Comprehensive Summary
Bartloff et al. analyzed how new, emerging technology is impacting therapy specifically for gait impairments; these impairments have severely affected mobility and quality of life for many, especially resulting from disease and neurologic injury. Traditional gait rehabilitation faces many hindrances in providing specificity, intensity, and ecological validity for optimal recovery. Therefore, the emergence of exoskeletons, biofeedback systems, and electrical stimulators are starting to emerge as solutions- providing more engaging intervention for patients even beyond the clinic. Bartloff et al. specifically reviewed current wearable technologies through detailed searching of clinical studies, feasibility trials, and clinical applications. The technology was divided into two categories: therapeutic interventions and sensory augmentation. Therapeutic interventions included soft exosuits and robotic exoskeletons. In addition, portable neuromodulation techniques like Functional Electrical Stimulation (FES), transcutaneous spinal cord stimulation (tSCS), and transcranial direct current stimulation (tDCS) were analyzed. Regarding sensory augmentation, virtual reality and augmented reality platforms and biofeedback systems related to the auditory, haptic, and visual sensory information were analyzed thoroughly. Through a comprehensive review of these current technologies, the authors reaffirmed that these wearable technologies are supporting gait rehabilitation immensely. Robotic exoskeletons, FES, and biofeedback are already supported by high levels of evidence, but neuromodulation, virtual reality, and augmented reality still require further research and validation in real-world applications.
Outcomes and Implications
As mentioned, robotic exoskeletons, FES, and biofeedback are already supported by high levels of evidence, but neuromodulation, virtual reality, and augmented reality still require more research and application. In addition to this, the researchers also highlighted the high costs, limited reimbursement, fragmented evidence, and usability issues that these new emerging technologies may come with. There is a high barrier with these issues at hand, but the authors did anticipate that in the next five years, wearable technologies for gait rehabilitation will be integrated into rehabilitation ecosystems. This anticipation includes the concept that these technologies will be vital for transforming care through collaboration with artificial intelligence and machine learning for optimized, personalized patient care.