Browse by author
Lookup NU author(s): Dr Lizeth SlootORCiD
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
© 2023, BioMed Central Ltd., part of Springer Nature.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.
Author(s): Sloot LH, Baker LM, Bae J, Porciuncula F, Clement BF, Siviy C, Nuckols RW, Baker T, Sloutsky R, Choe DK, O'Donnell K, Ellis TD, Awad LN, Walsh CJ
Publication type: Article
Publication status: Published
Journal: Journal of NeuroEngineering and Rehabilitation
Year: 2023
Volume: 20
Issue: 1
Online publication date: 01/09/2023
Acceptance date: 04/08/2023
Date deposited: 07/02/2024
ISSN (electronic): 1743-0003
Publisher: BioMed Central Ltd
URL: https://doi.org/10.1186/s12984-023-01231-7
DOI: 10.1186/s12984-023-01231-7
PubMed id: 37658408
Altmetrics provided by Altmetric
