Minireviews
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Sep 18, 2018; 9(9): 112-119
Published online Sep 18, 2018. doi: 10.5312/wjo.v9.i9.112
Robotic exoskeletons: The current pros and cons
Ashraf S Gorgey
Ashraf S Gorgey, Spinal Cord Injury and Disorders Center, Hunter Holmes McGuire VAMC, Richmond, VA 23249, United States
Ashraf S Gorgey, Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA 23249, United States
Author contributions: Gorgey AS solely contributed to this paper.
Conflict-of-interest statement: The author has nothing to declare related to the current work.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Ashraf S Gorgey, PhD, Academic Research, Associate Professor, Physiotherapist, Research Scientist, Spinal Cord Injury and Disorders Center, Hunter Holmes McGuire VAMC, 1201 Broad Rock Boulevard, Richmond, VA 23249, United States. ashraf.gorgey@va.gov
Telephone: +1-804-6755000 Fax: +1-804-6755223
Received: April 3, 2018
Peer-review started: April 3, 2018
First decision: June 5, 2018
Revised: July 2, 2018
Accepted: July 10, 2018
Article in press: July 10, 2018
Published online: September 18, 2018
Abstract

Robotic exoskeletons have emerged as rehabilitation tool that may ameliorate several of the existing health-related consequences after spinal cord injury (SCI). However, evidence to support its clinical application is still lacking considering their prohibitive cost. The current mini-review is written to highlight the main limitations and potential benefits of using exoskeletons in the rehabilitation of persons with SCI. We have recognized two main areas relevant to the design of exoskeletons and to their applications on major health consequences after SCI. The design prospective refers to safety concerns, fitting time and speed of exoskeletons. The health prospective refers to factors similar to body weight, physical activity, pressure injuries and bone health. Clinical trials are currently underway to address some of these limitations and to maximize the benefits in rehabilitation settings. Future directions highlight the need to use exoskeletons in conjunction with other existing and emerging technologies similar to functional electrical stimulation and brain-computer interface to address major limitations. Exoskeletons have the potential to revolutionize rehabilitation following SCI; however, it is still premature to make solid recommendations about their clinical use after SCI.

Keywords: Spinal cord injury, Exoskeleton, Robotics, Rehabilitation, Locomotion

Core tip: Robotic exoskeletons have emerged as rehabilitation tool for persons with spinal cord injury (SCI). Clinical evidence related to applications of exoskeletons is still lacking considering their prohibitive cost. Clinical trials are currently underway to address some of these limitations and to maximize their benefits in different rehabilitation settings. Exoskeletons have the potential to revolutionize rehabilitation following SCI; however, it is still premature to make solid recommendations about their clinical use after SCI. The current mini-review highlights the basic applications and limitations as well as future directions regarding applications and exoskeletons.