Long-Term Follow-Up of prosthetic rehabilitation programs for spinal cord injury
DOI:
https://doi.org/10.5281/zenodo.22815159Keywords:
spinal cord injury, exoskeleton, gait rehabilitation, orthosis, long-term follow-upAbstract
Background: Powered lower-limb exoskeletons and mechanical orthoses are both used to restore upright ambulation after spinal cord injury, but their clinical value is only established through structured programs that follow patients across months to years rather than a single training session.
Objective: This review synthesizes long-term follow-up evidence on prosthetic and orthotic rehabilitation programs for spinal cord injury, covering exoskeleton-assisted gait training, robotic treadmill systems, and mechanical orthoses.
Methods: We synthesized feasibility studies, systematic reviews, multicenter cohorts, and a randomized trial addressing walking speed, physiological outcomes, engagement, and device attrition in device-assisted ambulation.
Findings: Structured exoskeleton programs produce sustained gains in walking speed, bone mineral density, body composition, and quality of life, and randomized evidence of superiority over usual-care therapy in chronic incomplete injury; sustained use depends more on perceived independence than on gait metrics, while orthoses show markedly higher long-term attrition tied to their greater energy cost.
Conclusions: Long-term device-assisted rehabilitation can produce durable functional and physiological benefit, but program design should prioritize patient-selection and engagement predictors, and track outcomes well beyond the initial supervised training course.
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