Effects of a soft robotic exosuit on the quality and speed of overground walking depends on walking ability after stroke
Abstract Background Soft robotic exosuits can provide partial dorsiflexor and plantarflexor support in parallel with paretic muscles to improve poststroke walking capacity. Previous results indicate that baseline walking ability may impact a user’s ability to leverage the exosuit assistance, while t...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-09-01
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| Series: | Journal of NeuroEngineering and Rehabilitation |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12984-023-01231-7 |
| _version_ | 1797577670771343360 |
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| author | Lizeth H. Sloot Lauren M. Baker Jaehyun Bae Franchino Porciuncula Blandine F. Clément Christopher Siviy Richard W. Nuckols Teresa Baker Regina Sloutsky Dabin K. Choe Kathleen O’Donnell Terry D. Ellis Louis N. Awad Conor J. Walsh |
| author_facet | Lizeth H. Sloot Lauren M. Baker Jaehyun Bae Franchino Porciuncula Blandine F. Clément Christopher Siviy Richard W. Nuckols Teresa Baker Regina Sloutsky Dabin K. Choe Kathleen O’Donnell Terry D. Ellis Louis N. Awad Conor J. Walsh |
| author_sort | Lizeth H. Sloot |
| collection | DOAJ |
| description | Abstract Background Soft robotic exosuits can provide partial dorsiflexor and plantarflexor support in parallel with paretic muscles to improve poststroke walking capacity. Previous results indicate that baseline walking ability may impact a user’s ability to leverage the exosuit assistance, while the effects on continuous walking, walking stability, and muscle slacking have not been evaluated. Here we evaluated the effects of a portable ankle exosuit during continuous comfortable overground walking in 19 individuals with chronic hemiparesis. We also compared two speed-based subgroups (threshold: 0.93 m/s) to address poststroke heterogeneity. Methods We refined a previously developed portable lightweight soft exosuit to support continuous overground walking. We compared five minutes of continuous walking in a laboratory with the exosuit to walking without the exosuit in terms of ground clearance, foot landing and propulsion, as well as the energy cost of transport, walking stability and plantarflexor muscle slacking. Results Exosuit assistance was associated with improvements in the targeted gait impairments: 22% increase in ground clearance during swing, 5° increase in foot-to-floor angle at initial contact, and 22% increase in the center-of-mass propulsion during push-off. The improvements in propulsion and foot landing contributed to a 6.7% (0.04 m/s) increase in walking speed (R 2 = 0.82). This enhancement in gait function was achieved without deterioration in muscle effort, stability or cost of transport. Subgroup analyses revealed that all individuals profited from ground clearance support, but slower individuals leveraged plantarflexor assistance to improve propulsion by 35% to walk 13% faster, while faster individuals did not change either. Conclusions The immediate restorative benefits of the exosuit presented here underline its promise for rehabilitative gait training in poststroke individuals. |
| first_indexed | 2024-03-10T22:11:19Z |
| format | Article |
| id | doaj.art-5b6746e083ae46d18d29cb7e64a25160 |
| institution | Directory Open Access Journal |
| issn | 1743-0003 |
| language | English |
| last_indexed | 2024-03-10T22:11:19Z |
| publishDate | 2023-09-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of NeuroEngineering and Rehabilitation |
| spelling | doaj.art-5b6746e083ae46d18d29cb7e64a251602023-11-19T12:35:00ZengBMCJournal of NeuroEngineering and Rehabilitation1743-00032023-09-0120111610.1186/s12984-023-01231-7Effects of a soft robotic exosuit on the quality and speed of overground walking depends on walking ability after strokeLizeth H. Sloot0Lauren M. Baker1Jaehyun Bae2Franchino Porciuncula3Blandine F. Clément4Christopher Siviy5Richard W. Nuckols6Teresa Baker7Regina Sloutsky8Dabin K. Choe9Kathleen O’Donnell10Terry D. Ellis11Louis N. Awad12Conor J. Walsh13Harvard John A. Paulson School of Engineering and Applied SciencesHarvard John A. Paulson School of Engineering and Applied SciencesHarvard John A. Paulson School of Engineering and Applied SciencesHarvard John A. Paulson School of Engineering and Applied SciencesHarvard John A. Paulson School of Engineering and Applied SciencesHarvard John A. Paulson School of Engineering and Applied SciencesHarvard John A. Paulson School of Engineering and Applied SciencesWyss Institute for Biologically Inspired EngineeringWyss Institute for Biologically Inspired EngineeringHarvard John A. Paulson School of Engineering and Applied SciencesHarvard John A. Paulson School of Engineering and Applied SciencesDepartment of Physical Therapy, Boston UniversityWyss Institute for Biologically Inspired EngineeringHarvard John A. Paulson School of Engineering and Applied SciencesAbstract Background Soft robotic exosuits can provide partial dorsiflexor and plantarflexor support in parallel with paretic muscles to improve poststroke walking capacity. Previous results indicate that baseline walking ability may impact a user’s ability to leverage the exosuit assistance, while the effects on continuous walking, walking stability, and muscle slacking have not been evaluated. Here we evaluated the effects of a portable ankle exosuit during continuous comfortable overground walking in 19 individuals with chronic hemiparesis. We also compared two speed-based subgroups (threshold: 0.93 m/s) to address poststroke heterogeneity. Methods We refined a previously developed portable lightweight soft exosuit to support continuous overground walking. We compared five minutes of continuous walking in a laboratory with the exosuit to walking without the exosuit in terms of ground clearance, foot landing and propulsion, as well as the energy cost of transport, walking stability and plantarflexor muscle slacking. Results Exosuit assistance was associated with improvements in the targeted gait impairments: 22% increase in ground clearance during swing, 5° increase in foot-to-floor angle at initial contact, and 22% increase in the center-of-mass propulsion during push-off. The improvements in propulsion and foot landing contributed to a 6.7% (0.04 m/s) increase in walking speed (R 2 = 0.82). This enhancement in gait function was achieved without deterioration in muscle effort, stability or cost of transport. Subgroup analyses revealed that all individuals profited from ground clearance support, but slower individuals leveraged plantarflexor assistance to improve propulsion by 35% to walk 13% faster, while faster individuals did not change either. Conclusions The immediate restorative benefits of the exosuit presented here underline its promise for rehabilitative gait training in poststroke individuals.https://doi.org/10.1186/s12984-023-01231-7Soft exosuitExoskeletonStrokeWalking speedPush-offGround clearance |
| spellingShingle | Lizeth H. Sloot Lauren M. Baker Jaehyun Bae Franchino Porciuncula Blandine F. Clément Christopher Siviy Richard W. Nuckols Teresa Baker Regina Sloutsky Dabin K. Choe Kathleen O’Donnell Terry D. Ellis Louis N. Awad Conor J. Walsh Effects of a soft robotic exosuit on the quality and speed of overground walking depends on walking ability after stroke Journal of NeuroEngineering and Rehabilitation Soft exosuit Exoskeleton Stroke Walking speed Push-off Ground clearance |
| title | Effects of a soft robotic exosuit on the quality and speed of overground walking depends on walking ability after stroke |
| title_full | Effects of a soft robotic exosuit on the quality and speed of overground walking depends on walking ability after stroke |
| title_fullStr | Effects of a soft robotic exosuit on the quality and speed of overground walking depends on walking ability after stroke |
| title_full_unstemmed | Effects of a soft robotic exosuit on the quality and speed of overground walking depends on walking ability after stroke |
| title_short | Effects of a soft robotic exosuit on the quality and speed of overground walking depends on walking ability after stroke |
| title_sort | effects of a soft robotic exosuit on the quality and speed of overground walking depends on walking ability after stroke |
| topic | Soft exosuit Exoskeleton Stroke Walking speed Push-off Ground clearance |
| url | https://doi.org/10.1186/s12984-023-01231-7 |
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