Effects of an exoskeleton robot on motor function in patients with spinal cord injuries: a systematic review and meta-analysis
Abstract
This meta-analysis aimed to evaluate the impact of exoskeleton robotic training on motor function in spinal cord injury (SCI) patients. We systematically reviewed randomized and non-randomized controlled trials from five databases (PubMed, Embase, Cochrane Library, Scopus, Web of Science) up to September 2025. A total of 13 trials with 247 participants were included. Results showed that exoskeleton robotic training significantly improved several motor function measures: the 6-min walk test (6-MWT) (0.75 [95% CI = 0.42, 1.08]), 10-m walk test (0.91 [95% CI = 0.49, 1.33]), Walking Index for Spinal Cord Injury (WISCI-II) (0.76 [95% CI = 0.36, 1.15]), timed up and go (TUG) test (− 1.05 [95% CI = − 1.50, − 0.60]), and lower extremity motor score (LEMS) (0.65 [95% CI = 0.40, 0.90]). Subgroup analysis indicated that improvements in walking speed were consistent regardless of injury duration (> 6 vs. < 6 months). In contrast, when stratified by cumulative training time, a non-linear dose–response relationship was observed, with the greatest improvement occurring at 1000–2000 min of training, while both lower and higher doses yielded attenuated effects. Although there was high heterogeneity in some measures (6-MWT, 10-MWT, WISCI-II, TUG), excluding individual studies did not significantly alter the findings, indicating stable results. Exoskeleton robotics significantly improves motor function in SCI patients, with walking function benefiting both within and beyond 6 months after…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 247 participants or records.
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