Evidence map›Paper›PMID 41652436›Full record

Trial reportBiomedical engineering online2026

Walking rehabilitation in incomplete spinal cord injury: evaluating the impact of robotic exoskeleton-assisted training.

Fater A Khadour, Younes A Khadour, Gouda Xiang, Xiuli Dao

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in Biomedical engineering online, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Fater A KhadourDepartment of Rehabilitation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095#, Jie-Fang Avenue, Qiaokou District, Wuhan, 430030, Hubei, China. faterkhadour93@yahoo.com.
Younes A KhadourDepartment of Rehabilitation, Faculty of Medicine, Al Baath University, Homs, Syria.
Gouda XiangDepartment of Sport Education, Neijiang Normal University, Neijiang, 641004, Sichuan, China.
Xiuli DaoDepartment of Sport Education, Neijiang Normal University, Neijiang, 641004, Sichuan, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe use of lower limb exoskeletons in clinical rehabilitation has expanded in recent years, offering potential benefits for walking recovery. However, current clinical evidence on their effectiveness remains inconclusive. Additionally, the way individuals adapt to these robotic devices and how this adaptation contributes to functional improvements is not yet fully understood. This study was intended to (1) investigate the safety and feasibility of the Fourier X2 exoskeleton for walking rehabilitation and (2) examine its effect on walking function following a rehabilitation program.

methodsA randomized controlled trial was undertaken with 46 individuals who had suffered a spinal cord injury (SCI) within the last year. Participants were randomly allocated into two groups: an intervention group (IG), which received gait training using the Fourier X2 exoskeleton, and a control group (CG), which underwent conventional gait training. Each participant completed 20 gait training sessions lasting one hour. The neurological impairment ranged from C2 to L4, with participants classified under the American Spinal Injury Association Impairment Scale (AIS) C or D. The treatment program involved 20 gait training sessions, each lasting one hour, utilizing the Fourier X2 exoskeleton. Safety was assessed by tracking adverse events, while pain and fatigue levels were measured using the Visual Analogue Scale (VAS). Functional outcomes were evaluated through the Lower Extremity Motor Score (LEMS), Walking Index for Spinal Cord Injury II (WISCI-II), Spinal Cord Independence Measure III (SCIM-III), and various walking assessments, including the 10-Meter Walk Test (10MWT), 6-Minute Walk Test (6MWT), and Timed Up and Go (TUG).

resultsNo major complications were observed during the study. Participants in the intervention group (IG) reported experiencing mild pain (1.7 cm, SD 1.1) and moderate fatigue (3.3 cm, SD 1.6) as measured by the Visual Analogue Scale (VAS, 0-10 cm range). Statistical analysis of WISCI-II scores showed notable progress in both the "group" effect (F = 17.82, p < 0.001) and the "group-time" interaction (F = 7.27, p = 0.03). Further post-hoc evaluations revealed that the IG achieved a significant improvement of 3.20 points (SD 2.16, p < 0.0001), whereas the control group (CG) demonstrated a minor, non-significant increase of 0.5 points (SD 1.31, p = 0.32). No other variables showed significant differences between the two groups.

conclusionsThe Fourier X2 exoskeleton is both safe and well-tolerated in clinical environments. Participants who received training with the device exhibited enhanced walking independence, as reflected in their WISCI-II scores.

trial registrationThe Chinese Clinical Trial Register (ChiCTR) includes this study under registration number ChiCTR2000041186, dated December 21, 2020.

Indexed as

Exoskeleton DeviceRoboticsSpinal Cord InjuriesWalkingAdultFemaleGaitHumansMaleMiddle AgedTreatment OutcomeAmbulatory exoskeletonsFourier X2 exoskeletonFunctional improvementSpinal cord injuryWalking rehabilitation

Identifiers

PMID41652436
PMCPMC12973721

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.