Stroke is the leading cause of long-term disability worldwide, leading to considerable gait deficits in the majority of patients.
In recent years, a variety of practice guidelines promoting early intervention strategies and high-intensity training based on the principles of neuroplasticity have been established. However, despite extensive rehabilitation efforts, up to 80% of stroke survivors still experience considerable gait deficits. Current management strategies to overcome these barriers in gait are typically limited to either bracing, medication, or reducing the intensity, dose, and functional complexity of the mobility task. In order to optimize the potential of rehabilitation therapies, there remains a critical need for user-friendly rehabilitation technologies that can be modulated specific to patient needs in a collaborative way.
Soft robots comprised of compliant materials such as textile-based fabrics have emerged in recent years and hold great promise in bridging the gap between the clinic and real world. Soft wearable robots can be seamless, nonobtrusive therapeutic adjuvants to both functional mobility and/or impairment-specific training in any clinical setting. These robots can provide more stability and dynamic control of the lower extremities in a variety of gait and functional training activities, helping therapists and patients surmount prior barriers to achieve higher dose, intensity, and variable functional mobility levels during acute rehabilitation.
To address the need to maximize the potential of early in-patient recovery, we will evaluate a novel soft wearable robot (exosuit) suitable for in-patient rehabilitation. The device, designed at Harvard's Wyss Institute for Biologically Inspired Engineering, increases walking and functional mobility capacity through the unique use of force-transmitting conformal textiles that anchor to the body, proximally-mounted cable-based actuation systems, and adaptive control algorithms that use the minimum number of sensors. The device is unobtrusive and can be worn under clothes. In preliminary studies, it has shown promise in improving the gait of stroke patients.
Within the current funding cycle (2018-2023), we will:
- Develop individualized adaptive controller parameters and progression strategies for the exosuit specific for inpatient stroke rehabilitation
- Evaluate the impact of the exosuit on functional recovery when used during conventional rehabilitation versus conventional rehabilitation in acute stroke
- Evaluate the exosuit within an observational study at the Shirley Ryan AbilityLab
Arun Jayaraman, PT, PhD, Shirley Ryan AbilityLab & Northwestern University
Conor Walsh, PhD, Harvard & Wyss Institute for Biologically Inspired Engineering
David Brown, PT, PhD, University of Alabama at Birmingham
Heike Vallery, Dr.Ing, TU Delft
The contents of this webpage were developed under a grant from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR grant number 90REGE0005-01-00). NIDILRR is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). The contents of this webpage do not necessarily represent the policy of NIDILRR, ACL, or HHS, and you should not assume endorsement by the Federal Government.