Chapter 15 - Current Evidence for Use of Robotic Exoskeletons in Rehabilitation

Abstract

Despite the rapid development of exoskeletons in recent years, the clinical use of exoskeleton technology remains limited, and people with neurological disability rely primarily on other sources of mobility such as wheelchairs and orthoses. Although some studies have demonstrated the safety and efficacy of the four Food and Drug Administration–approved rigid exoskeletons and longer term studies are underway, it remains unclear as to whether these devices are effective medically, whether they are the best choice to provide standing or locomotor therapy, and whether they are cost-effective compared to current standards of care. In this chapter, we briefly review the history of exoskeletons and discuss the current state of evidence on their clinical use. We explore several constraints and difficulties associated with the development of strong evidence-based data sets justifying the use of exoskeletons. We also highlight ways future clinical trials and research studies can help clinicians determine which device and approach is best for use in therapy.