Overground Walking Program With Robotic Exoskeleton in Long-term Manual Wheelchair Users With Spinal Cord Injury

Inclusion Criteria: * Traumatic or non-traumatic spinal cord injury between C6 and T10 neurological level at least 18 months pre-enrollment * Long-term wheelchair use as primary means of mobility (non-ambulatory) * Normal cognition (Montreal Cognitive Assessment Score ≥26/30) * Understand and communicate in English of French * Reside in the community within 75 km of the research site Exoskeleton-specific inclusion criteria: * Body mass ≤100 kg * Height=1.52-1.93 m * Pelvis width=30-46 cm * Thigh length=51-61.4 cm * Lower leg length=48-63.4 cm * Standing tolerance ≥30 minutes with full lower extremity weight-bearing Exclusion Criteria: * Other neurological impairments aside from those linked to the spinal cord injury (e.g., severe traumatic brain injury) * Concomitant or secondary musculoskeletal impairments (e.g., hip heterotopic ossification) * History of lower extremity fracture within the past year * Unstable cardiovascular or autonomic system * Pregnancy * Any other other conditions that may preclude lower extremity weight-bearing, walking, or exercise tolerance in the wearable robotic exoskeleton Exoskeleton-specific exclusion criteria: * Inability to sit with hips and knees ≥90° flexion * Lower extremity passive range of motion limitations (hip flexion contracture ≥5°, knee flexion contracture ≥10°, and dorsiflexion ≤-5° with knee extended) * Moderate-to-sever lower extremity spasticity (\>3 modified Ashworth score) * Length discrepancy (≥1.3 or 1.9 cm at the thi…