Abstract
Objective
To describe systematic reviews (SRs) of the use of exoskeletons for gait and mobility
by persons with neurologic disorders and to evaluate their quality as guidance for
research and clinical practice.
Data Sources
PubMed, EMBASE, Web of Science, CINAHL Complete, PsycINFO, Cochrane Database of Systematic
Reviews, PEDro, and Google Scholar were searched from database inception to January
23, 2018.
Study Selection
A total of 331 deduplicated abstracts from bibliographic database and ancestor searching
were independently screened by 2 reviewers, resulting in 109 articles for which full
text was obtained. Independent screening of those 109 articles by 2 reviewers resulted
in a final selection of 17 SRs.
Data Extraction
Data were extracted by 1 reviewer using a pretested Excel form with 158 fields and
checked by a second reviewer. Key data included the purpose of the SR, methods used,
outcome measures presented, and conclusions. The Preferred Reporting Items for Systematic
Reviews and Meta-Analyses and A MeaSurement Tool to Assess Systematic Reviews version
2 were used to evaluate reporting and methodological quality, respectively, of the
SRs.
Data Synthesis
The SRs generally were of poor methodological and reporting quality. They failed to
report some information on patients (eg, height, weight, baseline ambulatory status)
and interventions (eg, treatment hours or sessions planned and delivered) that clinicians
and other stakeholders might want to have, and often failed to notice that the primary
studies duplicated subjects.
Conclusions
Published SRs on exoskeletons have many weaknesses in design and execution; clinicians,
researchers, and other stakeholders should be cautious in relying on them to make
decisions on the use of this technology. Future primary and secondary studies need
to address the multiple methodological limitations.
Keywords
List of abbreviations:
AMSTAR 2 (A MeaSurement Tool to Assess Systematic Reviews version 2), MA (meta-analysis), PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), SCI (spinal cord injury), SR (systematic review)To read this article in full you will need to make a payment
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Article Info
Publication History
Published online: March 05, 2019
Footnotes
Current affiliation for Galen, Department of Physical Therapy, Georgia State University, Atlanta, Georgia.
PROSPERO Systematic Review Registration No.: CRD42017058397.
Disclosures: none.
Identification
Copyright
© 2020 by the American Congress of Rehabilitation Medicine
