Exoskeleton Training

Reported benefits of exoskeleton training in iSCI include improved lower extremity strength, reduced spasticity, and enhanced motor relearning. Exoskeletons can psychosocially enable upright mobility, eye-level social interaction, improved self-esteem, and emotional well-being. Most existing exoskeleton studies focus on general gait and balance rather than task-specific turning-while-walking, and mechanisms such as sensorimotor integration and fear of falling remain underexplored. Trunk muscle activity during exoskeleton-assisted walking in chronic SCI can resemble electromyographic patterns seen in able-bodied individuals. Overground exoskeleton-assisted walking may improve weight-shifting control by increasing centre-of-mass excursion in mediolateral and anteroposterior directions. Exoskeleton use may reproduce the number and structure of muscle synergies seen in able-bodied gait, potentially improving motor coordination in iSCI. Known adverse effects of exoskeleton rehabilitation for people with SCI include falls, fractures, hypotension, autonomic dysreflexia, musculoskeletal injury, skin breakdown, and lower limb swelling.