A research study finds that people with home-use hip-knee powered assist walking exoskeletons used them to take about 3% as many steps as a non-walking-impaired sedentary person would. The paper, titled Exoskeletal-Assisted Walking in Veterans With Paralysis: A Randomized Clinical Trial, is published by lead author Ann M. Spungen. I have had the pleasure of meeting her at several exoskeleton events, and her knowledge and experience with walking assist exoskeletons for those who have suffered spinal cord injury can be rivaled by fewer than a dozen individuals on the planet.
The study aimed to find a difference in physical and mental outcomes for spinal cord injury patients who used a combination of a wheelchair and a Rewalk-powered exoskeleton provided for home use. Data collection occurred between 2016 and 2021, and data analysis took a little longer. The researchers found no statistical difference between the groups with a home-use exoskeleton for four months and those with only a wheelchair. However, the study emphasizes that the wearable robots were used on average to take 4321 steps per month. That is compared to ~5000 steps per day for someone who doesn’t actively exercise but can walk without a mobility aid. In other words, the home-use exoskeletons were used 3% of the time it could have potentially been utilized (exoskeleton users took about 3% of the steps compared to an average sedentary person without mobility impairments).
The low use of the exoskeletons is cited multiple times throughout the research paper. The main reason for not using the exos was a lack of a companion (or “operator” as defined by the ASTM International Terminology Standard)—someone who will walk behind the exoskeleton and assist with balance and controls. Exoskeleton technology has improved in the eight years since this study began. For example, Wandercraft now has a self-balancing walking assist exoskeleton meant for home use that could be easier to use (though a companion may still be required, time will tell). Other reasons for not using the devices included illness or medical condition, lack of time, travel, weather, lack of motivation, or device malfunction/charge.
The study results match my anecdotal information at different exo conferences or events from that period. The exoskeleton industry has proven that wearable robots can move a person with spinal cord injury from point A to point B. The next frontier is to have exoskeletons useful for everyday living tasks. For example, the Global Innovation Challenge in Japan uses a see-through replica of a one-bedroom apartment, and mobility aids are graded on their ability to help with everyday tasks like picking up a package or cleaning. The Cybathlon Exoskeleton Race series has also added tasks of every day living in its 2024 edition.
You can find the full paper here:
Spungen AMDematt EJBiswas K, et al. Exoskeletal-Assisted Walking in Veterans With Paralysis: A Randomized Clinical Trial. JAMA Netw Open. 2024;7(9):e2431501. doi:10.1001/jamanetworkopen.2024.31501 https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2823146
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