Stride management assist exoskeleton vs functional gait training in stroke: A randomized trial

Area of Science:

• Neuroscience
• Rehabilitation Medicine
• Robotics

Background:

• Chronic stroke frequently impairs gait and motor control.
• Restoring motor function requires targeted rehabilitation strategies.
• Robotic exoskeletons offer novel approaches to gait training.

Purpose of the Study:

• To evaluate the efficacy of hip-assistive robotic exoskeleton gait training.
• To assess improvements in clinical outcomes and corticospinal excitability (CME).
• To compare robotic-assisted training with intensity-matched functional gait training.

Main Methods:

• A randomized, single-blind, parallel study involving 50 participants with chronic stroke.
• Intervention: Gait training with the Honda Stride Management Assist (SMA) exoskeleton vs. functional gait training.
• Outcome measures: Walking speed, endurance, balance, and CME assessed via transcranial magnetic stimulation.

Main Results:

• The SMA group showed significant improvements in walking speed (0.24 m/s).
• SMA users exhibited greater gains in walking endurance, steps taken, and CME of the paretic rectus femoris.
• Participants with hemorrhagic stroke using SMA showed enhanced balance improvements.

Conclusions:

• Gait training with the hip-assistive SMA exoskeleton improves walking speed and CME in chronic stroke.
• This robotic approach may offer superior benefits for walking endurance and balance compared to functional gait training.