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

This single-visit 8-person comparison study examines the effect of an ankle-assisting soft exosuit on typical gait compensations post stroke. Eight participants with hemiparetic gait in the chronic phase of stroke walked on an instrumented treadmill to evaluate their walking during two conditions: with an exosuit powered and providing assistance to ankle dorsiflexion and plantarflexion; and with the same exosuit worn but unpowered. No verbal or other external cues were provided to the participants during the two bouts of walking. When walking with assistance from the exosuit, participants demonstrated a 27± 6% reduction in paretic hip hiking, and a 20±5% reduction of paretic circumduction (p=0.004). The powered exosuit also resulted in a significant increase (p=.002) in the nonparetic step length. Data analysis demonstrated that exosuit-induced increases in swing phase knee flexion contributed to reductions in hip hiking during exosuit assisted walking. The authors suggest that the rapid and substantial kinematic changes observed in the strategy used to advance the paretic limb in response to exosuit assistance speaks to the potential value of exosuits during gait retraining, particularly during early phases of stroke recovery before individuals develop such compensatory walking strategies resulting from paretic ankle dysfunction.

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