AUTHOR=Porciuncula Franchino , Baker Teresa C. , Arumukhom Revi Dheepak , Bae Jaehyun , Sloutsky Regina , Ellis Terry D. , Walsh Conor J. , Awad Louis N. 

TITLE=Targeting Paretic Propulsion and Walking Speed With a Soft Robotic Exosuit: A Consideration-of-Concept Trial

JOURNAL=Frontiers in Neurorobotics

VOLUME=15

YEAR=2021

URL=https://www.frontiersin.org/journals/neurorobotics/articles/10.3389/fnbot.2021.689577

DOI=10.3389/fnbot.2021.689577

ISSN=1662-5218

ABSTRACT=<p><bold>Background:</bold> Soft robotic exosuits can facilitate immediate increases in short- and long-distance walking speeds in people with post-stroke hemiparesis. We sought to assess the feasibility and rehabilitative potential of applying propulsion-augmenting exosuits as part of an individualized and progressive training program to retrain faster walking and the underlying propulsive strategy.</p><p><bold>Methods:</bold> A 54-yr old male with chronic hemiparesis completed five daily sessions of Robotic Exosuit Augmented Locomotion (REAL) gait training. REAL training consists of high-intensity, task-specific, and progressively challenging walking practice augmented by a soft robotic exosuit and is designed to facilitate faster walking by way of increased paretic propulsion. Repeated baseline assessments of comfortable walking speed over a 2-year period provided a stable baseline from which the effects of REAL training could be elucidated. Additional outcomes included paretic propulsion, maximum walking speed, and 6-minute walk test distance.</p><p><bold>Results:</bold> Comfortable walking speed was stable at 0.96 m/s prior to training and increased by 0.30 m/s after training. Clinically meaningful increases in maximum walking speed (Δ: 0.30 m/s) and 6-minute walk test distance (Δ: 59 m) were similarly observed. Improvements in paretic peak propulsion (Δ: 2.80 %BW), propulsive power (Δ: 0.41 W/kg), and trailing limb angle (Δ: 6.2 degrees) were observed at comfortable walking speed (<italic>p</italic>'s &lt; 0.05). Likewise, improvements in paretic peak propulsion (Δ: 4.63 %BW) and trailing limb angle (Δ: 4.30 degrees) were observed at maximum walking speed (<italic>p</italic>'s &lt; 0.05).</p><p><bold>Conclusions:</bold> The REAL training program is feasible to implement after stroke and capable of facilitating rapid and meaningful improvements in paretic propulsion, walking speed, and walking distance.</p>