Design and evaluation of an independent 4‐week, exosuit‐assisted, post‐stroke community walking program

Author:

Nuckols Richard W.12ORCID,Chang Chih‐Kang1ORCID,Kim Daekyum1ORCID,Eckert‐Erdheim Asa1,Orzel Dorothy1,Baker Lauren1,Baker Teresa3,Wendel Nicholas C.3,Quinlivan Brendan1,Murphy Patrick1,Grupper Jesse1,Villalobos Jacqueline1,Awad Louis N.3,Ellis Terry D.3,Walsh Conor J.1

Affiliation:

1. John A. Paulson School of Engineering and Applied Sciences Harvard University Boston Massachusetts USA

2. Department of Systems Design Engineering University of Waterloo Waterloo Ontario Canada

3. Department of Physical Therapy Boston University Boston Massachusetts USA

Abstract

AbstractChronic impairment in the paretic ankle following stroke often requires that individuals use compensatory patterns such as asymmetric propulsion to achieve effective walking speeds needed for community engagement. Ankle exosuit assistance can provide ankle biomechanical benefit in the lab, but such environments inherently limit the amount of practice available. Community walking studies without exosuits can provide massed practice and benefit walking speed but are limited in their ability to assist proper mechanics. In this study, we combined the positive aspects of community training with those of exosuit assistance. We developed and evaluated a community Robotic Exosuit Augmented Locomotion (cREAL) program. Four participants in the chronic stage of stroke independently used our community ankle exosuit for walking in the community 3–5 days/week for 4 weeks. We performed lab evaluations before and after the 4‐week program. Two participants significantly improved their unassisted paretic propulsion by an average of 27% after the program and walked on average 4001 steps/day more in the week following the program. Despite the small number of participants, this study provides preliminary evidence for the potential of exosuits to augment gait training and rehabilitation in the community.

Funder

National Institutes of Health

National Science Foundation

Publisher

Wiley

Subject

History and Philosophy of Science,General Biochemistry, Genetics and Molecular Biology,General Neuroscience

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