The effectiveness of powered, active lower limb exoskeletons in neurorehabilitation: A systematic review

NeuroRehabilitation

Volumn 37, Issue 3, 2015, Pages 321-340

  Federici, Stefano ^a   Meloni, Fabio ^a   Bracalenti, Marco ^a   De Filippis, Maria Laura ^b  

^a UNIVERSITY OF PERUGIA   (Italy)

^b INSTITUTE OF MENTAL HEALTH   (United Kingdom)

Author keywords

central nervous system lesions; gait disorders; neurorehabilitation; paraplegic patients; Powered active lower limb exoskeleton; PRISMA; systematic review

Indexed keywords

CENTRAL NERVOUS SYSTEM DISEASE; DEVICE SAFETY; EXPERIMENTAL TEST; GAIT; GAIT DISORDER; HUMAN; LEG EXOSKELETON; MOBILIZATION; PARAPLEGIA; PRACTICE GUIDELINE; REVIEW; RISK REDUCTION; SYSTEMATIC REVIEW; WORKING MEMORY; DEVICES; GAIT DISORDERS, NEUROLOGIC; GERMANY; ITALY; LOWER LIMB; MALE; META ANALYSIS; MIDDLE AGED; NERVOUS SYSTEM DISEASES; NEUROREHABILITATION; PHYSIOLOGY; PROCEDURES; SPAIN; SWEDEN; WALKING;

GAIT; GAIT DISORDERS, NEUROLOGIC; GERMANY; HUMANS; ITALY; LOWER EXTREMITY; MALE; MIDDLE AGED; NERVOUS SYSTEM DISEASES; NEUROLOGICAL REHABILITATION; PARAPLEGIA; SPAIN; SWEDEN; WALKING;

EID: 84948695683     PISSN: 10538135     EISSN: 18786448     Source Type: Journal    
DOI: 10.3233/NRE-151265     Document Type: Review

References (93)

1. Aach, M., Cruciger, O., Sczesny-Kaiser, M., Hoffken, O., Meindl, R. C., Tegenthoff, M., et al. (2014). Voluntary driven exoskeleton as a new tool for rehabilitation in chronic spinal cord injury: A pilot study. Spine Journal, 14(12), 2847-2853. doi:10. 1016/ J. Spinee. 2014. 03. 042
2. Aach, M., Meindl, R., Hayashi, T., Lange, I., Geßmann, J., Sander, A., et al. (2013). Exoskeletal Neuro-Rehabilitation in Chronic Paraplegic Patients-Initial Results. In J. L. Pons, D. Torricelli, & M. Pajaro (Eds.), Converging Clinical and Engineering Research on Neurorehabilitation (pp. 233-236). Berlin, DE: Springer.
3. Agrawal, Y., Carey, J. P., Hoffman, H. J., Sklare, D. A., & Schubert, M. C. (2011). The modified Romberg Balance Test: Normative data in U. S. adults. Otology and Neurotology, 32(8), 1309-1311. doi:10. 1097/MAO. 0b013e31822e5bee.
4. American Spinal Injury Association, &International Medical Society of Paraplegia (2000). International Standards for Neurological and Functional Classification of Spinal Cord Injury Patients. Chicago, IL: ASIA.
5. Andersson, P., & Franzen, E. (2015). Effects of weight-shift training on walking ability, ambulation, and weight distribution in individuals with chronic stroke: A pilot study. Topics in Stroke Rehabilitation [Epub ahead of print]. doi:10. 1179/1074935715Z. 00000000052
6. Belforte, G., Gastaldi, L., & Sorli, M. (2001). Pneumatic active gait orthosis. Mechatronics, 11(3), 301-323. doi:10. 1016/S0957-4158(00)00017-9
7. Bergstrom, N., Braden, B. J., Laguzza, A., & Holman, V. (1987). The Braden Scale for Predicting Pressure Sore Risk. Nursing Research, 36(4), 205-210.
8. Bishop, L., Stein, J., & Wong, C. K. (2012). Robot-aided gait training in an individual with chronic spinal cord injury: A case study. Journal of Neurologic Physical Therapy, 36(3), 138-143. doi:10. 1097/NPT. 0b013e3182624c87
9. Bogue, R. (2009). Exoskeletons and robotic prosthetics: A review of recent developments. Industrial Robot, 36(5), 421-427. doi:10. 11 08/01439910910980141
10. Buxton, R. B. (2013). The physics of functional magnetic resonance imaging (fMRI). Reports on Progress in Physics, 76(9), 096601. doi:10. 1088/0034-4885/76/9/096601
11. Carpino, G., Accoto, D., Tagliamonte, N. L., Ghilardi, G., & Guglielmelli, E. (2013). Lower limb wearable robots for physiological gait restoration: State of the art and motivations. Methodology & Education for Clinical Innovation, 21(2), 72-80.
12. Chaigneau, D., Arsicault, M., Gazeau, J. P., & Zeghloul, S. (2008). LMS robotic hand grasp and manipulation planning (an isomorphic exoskeleton approach). Robotica, 26(2), 177-188. doi:10. 1017/S0263574707003736
13. Corradi, F., Scherer, M. J., & Lo Presti, A. (2012). Measuring the Assistive Technology Match. In S. Federici & M. J. Scherer (Eds.), Assistive Technology Assessment Handbook (pp. 49-65). London, UK: CRC Press.
14. Cuesta-Vargas, A. I., & Perez-Cruzado, D. (2014). Relationship between Barthel index with physical tests in adults with intellectual disabilities. Springerplus, 3(543). doi:10. 1186/2193-1801-3-543
15. del-Ama, A. J., Koutsou, A. D., Moreno, J. C., de-los-Reyes, A., Gil-Agudo, Á., & Pons, J. L. (2012). Review of hybrid exoskeletons to restore gait following spinal cord injury. Journal of Rehabilitation Research and Development, 49(4), 497-514. doi:10. 16 82/JRRD. 2011. 03. 0043
16. Diaz, I., Gil, J. J., & Sánchez, E. (2011). Lower-Limb Robotic Rehabilitation: Literature Reviewand Challenges. Journal of Robotics, 2011, 1-11. doi:10. 1155/2011/759764
17. Dietz, V., Nef, T., &Rymer, W. Z. (Eds.). (2012). Neurorehabilitation Technology. London, UK: Springer.
18. Dietz, V., &Ward, N. (Eds.). (2015). Oxford Textbook of Neurorehabilitation. Oxford, UK: Oxford University Press.
19. Ditunno, J. F. J., Ditunno, P. L., Scivoletto, G., Patrick, M., Dijkers, M., Barbeau, H., et al. (2013). The Walking Index for Spinal Cord Injury (WISCI/WISCI II): Nature, metric properties, use and misuse. Spinal Cord, 51(5), 346-355. doi:10. 10 38/sc. 2013. 9
20. Dollar, A. M., &Herr, H. (2007). Active orthoses for the lower-limbs: Challenges and state of the art. Paper presented at the 10th IEEE International Conference on Rehabilitation Robotics, Noordwijk, NL.
21. Dollar, A. M., & Herr, H. (2008). Lower Extremity Exoskeletons and Active Orthoses: Challenges and State-of-the-Art. IEEE Transactions on Robotics, 24(1), 144-158. doi:10. 1109/TRO. 2008. 915453
22. Downs, S., Marquez, J., & Chiarelli, P. (2013). The Berg Balance Scale has high intra-and inter-rater reliability but absolute reliability varies across the scale: A systematic review. J Physiother, 59(2), 93-99. doi:10. 1016/S1836-9553(13)70161-9
23. Esquenazi, A., & Packel, A. (2012). Robotic-assisted gait training and restoration. American Journal of Physical Medicine and Rehabilitation, 91(11 Suppl 3), 217-227. doi:10. 1097/PHM. 0b013e31826bce18
24. Esquenazi, A., Talaty, M., Packel, A., & Saulino, M. (2012). The ReWalk powered exoskeleton to restore ambulatory function to individuals with thoracic-level motor-complete spinal cord injury. American Journal of Physical Medicine and Rehabilitation, 91(11), 911-921. doi:10. 1097/PHM. 0b013e318269d9a3
25. Farris, R. J., Quintero, H. A., & Goldfarb, M. (2011). Preliminary evaluation of a powered lower limb orthosis to aid walking in paraplegic individuals. IEEE Transactions on Neural Systems and Rehabilitation Engineering, 19(6), 652-659. doi:10. 1109/ TNSRE. 2011. 2163083
26. Farris, R. J., Quintero, H. A., & Goldfarb, M. (2012, Aug 28-Sep 1). Performance evaluation of a lower limb exoskeleton for stair ascent and descent with Paraplegia. Paper presented at the 34th Annual International Conference of the IEEE Engineering in Medicine and Biology Society: EMBC 2012, San Diego, CA.
27. Farris, R. J., Quintero, H. A., Murray, S. A., Ha, K. H., Hartigan, C., & Goldfarb, M. (2014). A preliminary assessment of legged mobility provided by a lower limb exoskeleton for persons with paraplegia. IEEE Transactions on Neural Systems and Rehabilitation Engineering, 22(3), 482-490. doi:10. 1109/TNSRE. 2013. 2268320
28. Federici, S., & Scherer, M. J. (Eds.). (2012). Assistive Technology Assessment Handbook. Boca Raton, FL: CRC Press.
29. Ferris, D., Sawicki, G., &Domingo, A. (2005). Powered Lower Limb Orthoses for Gait Rehabilitation. Topics in Spinal Cord Injury Rehabilitation, 11(2), 34-49. doi:10. 1310/6GL4-UM7X-519H-9JYD
30. Fondazione Santa Lucia (2015, Mar 19). Maratona di Roma 2015, un esoscheletro hi-tech per tornare a correre. Retrieved from http:// www. hsantalucia. it/modules. php?name=News&file=article& sid=989
31. Fung, S., Byl, N., Melnick, M., Callahan, P., Selinger, A., Ishii, K., et al. (1997). Functional outcomes: The development of a new instrument to monitor the effectiveness of physical therapy. European Journal of Physical Medicine & Rehabilitation, 7(2), 31-41.
32. Hellstrom, K., Lindmark, B., & Fugl-Meyer, A. (2002). The Falls-Efficacy Scale, Swedish version: Does it reflect clinically meaningful changes after stroke? Disability and Rehabilitation, 24(9), 471-481. doi:10. 1080/09638280110105259
33. Herr, H. (2009). Exoskeletons and orthoses: Classification, design challenges and future directions. Journal of Neuroengineering and Rehabilitation, 6(1), 1-9. doi:10. 1186/1743-0003-6-21
34. Hong, Y. W., King, Y.-J., Yeo, W.-H., Ting, C.-H., Chuah, Y.-D., Lee, J.-V., & Chok, E.-T. (2013). Lower extremity exoskeleton: Review and challenges surrounding the technology and its role in rehabilitation of lower limbs. Australian Journal of Basic and Applied Sciences, 7(7), 520-524.
35. Ikehara, T., Nagamura, K., Ushida, T., Tanaka, E., Saegusa, S., Kojima, S., & Yuge, L. (2011, Jun 29-Jul 1). Development of closed-fitting-type walking assistance device for legs and evaluation of muscle activity. Paper presented at the IEEE International Conference on Rehabilitation Robotics: ICORR 2011, Zurich, CH.
36. Kao, P.-C., Lewis, C. L., & Ferris, D. P. (2010). Invariant ankle moment patterns when walking with and without a robotic ankle exoskeleton. Journal of Biomechanics, 43(2), 203-209. doi:10. 1016/j. jbiomech. 2009. 09. 030
37. Kawamoto, H., Taal, S., Niniss, H., Hayashi, T., Kamibayashi, K., Eguchi, K., &Sankai, Y. (2010, Aug 31-Sep 4). Voluntary motion support control of Robot Suit HAL triggered by bioelectrical signal for hemiplegia. Paper presented at the 32nd Annual International Conference of the IEEE Engineering in Medicine and Biology Society: EMBC 2010, Buenos Aires, AR.
38. Keller, T., & Veneman, J. (2013). Robotics for neurorehabilitation: Current state and future challenges. Applied Mechanics and Materials, 245, 3-8. doi:10. 4028/ www. scientific. net/MM. 245. 3
39. Koceska, N., & Koceski, S. (2013). Review: Robot Devices for Gait Rehabilitation. International Journal of Computer Applications, 62(13), 1-8. doi:10. 5120/10137-4279
40. Kolakowsky-Hayner, S. A. (2013). Safety and Feasibility of using the EksoTM Bionic Exoskeleton to AidAmbulation after Spinal Cord Injury. Journal of Spine, S4(3), 1-8. doi:10. 4172/2165-7939. S4-003
41. Lee, H. S., Song, J., Min, K., Choi, Y.-S., Kim, S.-M., Cho, S.-R., et al. (2014). Short-term effects of erythropoietin on neurodevelopment in infants with cerebral palsy: A pilot study. Brain and Development, 36(9), 764-769. doi:10. 1016/j. braindev. 2013. 11. 002
42. Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gøtzsche, P. C., Ioannidis, J. P. A., & Moher, D. (2009). The PRISMA Statement for Reporting Systematic Reviews and Meta-Analyses of Studies That Evaluate Health Care Interventions: Explanation and Elaboration. PLoS Medicine, 6(7), e1000100. doi:10. 1371/journal. pmed. 1000100
43. Low, K. H. (2011, Aug 3-5). Robot-assisted gait rehabilitation: From exoskeletons to gait systems. Paper presented at the Defense Science Research Conference and Expo: DSR 2011, Singapore, SG.
44. McMillan, T. M., Williams, W. H., & Bryant, R. A. (2003). Posttraumatic stress disorder and traumatic brain injury: A review of causal mechanisms, assessment, and treatment. In H. Williams & J. J. Edwards (Eds.), Biopsychosocial Approaches in Neurorehabilitation: Assessment and Management of Neuropsychiatric, Mood and Behavioural Disorders (pp. 149-164). Hove, UK: Psychology Press.
45. Mehrholz, J., Wagner, K., Rutte, K., Meissner, D., &Pohl, M. (2007). Predictive validity and responsiveness of the functional ambulation category in hemiparetic patients after stroke. Archives of Physical Medicine and Rehabilitation, 88(10), 1314-1319. doi:10. 1016/j. apmr. 2007. 06. 764
46. Meloni, F., Federici, S., & Stella, A. (2011). The Psychologist's Role: A Neglected Presence in the Assistive Technology Assessment Process. In G. J. Gelderblom, M. Soede, L. Adriaens, & K. Miesenberger (Eds.), Everyday Technology for Independence and Care: AAATE 2011 (Vol. 29, pp. 1199-1206). Amsterdam, NL: IOS Press.
47. Meloni, F., Federici, S., Stella, A., Mazzeschi, C., Cordella, B., Greco, F., & Grasso, M. (2012). The Psychologist. In S. Federici &M. J. Scherer (Eds.), Assistive Technology Assessment Handbook (pp. 149-177). Boca Raton, FL: CRC Press.
48. Mohammed, S., Amirat, Y., & Rifai, H. (2012). Lower-Limb Movement Assistance through Wearable Robots: State of the Art and Challenges. Advanced Robotics, 26(1-2), 1-22. doi:10. 1163/016918611x607356
49. Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & The, P. G. (2009). Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Medicine, 6(7), e1000097. doi:10. 1371/journal. pmed. 1000097
50. Mohseni Bandpei, M. A., Rahmani, N., Majdoleslam, B., Abdollahi, I., Ali, S. S., & Ahmad, A. (2014). Reliability of surface electromyography in the assessment of paraspinal muscle fatigue: An updated systematic review. Journal of Manipulative and Physiological Therapeutics, 37(7), 510-521. doi:10. 1016/j. jmpt. 2014. 05. 006
51. Mooney, L. M., Rouse, E. J., & Herr, H. M. (2014). Autonomous exoskeleton reduces metabolic cost of human walking. Journal of Neuroengineering and Rehabilitation, 11(151), 2-5. doi:10. 1186/1743-0003-11-151
52. Moreno, J., Ama, A., Reyes-GuzmÁn, A., Gil-Agudo, Á., Ceres, R., & Pons, J. (2011). Neurorobotic and hybrid management of lower limb motor disorders: A review. Medical and Biological Engineering and Computing, 49(10), 1119-1130. doi:10. 1007/s11517-011-0821-4
53. Mori, Y., Okada, J., & Takayama, K. (2006). Development of a standing style transfer system "ABLE" for disabled lower limbs. IEEE/ASME Transactions on Mechatronics, 11(4), 372-380. doi:10. 1109/TMECH. 2006. 878558
54. Mori, Y., Takayama, K., Zengo, T., & Nakamura, T. (2004). Development of straight style transfer equipment for lower limbs disabled "ABLE". Journal of Robotics and Mechatronics, 16(5), 456-463.
55. Nef, T., & Riener, R. (2012). Three-Dimensional Multi-Degree-of-Freedom Arm Therapy Robot (ARMin). In V. Dietz, T. Nef, &W. Z. Rymer (Eds.), Neurorehabilitation Technology (pp. 141-157). London, UK: Springer.
56. Neuhaus, P. D., Noorden, J. H., Craig, T. J., Torres, T., Kirschbaum, J., & Pratt, J. E. (2011, Jun 29-Jul 1). Design and evaluation of Mina: A robotic orthosis for paraplegics. Paper presented at the IEEE International Conference on Rehabilitation Robotics: ICORR 2011, Zurich, CH.
57. Nilsson, A., Vreede, K. S., Haglund, V., Kawamoto, H., Sankai, Y., & Borg, J. (2014). Gait training early after stroke with a new exoskeleton-the hybrid assistive limb: A study of safety and feasibility. Journal of Neuroengineering and Rehabilitation, 11(92), 1-10. doi:10. 1186/1743-0003-11-92
58. Norhafizan, A., Ghazilla, R. A. R., Kasi, V., Taha, Z., & Hamid, B. (2014). A Review on lower-Limb Exoskeleton System for Sit to Stand, Ascending and Descending Staircase Motion. Applied Mechanics and Materials, 541-542, 1150-1155. doi:10. 4028/ www. scientific. net/AMM. 541-542. 1150
59. Pandyan, A. D., Johnson, G. R., Price, C. I., Curless, R. H., Barnes, M. P., & Rodgers, H. (1999). A review of the properties and limitations of the Ashworth and modified Ashworth Scales as measures of spasticity. Clinical Rehabilitation, 13(5), 373-383.
60. Park, E. Y., & Choi, Y. I. (2014). Psychometric Properties of the Lower Extremity Subscale of the Fugl-Myer Assessment for Community-dwelling Hemiplegic Stroke Patients. Journal of Physical Therapy Science, 26(11), 1775-1777. doi:10. 1589/jpts. 26. 1775
61. Pennycott, A., Wyss, D., Vallery, H., Klamroth-Marganska, V., & Riener, R. (2012). Towards more effective robotic gait training for stroke rehabilitation: A review. Journal of Neuroengineering and Rehabilitation, 9(65), 65. doi:10. 1186/1743-0003-9-65
62. Peters, D. M., Middleton, A., Donley, J. W., Blanck, E. L., & Fritz, S. L. (2014). Concurrent validity of walking speed values calculated via the GAITRite electronic walkway and 3 meter walk test in the chronic stroke population. Physiotherapy Theory and Practice, 30(3), 183-188. doi:10. 3109/09593985. 2013. 845805
63. Playford, D. (2015). The International Classification of Functioning, Disability, and Health. In V. Dietz & N. Ward (Eds.), Oxford Textbook of Neurorehabilitation (pp. 3-7). Oxford, UK: Oxford University Press.
64. Podsiadlo, D., & Richardson, S. (1991). The timed "Up & Go": A test of basic functional mobility for frail elderly persons. Journal of the American Geriatrics Society, 39(2), 142-148.
65. Pons, J. L. (2010). Rehabilitation Exoskeletal Robotics. IEEE Engineering in Medicine and Biology Magazine, 29(3), 57-63. doi:10. 1109/MEMB. 2010. 936548
66. Pons, J. L., & Torricelli, D. (Eds.). (2014). Emerging Therapies in Neurorehabilitation. Berlin, DE: Springer-Verlag.
67. Quintero, H. A., Farris, R. J., & Goldfarb, M. (2012). A Method for the Autonomous Control of Lower Limb Exoskeletons for Persons With Paraplegia. Journal of Medical Devices, 6(4), 1-6. doi:10. 1115/1. 4007181
68. Rahman, T., Sample, W., Jayakumar, S., King, M. M., Wee, J. Y., Seliktar, R., et al. (2006). Passive exoskeletons for assisting limb movement. Journal of Rehabilitation Research and Development, 43(5), 583-590. doi:10. 1682/JRRD. 2005. 04. 0070
69. Reed, M. D., & Van Nostran, W. (2014). Assessing pain intensity with the visual analog scale: A plea for uniformity. Journal of Clinical Pharmacology, 54(3), 241-144. doi:10. 1002/jcph. 250
70. Reybrouck, T. (2003). Clinical usefulness and limitations of the 6-minute walk test in patients with cardiovascular or pulmonary disease. Chest, 123(2), 325-327. doi:10. 1378/chest. 123. 2. 325
71. Saji, N., Kimura, K., Ohsaka, G., Higashi, Y., Teramoto, Y., Usui, M., & Kita, Y. (2015). Functional independence measure scores predict level of long-term care required by patients after stroke: A multicenter retrospective cohort study. Disability and Rehabilitation, 37(4), 331-337. doi:10. 3109/09638288. 2014. 918195
72. Sanz-Merodio, D., Cestari, M., Arevalo, J. C., &Garcia, E. (2012, Dec 11-14). A lower-limb exoskeleton for gait assistance in quadriplegia. Paper presented at the IEEE International Conference on Robotics and Biomimetics: ROBIO 2012, Guangzhou, CN.
73. Sczesny-Kaiser, M., Höffken, O., Lissek, S., Lenz, M., Schlaffke, L., Nicolas, V., et al. (2013). Neurorehabilitation in Chronic Paraplegic Patients with the HAL® Exoskeleton-Preliminary Electrophysiological and fMRI Data of a Pilot Study. In J. L. Pons, D. Torricelli, & M. Pajaro (Eds.), Converging Clinical and Engineering Research on Neurorehabilitation (pp. 611-615). Berlin, DE: Springer.
74. Shin, J. C., Yoo, J. H., Jung, T. H., & Goo, H. R. (2011). Comparison of lower extremity motor score parameters for patients with motor incomplete spinal cord injury using gait parameters. Spinal Cord, 49(4), 529-533. doi:10. 1038/sc. 2010. 158
75. Spungen, A. M., Asselin, P., Fineberg, D. B., Kornfeld, S. D., & Harel, N. Y. (2013, Apr 15-17). Exoskeletal-Assisted Walking for Persons with Motor-Complete Paraplegia. Paper presented at the STO Human Factors and Medicine Panel (HFM) Symposium, Milan, IT.
76. Stein, J., Bishop, L., Stein, D. J., &Wong, C. K. (2014). Gait training with a robotic leg brace after stroke: A randomized controlled pilot study. American Journal of Physical Medicine and Rehabilitation, 93(11), 987-994. doi:10. 1097/PHM. 0000000000000119
77. Stookey, A. D., Katzel, L. I., Steinbrenner, G., Shaughnessy, M., & Ivey, F. M. (2014). The short physical performance battery as a predictor of functional capacity after stroke. Journal of Stroke and Cerebrovascular Diseases, 23(1), 130-135. doi:10. 1016/j. jstrokecerebrovasdis. 2012. 11. 003
78. Strausser, K. A., & Kazerooni, H. (2011, Sep 25-30). The development and testing of a human machine interface for a mobile medical exoskeleton. Paper presented at the IEEE/RSJ International Conference on Intelligent Robots and Systems: IROS 2011, San Francisco, CA.
79. Strausser, K. A., Swift, T. A., Zoss, A. B., & Kazerooni, H. (2010, Sep 12-15). Prototype medical exoskeleton for paraplegic mobility: First experimental results. Paper presented at the ASME 2010 Dynamic Systems and Control Conference: DSCC 2010, Cambridge, MA.
80. Suzuki, K., Kawamura, Y., Hayashi, T., Sakurai, T., Hasegawa, Y., & Sankai, Y. (2005, Oct 10-12). Intention-based walking support for paraplegia patient. Paper presented at the IEEE International Conference on Systems, Man and Cybernetics, Waikoloa, HI.
81. Sylos-Labini, F., La Scaleia, V., d'Avella, A., Pisotta, I., Tamburella, F., Scivoletto, G., et al. (2014). EMG patterns during assisted walking in the exoskeleton. Frontiers in Human Neuroscience, 8(423), 1-12. doi:10. 3389/fnhum. 2014. 00423
82. Talaty, M., Esquenazi, A., & Briceño, J. E. (2013, Jun 24-26). Differentiating ability in users of the ReWalkTM powered exoskeleton: An analysis of walking kinematics. Paper presented at the IEEE International Conference on Rehabilitation Robotics: ICORR 2013 Seattle, WA.
83. Tsukahara, A., Hasegawa, Y., & Sankai, Y. (2009, Jun 23-26). Standing-up motion support for paraplegic patient with Robot Suit HAL. Paper presented at the IEEE International Conference on Rehabilitation Robotics: ICORR 2009, Kyoto, JP.
84. Tsukahara, A., Kawanishi, R., Hasegawa, Y., & Sankai, Y. (2010). Sit-to-Stand and Stand-to-Sit Transfer Support for Complete Paraplegic Patients with Robot Suit HAL. Advanced Robotics, 24(11), 1615-1638. doi:10. 1163/016918610X512622
85. Viteckova, S., Kutilek, P., & Jirina, M. (2013). Wearable lower limb robotics: A review. Biocybernetics and Biomedical Engineering, 33(2), 96-105. doi:10. 1016/J. Bbe. 2013. 03. 005
86. Wall, A., Borg, J., & Palmcrantz, S. (2015). Clinical application of the Hybrid Assistive Limb (HAL) for gait training-a systematic review. Frontiers in Systems Neuroscience, 9(48), 1-10. doi:10. 3389/fnsys. 2015. 00048
87. Watanabe, H., Tanaka, N., Inuta, T., Saitou, H., & Yanagi, H. (2014). Locomotion Improvement Using a Hybrid Assistive Limb in Recovery Phase Stroke Patients: A Randomized Controlled Pilot Study. Archives of Physical Medicine and Rehabilitation, 95(11), 2006-2012. doi:10. 1016/J. Apmr. 2014. 07. 002
88. Whitney, S. L., Wrisley, D. M., Marchetti, G. F., Gee, M. A., Redfern, M. S., & Furman, J. M. (2005). Clinical measurement of sit-to-stand performance in people with balance disorders: Validity of data for the Five-Times-Sit-to-Stand Test. Physical Therapy, 85(10), 1034-1045.
89. Williams, H., & Edwards, J. J. (Eds.). (2003). Biopsychosocial Approaches in Neurorehabilitation: Assessment andManagement of Neuropsychiatric, Mood and Behavioural Disorders. Hove, UK: Psychology Press.
90. Wolf, S. L., Catlin, P. A., Gage, K., Gurucharri, K., Robertson, R., & Stephen, K. (1999). Establishing the reliability and validity of measurements of walking time using the Emory Functional Ambulation Profile. Physical Therapy, 79(12), 1122-1133.
91. Yan, T., Cempini, M., Oddo, C. M., & Vitiello, N. (2015). Review of assistive strategies in powered lower-limb orthoses and exoskeletons. Robotics and Autonomous Systems, 64, 120-136. doi:10. 1016/j. robot. 2014. 09. 032
92. Yang, N., Zhang, B., & Gao, C. (2014). The baseline NIHSS score in female and male patients and short-time outcome: A study in young ischemic stroke. Journal of Thrombosis and Thrombolysis, 37(4), 565-570. doi:10. 1007/s11239-013-0986-9
93. Zeilig, G., Weingarden, H., Zwecker, M., Dudkiewicz, I., Bloch, A., & Esquenazi, A. (2012). Safety and tolerance of the ReWalk™ exoskeleton suit for ambulation by people with complete spinal cord injury:Apilot study. Journal of Spinal Cord Medicine, 35(2), 96-101. doi:10. 1179/2045772312Y. 0000000003