Recommendations for clinical decision-making when offering exoskeletons for community use in individuals with spinal cord injury

• Main Authors: Derrick Onate (Author), Cassandra Hogan (Author), Kathryn Fitzgerald (Author), Kevin T. White (Author), Keith Tansey (Author)
• Format: Book
• Published: Frontiers Media S.A., 2024-08-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 2673-6861; 10.3389/fresc.2024.1428708
• Keywords: personal powered exoskeleton; mobility; community ambulation; quality of life; spinal cord injury; Other systems of medicine; RZ201-999; Medical technology; R855-855.5
• Source: Frontiers in Rehabilitation Sciences, Vol 5 (2024)

Approved in 2014 by the Food and Drug Administration (FDA) for use with a trained companion, personal powered exoskeletons (PPE) for individuals with spinal cord injury (SCI) provide an opportunity for the appropriate candidate to ambulate in their home and community. As an adjunct to wheeled mobility, PPE use allows those individuals who desire to ambulate the opportunity to experience the potential physiological and psychosocial benefits of assisted walking outside of a rehabilitation setting. There exists, however, a knowledge gap for clinicians regarding appropriate candidate selection for use, as well as who might benefit from ambulating with a PPE. The purpose of this paper is to provide guidance for clinicians working with individuals living with SCI by outlining an expert consensus for a PPE decision-making algorithm, as well as a discussion of potential physiological and psychosocial benefits from PPE use based on early evidence in publication.