Lower limb exoskeleton training as part of home rehabilitation: a systematic review

Philip Abery*, W. Hing, A. Febo, U. Patel, E. F.D. Canetti

*Corresponding author for this work

    Research output: Contribution to journalReview articleResearchpeer-review

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    Abstract

    Introduction:
    Individuals with neurological conditions often have difficulty accessing and mobilising in the community, requiring home rehabilitation. Portable lower-limb exoskeletons, often used for indoor gait training, may have broader applications and assist in community mobility. This review explores the feasibility and effectiveness of using an exoskeleton in home rehabilitation.

    Methods:
    A search of PubMed, Embase, Web of Science, CINAHL, and Scopus. Studies reporting on exoskeleton-based home rehabilitation for individuals with mobility-impairing health conditions, compared to physiotherapy, with outcomes focused on balance, mobility, or functional improvement were eligible for inclusion. Reported outcomes were categorised based on the purpose of exoskeleton use, i.e. rehabilitation, performance, or training effects.

    Results:
    The initial search yielded 7444 records, of which seven studies and one follow-up report were included. Participants had a range of neurological conditions all used a different exoskeleton. The supervision provided by clinicians varied from none to continuous. The activities undertaken with the exoskeletons differed. Five studies reported on the rehabilitation effects, showing improvements in distance, balance, complex walking, and physiological cost. Five studies also reported on performance, with some improvement in peak propulsion of the ankle and an increase in the number of steps. Two studies reported on the training effect: participants with wheelchair-dependent spinal cord injuries took 5000 steps, and their most common activity was individual exercises.

    Discussion:
    Findings from this review indicate that the use of exoskeletons as part of home rehabilitation for different neurological conditions, including wheelchair-dependent participants, is feasible and effective, particularly when targeting the rehabilitation effect.
    Original languageEnglish
    Pages (from-to)1-15
    Number of pages15
    JournalPhysical Therapy Reviews
    Early online date19 Aug 2025
    DOIs
    Publication statusE-pub ahead of print - 19 Aug 2025

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