Table 2 Evidence Level and Downs and Black Tool sub-sections and total scores reported for each study
| Â | Study | Title | Evidence Level | Downs and Black Tool | |||||
|---|---|---|---|---|---|---|---|---|---|
Subsections | Total Score | ||||||||
Reporting | External Validity | Internal Validity: Bias | Internal Validity: Confounding | Power | |||||
1 | Chang et al. 2018 | Exoskeleton-assisted gait training to improve gait in individuals with spinal cord injury: A pilot randomized study | 2B | 7 | 2 | 5 | 4 | 0 | 18 (Moderate) |
2 | Tsai et al. 2020 | Exoskeletal-Assisted Walking During Acute Inpatient Rehabilitation Leads to Motor and Functional Improvement in Persons With Spinal Cord Injury: A Pilot Study | 3B | 10 | 0 | 3 | 2 | 0 | 15 (Moderate) |
3 | Asselin et al. 2015 | Heart Rate and Oxygen demand of Powered Exoskeleton-Assisted Walking in person with paraplegia | 2B | 8 | 3 | 3 | 0 | 0 | 14 (Moderate) |
4 | Gagnon et al. 2018 (A) | Locomotor training using an overground robotic exoskeleton in long-term manual wheelchair users with a chronic spinal cord injury living in the community: Lessons learned from a feasibility study in terms of recruitment, attendance, learnability, performance and safety | 2B | 8 | 3 | 3 | 0 | 0 | 14 (Moderate) |
5 | Khan et al. 2019 | Retraining walking over ground in a powered exoskeleton after spinal cord injury: a prospective cohort study to examine functional gains and neuroplasticity | 2B | 9 | 1 | 3 | 1 | 0 | 14 (Moderate) |
6 | Platz et al. 2016 | Device-Training for Individuals with Thoracic and Lumbar Spinal Cord Injury Using a Powered Exoskeleton for Technically Assisted Mobility: Achievements and User Satisfaction | 2B | 8 | 3 | 3 | 0 | 0 | 14 (Moderate) |
7 | Baunsgaard et al. 2018 (A) | Gait training after spinal cord injury: safety, feasibility and gait function following 8Â weeks of training with the exoskeletons from Ekso Bionics | 2B | 8 | 1 | 3 | 1 | 0 | 13 (Moderate) |
8 | Baunsgaard et al. 2018 (B) | Exoskeleton gait training after spinal cord injury: An exploratory study on secondary health conditions | 2B | 8 | 1 | 3 | 1 | 0 | 13 (Moderate) |
9 | van Dijsseldonk et al. 2019 | Predictors of exoskeleton motor learning in spinal cord injured patients | 2B | 7 | 2 | 3 | 1 | 0 | 13 (Moderate) |
10 | Chun et al. 2020 | Changes in Bowel Function Following Exoskeletal-Assisted Walking in Persons with Spinal Cord Injury: An Observational Pilot Study | 2B | 7 | 3 | 2 | 0 | 0 | 12 (Moderate) |
11 | Tefertiller et al. 2018 | Initial Outcomes from a Multicenter Study Utilizing the Indego Powered Exoskeleton in Spinal Cord Injury | 2B | 8 | 1 | 3 | 0 | 0 | 12 (Moderate) |
12 | Yang et al. 2015 | Assessment of In-Hospital Walking Velocity and Level of Assistance in a Powered Exoskeleton in Persons with Spinal Cord Injury | 2B | 8 | 1 | 3 | 0 | 0 | 12 (Moderate) |
13 | Yatsugi et al. 2018 | Feasibility of Neurorehabilitation Using a Hybrid Assistive Limb for Patients Who Underwent Spine Surgery | 2B | 7 | 2 | 3 | 0 | 0 | 12 (Moderate) |
14 | Benson et al. 2016 | Lower-limb exoskeletons for individuals with chronic spinal cord injury: Findings from a feasibility study | 2B | 6 | 3 | 2 | 0 | 0 | 11 (Moderate) |
15 | Escalona et al. 2018 | Cardiorespiratory demand and rate of perceived exertion during overground walking with a robotic exoskeleton in long-term manual wheelchair users with chronic spinal cord injury: A cross-sectional study | 2B | 7 | 1 | 3 | 0 | 0 | 11 (Moderate) |
16 | Fineberg et al. 2013 | Vertical ground reaction force-based analysis of powered exoskeleton-assisted walking in persons with motor-complete paraplegia | 2B | 7 | 1 | 3 | 0 | 0 | 11 (Moderate) |
17 | Guanziroli et al. 2019 | Assistive powered exoskeleton for complete spinal cord injury: correlations between walking ability and exoskeleton control | 3B | 7 | 1 | 3 | 0 | 0 | 11 (Moderate) |
18 | Kubota et al. 2019 | Hybrid assistive limb (HAL) treatment for patients with severe thoracic myelopathy due to ossification of the posterior longitudinal ligament (OPLL) in the postoperative acute/subacute phase: A clinical trial | 2B | 8 | 0 | 3 | 0 | Â | 11 (Moderate) |
19 | Sale et al. 2016 (A) | Effects on mobility training and de-adaptations in subjects with Spinal Cord Injury due to a Wearable Robot: A preliminary report | 4 | 8 | 0 | 3 | 0 | 0 | 11 (Moderate) |
20 | Stampacchia et al. 2016 | Walking with a powered robotic exoskeleton: Subjective experience, spasticity and pain in spinal cord injured persons | 2B | 7 | 1 | 3 | 0 | 0 | 11 (Moderate) |
21 | Zeilig et al. 2012 | Safety and tolerance of the ReWalkTM exoskeleton suit for ambulation by people with complete spinal cord injury: A pilot study | 4 | 7 | 1 | 3 | 0 | 0 | 11 (Moderate) |
22 | Alamro et al. 2018 | Overground walking with a robotic exoskeleton elicits trunk muscle activity in people with high-thoracic motor-complete spinal cord injury | 3B | 7 | 0 | 3 | 0 | 0 | 10 (Poor) |
23 | Esquenazi et al. 2012 | The ReWalk Powered Exoskeleton to Restore Ambulatory Function to Individuals with Thoracic-Level Motor-Complete Spinal Cord Injury | 2B | 7 | 0 | 2 | 1 | 0 | 10 (Poor) |
24 | Juszczak et al. 2018 | Examining the Effects of a Powered Exoskeleton on Quality of Life and Secondary Impairments in People Living With Spinal Cord Injury | 2B | 6 | 1 | 3 | 0 | 0 | 10 (Poor) |
25 | Karelis et al. 2017 | Effect on body composition and bone mineral density of walking with a robotic exoskeleton in adults with chronic spinal cord injury | 2B | 7 | 0 | 3 | 0 | 0 | 10 (Poor) |
26 | Kozlowski et al. 2015 | Time and effort required by persons with spinal cord injury to learn to use a powered exoskeleton for assisted walking | 2B | 7 | 1 | 2 | 0 | 0 | 10 (Poor) |
27 | McIntosh et al. 2020 | The Safety and Feasibility of Exoskeletal-Assisted Walking in Acute Rehabilitation After Spinal Cord Injury | 4 | 6 | 1 | 3 | 0 | 0 | 10 (Poor) |
28 | Ramanujam et al. 2018 (A) | Neuromechanical adaptations during a robotic powered exoskeleton assisted walking session | 3B | 7 | 0 | 3 | 0 | 0 | 10 (Poor) |
29 | Sale et al. 2018 (B) | Training for mobility with exoskeleton robot in spinal cord injury patients: a pilot study | 2B | 7 | 0 | 3 | 0 | 0 | 10 (Poor) |
30 | Birch et al. 2017 | Results of the first interim analysis of the RAPPER II trial in patients with spinal cord injury: ambulation and functional exercise programs in the REX powered walking aid | 2B | 7 | 1 | 1 | 0 | 0 | 9 (Poor) |
31 | Evans et al. 2015 | Acute Cardiorespiratory and Metabolic Responses During Exoskeleton-Assisted Walking Overground Among Persons with Chronic Spinal Cord Injury | 2B | 6 | 0 | 3 | 0 | 0 | 9 (Poor) |
32 | Gagnon et al. 2019 (B) | Satisfaction and perceptions of long-term manual wheelchair users with a spinal cord injury upon completion of a locomotor training program with an overground robotic exoskeleton | 2B | 6 | 0 | 3 | 0 | 0 | 9 (Poor) |
33 | Hartigan et al. 2015 | Mobility outcomes following five training sessions with a powered exoskeleton | 2B | 6 | 1 | 2 | 0 | 0 | 9 (Poor) |
34 | Lonini et al. 2016 | Accelerometry-enabled measurement of walking performance with a robotic exoskeleton: a pilot study | 3B | 5 | 1 | 3 | 0 | 0 | 9 (Poor) |
35 | Ramanujam et al. 2018 (B) | Mechanisms for improving walking speed after longitudinal powered robotic exoskeleton training for individuals with spinal cord injury | 3B | 6 | 0 | 3 | 0 | 0 | 9 (Poor) |
36 | Kressler et al. 2014 (A) | Understanding therapeutic benefits of overground bionic ambulation: exploratory case series in persons with chronic, complete spinal cord injury | 4 | 6 | 0 | 2 | 0 | 0 | 8 (Poor) |
37 | Kolakowsky-Hayner et al. 2013 | Safety and Feasibility of using the EksoTM Bionic Exoskeleton to Aid Ambulation after Spinal Cord Injury | 2B | 5 | 1 | 1 | 0 | Â | 7 (Poor) |
38 | Kressler et al. 2019 (B) | Cardiometabolic Challenges Provided by Variable Assisted Exoskeletal Versus Overground Walking in Chronic Motor-incomplete Paraplegia: A Case Series | 4 | 5 | 0 | 2 | 0 | 0 | 7 (Poor) |
39 | Manns et al. 2019 | Perspectives of people with spinal cord injury learning to walk using a powered exoskeleton | 2B | 5 | 0 | 1 | 0 | 0 | 6 (Poor) |
40 | Talaty et al. 2013 | Differentiating ability in users of the ReWalk(TM) powered exoskeleton: an analysis of walking kinematics | 3B | 3 | 0 | 0 | 0 | 0 | 3 (Poor) |
41 | Cahill et al. 2018 | Gym-based exoskeleton walking: A preliminary exploration of non-ambulatory end-user perspectives | 4 | 2 | 0 | 0 | 0 | 0 | 2 (Poor) |