Spatiotemporalgait analysis can provide quantitative information to assess treatment outcomes in stroke survivors. Therefore, clinicians need a portable, easy-to-use and low-cost tool, which accurately and reliably measures spatiotemporal gait parameters. This study examined the concurrent validity and reproducibility of the Gait Up© gait analysis package for spatiotemporal gait analysis in subacute stroke survivors. Twenty-five subacute stroke survivors participated in 2 walking tests. Spatiotemporal gait parameters were synchronously measured by 2 foot-worn inertial sensors (Physilog®) and three-dimensional motion capturing (Vicon). Intraclass correlation coefficients, standard errors of measurement, smallest detectable changes, limits of agreement and Bland-Altman plots were calculated for the paretic and nonparetic side. After removing a consistent outlier (i.e. data of the paretic side of subject 36 who dragged his foot), agreement between both devices was good to excellent for paretic and nonparetic gait cycle time, cadence, stride length, stride velocity and double support; and moderate for paretic and non-paretic stance and swing. Bland-Altman plots supported these findings. Testretest reliability was good to excellent for most parameters, except paretic stance and swing. In conclusion, the Gait Up© gait analysis package is a valid and reliable tool to measure paretic and nonparetic gait cycle time, cadence, stride length and stride velocity in subacute patients with stroke, who don't exhibit severe dragging of the paretic foot. However, the algorithm should be improved for the analysis of paretic stance and swing phase.

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Generally, results suggest that RAG is less energy-consuming and cardiorespiratory stressful than walking without robot-assistance, but results depend on factors such as robot type, walking speed, BWS and effort. Additional research is needed to draw firm conclusions. Implications for Rehabilitation Awareness of the energy consumption and cardiorespiratory load of robot-assisted gait (RAG) training is important in the rehabilitation of (neurological) patients with impaired cardiorespiratory fitness and patients who are at risk of cardiovascular diseases. On the other hand, the integration of sufficient cardiometabolic stress in RAG training could combine the effects of both RAG and aerobic training. Energy consumption and cardiorespiratory load during walking with robot-assistance seems to depend on factors such as robot type, walking speed, body-weight support or amount of effort. These parameters could be adjusted in RAG rehabilitation to make RAG more or less energy-consuming and cardiorespiratory stressful. Overall, short duration exoskeleton walking seems less energy-consuming and cardiorespiratory stressful than walking without robot-assistance. This might implicate that the exercise intensity is safe for (neurological) patients at risk of cardiovascular diseases. How this changes in extended walking time is unclear.

Stroke user group patients seem quite motivated to train with the DGO and both patients and therapists reasonably believe that this training could improve gait functioning. Therapists are moderately satisfied with the usability of the DGO, but there is room for improvement with respect to usefulness and ease of use.

A shared design goal for most robotic lower limb exoskeletons is to reduce the metabolic cost of locomotion for the user. Despite this, only a limited amount of devices was able to actually reduce user metabolic consumption. Preservation of the natural motion kinematics was defined as an important requirement for a device to be metabolically beneficial. This requires the inclusion of all human degrees of freedom (DOF) in a design, as well as perfect alignment of the rotation axes. As perfect alignment is impossible, compensation for misalignment effects should be provided. A misalignment compensation mechanism for a 3-DOF system is presented in this paper. It is validated by the implementation in a bilateral hip exoskeleton, resulting in a compact and lightweight device that can be donned fast and autonomously, with a minimum of required adaptations. Extensive testing of the prototype has shown that hip range of motion of the user is maintained while wearing the device and this for all three hip DOFs. This allowed the users to maintain their natural motion patterns when they are walking with the novel hip exoskeleton.