To perform a systematic review of the literature regarding amputee self-care, and analyze current experts' opinions. The research in Medline and Cochrane Library databases was performed using the keywords "amputee self-care", "amputee health care", "amputee education", and "amputee health management". The methodological quality of the articles was assessed using four levels of evidence and three guideline grades (A: strong; B: moderate; C: poor). One prospective randomized controlled study confirm the level of evidence of self-care amputee persons with grade B, which is similar others chronic diseases self-care. Self-care of amputee persons contributes to improve functional status, depressive syndrome, and also health-related quality of life. A review of the patients' needs and expectations in self-care amputee persons has been established thanks to the presence of qualitative focus group study. A multidisciplinary self-care of amputee persons can be recommended. Regarding literature date, the level of evidence of self-care amputee persons is moderate (grade B). Experts groups are currently working on a self-care amputee persons guideline book in order to standardize practicing and programs in the physical medicine and rehabilitation departments.

How does the level of lower limb amputation affect spatiotemporal gait asymmetry and cautious gait criteria to inform tailored rehabilitation interventions? A retrospective study analyzing gait patterns in individuals with unilateral lower limb amputations. 49 amputees (22 (45 %) transtibial, 27 (55 %) transfemoral) compared to 30 healthy controls, evaluated between January 2018 and June 2023. INTERVENTION PARTICIPANTS: performed a spontaneous walking speed test on a pressure mat (Zebris® FDM 2 & 3 System, 100 Hz, v 1.18.44, GmbH, Isny, Germany) after completing rehabilitation. Gait symmetry and cautious gait were assessed using spatio-temporal parameters, center of pressure (CoP) displacement, and foot segment forces. Increased asymmetry was observed in stance phase duration, step length, stance duration, and walking speed (95 % CI 0.398-0.658) depending on the level of amputation. Transfemoral amputees showed significant increases in step width (95 % CI 0.201-0.512), double support phase (95 % CI 0.000-0.150), and medio-lateral CoP displacement (95 % CI 0.039-0.326). The increased asymmetry in spatio-temporal parameters suggests different compensation strategies between transfemoral and transtibial levels. These differences highlight the importance of the rehabilitation paradigm in managing asymmetry and its underlying compensations during locomotor activities. The level of amputation significantly impacts gait asymmetry and cautious gait parameters. Transfemoral amputees exhibit more pronounced cautious gait characteristics, likely due to the need for greater stabilization. These findings underscore the importance of personalized rehabilitation to address specific compensations and gait abnormalities based on amputation level.

Objective: To perform a systematic review of the literature regarding scientific reality of hippotherapy in children with cerebral palsy graded according to France HAS (Haute Autorité de Santé) recommendations and applied to the International Classification of Functioning. Methods: The research in MEDLINE and Cochrane Library databases was performed using the keywords: “Equestrian therapy,” “Riding for the disabled,” “Hippotherapy,” “Equine-movement therapy,” and “Therapeutic horse (back) riding.” The methodological quality of the articles was assessed using four levels of proof and three guideline grades (A: strong; B: moderate; C: poor). Results: Seven prospective, randomized controlled studies and one systematic review confirm the level of proof of hippotherapy in children with cerebral palsy with grade B. Hippotherapy in children with cerebral palsy contributes to improve motor function, symmetry of muscle contraction, spasticity, posture, and walking. Fifty prospective no randomized studies confirm the level with grade C for balance, motor coordination, lumbopelvic mobility, walking speed, functional development, and social behavior. Conclusions: Hippotherapy in children with cerebral palsy can be recommended. Regarding the literature data, the level of proof of hippotherapy in children with cerebral palsy is moderate (grade B).

Robotic exoskeletons are increasingly used in neurorehabilitation, yet evidence remains limited regarding their role as assistive locomotion devices within a compensatory rehabilitation framework, particularly in individuals with complete spinal cord injury. Multidimensional evaluations integrating safety, usability, and patient-reported experience are still scarce. To evaluate the Atalante self-balancing exoskeleton as an assistive locomotion device in individuals with complete paraplegia through a multidimensional analysis conducted in a controlled clinical environment. This prospective, monocentric, longitudinal study included adults with chronic complete thoracic spinal cord injury (American Spinal Injury Association Impairment Scale grade A, neurological level T6-T12). Participants underwent an intensive 6-week program comprising 60 supervised sessions of exoskeleton-assisted training including 40 m walking per session. Outcomes were assessed across three complementary dimensions: (1) safety (medical adverse events, safety-related technical incidents, near-falls); (2) techno-functional usability (donning/doffing performance, assistance levels, cumulative walking exposure); and (3) acceptability (patient-reported comfort and perceived safety using session-based visual analogue scales). Physiological responses were evaluated using exoskeleton-assisted 6-minute walk tests. Thirteen participants were enrolled; eleven completed the full protocol. One serious adverse event occurred, a tibial plateau fracture in a participant with severe osteoporosis (hip T-score - 3.8), leading to study withdrawal. No other serious medical adverse events were observed. Across 651 sessions, four near-fall events were recorded (0.61% of sessions and 0.16% per 10 m walked). Minor adverse events were transient, and no symptomatic orthostatic hypotension was reported. Oxygen consumption, walking speed, and cost of transport (p > 0.05) remained stable between mid- and end-program assessments, while perceived exertion decreased significantly (p = 0.003). Donning time decreased from 790 [475-966] s during the first session to 223 [159-259] s during the final sessions, and doffing time from 242 [152-275] s to 55 [50-69] s, with familiarization plateau points observed after 14 and 18 sessions, respectively. Harness comfort improved over time, whereas perceived safety remained globally stable, except for transient decreases following fall-prone gait events or technical disengagements. Under supervised clinical conditions, the Atalante exoskeleton demonstrated acceptable safety and feasibility as an assistive locomotion device for individuals with complete paraplegia, enabling hands-free upright indoor walking with low metabolic demand. Severe osteoporosis emerged as a critical risk factor, supporting systematic bone densitometry and cautious exclusion criteria. These findings support the integration of self-balancing exoskeletons into compensatory rehabilitation programs and justify further studies in ecological settings to assess real-world autonomy and participation outcomes. Trial registration ClinicalTrials.gov Identifier: NCT06941896 (retrospective registration).