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

Sung Yul Shin; Kristen Hohl; Matt Giffhorn; Louis N Awad; Conor J Walsh; Arun Jayaraman

doi:10.1186/s12984-022-01034-2

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

J Neuroeng Rehabil. 2022 Jun 3;19(1):51. doi: 10.1186/s12984-022-01034-2.

Authors

Sung Yul Shin^{1

2}, Kristen Hohl¹, Matt Giffhorn¹, Louis N Awad^{3

4}, Conor J Walsh^{5

4}, Arun Jayaraman^{6

7}

Affiliations

¹ Max Nader Lab for Rehabilitation Technologies and Outcomes Research, Shirley Ryan AbilityLab, 355 E Erie St., Chicago, IL, 60611, USA.
² Department of Physical Medicine and Rehabilitation, Northwestern University, 710 N Lake Shore Dr, Chicago, IL, 60611, USA.
³ College of Health and Rehabilitation Sciences: Sargent College, Boston University, Boston, USA.
⁴ Wyss Institute for Biologically Inspired Engineering, Harvard University, Cambridge, USA.
⁵ Harvard John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, USA.
⁶ Max Nader Lab for Rehabilitation Technologies and Outcomes Research, Shirley Ryan AbilityLab, 355 E Erie St., Chicago, IL, 60611, USA. a-jayaraman@northwestern.edu.
⁷ Department of Physical Medicine and Rehabilitation, Northwestern University, 710 N Lake Shore Dr, Chicago, IL, 60611, USA. a-jayaraman@northwestern.edu.

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 ([Formula: see text] < 0.05) and endurance ([Formula: see text] < 0.01) together with other traditional gait related outcomes. The gait quality measures including hip ([Formula: see text] < 0.01) and knee ([Formula: see text] < 0.05) flexion/extension exhibited an increase in range of motion in a symmetric manner ([Formula: see text] < 0.05). We also observed an increase in bilateral ankle angular velocities ([Formula: see text] < 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).

Keywords: Clinical outcomes; Exosuit; Gait quality; High intensity gait training; Soft robotics; Stroke.

Publication types

Research Support, Non-U.S. Gov't
Research Support, N.I.H., Extramural

MeSH terms

Exercise Therapy
Gait
Humans
Pilot Projects
Robotics*
Stroke* / complications
Survivors

Associated data

ClinicalTrials.gov/NCT04251091

Abstract

Publication types

MeSH terms

Associated data

Grants and funding