scholarly journals Targeting Paretic Propulsion and Walking Speed With a Soft Robotic Exosuit: A Consideration-of-Concept Trial

2021 ◽  
Vol 15 ◽  
Author(s):  
Franchino Porciuncula ◽  
Teresa C. Baker ◽  
Dheepak Arumukhom Revi ◽  
Jaehyun Bae ◽  
Regina Sloutsky ◽  
...  

Background: Soft robotic exosuits can facilitate immediate increases in short- and long-distance walking speeds in people with post-stroke hemiparesis. We sought to assess the feasibility and rehabilitative potential of applying propulsion-augmenting exosuits as part of an individualized and progressive training program to retrain faster walking and the underlying propulsive strategy.Methods: A 54-yr old male with chronic hemiparesis completed five daily sessions of Robotic Exosuit Augmented Locomotion (REAL) gait training. REAL training consists of high-intensity, task-specific, and progressively challenging walking practice augmented by a soft robotic exosuit and is designed to facilitate faster walking by way of increased paretic propulsion. Repeated baseline assessments of comfortable walking speed over a 2-year period provided a stable baseline from which the effects of REAL training could be elucidated. Additional outcomes included paretic propulsion, maximum walking speed, and 6-minute walk test distance.Results: Comfortable walking speed was stable at 0.96 m/s prior to training and increased by 0.30 m/s after training. Clinically meaningful increases in maximum walking speed (Δ: 0.30 m/s) and 6-minute walk test distance (Δ: 59 m) were similarly observed. Improvements in paretic peak propulsion (Δ: 2.80 %BW), propulsive power (Δ: 0.41 W/kg), and trailing limb angle (Δ: 6.2 degrees) were observed at comfortable walking speed (p's < 0.05). Likewise, improvements in paretic peak propulsion (Δ: 4.63 %BW) and trailing limb angle (Δ: 4.30 degrees) were observed at maximum walking speed (p's < 0.05).Conclusions: The REAL training program is feasible to implement after stroke and capable of facilitating rapid and meaningful improvements in paretic propulsion, walking speed, and walking distance.

Author(s):  
James Roush ◽  
John Heick ◽  
Tanner Hawk ◽  
Dillon Eurek ◽  
Austin Wallis ◽  
...  

Background: Walking speed is considered the sixth vital sign because it is a valid, reliable, and sensitive measure for assessing functional status in various populations. Purpose: The current study assessed agreement in walking speed using the 6-meter walk test, (6MWT) 10-meter walk test (10MWT), 2-minute walk test (2minWT), and 6-minute walk test (6minWT). We also determined differences in walking speed. Methods: Seventy-three healthy adults (44 females, 29 males; mean [SD] age=31.36 [10.33] years) participated. Lafayette Electronic timing devices measured walking speed for the 6MWT and 10MWT. Measuring wheels and stopwatches measured walking distance and speed for the 2minWT and 6minWT. Participants completed 1 trial, and all tests were administered simultaneously. Results: The intraclass correlation coefficient (2, 4) for the different measures of walking speed was excellent at 0.90 (95% confidence intervals, 0.86-0.93). The correlation was 0.95 between 6MWT and 10MWT, 0.94 between 2minWT and 6minWT, 0.67 between 6MWT and 2minWT, 0.63 between 10MWT and 2minWT, and 0.59 between 10MWT and 6minWT (all p < 0.05). No differences in walking speed were found between the four walking tests. Conclusion: Administration of any of the four walking tests provided reliable measurement of walking speed.


2019 ◽  
Author(s):  
Isadora S. Rocco ◽  
Walter J. Gomes ◽  
Hayanne O. Pauletti ◽  
Marcela Viceconte ◽  
Bruna C. Matos-Garcia ◽  
...  

Abstract Background The 6-minute walk test distance is frequently used to assess functional capacity of cardiac disease population. Nevertheless, anthropometric differences can confound or misestimate performance, which highlights the need for new parameters. This study aims to investigate the potential of the body weight-walking distance product (D.W), compared to 6-minute walk test distance, to predict exercise capacity measured by VO 2 on-kinetics in coronary artery disease (CAD) patients.Methods Cross-section study in a tertiary-care reference institution. Forty-six participants with multiarterial CAD with and without left ventricular dysfunction underwent a 6-minute walk test with simultaneous use of mobile telemetric cardiopulmonary monitoring to evaluate oxygen uptake (VO 2 ) on-kinetics and other cardiorespiratory responses.Results Perceived effort Borg for lower limb fatigue was only correlated with the D.W (p=0.007). The percent-predicted and actual distance were only modestly to moderately correlated with VO 2 on-kinetics (p<0.05). All the associations of VO 2 on-kinetics parameters were improved by showing a stronger correlation to the D.W (p<0.0001), which also had a larger effect size to identify differences between coronary disease patients compared to distance ( d =1.32 vs d =0.84).Conclusion The D.W demonstrates potential as a measure superior to the distance in determining VO 2 on-kinetics in participants with CAD with and without left ventricular dysfunction.


PLoS ONE ◽  
2019 ◽  
Vol 14 (4) ◽  
pp. e0212975 ◽  
Author(s):  
Tom E. Robertson ◽  
Mehdi Nouraie ◽  
Shulin Qin ◽  
Kristina A. Crothers ◽  
Cathy J. Kessinger ◽  
...  

2020 ◽  
Vol 9 (19) ◽  
Author(s):  
David W. Schopfer ◽  
Mary A. Whooley ◽  
Kelly Allsup ◽  
Mark Pabst ◽  
Hui Shen ◽  
...  

Background Cardiac rehabilitation is an established performance measure for adults with ischemic heart disease, but patient participation is remarkably low. Home‐based cardiac rehabilitation (HBCR) may be more practical and feasible, but evidence regarding its efficacy is limited. We sought to compare the effects of HBCR versus facility‐based cardiac rehabilitation (FBCR) on functional status in patients with ischemic heart disease. Methods and Results This was a pragmatic trial of 237 selected patients with a recent ischemic heart disease event, who enrolled in HBCR or FBCR between August 2015 and September 2017. The primary outcome was 3‐month change in distance completed on a 6‐minute walk test. Secondary outcomes included rehospitalization as well as patient‐reported physical activity, quality of life, and self‐efficacy. Characteristics of the 116 patients enrolled in FBCR and 121 enrolled in HBCR were similar, except the mean time from index event to enrollment was shorter for HBCR (25 versus 77 days; P <0.001). As compared with patients undergoing FBCR, those in HBCR achieved greater 3‐month gains in 6‐minute walk test distance (+95 versus +41 m; P <0.001). After adjusting for demographics, comorbid conditions, and indication, the mean change in 6‐minute walk test distance remained significantly greater for patients enrolled in HBCR (+101 versus +40 m; P <0.001). HBCR participants reported greater improvements in quality of life and physical activity but less improvement in exercise self‐efficacy. There were no deaths or cardiovascular hospitalizations. Conclusions Patients enrolled in HBCR achieved greater 3‐month functional gains than those enrolled in FBCR. Our data suggest that HBCR may safely derive equivalent benefits in exercise capacity and overall program efficacy in selected patients. Registration URL: https://www.clini​caltr​ials.gov ; Unique identifier: NCT02105246.


2020 ◽  
Vol 26 (10) ◽  
pp. S10
Author(s):  
Mathew S. Maurer ◽  
Eric Adler ◽  
Balarama Gundapaneni ◽  
Marla B. Sultan ◽  
Claudio Rapezzi

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