Journal of Rehabilitation Research & Development (JRRD)

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Volume 49 Number 4, 2012
   Pages 497 — 514

Abstract — Review of hybrid exoskeletons to restore gait following spinal cord injury

Antonio J. del-Ama, Eng MSc;1–2* Aikaterini D. Koutsou, Eng MSc;2 Juan C. Moreno, Eng PhD;2 Ana de-los-Reyes, Eng MSc;1 Ángel Gil-Agudo, MD, PhD;1 José L. Pons, Prof Eng PhD2
1Biomechanics and Technical Aids Unit, National Hospital for Spinal Cord Injury, SESCAM, Toledo, Spain; 2BioEngineering Group, National Council for Scientific Research, Arganda del Rey, Madrid, Spain

Abstract — Different approaches are available to compensate gait in persons with spinal cord injury, including passive orthoses, functional electrical stimulation (FES), and robotic exoskeletons. However, several drawbacks arise from each specific approach. Orthotic gait is energy-demanding for the user and functionally ineffective. FES uses the muscles as natural actuators to generate gait, providing not only functional but also psychological benefits to the users. However, disadvantages are also related to the early appearance of muscle fatigue and the control of joint trajectories. Robotic exoskeletons that provide joint moment compensation or substitution to the body during walking have been developed in recent years. Significant advances have been achieved, but the technology itself is not mature yet because of many limitations related to both physical and cognitive interaction as well as portability and energy-management issues. Meanwhile, the combination of FES technology and exoskeletons has emerged as a promising approach to both gait compensation and rehabilitation, bringing together technologies, methods, and rehabilitation principles that can overcome the drawbacks of each individual approach. This article presents an overview of hybrid lower-limb exoskeletons, related technologies, and advances in actuation and control systems. Also, we highlight the functional assessment of individuals with spinal cord injury.

Keywords:exoskeleton, functional electrical stimulation, gait, hybrid control, muscle fatigue, neuroprosthesis, neurorobot, orthosis, rehabilitation, robot control, spinal cord injury, wearable robot.

View HTML  ¦  View PDF  ¦  Contents Vol. 49, No. 4
This article and any supplementary material should be cited as follows:
del-Ama AJ, Koutsou AD, Moreno JC, de-los-Reyes A, Gil-Agudo A, Pons JL. Review of hybrid exoskeletons to restore gait following spinal cord injury. J Rehabil Res Dev. 2012;49(4):497–514.

Last Reviewed or Updated  Wednesday, May 30, 2012 10:28 AM

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