Abstract TP90: Feasibility of Robotic Exoskeleton Intervention in the Stroke Population During Acute Hospitalization

Abstract

Introduction: Patients hospitalized with a stroke have limited mobility during the acute recovery phase. Those requiring significant assistance to mobilize often experience greater periods of immobility. Research in subacute rehabilitation demonstrates safe and feasible use of robotic exoskeletons for upright positioning and reciprocal motions similar to gait kinematics post stroke. This study explores the feasibility and frequency of adverse events with robotic exoskeleton during acute hospitalization post stroke. Methods: Retrospective design using the electronic health record to identify patients hospitalized with a stroke between 1/1/19 and 12/31/22. Patients that completed a single session of robotic exoskeleton in conjunction with traditional physical therapy met criteria. All participants met the manufacturer’s criteria for device use. Those who did not complete robotic intervention were excluded. Thirty-four patients were included and data obtained from physical therapy documentation of the initial session in the robotic device. Data collected included adverse events atypical of physiologic responses found with traditional physical therapy movement strategies including fracture, cardiac event, skin tear, dislocation and declining neurologic function. Further data collected includes stroke etiology, location, post stroke day intervention completed, steps taken and duration of upright weight bearing in the device. Results: Data revealed 0 patients had an adverse event with a total of 5 sessions terminated, all in patients with ischemic infarcts. Reasons for termination included orthostatic hypotension, pain in stance and fatigue. The mean step count was 106 with standard deviation (SD)of 102. The mean upright time was 19 minutes with SD of 8 minutes. Intervention was initiated on average at day 8 with SD of 7 days. Conclusion: Robotic exoskeleton is feasible during acute hospitalization with patients post stroke and yields no adverse events. Adjunct use of this device allows patients to participate in weight bearing, upright posture and neuromuscular facilitation for reciprocal motion allowing movement which otherwise may not be possible at this acute stage given the burden of mobility and level of neurologic impairment.