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Use of Lower-Limb Robotics to Enhance Practice and Participation in Individuals With Neurological Conditions

Jayaraman, Arun PT, PhD; Burt, Sheila BS; Rymer, William Zev MD, PhD

doi: 10.1097/PEP.0000000000000379
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Purpose: To review lower-limb technology currently available for people with neurological disorders, such as spinal cord injury, stroke, or other conditions. We focus on 3 emerging technologies: treadmill-based training devices, exoskeletons, and other wearable robots.

Summary of Key Points: Efficacy for these devices remains unclear, although preliminary data indicate that specific patient populations may benefit from robotic training used with more traditional physical therapy. Potential benefits include improved lower-limb function and a more typical gait trajectory.

Statement of Conclusions: Use of these devices is limited by insufficient data, cost, and in some cases size of the machine. However, robotic technology is likely to become more prevalent as these machines are enhanced and able to produce targeted physical rehabilitation.

Recommendations for Clinical Practice: Therapists should be aware of these technologies as they continue to advance but understand the limitations and challenges posed with therapeutic/mobility robots.

This is a review lower-limb technology currently available for persons with neurological disorders, such as spinal cord injury, stroke, or other conditions. We focus on three emerging technologies: treadmill-based training devices, exoskeletons, and wearable robots.

Max Nader Center for Rehabilitation Technologies & Outcomes, Center for Bionic Medicine, Rehabilitation Institute of Chicago, and Departments of Physical Medicine & Rehabilitation, Physiology, and Biomedical Engineering, Northwestern University, Chicago, Illinois (Dr Jayaraman); Center for Bionic Medicine (Ms Burt), Rehabilitation Institute of Chicago, Illinois; and Sensory Motor Performance Program, Rehabilitation Institute of Chicago, and Departments of Physical Medicine & Rehabilitation, Physiology, and Biomedical Engineering (Dr Rymer), Northwestern University, Chicago, Illinois.

Correspondence: Arun Jayaraman, PT, PhD, Rehabilitation Institute of Chicago, 1771, 345 E. Superior St, Chicago, IL 60611 (ajayaraman@ricres.org).

Grant Support: HHS grant award number 90RE5010-01-01; NIDILRR grant number 90RE5014-02-00.

The views expressed in this article are the authors' own and do not reflect the official position of any institution or funder.

Dr Rymer is a member of the Scientific Advisory Board for Hocoma Inc. and Ekso Bionics. The authors declare no other potential conflicts of interest.

Copyright © 2017 Wolters Kluwer Health, Inc. and Section on Pediatrics of the American Physical Therapy Association. All rights reserved.