Delivering Gait Training to Children at Home with a Robotic Knee Exoskeleton: Initial Findings on Feasibility and Patient Satisfaction

Abstract

Robotic exoskeletons offer the potential to increase gait training dosage by providing therapy outside the clinic. Exoskeleton use in naturalistic settings has been reported but under researcher supervision and for the purposes of assisting mobility. Here, we examined the feasibility of delivering a resistance-based exoskeleton gait training paradigm in the community setting. Five children aged 6-15 years with crouch gait/knee extension deficiency completed 12-weeks of gait training (5 days/week) at home with the exoskeleton as part of an ongoing interventional trial. Weekly telehealth check-ins were completed. Feasibility was assessed using patient-reported adherence to the prescribed dosage, number of adverse events, and exoskeleton hardware and software robustness during the intervention period. User satisfaction was assessed using the QUEST 2.0. No serious adverse events were reported. Participants completed between 44-57 of the targeted 60 sessions of gait training. Exoskeleton hardware and software were reliable with the most common controller adjustments involving tuning of underfoot sensing thresholds to detect stance and swing. Participant satisfaction with the exoskeleton (mean: 3.65/5) and service (4.7/5) were high. Thus, our findings indicate that resistive gait training with an exoskeleton in the real-world is safe and tolerable in children with neuromotor disorders and should be further investigated to determine effectiveness for improving functional mobility.