Reducing Circumduction and Hip Hiking During Hemiparetic Walking Through Targeted Assistance of the Paretic Limb Using a Soft Robotic Exosuit

Am J Phys Med Rehabil. 2017 Oct;96(10 Suppl 1):S157-S164. doi: 10.1097/PHM.0000000000000800.

Abstract

Objective: The aim of the study was to evaluate the effects on common poststroke gait compensations of a soft wearable robot (exosuit) designed to assist the paretic limb during hemiparetic walking.

Design: A single-session study of eight individuals in the chronic phase of stroke recovery was conducted. Two testing conditions were compared: walking with the exosuit powered versus walking with the exosuit unpowered. Each condition was 8 minutes in duration.

Results: Compared with walking with the exosuit unpowered, walking with the exosuit powered resulted in reductions in hip hiking (27 [6%], P = 0.004) and circumduction (20 [5%], P = 0.004). A relationship between changes in knee flexion and changes in hip hiking was observed (Pearson r = -0.913, P < 0.001). Similarly, multivariate regression revealed that changes in knee flexion (β = -0.912, P = 0.007), but not ankle dorsiflexion (β = -0.194, P = 0.341), independently predicted changes in hip hiking (R = 0.87, F(2, 4) = 13.48, P = 0.017).

Conclusions: Exosuit assistance of the paretic limb during walking produces immediate changes in the kinematic strategy used to advance the paretic limb. Future work is necessary to determine how exosuit-induced reductions in paretic hip hiking and circumduction during gait training could be leveraged to facilitate more normal walking behavior during unassisted walking.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Biomechanical Phenomena
  • Exercise Therapy / instrumentation*
  • Exercise Therapy / methods
  • Female
  • Hip / physiopathology
  • Humans
  • Knee / physiopathology
  • Male
  • Middle Aged
  • Movement
  • Multivariate Analysis
  • Paresis / etiology
  • Paresis / physiopathology
  • Paresis / rehabilitation*
  • Regression Analysis
  • Robotics / instrumentation*
  • Stroke / complications
  • Stroke / physiopathology
  • Stroke Rehabilitation / instrumentation*
  • Stroke Rehabilitation / methods
  • Treatment Outcome
  • Walk Test
  • Walking / physiology*