Immediate effects of the honda walking assist on spatiotemporal gait characteristics in individuals after stroke

Abstract

The use of unconstrained lower limb exoskeletons has become a promising approach to assist individuals with gait impairments. The Honda Walking Assist (HWA) is a hip-assistive exoskeleton functioning as a gait trainer and has been shown to improve several gait related outcomes after training. Studies investigating its immediate effects on spatiotemporal gait parameters other than walking speed in stroke survivors are lacking. The aim of this study was to investigate immediate differences in spatiotemporal gait parameters of stroke survivors between normal overground walking, walking with an unpowered, non-assisting HWA and walking with an optimally assisting HWA. Five ischemic stroke survivors (mean time since stroke 115 ​± ​213.6 days) walked 3 times 5 ​m in each condition. Differences in 14 spatiotemporal gait parameters between all 3 conditions were registered and reported in a descriptive manner. With optimal assistance, 4 patients walked faster (0.057–0.095 ​m/s) with longer strides of the paretic (0.055–0.069 ​m) and non-paretic (0.053–0.077 ​m) leg compared to normal walking. Compared to unpowered walking, all patients walked faster (0.020–0.063 ​m/s) in the optimal assist condition, with longer strides of the paretic (0.036–0.072 ​m) and non-paretic leg (0.045–0.082 ​m). During unpowered walking, gait velocity remained unchanged in 2 patients, increased (0.012–0.051 ​m/s) in 2 patients and decreased (−0.022 ​m/s) in 1 patient compared to normal walking. Changes in paretic stride lengths ranged from −0.066 to 0.029 ​m. The optimal individualized motor assistance provided by the HWA induces small, positive changes in gait parameters. This indicates that this light-weight hip-assistive exoskeleton can be of value in rehabilitation setting, where multiple training sessions with the device are possible.