // NeuroRehabilitation. – 2022. – Т. 51, № 3. – С. 499–508. – DOI: 10.3233/NRE-220124.
Edwards D.J., Forrest G., Cortes M., Weightman M.M., Sadowsky C., Chang S.-H., Furman K., Bialek A., Prokup S., Carlow J., VanHiel L., Kemp L., Musick D., Campo M., Jayaraman A. Walking improvement in chronic incomplete spinal cord injury with exoskeleton robotic training (WISE): a randomized controlled trial // Spinal Cord. – 2022. – Vol. 60, No. 6. – P. 522–532. – DOI: 10.1038/s41393-022-00751-8.
Zieriacks A., Aach M., Brinkemper A., Koller D., Schildhauer T.A., Grasmücke D. Rehabilitation of acute vs. chronic patients with spinal cord injury with a neurologically controlled hybrid assistive limb exoskeleton: is there a difference in outcome? // Frontiers in Neurorobotics. – 2021. – Vol. 15. – Article 728327. – DOI: 10.3389/fnbot.2021.728327.
Gil Agudo Á., Megía García Á., Pons J.L., Sinovas Alonso I., Comino Suárez N., Lozano Berrio V., Del Ama A.J. Exoskeleton-based training improves walking independence in incomplete spinal cord injury patients: results from a randomized controlled trial // Journal of NeuroEngineering and Rehabilitation. – 2023. – Vol. 20, No. 1. – Article 36. – DOI: 10.1186/s12984-023-01158-z.
Aach M., Schildhauer T.A., Zieriacks A., Jansen O., Weßling M., Brinkemper A., Grasmücke D. Feasibility, safety, and functional outcomes using the neurological controlled Hybrid Assistive Limb exoskeleton (HAL®) following acute incomplete and complete spinal cord injury – results of 50 patients // The Journal of Spinal Cord Medicine. – 2023. – Vol. 46, No. 4. – P. 574–581. – DOI: 10.1080/10790268.2023.2200362.
Shin J.C., Jeon H.R., Kim D., Min W.K., Lee J.S., Choe S.I., Oh D.S., Yoo J. Effects of end-effector robot-assisted gait training on gait ability, muscle strength, and balance in patients with spinal cord injury // NeuroRehabilitation. – 2023. – Vol. 53, No. 3. – P. 335–346. – DOI: 10.3233/NRE-230085.
Stampacchia G., Olivieri M., Rustici A., D’Avino C., Gerini A., Mazzoleni S. Gait rehabilitation in persons with spinal cord injury using innovative technologies: an observational study // Spinal Cord. – 2020. – Vol. 58. – P. 988–997. – DOI: 10.1038/s41393-020-0454-2.
Gupta A., Prakash N.B., Honavar P.R. Gait training with robotic exoskeleton assisted rehabilitation system in patients with incomplete traumatic and non-traumatic spinal cord injury: a pilot study and review of literature // Annals of Indian Academy of Neurology. – 2023. – Vol. 26, Suppl. №1. – P. S26–S31. – DOI: 10.4103/aian.aian_1075_21.
Brinkemper A., Aach M., Grasmücke D., Jettkant B., Rosteius T., Dudda M., Yilmaz E., Schildhauer T.A. Improved physiological gait in acute and chronic SCI patients after training with wearable cyborg Hybrid Assistive Limb // Frontiers in Neurorobotics. – 2021. – Vol. 15. – Article 723206. – DOI: 10.3389/fnbot.2021.723206.
Koljonen P.A., Virk A.S., Jeong Y., McKinley M., Latorre J., Caballero A., Hu Y., Wong Y.W., Cheung K., Kazerooni H. Outcomes of a multicenter safety and efficacy study of the SuitX Phoenix powered exoskeleton for ambulation by patients with spinal cord injury // Frontiers in Neurology. – 2021. – Vol. 12. – Article 689751. – DOI: 10.3389/fneur.2021.689751.
Shin J.C., Jeon H.R., Kim D., Cho S.I., Min W.K., Lee J.S., Oh D.S., Yoo J. Effects on the motor function, proprioception, balance, and gait ability of the end-effector robot-assisted gait training for spinal cord injury patients // Brain Sciences. – 2021. – Vol. 11, No. 10. – Article 1281. – DOI: 10.3390/brainsci11101281.
Jansen O., Schildhauer T.A., Meindl R.C., Tegenthoff M., Schwenkreis P., Sczesny-Kaiser M., Grasmücke D., Fisahn C., Aach M. Functional outcome of neurologic-controlled HAL-exoskeletal neurorehabilitation in chronic spinal cord injury: a pilot with one year treatment and variable treatment frequency // Global Spine Journal. – 2017. – Vol. 7, No. 8. – P. 735–743. – DOI: 10.1177/2192568217713754.
Comino Suárez N., Moreno J.C., Megía García Á., Del Ama A.J., Serrano Muñoz D., Avendaño Coy J., Gil Agudo Á., Alcobendas Maestro M., López López E., Gómez Soriano J. Transcutaneous spinal cord stimulation combined with robotic-assisted body weight-supported treadmill training enhances motor score and gait recovery in incomplete spinal cord injury: a double-blind randomized controlled clinical trial // Journal of NeuroEngineering and Rehabilitation. – 2025. – Vol. 22, No. 1. – Article 15. – DOI: 10.1186/s12984-025-01545-8.
Marino R.J., Scivoletto G., Patrick M., Tamburella F., Read M.S., Burns A.S., Hauck W., Ditunno J. Walking index for spinal cord injury version 2 (WISCI-II) with repeatability of the 10-m walk time: inter- and intrarater reliabilities // American Journal of Physical Medicine & Rehabilitation. – 2010. – Vol. 89, No. 1. – P. 7–15. – DOI: 10.1097/PHM.0b013e3181c560eb.
Scivoletto G., Tamburella F., Laurenza L., Foti C., Ditunno J.F., Molinari M. Validity and reliability of the 10-m walk test and the 6-min walk test in spinal cord injury patients // Spinal Cord. – 2011. – Vol. 49, No. 6. – P. 736–740. – DOI: 10.1038/sc.2010.180.
Chang S.-H., Tseng S.-C., Su H., Francisco G.E. Editorial: how can wearable robotic and sensor technology advance neurorehabilitation? // Frontiers in Neurorobotics. – 2022. – Vol. 16. – Article 1033516. – DOI: 10.3389/fnbot.2022.1033516.
Hubli M., Dietz V. The physiological basis of neurorehabilitation – locomotor training after spinal cord injury // Journal of NeuroEngineering and Rehabilitation. – 2013. – Vol. 10. – Article 5. – DOI: 10.1186/1743-0003-10-5.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Наталія НЕСТЕРЧУК, Юрій КОВАЛЬЧУК
This work is licensed under a Creative Commons Attribution 4.0 International License.
