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The H2 robotic exoskeleton for gait rehabilitation after stroke: early findings from a clinical study.

Bortole M, Venkatakrishnan A, Zhu F, Moreno JC, Francisco GE, Pons JL, Contreras-Vidal JL - J Neuroeng Rehabil (2015)

Bottom Line: The training was well tolerated and no adverse events occurred.Early findings demonstrate that H2 appears to be safe and easy to use in the participants of this study.These results are promising and encourage future rehabilitation training with a larger cohort of patients.

View Article: PubMed Central - PubMed

Affiliation: Neural Rehabilitation Group, Cajal Institute, Spanish Research Council, Av. Doctor Arce 37, Madrid, 28002, Spain. m.bortole@csic.es.

ABSTRACT

Background: Stroke significantly affects thousands of individuals annually, leading to considerable physical impairment and functional disability. Gait is one of the most important activities of daily living affected in stroke survivors. Recent technological developments in powered robotics exoskeletons can create powerful adjunctive tools for rehabilitation and potentially accelerate functional recovery. Here, we present the development and evaluation of a novel lower limb robotic exoskeleton, namely H2 (Technaid S.L., Spain), for gait rehabilitation in stroke survivors.

Methods: H2 has six actuated joints and is designed to allow intensive overground gait training. An assistive gait control algorithm was developed to create a force field along a desired trajectory, only applying torque when patients deviate from the prescribed movement pattern. The device was evaluated in 3 hemiparetic stroke patients across 4 weeks of training per individual (approximately 12 sessions). The study was approved by the Institutional Review Board at the University of Houston. The main objective of this initial pre-clinical study was to evaluate the safety and usability of the exoskeleton. A Likert scale was used to measure patient's perception about the easy of use of the device.

Results: Three stroke patients completed the study. The training was well tolerated and no adverse events occurred. Early findings demonstrate that H2 appears to be safe and easy to use in the participants of this study. The overground training environment employed as a means to enhance active patient engagement proved to be challenging and exciting for patients. These results are promising and encourage future rehabilitation training with a larger cohort of patients.

Conclusions: The developed exoskeleton enables longitudinal overground training of walking in hemiparetic patients after stroke. The system is robust and safe when applied to assist a stroke patient performing an overground walking task. Such device opens the opportunity to study means to optimize a rehabilitation treatment that can be customized for individuals.

Trial registration: This study was registered at ClinicalTrials.gov ( https://clinicaltrials.gov/show/NCT02114450 ).

No MeSH data available.


Related in: MedlinePlus

Stroke patient using H2 exoskeleton at the beginning of one training session
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Fig4: Stroke patient using H2 exoskeleton at the beginning of one training session

Mentions: In this pilot clinical investigation, the study design consisted of an open-label assignment of participants to H2 robot-assisted gait training. During each training session, subjects were asked to perform an overground walking task guided by the H2 in assist-as-needed mode with a pre-selected gait speed along a 50 m circular or 120 m linear path. After wearing the exoskeleton, patients were instructed to walk as much as they were able and encouraged to take rest breaks as necessary. Figure 4 illustrates a patient using H2 in the beginning of a training session. The gait start and stop process was controlled by the patient using two hand buttons placed on a walker, which was used as a gait assistive device during training.Fig. 4


The H2 robotic exoskeleton for gait rehabilitation after stroke: early findings from a clinical study.

Bortole M, Venkatakrishnan A, Zhu F, Moreno JC, Francisco GE, Pons JL, Contreras-Vidal JL - J Neuroeng Rehabil (2015)

Stroke patient using H2 exoskeleton at the beginning of one training session
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4469252&req=5

Fig4: Stroke patient using H2 exoskeleton at the beginning of one training session
Mentions: In this pilot clinical investigation, the study design consisted of an open-label assignment of participants to H2 robot-assisted gait training. During each training session, subjects were asked to perform an overground walking task guided by the H2 in assist-as-needed mode with a pre-selected gait speed along a 50 m circular or 120 m linear path. After wearing the exoskeleton, patients were instructed to walk as much as they were able and encouraged to take rest breaks as necessary. Figure 4 illustrates a patient using H2 in the beginning of a training session. The gait start and stop process was controlled by the patient using two hand buttons placed on a walker, which was used as a gait assistive device during training.Fig. 4

Bottom Line: The training was well tolerated and no adverse events occurred.Early findings demonstrate that H2 appears to be safe and easy to use in the participants of this study.These results are promising and encourage future rehabilitation training with a larger cohort of patients.

View Article: PubMed Central - PubMed

Affiliation: Neural Rehabilitation Group, Cajal Institute, Spanish Research Council, Av. Doctor Arce 37, Madrid, 28002, Spain. m.bortole@csic.es.

ABSTRACT

Background: Stroke significantly affects thousands of individuals annually, leading to considerable physical impairment and functional disability. Gait is one of the most important activities of daily living affected in stroke survivors. Recent technological developments in powered robotics exoskeletons can create powerful adjunctive tools for rehabilitation and potentially accelerate functional recovery. Here, we present the development and evaluation of a novel lower limb robotic exoskeleton, namely H2 (Technaid S.L., Spain), for gait rehabilitation in stroke survivors.

Methods: H2 has six actuated joints and is designed to allow intensive overground gait training. An assistive gait control algorithm was developed to create a force field along a desired trajectory, only applying torque when patients deviate from the prescribed movement pattern. The device was evaluated in 3 hemiparetic stroke patients across 4 weeks of training per individual (approximately 12 sessions). The study was approved by the Institutional Review Board at the University of Houston. The main objective of this initial pre-clinical study was to evaluate the safety and usability of the exoskeleton. A Likert scale was used to measure patient's perception about the easy of use of the device.

Results: Three stroke patients completed the study. The training was well tolerated and no adverse events occurred. Early findings demonstrate that H2 appears to be safe and easy to use in the participants of this study. The overground training environment employed as a means to enhance active patient engagement proved to be challenging and exciting for patients. These results are promising and encourage future rehabilitation training with a larger cohort of patients.

Conclusions: The developed exoskeleton enables longitudinal overground training of walking in hemiparetic patients after stroke. The system is robust and safe when applied to assist a stroke patient performing an overground walking task. Such device opens the opportunity to study means to optimize a rehabilitation treatment that can be customized for individuals.

Trial registration: This study was registered at ClinicalTrials.gov ( https://clinicaltrials.gov/show/NCT02114450 ).

No MeSH data available.


Related in: MedlinePlus