Evidence map›Paper›PMID 39026268›Full record

ArticleJournal of neuroengineering and rehabilitation2024

Implementation of a unilateral hip flexion exosuit to aid paretic limb advancement during inpatient gait retraining for individuals post-stroke: a feasibility study.

Chih-Kang Chang, Christina Lee, Richard W Nuckols, Asa Eckert-Erdheim, Dorothy Orzel, Maxwell Herman, Jennifer Traines, Sara Prokup, Arun Jayaraman, Conor J Walsh

Abstract read
In one paragraph

Article in Journal of neuroengineering and rehabilitation, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Chih-Kang ChangJohn A. Paulson School of Engineering and Applied Sciences, Harvard University, Boston, MA, USA.
Christina LeeJohn A. Paulson School of Engineering and Applied Sciences, Harvard University, Boston, MA, USA.
Richard W NuckolsJohn A. Paulson School of Engineering and Applied Sciences, Harvard University, Boston, MA, USA.
Asa Eckert-ErdheimJohn A. Paulson School of Engineering and Applied Sciences, Harvard University, Boston, MA, USA.
Dorothy OrzelJohn A. Paulson School of Engineering and Applied Sciences, Harvard University, Boston, MA, USA.
Maxwell HermanJohn A. Paulson School of Engineering and Applied Sciences, Harvard University, Boston, MA, USA.
Jennifer TrainesShirley Ryan AbilityLab, Chicago, IL, USA.
Sara ProkupShirley Ryan AbilityLab, Chicago, IL, USA.
Arun JayaramanShirley Ryan AbilityLab, Chicago, IL, USA.
Conor J WalshJohn A. Paulson School of Engineering and Applied Sciences, Harvard University, Boston, MA, USA. walsh@seas.harvard.edu.

Funding

Development of a Modular Soft Exosuit Platform Suitable for Community-Based NeurorehabilitationR01HD088619 · NICHD · HARVARD UNIVERSITY · PI WALSH, CONOR · 2016 to 2021
$3.9M
National Institute of Health BRG-R01HD088619National Science Foundation CMMI-1925085NICHD NIH HHS R01 HD088619
6 · The paper itself

Abstract

backgroundDuring inpatient rehabilitation, physical therapists (PTs) often need to manually advance patients' limbs, adding physical burden to PTs and impacting gait retraining quality. Different electromechanical devices alleviate this burden by assisting a patient's limb advancement and supporting their body weight. However, they are less ideal for neuromuscular engagement when patients no longer need body weight support but continue to require assistance with limb advancement as they recover. The objective of this study was to determine the feasibility of using a hip flexion exosuit to aid paretic limb advancement during inpatient rehabilitation post-stroke.

methodsFourteen individuals post-stroke received three to seven 1-hour walking sessions with the exosuit over one to two weeks in addition to standard care of inpatient rehabilitation. The exosuit assistance was either triggered by PTs or based on gait events detected by body-worn sensors. We evaluated clinical (distance, speed) and spatiotemporal (cadence, stride length, swing time symmetry) gait measures with and without exosuit assistance during 2-minute and 10-meter walk tests. Sessions were grouped by the assistance required from the PTs (limb advancement and balance support, balance support only, or none) without exosuit assistance.

resultsPTs successfully operated the exosuit in 97% of sessions, of which 70% assistance timing was PT-triggered to accommodate atypical gait. Exosuit assistance eliminated the need for manual limb advancement from PTs. In sessions with participants requiring limb advancement and balance support, the average distance and cadence during 2-minute walk test increased with exosuit assistance by 2.2 ± 3.1 m and 3.4 ± 1.9 steps/min, respectively (p < 0.017). In sessions with participants requiring balance support only, the average speed during 10-meter walk test increased with exosuit by 0.07 ± 0.12 m/s (p = 0.042). Clinical and spatiotemporal measures of independent ambulators were similar with and without exosuit (p > 0.339).

conclusionsWe incorporated a unilateral hip flexion exosuit into inpatient stroke rehabilitation in individuals with varying levels of impairments. The exosuit assistance removed the burden of manual limb advancement from the PTs and resulted in improved gait measures in some conditions. Future work will understand how to optimize controller and assistance profiles for this population.

Indexed as

Exoskeleton DeviceFeasibility StudiesStroke RehabilitationAdultAgedFemaleGaitGait Disorders, NeurologicHumansInpatientsMaleMiddle AgedParesisStrokeAssistive deviceInpatient rehabilitationPhysical therapySoft exosuitStroke rehabilitation

Identifiers

PMID39026268
PMCPMC11256417

What Socratic holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.