Stroke commonly results in gait deficits which impacts functional ambulation and quality of life. Robotic exoskeletons (RE) for overground walking are devices that are programmable to provide high dose and movement-impairment specific assistance thus offering new rehabilitation possibilities for recovery progression in individuals post stroke. The purpose of this investigation is to present preliminary utilization data in individuals with acute and chronic stroke after walking overground with an RE. Secondary analysis on a subset of individuals is presented to understand the mechanistic changes due to RE overground walking. Thirty-eight participants with hemiplegia secondary to stroke were enrolled in a clinical trial conducted at eight rehabilitation centers. Data is presented for four sessions of overground walking in the RE over the course of two weeks. Participants continued their standard of care if they had any ongoing therapy at the time of study enrollment. Gait speed during the 10 Meter Walk Test, Gait deviations and the Functional Ambulation Category (FAC) data were collected before (baseline) and after (follow-up) following the RE walking sessions. Walking speed significantly increased between baseline and follow-up for participants in the chronic (p<0.01) and acute (p<0.05) stage of stroke recovery. FAC level significantly improved (p<0.05) and there were significantly fewer (p<0.05) gait deviations observed for participants in the acute stages of stroke recovery between baseline and follow-up. Secondary analysis on a subset of eight participants indicated that after four sessions of overground walking with the RE, the participants significantly improved their spatial symmetry. The walk time, step count and ratio of walk time to up time increased from first session to the last session for participants in the chronic and acute stages of stroke. The RE was effectively utilized for overground walking for individuals with acute and chronic stroke with varying severity levels. The results demonstrated an increase in walking speed, improvement in FAC and a decrease in gait deviations (from baseline to follow-up) after four sessions of overground walking in the RE for participants. In addition, preliminary data indicated that spatial symmetry and step length also improved after utilization of an RE for overground walking.

中文翻译：

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机器人外骨骼在急性和慢性中风的地上行走中的应用

中风通常会导致步态缺陷，影响功能性行走和生活质量。用于地上行走的机器人外骨骼 (RE) 是可编程的设备，可提供高剂量和特定于运动障碍的辅助，从而为中风后个体的康复进程提供新的康复可能性。本次调查的目的是提供使用 RE 在地上行走后急性和慢性中风个体的初步利用数据。对一部分个体进行二次分析，以了解 RE 地上行走引起的机械变化。38 名继发于中风的偏瘫参与者参加了在 8 个康复中心进行的临床试验。提供了两周内在 RE 中进行的四次地上步行的数据。如果参与者在研究登记时有任何正在进行的治疗，他们将继续他们的标准护理。在 10 米步行测试期间的步态速度、步态偏差和功能行走类别 (FAC) 数据在 RE 步行会话之前（基线）和之后（后续）收集。对于中风恢复的慢性 (p<0.01) 和急性 (p<0.05) 阶段的参与者，步行速度在基线和随访之间显着增加。FAC 水平显着改善 (p<0.05)，并且在基线和随访之间中风恢复急性阶段的参与者中观察到的步态偏差显着减少 (p<0.05)。对八名参与者的子集进行的二次分析表明，在使用 RE 进行四次地上行走后，参与者显着改善了他们的空间对称性。对于中风慢性和急性阶段的参与者，步行时间、步数和步行时间与正常时间的比率从第一次会议到最后一次会议增加。RE 被有效地用于地面行走，用于患有不同严重程度的急性和慢性中风的个体。结果表明，参与者在 RE 进行四次地上步行后，步行速度提高，FAC 改善，步态偏差（从基线到随访）减少。此外，初步数据表明，使用 RE 进行地上行走后，空间对称性和步长也有所改善。对于中风慢性和急性阶段的参与者，步数和步行时间与起床时间的比率从第一次会议到最后一次会议增加。RE 被有效地用于地面行走，用于患有不同严重程度的急性和慢性中风的个体。结果表明，参与者在 RE 进行四次地上步行后，步行速度提高，FAC 改善，步态偏差（从基线到随访）减少。此外，初步数据表明，使用 RE 进行地上行走后，空间对称性和步长也有所改善。对于中风慢性和急性阶段的参与者，步数和步行时间与起床时间的比率从第一次会议到最后一次会议增加。RE 被有效地用于地面行走，用于患有不同严重程度的急性和慢性中风的个体。结果表明，参与者在 RE 进行四次地上步行后，步行速度提高，FAC 改善，步态偏差（从基线到随访）减少。此外，初步数据表明，使用 RE 进行地上行走后，空间对称性和步长也有所改善。RE 被有效地用于地面行走，用于患有不同严重程度的急性和慢性中风的个体。结果表明，参与者在 RE 进行四次地上步行后，步行速度提高，FAC 改善，步态偏差（从基线到随访）减少。此外，初步数据表明，使用 RE 进行地上行走后，空间对称性和步长也有所改善。RE 被有效地用于地面行走，用于患有不同严重程度的急性和慢性中风的个体。结果表明，参与者在 RE 进行四次地上步行后，步行速度提高，FAC 改善，步态偏差（从基线到随访）减少。此外，初步数据表明，使用 RE 进行地上行走后，空间对称性和步长也有所改善。