A team of researchers in New Jersey has proven that high-dose gait therapy training using robotic exoskeletons may help with early recovery for a stroke. The article, “Robotic exoskeleton gait training during rehabilitation of patients within stroke” (doi: 10.339 / fnbot.2020.581815), was published 30 October 2020 in Frontiers in Neurorobotics available for open access at: https: /
The authors are Karen Nolan, PhD, Kiran Karunakaran, PhD, and Kathleen Chervin, of Kessler Foundation, Michael Monfett, MD, of Children’s Special Hospital, Radhika Bapineedu, MD, and Neil N. Jasey Jr., MD, of Institute Kessler for Rehabilitation, and Mooyeon Oh-Park, MD, of Burke Rehabilitation Hospital, formerly of Kessler. Drs. Nolan and Karunakaran are also affiliated with Children’s Special Hospital. Kessler scientists and clinicians have held faculty positions at Rutgers School of Medicine New Jersey.
The need for stroke rehabilitation is huge, as the large numbers of stroke survivors have deficits in movement, balance and coordination that limit their activities of daily life. Advances in robotics and biochemical engineering expand the options for rehabilitative care.
Researchers are applying new technologies to gait training that may provide benefits over labor-intensive physical therapy. This patient study of a robotic exoskeleton (Ekso GT, Ekso Bionics, Inc.,) demonstrated the ability to improve gait training after a severe stroke toward the goal of overcoming earlier motor function.
Participants included 44 people (ages 18 to 82 years) who were admitted to the Kessler Institute for Rehabilitation for severe stroke. The other half received the standard of care (SOC), and the other half received SOC with the option of overland gait training in the Ekso GT (RE + SOC). Both groups received the same amount of total treatment time.
Overland gait training in the exoskeleton was led by an approved physical therapist who adjusted the variable bilateral support of the Ekso GT according to each person’s progress. Outcome measures were walked full distance during patient rehabilitation score and functional independence measure (FIM). The RE-SOC group trained in the Ekso GT at least three times while there.
We found that gait training in the exoskeleton allowed us to increase the dose of gait training without increasing the duration of patient rehabilitation. Because cross-ground walking in the exoskeleton requires active effort on the part of the partner, ”she said,“ early intervention with this type of gait training stimulates brain plasticity that may follow. to greater functional improvements and more lasting effects when combined with routine training. “
Dr. Karen Nolan, Deputy Director, Center for Motion Engineering Research and Rehabilitation, Kessler Foundation
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Magazine Reference:
Nolan, KJ, et al. (2020) Robotic Exoskeleton Gait Training during In-Stroke Patient Rehabilitation. Frontiers in Neurorobotics. doi.org/10.3389/fnbot.2020.581815.