Evidence map›Paper›PMID 41803279›Full record

ArticleSpinal cord2026

Wearable powered overground exoskeleton reduces dose-dependently the spasticity in individuals with spinal cord injury.

Sanaz Pournajaf, Giovanni Morone, Giorgio Felzani, Leonardo Pellicciari, Elena Sofia Cocco, Carlotta Maria Manzia, Laura Simoncini, Rocco Salvatore Calabrò, Marco Franceschini

Abstract readMulticenter Study
In one paragraph

Article in Spinal cord, 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. Review
  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

9 authors.

Sanaz PournajafResearch Area in Neuromotor Rehabilitation and Rehabilitation Robotics, Department of Neuroscience, IRCCS San Raffaele Roma, Rome, Italy.ORCID http://orcid.org/0000-0001-8749-2236
Giovanni MoroneDepartment of Life, Health and Environmental Sciences, University of L'Aquila, 67100, L'Aquila, Italy. giovanni.morone@univaq.it.ORCID http://orcid.org/0000-0003-3602-4197
Giorgio FelzaniSan Raffaele Institute of Sulmona, 67039, Sulmona, Italy.
Leonardo PellicciariIRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.
Elena Sofia CoccoResearch Area in Neuromotor Rehabilitation and Rehabilitation Robotics, Department of Neuroscience, IRCCS San Raffaele Roma, Rome, Italy.ORCID http://orcid.org/0009-0008-5825-5707
Carlotta Maria ManziaResearch Area in Neuromotor Rehabilitation and Rehabilitation Robotics, Department of Neuroscience, IRCCS San Raffaele Roma, Rome, Italy.
Laura SimonciniSpinal Unit, Montecatone Rehabilitation Institute, Imola, Italy.
Rocco Salvatore CalabròIRCCS Centro Neurolesi Bonino-Pulejo, 98124, Messina, Italy.
Marco FranceschiniResearch Area in Neuromotor Rehabilitation and Rehabilitation Robotics, Department of Neuroscience, IRCCS San Raffaele Roma, Rome, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

STUDY

designA multicenter retrospective pre-post cohort study.

objectiveThis study aimed to evaluate the dose-dependent effects of overground exoskeleton-assisted gait training on spasticity and functional independence in individuals with SCI.

settingIRCCS San Raffaele Rome, San Raffaele Sulmona, Centro Neurolesi Bonino Pulejo IRCCS in Messina, and Montecatone Rehabilitation Institute in Imola.

methodsSeventy-four participants with SCI underwent a minimum of five gait training sessions using the Ekso™ exoskeleton. Primary outcomes included changes in spasticity, measured via the aggregated Modified Ashworth Scale (MAS), and functional independence, assessed by the Spinal Cord Independence Measure (SCIM) III. Secondary analyses explored the influence of treatment dosage.

resultsSignificant reductions in spasticity were observed across all muscle groups (proximal, intermediate, and distal) post-intervention (p < 0.0001). SCIM scores also showed substantial improvements (p < 0.0001), indicating enhanced functional independence. Participants receiving ≥15 sessions demonstrated greater gains compared to those with fewer sessions (p < 0.05).

conclusionsOverground exoskeleton-assisted gait training effectively reduces spasticity and improves functional independence in individuals with SCI, with greater benefits observed at higher session frequencies. These findings support the integration of wearable powered exoskeletons into standard rehabilitation protocols for SCI.

Indexed as

Exoskeleton DeviceMuscle SpasticitySpinal Cord InjuriesWearable Electronic DevicesAdultAgedFemaleGaitHumansMaleMiddle AgedRetrospective StudiesTreatment OutcomeYoung Adult

Identifiers

PMID41803279
PMCPMC13441877

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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.