Researchers from the NIH Clinical Center Rehabilitation Medicine Department have created the first robotic exoskeleton that demonstrated significant reduction among crouch gait in children and adolescents with cerebral palsy, according to results recently published in Science Translational Medicine.
“Most wearable exoskeletons have been designed for adults with paralysis, with the exoskeleton replacing the lost function of the user’s,” researcher Thomas C. Bulea, PhD, staff scientist in the NIH Clinical Center Department of Rehabilitator Medicine, said in a press release from the NIH. “We sought to create a device that could safety and effectively improve the posture of children with crouch gait while they walked. The improvements in their walking along with their preserved muscle activity, make us optimistic that our approach could train a new walking pattern in these children if deployed over an extended time.”
Seven patients aged 5 years to 19 years (four male patients) who were diagnosed with crouch gait from cerebral palsy and could walk at least 30 feet without using a walking aid participated in the multiweek study. There was an initial visit for fit adjustment of the prototype, powered knee exoskeleton and exoskeleton tuning, followed by five additional 2-hour to 3-hour visits to the NIH Clinical Center.
The exoskeleton provided powered knee extension assistance at key points during the walking cycle, according to the release. The exoskeleton was reported to be safe and well-tolerated, with all participants being able to walk independently while using the device.
Six of the seven patients had improvements in knee extension with gains that were similar to or greater than outcomes reported from invasive surgical intervention.
“Our results suggest that powered knee exoskeletons should be investigated as an alternative to or in conjunction with existing treatments for crouch gait, including orthopedic surgery, muscle injections and physical therapy,” the researchers wrote in the study.
References:
Lerner ZF, et al. Sci Transl Med. 2017;doi:10.1126/scitranslmed.aam9145.
Disclosures: The researchers reported that they are named inventors on a provisional patent application (U.S. patent application no. 62/368,926. “Powered Gait Assistance Systems”) covering the exoskeleton used in the study, which is held by the NIH.
