Exoskeleton-Assisted Gait Training for Subacute Stroke Patients: Feasibility Study and Preliminary Results

Research Objectives: To evaluate the effect of exoskeleton-assisted gait training on walking velocity and gait parameters of subacute stroke patients

Design: Before-after trial

Setting: Inpatient rehabilitation department at a regional hospital

Participants: Three patients completed 20 training sessions. Inclusion criteria were: first stroke, supratentorial stroke, one to six months post stroke, independent ambulation before the stroke, Functional Ambulation Categories 3 or 4, able to understand and follow the study protocol.

Interventions: Gait training with the “Keeogo” exoskeleton (30 minutes) combined with conventional physical therapy (30 minutes) were given five days a week for four weeks. The lower extremity robotic device assists in knee flexion/extension upon sensing patient-initiated movement at the hip and knee joints.

Main Outcome Measures: 6-minute walk test (6MWT), 10-meter walk test (10MWT), Fugl-Meyer Assessment of Lower Extremity (FMA-LE), and gait parameters including walking speed, stride length, cadence and gait symmetry index were assessed during walking without exoskeleton at baseline and immediately after the training course.

Results: Three male patients with a mean age of 54.7 years were analyzed. Two patients had ischemic stroke and one had hemorrhagic stroke. No adverse event occurred during training. After the intervention, the mean 6MWT distance increased from 40.0 to 116.4 meters, the mean 10MWT speed increased from 0.13 to 0.50 meters/second, and the mean FMA-LE score increased from 49.7 to 66.3. Walking speed, cadence and stride length were increased in all subjects. The mean symmetric index improved from 29.0% to 18.4% and from 53.2% to 29.7% in stance time and swing time, respectively.

Conclusions: Exoskeleton-assisted training with “Keeogo” could be a safe intervention to improve ambulation function for subacute stroke patients.

Author(s) Disclosures: The authors declare no conflicts of interest.