Motorized Walking Devices for Patients with Compromised Mobility: A Review of Clinical Effectiveness, Cost-Effectiveness, and Guidelines [Internet]

Excerpt

Walking aids have been resorted to for millennia, by individuals requiring assistance with ambulation. Canes, crutches, braces, and orthoses comprise some of the assistive devices available to modern-day individuals with limited or compromised lower limb mobility. The late 1960s saw the development of powered, motorized, and robotic walking devices, which have since improved in design and, in recent years, making their way to market.

Robotic walking assistive devices function largely by detecting the user’s movement intent and by way of motorized joint modules, they assist in completing the movement. Also known as exoskeletons, these devices allow the user to stand, sit, walk, use stairs, and step over obstacles with a relatively natural posture and gait. They have various design features; however, they usually include a waist harness with mechanical joints that extend partially or fully down the legs, a battery unit, and a computer control module. The device is secured around the waist, and the mechanical joints secured around the legs, by means of straps. These devices can be used in conjunction with clinical therapy (e.g., treadmill or physiotherapy exercises) for rehabilitation purposes, or outside of a clinical setting to allow the user to ambulate during their activities of daily living.

In a previous CADTH report (reference list), published in 2015, entitled “Wearable Motorized and Robotic Walking Assistive Devices for Patient with Compromised Mobility: Clinical and Cost-Effectiveness”, three non-randomized studies were found to be relevant, while no economic evaluations were identified. The objective of this report is to update and evaluate the clinical effectiveness and cost-effectiveness, and evidence-based guidelines on the use of motorized or robotic wearable walking assistive devices for adults with compromised mobility.