Current gait rehabilitation strategies rely heavily on motor learning principles, which involve facilitating active patient participation, high-doses of biomechanical task-related motor activities and accurate feedback. Furthermore, appropriate muscle groups need to be recruited for the joint movements that constitute the biomechanical task-related activities in order to effectively promote motor learning. Recently, exoskeleton-type robots utilizing crutches have been incorporated into overground gait rehabilitation programs. However, it is unclear which gait-related tasks are being trained because the joint movements and muscle recruitment patterns deviate from those of natural gait. This raises concerns because repetitive training with these devices may not lead to desirable rehabilitative gains. In this study, we compare the lower limb joint angles and electromyography patterns of healthy subjects walking with and without ReWalk in accordance with the three major biomechanical tasks required by bipedal gait: weight acceptance (WA), single-limb support, and limb advancement. Furthermore, we investigate whether the physical constraints of ReWalk, most noticeably the use of crutches and fixed ankle joints, were responsible for the specific changes by conducting additional walking sessions with either crutches or ankle foot orthoses. The results from the six healthy male volunteers suggest that the gait patterns observed with ReWalk deviate significantly from those of natural gait, particularly during the WA, and closely resemble those of crutch gait.

Basic human ambulation relies on a bipedal gait, which has been reported to be directly related to quality of life. However, injuries to the lower limb can cause an inability to walk and require non-weightbearing periods to heal. Among the many ambulatory aids, standard axillary crutches are prescribed. However, due to the disadvantages of having to use both hands, a slow gait, pain, nerve damage, and gait patterns that differ from that of healthy subjects, currently, a new generation of ambulatory aids has emerged. Among such aids, hands-free crutches (HFCs) are of particular interest due to their form factor, which does not require the use of the hands and facilitates a bipedal gait. In this study, we present an assessment of whether any different gait patterns, compared to overground gait, appeared on the unaffected limb during walking with an HFC. The spatiotemporal parameters, plantar force, lower-limb joint angles, and EMG patterns were evaluated. In conclusion, the results from 10 healthy subjects suggest that wearing an HFC causes only slight changes in the biomechanical gait patterns examined in the unaffected limb compared with overground walking without an HFC.