Article

Individuals with central nervous system injuries are a large and apparently
rapidly expanding population-as suggested by 2013 statistics from the American
Heart Association. Increasing survival rates and lifespans emphasize the need to
improve the quality of life for this population. In persons with central nervous
system injuries, mobility limitations are among the most important factors
contributing to reduced life satisfaction. Decreased mobility and subsequently
reduced overall activity levels also contribute to lower levels of physical
health. Braces to assist walking are options for greater-functioning individuals
but still limit overall mobility as the result of increased energy expenditure
and difficulty of use. For individuals with greater levels of mobility
impairment, wheelchairs remain the preferred mobility aid yet still fall
considerably short compared with upright bipedal walking. Furthermore, the
promise of functional electrical stimulation as a means to achieve walking has
yet to materialize. None of these options allow individuals to achieve walking at
speeds or levels comparable with those seen in individuals with unimpaired gait.
Medical exoskeletons hold much promise to fulfill this unmet need and have
advanced as a viable option in both therapeutic and personal mobility state,
particularly during the past decade. The present review highlights the major
developments in this technology, with a focus on exoskeletons for lower limb that
may encompass the spine and that aim to allow independent upright walking for
those who otherwise do not have this option. Specifically reviewed are powered
exoskeletons that are either commercially available or have the potential to
restore upright walking function. This paper includes a basic description of how
each exoskeleton device works, a summation of key features, their known
limitations, and a discussion of current and future clinical applicability.
CI - Copyright (c) 2017 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS