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Cited by 111Prosthetics and Rehabilitation RoboticsStroke Rehabilitation and RecoverySoft Robotics and Applications

The DOI matches its Crossref record; 36 of the 36 references it cites were found in a registry or an index.

Walking Faster and Farther With a Soft Robotic Exosuit: Implications for Post-Stroke Gait Assistance and Rehabilitation

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Awad, Louis N., Kudzia, Pawel, Revi, Dheepak Arumukhom, Ellis, Terry D., Walsh, Conor J.·2020·IEEE Open Journal of Engineering in Medicine and Biology
DOI 10.1109/ojemb.2020.2984429PMC PMC7971412
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Abstract

OBJECTIVE: Soft robotic exosuits can improve the mechanics and energetics of walking after stroke. Building on this prior work, we evaluated the effects of the first prototype of a portable soft robotic exosuit. METHODS: Exosuit-induced changes in the overground walking speed, distance, and energy expenditure of individuals post-stroke were evaluated statistically with alpha set to 0.05 and compared to minimal clinically important difference scores. RESULTS: 5kg exosuit did not substantially modify walking speed, distance, or energy expenditure when worn unpowered. In contrast, when the exosuit was powered on to provide an average 22.87±0.58 %bodyweight of plantarflexor force assistance during the paretic limb's stance phase and assist the paretic dorsiflexors during swing phase to reduce drop-foot, study participants walked a median 0.14±0.06 m/s faster during the 10-meter walk test and traveled 32±8 m farther during the six minute walk test. CONCLUSIONS: Individuals post-stroke can leverage the paretic plantarflexor and dorsiflexor assistance provided by soft robotic exosuits to achieve clinically-meaningful increases in speed and distance.

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Figure 1. (A) Total 6-minute walk test (6MWT) distances for each condition. Right – Difference in 6MWT distance between the no exosuit condition and each of the two unpowered exosuit conditions and the powered exosuit condition. Circles represent individual study participants. (B) Distance per minute of the 6MWT for each condition. The minimal clinically important difference (MCID) is depicted in each plot with the dashed horizontal lines. Significance (}{}$P < 0.05$) relative to }{}$^\ast$no exosuit and }{}$^\dagger$unpowered exosuit conditions. Medians and sIQR are reported.
Figure 1. (A) Total 6-minute walk test (6MWT) distances for each condition. Right – Difference in 6MWT distance between the no exosuit condition and each of the two unpowered exosuit conditions and the powered exosuit condition. Circles represent individual study participants. (B) Distance per minute of the 6MWT for each condition. The minimal clinically important difference (MCID) is depicted in each plot with the dashed horizontal lines. Significance (}{}$P < 0.05$) relative to }{}$^\ast$no exosuit and }{}$^\dagger$unpowered exosuit conditions. Medians and sIQR are reported.CC BY · PubMed Central
Figure 2. (A) Usual and (B) Maximum walking speeds, as measured using the 10-meter walk test, are shown for each condition tested. Right – The difference in each speed between the no exosuit condition and each of the two unpowered exosuit conditions and the powered exosuit condition. Circles represent individual study participants. The minimal clinically important difference (MCID) is depicted in each plot with the dashed horizontal lines. Significance (}{}$P < 0.05$) relative to }{}$^\ast$no exosuit and }{}$^\dagger$unpowered exosuit conditions. Medians and sIQR are reported.
Figure 2. (A) Usual and (B) Maximum walking speeds, as measured using the 10-meter walk test, are shown for each condition tested. Right – The difference in each speed between the no exosuit condition and each of the two unpowered exosuit conditions and the powered exosuit condition. Circles represent individual study participants. The minimal clinically important difference (MCID) is depicted in each plot with the dashed horizontal lines. Significance (}{}$P < 0.05$) relative to }{}$^\ast$no exosuit and }{}$^\dagger$unpowered exosuit conditions. Medians and sIQR are reported.CC BY · PubMed Central
Figure 3. (A) Energy expenditure, measured with indirect calorimetry as oxygen utilization per kilogram of bodyweight and minute and (B) energy cost of walking, measured as oxygen utilization per kilogram of bodyweight and meter walked are presented for each condition. Medians and sIQR are reported.
Figure 3. (A) Energy expenditure, measured with indirect calorimetry as oxygen utilization per kilogram of bodyweight and minute and (B) energy cost of walking, measured as oxygen utilization per kilogram of bodyweight and meter walked are presented for each condition. Medians and sIQR are reported.CC BY · PubMed Central
Figure 4. (A) Overview of the soft robotic exosuit used to augment paretic ankle plantarflexion (PF) and dorsiflexion (DF) function during post-stroke hemiparetic walking. (B) Exemplar force profiles for PF and DF assistance are shown. The onset timing and peak magnitude of PF assistance and the onset and off timing of DF assistance were commanded as described in previous work [5]. Assistance timing was delivered as a function of the paretic and nonparetic gait cycles defined by the detection of paretic (green) and nonparetic (red) foot strike and foot off. Photo in panel A courtesy of Rolex Foundation.
Figure 4. (A) Overview of the soft robotic exosuit used to augment paretic ankle plantarflexion (PF) and dorsiflexion (DF) function during post-stroke hemiparetic walking. (B) Exemplar force profiles for PF and DF assistance are shown. The onset timing and peak magnitude of PF assistance and the onset and off timing of DF assistance were commanded as described in previous work [5]. Assistance timing was delivered as a function of the paretic and nonparetic gait cycles defined by the detection of paretic (green) and nonparetic (red) foot strike and foot off. Photo in panel A courtesy of Rolex Foundation.CC BY · PubMed Central

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  1. mcdonald, 2014, Multiple Comparisons - Handbook of Biological Statistics

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Metadata

Authors
Awad, L. N., Kudzia, P., Revi, D. A., Ellis, T. D., & Walsh, C. J.
Affiliations
  • Boston University (US)
  • Harvard University (US)
Corresponding author
  • Awad, Louis N.
  • Walsh, Conor J.
ORCID
Venue
IEEE Open Journal of Engineering in Medicine and Biology
Publisher
Institute of Electrical and Electronics Engineers (IEEE)
Published
2020
Volume
1
Pages
108-115
ISSN
2644-1276 (ISSN-L)
DOI
10.1109/ojemb.2020.2984429
PMC
PMC7971412
OpenAlex
W3014201768
Cited by
111
References
36
Citations by year
2026: 9 · 2025: 19 · 2024: 17 · 2023: 19 · 2022: 23 · 2021: 18 · 2020: 6
FWCI
5.18
Type
journal article
Language
en
Open access
Licence
Locations
  • IEEE Open Journal of Engineering in Medicine and Biology (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • National Institutes of Health (R01HD088619)
  • American Heart Association (18TPA34170171)
  • Wyss Institute at Harvard University
Topics
  • Physical Sciences › Engineering › Biomedical Engineering › Prosthetics and Rehabilitation Robotics
  • Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
  • Physical Sciences › Engineering › Biomedical Engineering › Soft Robotics and Applications
Keywords
stroke rehabilitation, gait assistance, walking speed, walking distance, energy expenditure, foot drop, paretic limb, powered exoskeleton, overground walking

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