Soft robotic exosuit augmented high intensity gait training on stroke survivors: a pilot study

Abstract

Background Stroke is a leading cause of serious gait impairments and restoring walking ability is a major goal of physical therapy interventions. Soft robotic exosuits are portable, lightweight, and unobtrusive assistive devices designed to improve the mobility of post-stroke individuals through facilitation of more natural paretic limb function during walking training. However, it is unknown whether long-term gait training using soft robotic exosuits will clinically impact gait function and quality of movement post-stroke. Objective The objective of this pilot study was to examine the therapeutic effects of soft robotic exosuit-augmented gait training on clinical and biomechanical gait outcomes in chronic post-stroke individuals. Methods Five post-stroke individuals received high intensity gait training augmented with a soft robotic exosuit, delivered in 18 sessions over 6–8 weeks. Performance based clinical outcomes and biomechanical gait quality parameters were measured at baseline, midpoint, and completion. Results Clinically meaningful improvements were observed in walking speed ($$p$$ p < 0.05) and endurance ($$p$$ p < 0.01) together with other traditional gait related outcomes. The gait quality measures including hip ($$p$$ p < 0.01) and knee ($$p$$ p < 0.05) flexion/extension exhibited an increase in range of motion in a symmetric manner ($$p$$ p < 0.05). We also observed an increase in bilateral ankle angular velocities ($$p$$ p < 0.05), suggesting biomechanical improvements in walking function. Conclusions The results in this study offer preliminary evidence that a soft robotic exosuit can be a useful tool to augment high intensity gait training in a clinical setting. This study justifies more expanded research on soft exosuit technology with a larger post-stroke population for more reliable generalization. Trial registration This study is registered with ClinicalTrials.gov (ID: NCT04251091)

Opportunities and challenges in the development of exoskeletons for locomotor assistance

“…Several commercial devices have been examined for their clinical potential, including Ekso [158][159][160] and Indego 161 for SCI, ReWalk for MS 162 , as well as HAL 163 and ReStore 122,164 for stroke. The results have shown acceptable feasibility and safety; however, occurrences of non-injurious falls 158 and skin issues owing to device fit (such as redness and minor abrasion) 122,161 were noted.…”

Soft Wearable Robots: Development Status and Technical Challenges

“…To accommodate variability during hemiparetic walking, specialized schemes such as offline assistance optimization [ 83 ] and muscle-based assistance [ 84 ] took charge of customizing the assistance profile. Some evaluation experiments [ 85 , 86 ] were carried out with stroke survivors, demonstrating that this system could lead to an increase in walking speed/distance and a decrease in metabolic expenditure. The exosuit designed by Schubert et al [ 54 ] transmitted power to the ankle through utilizing Bowden cables, and realized plantarflexion support and dorsiflexion augmentation based on autonomous gait recognition.…”

Correction to: Soft robotic exosuit augmented high intensity gait training on stroke survivors: a pilot study

“…Following the publication of the original article [ 1 ], the text “ Patents describing the exosuit components documented in this article have been filed with the U.S. Patent Office. They are licensed by ReWalk Robotics and C.J.W.…”