Effects and Safety of Wearable Exoskeleton for Robot-Assisted Gait Training: A Retrospective Preliminary Study

Abstract

Background: Wearable devices for robot-assisted gait training (RAGT) provide overground gait training for the rehabilitation of neurological injuries. We aimed to evaluate the effectiveness and safety of RAGT in patients with a neurologic deficit. Methods: Twenty-eight patients receiving more than ten sessions of overground RAGT using a joint-torque-assisting wearable exoskeletal robot were retrospectively analyzed in this study. Nineteen patients with brain injury, seven patients with spinal cord injury and two patients with peripheral nerve injury were included. Clinical outcomes, such as the Medical Research Council scale for muscle strength, Berg balance scale, functional ambulation category, trunk control tests, and Fugl–Meyer motor assessment of the lower extremities, were recorded before and after RAGT. Parameters for RAGT and adverse events were also recorded. Results: The Medical Research Council scale scores for muscle strength (36.6 to 37.8), Berg balance scale (24.9 to 32.2), and functional ambulation category (1.8 to 2.7) significantly improved after overground RAGT (p < 0.05). The familiarization process was completed within six sessions of RAGT. Only two mild adverse events were reported. Conclusions: Overground RAGT using wearable devices can improve muscle strength, balance, and gait function. It is safe in patients with neurologic injury.

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“…Other authors use potentiometers [ 51 ], although they share the limitations of IMUs. Therapies with exoskeletons [ 52 , 53 , 54 ] have also been developed, albeit for rehabilitation and training purposes and digitally assisted through screens [ 55 ].…”

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“…In order to resolve this issue, more recently, various wearable robots have been incorporated into the exercise regimen [26][27][28][29]. While hard exoskeletons were initially developed to assist patients with total loss of lower extremity function, they are now being utilized for more general RAGT purposes [30,31].…”

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“…However, these methods often heavily rely on the experience of therapists, which can lead to variability in treatment effectiveness [6]. To overcome these limitations, various lower limb robot-assisted gait training systems and exoskeleton robots have been developed over the past several decades, and their effectiveness has been verified in numerous clinical studies [7][8][9][10][11]. This progress has extended the role of physical therapists beyond providing physical assistance to also performing a supervisory role, thereby contributing to the efficiency of wearable robot-assisted gait training [7,10].…”