# Effectiveness of overground robotic exoskeletons in early inpatient rehabilitation for incomplete spinal cord injury: a systematic review protocol

## TL;DR

This paper outlines a systematic review protocol to assess how effective robotic exoskeletons are compared to traditional methods in early rehabilitation for people with incomplete spinal cord injuries.

## Contribution

The study introduces a structured protocol to evaluate the effectiveness of overground robotic exoskeletons in early inpatient rehabilitation for incomplete spinal cord injury.

## Key findings

- The protocol will use PRISMA-P guidelines to systematically evaluate evidence.
- It will include randomized and non-randomized controlled trials up to December 2025.
- The review aims to address a gap in clinical guidelines for spinal cord injury rehabilitation.

## Abstract

Spinal cord injury affects approximately 9 million people worldwide, with incomplete injuries representing the majority of cases and offering greater potential for functional recovery. Overground robotic exoskeletons have emerged as promising rehabilitation tools, yet evidence regarding their effectiveness specifically during early inpatient rehabilitation remains inadequately synthesised.

To systematically evaluate the effectiveness of overground robotic exoskeletons compared to conventional rehabilitation for improving walking function in adults with incomplete spinal cord injury during early inpatient rehabilitation.

This protocol follows PRISMA-P guidelines. Searches will be conducted across MEDLINE, Embase, CINAHL, Cochrane Library, and PEDro from inception through December 2025. Randomised and non-randomised controlled trials will be included. Two reviewers will independently screen studies using Covidence, extract data, and assess risk of bias using RoB 2 and ROBINS-I tools. Meta-analysis will be conducted where appropriate.

This protocol establishes a rigorous framework for synthesising evidence on early exoskeleton-assisted rehabilitation, addressing a critical gap in clinical practice guidelines for spinal cord injury rehabilitation.