Effects of a wearable exoskeleton stride management assist system (SMA®) on spatiotemporal gait characteristics in individuals after stroke: a randomized controlled trial

Ask your hospital when they are going to get this along with the protocols used. 

Effects of a wearable exoskeleton stride management assist system (SMA®) on spatiotemporal gait characteristics in individuals after stroke: a randomized controlled trial

 Carolyn Buesing
1
†
, Gabriela Fisch
1
†
, Megan O
’
Donnell
1
, Ida Shahidi
1
†
, Lauren Thomas
1
†
,Chaithanya K. Mummidisetty
2
†
, Kenton J. Williams
3
, Hideaki Takahashi
3
, William Zev Rymer
4
and Arun Jayaraman
2*

Abstract

Background:
 Robots offer an alternative, potentially advantageous method of providing repetitive, high-dosage,and high-intensity training to address the gait impairments caused by stroke. In this study, we compared the effects of the Stride Management Assist (SMA®) System, a new wearable robotic device developed by Honda R&D Corporation, Japan, with functional task specific training (FTST) on spatiotemporal gait parameters in stroke survivors.
Methods:
 A single blinded randomized control trial was performed to assess the effect of FTST and task specific walking training with the SMA® device on spatiotemporal gait parameters. Participants (n=50) were randomly assigned to FTST or SMA. Subjects in both groups received training 3 times per week for 6–8 weeks for a maximum of 18 training sessions. The GAITRite® system was used to collect data on subjects’ spatiotemporal gait characteristics before training (baseline), at mid-training, post-training, and at a 3-month follow-up.
Results:
 After training, significant improvements in gait parameters were observed in both training groups compared to baseline, including an increase in velocity and cadence, a decrease in swing time on the impaired side, a decrease in double support time, an increase in stride length on impaired and non-impaired sides, and an increase in step length on impaired and non-impaired sides. No significant differences were observed between training groups; except for SMA group, step length on the impaired side increased significantly during self-selected walking speed trials and spatial asymmetry decreased significantly during fast-velocity walking trials.
Conclusions:
 SMA and FTST interventions provided similar, significant improvements in spatiotemporal gait parameters; however, the SMA group showed additional improvements across more parameters at various time points. These results indicate that the SMA® device could be a useful therapeutic tool to improve spatiotemporal parameters and contribute to improved functional mobility in stroke survivors. Further research is needed to determine the feasibility of using this device in a home setting vs a clinic setting, and whether such home use provides continued benefits.
Trial registration:
 This study is registered under the title
 “
Development of walk assist device to improve community ambulation
”
 and can be located in clinicaltrials.gov with the study identifier: NCT01994395.

Effects of a wearable exoskeleton stride management assist system (SMA®) on spatiotemporal gait characteristics in individuals after stroke: a randomized controlled trial

This would barely help me at all. It does nothing for the lower legs which is where my spasticity forces my left foot to angle out to the left.
The Honda site with pictures and video.
http://corporate.honda.com/innovation/walk-assist/
The research here:
http://www.jneuroengrehab.com/content/12/1/69

Carolyn Buesing^1†, Gabriela Fisch^1†, Megan O’Donnell^1†, Ida Shahidi^1†, Lauren Thomas^1†, Chaithanya K. Mummidisetty^2†, Kenton J. Williams³, Hideaki Takahashi³, William Zev Rymer⁴ and Arun Jayaraman^2*

• * Corresponding author: Arun Jayaraman a-jayaraman@northwestern.edu
• † Equal contributors

Author Affiliations

¹ Northwestern University Physical Therapy and Human Movement Sciences, 645 N. Michigan Ave, Suite 1100, Chicago 60611, IL, USA
² Max Nader Lab for Rehabilitation Technologies and Outcomes Research, Rehabilitation Institute of Chicago, 345 E. Superior St, Chicago 60611, IL, USA
³ Honda R&D Americas, Inc, 21001 State Route 739, Raymond 43067, OH, USA
⁴ Director, Research Planning, Rehabilitation Institute of Chicago, 345 E. Superior St, Chicago 60611, IL, USA

For all author emails, please log on.

Journal of NeuroEngineering and Rehabilitation 2015, 12:69  doi:10.1186/s12984-015-0062-0

Carolyn Buesing, Gabriela Fisch, Megan O'Donnell, Ida Shahidi, Lauren Thomas, and Chaithanya K. Mummidisetty contributed equally to this work.
The electronic version of this article is the complete one and can be found online at: http://www.jneuroengrehab.com/content/12/1/69

Received:	31 March 2015
Accepted:	11 August 2015
Published:	20 August 2015

© 2015 Buesing et al.

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Abstract

Background

Robots offer an alternative, potentially advantageous method of providing repetitive, high-dosage, and high-intensity training to address the gait impairments caused by stroke. In this study, we compared the effects of the Stride Management Assist (SMA®) System, a new wearable robotic device developed by Honda R&D Corporation, Japan, with functional task specific training (FTST) on spatiotemporal gait parameters in stroke survivors.

Methods

A single blinded randomized control trial was performed to assess the effect of FTST and task-specific walking training with the SMA® device on spatiotemporal gait parameters. Participants (n = 50) were randomly assigned to FTST or SMA. Subjects in both groups received training 3 times per week for 6–8 weeks for a maximum of 18 training sessions. The GAITRite® system was used to collect data on subjects’ spatiotemporal gait characteristics before training (baseline), at mid-training, post-training, and at a 3-month follow-up.

Results

After training, significant improvements in gait parameters were observed in both training groups compared to baseline, including an increase in velocity and cadence, a decrease in swing time on the impaired side, a decrease in double support time, an increase in stride length on impaired and non-impaired sides, and an increase in step length on impaired and non-impaired sides. No significant differences were observed between training groups; except for SMA group, step length on the impaired side increased significantly during self-selected walking speed trials and spatial asymmetry decreased significantly during fast-velocity walking trials.

Conclusions

SMA and FTST interventions provided similar, significant improvements in spatiotemporal gait parameters; however, the SMA group showed additional improvements across more parameters at various time points. These results indicate that the SMA® device could be a useful therapeutic tool to improve spatiotemporal parameters and contribute to improved functional mobility in stroke survivors. Further research is needed to determine the feasibility of using this device in a home setting vs a clinic setting, and whether such home use provides continued benefits.

Trial registration

This study is registered under the title “Development of walk assist device to improve community ambulation” and can be located in clinicaltrials.gov with the study identifier: NCT01994395.

One-Wheeled Self-Balancing Electric Scooter

This would be perfect for stroke rehab and a replacement for boring wheelchairs that don't work for one-handed patients anyway.  Call up the stroke department head and ask for the innovative person that will approve such an expenditure. So useful; balance therapy, hamstring therapy, preparation for driving.
Or maybe you would rather do the boring Honda version.

URBAN TRANSPORT Testing Honda's "mind-controlled" UNI-CUB β

 

One-Wheeled Self-Balancing Electric Scooter

Ekso Bionics Announces a New Generation of Robotic Exoskeleton

I don't know what this looks like. RIC can compare this to the Honda Walking Assist Device which is also being tested there.

http://www.eksobionics.com/pressrelease
Ekso Bionics™ today announced the first delivery of Ekso GT™, a robotic exoskeleton which enables individuals with lower extremity paralysis or weakness to stand and walk. Ekso GT introduces new advancements designed to make it easier for clinicians to provide therapy to a wide variety of patients, as well as provides new opportunities to explore therapeutic interventions, particularly for patients with some preservation of motor ability such as those who have experienced a stroke. The first device was delivered to US News’ #1 ranked hospital in rehabilitation, the Rehabilitation Institute of Chicago (RIC).
Ekso GT is the next generation of Ekso™; a wearable bionic suit which enables individuals with lower extremity paralysis to walk over ground with a fully weight bearing, reciprocal gait. Battery-powered motors drive the legs and replace deficient neuromuscular function to either or both legs. Technological advancements in the newest model of Ekso further optimize the device as a functional-based, rehabilitative tool for hospitals and clinics serving patients with various forms of paralysis due to neurological conditions such as stroke, spinal cord injury or disease, traumatic brain injury and more.
“This is our fourth product in the evolution of Ekso technology in less than two years, demonstrating not only how quickly the technology is advancing, but how rapidly the clinical community is adopting it into their rehab programs,” said Ekso Bionics chief executive officer, Nathan Harding. “We’re witnessing an exciting new approach to neurorehabilitation.”
The first Ekso GT was delivered to RIC and this is their second Ekso. It will be used to study post-stroke gait training and rehabilitation under a National Institute on Disability and Rehabilitation Research (NIDRR) funded grant. RIC and Ekso Bionics will collaborate and share data under a newly signed research agreement.
“The results we’ve seen using the previous Ekso among our stroke and spinal cord injured patients have demonstrated we have every reason to embrace and explore this technology further,” said RIC’s vice president, research, W. Zev Rymer, MD, PhD. “ This is an exciting opportunity to be at the forefront of this incredibly innovative technology helping to improve outcomes for our patients.”
Mechanical advancements in Ekso GT include; easier, faster adjustment capability between patients, releasable hip abduction and thigh rotation to provide patients with appropriate strength and motor function more freedom, adjustable foot ankle stiffness and angle enable a more stable gait, and the new composite foot design encourages improved weight shifts. In addition, the Ekso GT’s software hosts several new advancements, such as a feature for turning in place, and the ability to adjust software settings while patients are walking.

URBAN TRANSPORT Testing Honda's "mind-controlled" UNI-CUB β

Personal transport, maybe you should ask your hospital when they are going to get these for survivors instead of obsolete wheelchairs.

http://www.gizmag.com/riding-hondas-uni-cub/29887/
Learning to ride the UNI-CUB β is infinitely easier than learning to ride a bicycle. You sit down on it, lift the release lever at the rear of the seat that stabilizes it at standstill, and … away you go.
There’s no balancing involved because it does that for you.
It’s also not like learning to drive a car where you need to master and coordinate a number of skills such as revving the motor and releasing the clutch, coordinating the throttle, clutch, and gearstick for changing gears and so on, because it is auto-everything.
Pictures and more at link.
videos here;

2012 Honda UNI-CUB Personal Mobility Device - Riding and Forward Movement 

2012 Honda UNI-CUB Personal Mobility Device - Diagonal Movement

2012 Honda UNI-CUB Personal Mobility Device - Turning in Place

close to the same height as a standing person.

2012 Honda UNI-CUB Personal Mobility Device - Applications

U.S. Research Begins on Honda Walking Assist Device

I'm not sure which of the two pictures below is the device, ask your doctor or call the RIC.

The one below is the SMA, or stride management assist device
This is the one being tested at the RIC.

A SMA, or stride management assist device

 http://hondanews.com/channels/corporate-headlines/releases/u-s-research-begins-on-honda-walking-assist-device
Honda announced today that a clinical research study of its Walking Assist Device has begun at the Rehabilitation Institute of Chicago (RIC).
At RIC, physical therapists and researchers will perform a scientific assessment of the ability of the Honda Walking Assist Device or Stride Management Assist (SMA) to improve the mobility of patients who have experienced a stroke. This will serve as the first large scale clinical research study on the Honda Walking Assist Device to take place in the U.S.
The Honda Walking Assist Device is worn outside of clothing and consists of a stylish frame and battery-powered compact motors designed to assist people with reduced walking ability due to injury, illness or other causes. The device was developed by Honda R&D Co., Ltd.
"We are excited about bringing the Honda Walking Assist Device to the Rehabilitation Institute of Chicago for research with the hope of helping adults in America recover from stroke and improve over-ground mobility," said Ryan Harty, manager of the Environmental Business Development Office of American Honda Motor Co., Inc. "As a mobility company, Honda envisions a society where all people can experience the joy and freedom of personal mobility."
Stroke is the leading cause of the adult-onset of disability, affecting about 795,000 people in the U.S. each year^i,ii. A large proportion of these stroke survivors (up to 80%) experience considerable problems with walking, including reduced walking speeds and asymmetrical walking patterns, limiting their ability to walk.ⁱⁱⁱ
"The goal of post-stroke rehabilitation is to reintegrate individuals back to their highest level of function for employment, social and community participation. The return of mobility and walking is a crucial part of this return to function," said Arun Jayaraman, PT PhD, of the Department of Physical Medicine & Rehabilitation and Physical Therapy, Northwestern University and the Rehabilitation Institute of Chicago, and Principal Investigator in the clinical research study.
Honda began research and development of the Walking Assist Device in 1999. As with ASIMO, Honda’s humanoid robot, the Walking Assist Device adopts cooperative control technology^iv that was developed based on Honda’s cumulative study of human walking. The control computer activates motors based on information obtained from hip angle sensors while walking to improve the symmetry of the timing of each leg lifting from the ground and extending forward and backward, and to promote a longer stride for easier walking. The compact design of the device was achieved through the adoption of thin motors and a control system developed by Honda, as well as a simple design with adjustable belts that enables the device to be worn by people of varied body size.
"We are committed to leveraging our research into humanoid robotics to improve people’s lives," said Harty.
From the early stages of the research and development of the Walking Assist Device, Honda has worked with research institutions and other organizations in Japan. Through this process, Honda has received encouraging feedback from patients who underwent walking training, physical therapists, medical doctors, and researchers, all of whom acknowledge certain effectiveness and compatibility of the device in the rehabilitation process.
* A total of 9 sets of devices will be tested in the clinical research at RIC.

Honda To Exhibit Walking Legs at the Smithsonian in New York

They look weird. 

Honda To Exhibit Walking Legs at the Smithsonian in New York

Rather goofy-looking at first glance, Honda’s new legs (aka Bodyweight Support Assist Device) makes walking and stair-climbing easier for the elderly and folks on rehab. Leveraging walking technology from full-body ASIMO robot, the leggy device provides natural walking and crouching support with its combined saddle, motorized leg frame and force-sensing shoes. With a control computer and battery pack neatly tucked away under the femur of the frame, the legs sense and guide motion while walking, going up and down stairs and in a semi-crouching position. An assisting force is directed towards the user’s center of gravity and in sync with movement to support one’s bodyweight and reduce the load on the user’s leg muscles and joints.

More at link.