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 th...

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Main Authors: Sung Yul Shin, Kristen Hohl, Matt Giffhorn, Louis N. Awad, Conor J. Walsh, Arun Jayaraman
Format: Article
Language:English
Published: BMC 2022-06-01
Series:Journal of NeuroEngineering and Rehabilitation
Subjects:
Online Access:https://doi.org/10.1186/s12984-022-01034-2
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author Sung Yul Shin
Kristen Hohl
Matt Giffhorn
Louis N. Awad
Conor J. Walsh
Arun Jayaraman
author_facet Sung Yul Shin
Kristen Hohl
Matt Giffhorn
Louis N. Awad
Conor J. Walsh
Arun Jayaraman
author_sort Sung Yul Shin
collection DOAJ
description 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)
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spelling doaj.art-d27ea098d1a848e99652df8995760e0d2022-12-22T00:55:50ZengBMCJournal of NeuroEngineering and Rehabilitation1743-00032022-06-0119111210.1186/s12984-022-01034-2Soft robotic exosuit augmented high intensity gait training on stroke survivors: a pilot studySung Yul Shin0Kristen Hohl1Matt Giffhorn2Louis N. Awad3Conor J. Walsh4Arun Jayaraman5Max Nader Lab for Rehabilitation Technologies and Outcomes Research, Shirley Ryan AbilityLabMax Nader Lab for Rehabilitation Technologies and Outcomes Research, Shirley Ryan AbilityLabMax Nader Lab for Rehabilitation Technologies and Outcomes Research, Shirley Ryan AbilityLabCollege of Health and Rehabilitation Sciences: Sargent College, Boston UniversityHarvard John A. Paulson School of Engineering and Applied Sciences, Harvard UniversityMax Nader Lab for Rehabilitation Technologies and Outcomes Research, Shirley Ryan AbilityLabAbstract 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)https://doi.org/10.1186/s12984-022-01034-2ExosuitSoft roboticsHigh intensity gait trainingClinical outcomesGait qualityStroke
spellingShingle Sung Yul Shin
Kristen Hohl
Matt Giffhorn
Louis N. Awad
Conor J. Walsh
Arun Jayaraman
Soft robotic exosuit augmented high intensity gait training on stroke survivors: a pilot study
Journal of NeuroEngineering and Rehabilitation
Exosuit
Soft robotics
High intensity gait training
Clinical outcomes
Gait quality
Stroke
title Soft robotic exosuit augmented high intensity gait training on stroke survivors: a pilot study
title_full Soft robotic exosuit augmented high intensity gait training on stroke survivors: a pilot study
title_fullStr Soft robotic exosuit augmented high intensity gait training on stroke survivors: a pilot study
title_full_unstemmed Soft robotic exosuit augmented high intensity gait training on stroke survivors: a pilot study
title_short Soft robotic exosuit augmented high intensity gait training on stroke survivors: a pilot study
title_sort soft robotic exosuit augmented high intensity gait training on stroke survivors a pilot study
topic Exosuit
Soft robotics
High intensity gait training
Clinical outcomes
Gait quality
Stroke
url https://doi.org/10.1186/s12984-022-01034-2
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