Background
cord injury
PARTIAL PARALYSIS, STILL
One of the most limiting consequences of spinal cord injury (SCI) is the complete or partial paralysis of the lower limbs. Still, independent from the severity of the spinal injury, the time after lesion, or age at the time of injury, the restoration of walking is given high priority by subjects with SCI [Functional walking rehabilitation has therefore to be intensive and task-oriented. Robotic devices were developed more than 20 years ago to allow for intensive, weight-bearing, stepping training with precise movement control [In this sense, ambulatory robotic exoskeletons have been proposed in the last decade to provide task-specific, ambulatory overground walking training, mainly in incomplete SCI patients that have improvement prognosis. In contrast to robotic trainers, robotic exoskeletons may optimally challenge the patient in the domains of balance and physical exercise, while providing walking-consistent visual and functional feedback. The safety and comfort of robotic exoskeletons as a rehabilitation tool have been previously assessed in patients with acute and chronic SCI [While some studies have reported improvements in some functional and spatial–temporal variables of walking (i.e. gait speed), the literature concerning the walking outcomes due after a rehabilitation program with robotic exoskeletons is nowadays limited and nonconclusive. One of the main rationales is related to the differences in interventions (robot type and control, treatment time, and the number of sessions), which makes it difficult to obtain a clinically reliable conclusion [Currently, one of the main issues to be addressed is whether walking training with robotic exoskeletons generates improvements in the person’s walking ability, and what device-related rationales are responsible for the outcomes. In this article, we present the results of a prospective, randomized, and comparative study conducted to assess the clinical efficacy of a novel robotic lower-limb robotic exoskeleton named HANK. While the main features of this exoskeleton are similar to others available on the market or tested in similar studies, there are slight differences that justify the present study. We also provide evidence on the impact of delivering walking training with this kind of technology in incomplete SCI patients, contributing to answering the fundamental question related to the outcomes of robotic walking rehabilitation conveyed with exoskeletons [