Midwest Regional Spinal Cord Injury Care System Robotic Exoskeleton Module

Using a Health Technology Assessment Framework for Evaluating the Utilization and Efficiency of Wearable Exoskeleton for Spinal Cord Injury Rehabilitation

Posted By Allison Peipert

Background Information


Robot-assisted therapy (RT) is used increasingly as a treatment to improve walking after SCI; the field has seen sustained, rapid growth over the past decade. While RT was expected to provide enhanced benefits over more labor-intensive, less controlled motor learning strategies, so far, it has not demonstrated greater effectiveness than conventional therapy in improving function in patients with a range of neurological conditions. Where some investigators are calling for RT to “trot back to the starting gate” due to its lack of superiority over standard care with respect to functional gains, an alternative scenario that could make RT an attractive supplement to conventional therapy is one in which RT provides similar patient benefits at a lower cost. Indeed, one of the main arguments supporting the continued use and development of RT in rehabilitation has been the assumption that cost savings would be achieved by reducing labor costs.

What is the goal of this project?


The goal of this collaborative module is to obtain evidence that informs consumers, clinicians, insurers, and manufacturers about the utilization and cost-effectiveness of robotic exoskeletons in inpatient, outpatient, and community settings. Findings will inform clinical practice, guide commercial development of rehabilitation robots for human mobility, and assist in planning of clinical trials.

What are the aims of this project?


  1. Describe the physical, psychological, demographic, and socio-economic characteristics, and insurance coverage of patients who receive RT-exo therapy

  2. Compare the treatment goals and outcomes of patients who receive RT-exo therapy vs. conventional therapy in terms of functional goals and targeted impairments using performance-based measures (motor strength, endurance, gait characteristics), and patient-reported outcomes stratified by injury level, completeness, and chronicity.

  3. Evaluate the cost effectiveness and budget impact of RT-exo therapy vs. conventional therapy to the individual, the health care system, and society.

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