Movement therapy in advanced heart failure assisted by a lightweight wearable robot: a feasibility pilot study

Abstract

Aims The aim of this pilot study was to investigate the safety, feasibility, tolerability, and acceptability of an assisted mobilization of advanced heart failure patients, using a lightweight, exoskeleton‐type robot (Myosuit, MyoSwiss AG, Zurich, Switzerland). Methods and results Twenty patients in functional NYHA class III performed activities of daily life (ADL, n = 10) or participated in a single, standardized, 60 min rehabilitation exercise unit (REU, n = 10) with and without the Myosuit. The outcome assessment included the evaluation of vital signs, adverse events, rates of perceived exertion and dyspnoea (RPE, RPD), the ability to perform ADL or REU, and the individual acceptability. The mean age of the subjects was 49.4 (±11.0) years; 80% were male. The mean left ventricular ejection fraction was 22.1% (±7.4%) and the median NT‐proBNP 2054 pg/mL (IQR 677, 3270 pg/mL). In all patients, mobilization with the Myosuit was feasible independently or with minor support. The mean individual difference in the total walking distance of the patients without and with robotic assistance was −26.5 m (95% confidence interval (CI) −142 to 78 m, P = 0.241). No adverse events occurred. RPE and RPD showed no significant difference with or without the device (ADL: RPE −0.1 m, 95% CI −1.42 to 1.62, P = 0.932 and RPD −0.95 m, 95% CI −0.38 to 2.28, P = 0.141; REU: RPE 1.1 m, 95% CI −2.90 to 0.70, P = 0.201 and RPD 0.5 m, 95% CI −2.02 to 1.02, P = 0.435). All median responses in the acceptability questionnaire were positive. The patients felt safe and enjoyed the experience; 85% would be interested in participating in robot‐assisted training on a regular basis. Conclusion This feasibility pilot trial provides first indications that a robotic exoskeleton‐assisted mobilization of patients with advanced heart failure is safe, feasible, well‐tolerated, and well‐accepted. The results are highly encouraging to further pursue this innovative approach in rehabilitation programmes. This trial was registered at http://ClinicalTrials.gov: NCT04839133.

Benefits of a Balance Exercise Assist Robot in the Cardiac Rehabilitation of Older Adults with Cardiovascular Disease: A Preliminary Study

“…Exercise therapy with a robotic walking support device improved the exercise ability and quality of life of patients with heart failure [ 38 ]. An exoskeleton-type robot was safe to use in patients with heart failure, and the subjects showed a high interest in using this tool [ 39 ]. To our knowledge, our current study is the first to report on exercise therapy using a BEAR in CR protocols for older adults with CVD.…”

Effects of cardiac rehabilitation with motion assistance from a wearable cyborg hybrid assistive limb on patients with chronic heart failure: a randomized controlled trial with a one-year follow-up

“…It is, therefore, necessary to establish safer and more effective exercise therapies for the elderly and HF patients with frailty. Functional electrical stimulation to the lower limbs and exercise using robot assistance have been performed in the clinical trial as an exercise therapy other than aerobic exercise 14,15) .…”

Robot-Assisted Early Mobilization for Intensive Care Unit Patients: Feasibility and First-Time Clinical Use

“…These systems, which are technically adapted to the patient population, are already being tested and implemented in some hospitals (Dieterich et al, 2022;Calabrò et al, 2015;Charite University, n.d.;Peper et al, 2022). Studies have focused more on safe handling and feasibility concerning patient outcomes (Just et al, 2022), and less on implementation and feasibility in the context of intensive care units concerning aspects such as staff retention or time and effort.…”