Use of a Robotic Walking Device for Home and Community Mobility in Parkinson Disease: A Randomized Controlled Trial.
Study Goal
The researchers aimed to examine the immediate and longer-term effects of a robotic exoskeleton device (EXOD) on gait in individuals with Parkinson's disease.
Results Summary
No significant immediate impact of EXOD usage on gait measures was found, and post-intervention differences in gait speed and secondary outcomes were not significant between the intervention and control groups. Participants with greater disease severity showed some improvement in stride length during unassisted walking after the intervention.
Population
Individuals with Parkinson's disease (Hoehn and Yahr stages 1-3).
Effective Dosage
Supervised in-home and community training with the EXOD twice weekly.
Duration
8 weeks.
Interactions
None mentioned.
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
robotic-assisted gait training (RAGT) with a single joint robotic exoskeleton device (EXOD), the Honda Walking Assist device | no change | gait measures | participants with Parkinson disease (Hoehn and Yahr stages 1-3) | no significant change | No significant immediate impact | #1 |
robotic-assisted gait training (RAGT) with a single joint robotic exoskeleton device (EXOD), the Honda Walking Assist device | no change | gait speed and secondary outcome measures | participants with Parkinson disease (Hoehn and Yahr stages 1-3) | no significant change | Differences were not significantly different | #2 |
robotic-assisted gait training (RAGT) with a single joint robotic exoskeleton device (EXOD), the Honda Walking Assist device | increase | stride length during unassisted walking | Participants with greater disease severity (worse baseline motor scores) | mean difference: 3.22, 95% confidence interval: 0.05-6.40; P = 0.04 | had greater improvements | #3 |
robotic-assisted gait training (RAGT) with a single joint robotic exoskeleton device (EXOD), the Honda Walking Assist device | no change | treatment effect | mostly low impairment population of people with PD | - | may be ineffective and/or was insufficiently dosed to see a positive treatment effect | #4 |
RAGT interventions | increase | treatment effect | individuals with greater motor impairments | - | may be more effective | #5 |
BACKGROUND/PURPOSE: Gait impairments in Parkinson disease (PD) contribute to decreased quality of life. This randomized controlled trial examined immediate- and longer-term effects of a single joint robotic exoskeleton device (EXOD), the Honda Walking Assist device, on gait. METHODS: Participants (n = 45) with PD (Hoehn and Yahr stages 1-3) were randomized to a robotic-assisted gait training (RAGT) group (n = 23) or control (CON) group (n = 22). The RAGT group was tested with and without the EXOD at baseline and then received supervised in-home and community training with the EXOD twice weekly for 8 weeks. The CON group received no interventions. Outcome measures included gait speed (primary), gait endurance (6-minute walk test), perceived ease of walking, and questionnaires and logs assessing performance of daily activities, freezing of gait, and daily activity levels. RESULTS: Forty participants completed the study. No significant immediate impact of EXOD usage on participants' gait measures was found. Differences in gait speed and secondary outcome measures postintervention were not significantly different between the RAGT and CON groups. Participants with greater disease severity (worse baseline motor scores) had greater improvements in stride length during unassisted walking after the intervention than those with lower severity (mean difference: 3.22, 95% confidence interval: 0.05-6.40; P = 0.04). DISCUSSION AND CONCLUSIONS: All RAGT participants could use the EXOD safely. The RAGT treatment used in this mostly low impairment population of people with PD may be ineffective and/or was insufficiently dosed to see a positive treatment effect. Our findings suggest that RAGT interventions in PD may be more effective in individuals with greater motor impairments.