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Soft Robotics for Post-Stroke Gait Rehabilitation

We all know that if we can’t walk around properly, it significantly impacts on our independence. Recent research highlights the effectiveness and safety of the ReWalk ReStore™ soft robotic exosuit for improving walking ability in stroke survivors. This innovative device is revolutionising gait training by providing targeted, active assistance to the affected ankle, helping to overcome common mobility challenges.

It consists of an actuator assembly, calf wrap assembly, and shoe insole. A power supply is integrated into the actuator assembly. Bowden cables span these components to transmit assistive forces generated by the actuator to the ankle. One of the cables is located anterior to the ankle and the other is located posterior to the ankle. When the anterior cable is retracted, an ankle dorsiflexion torque is produced. When the posterior cable is retracted, an ankle plantarflexion torque is produced.

The ReStore is uniquely designed to assist both the dorsiflexion (lifting the foot) and plantarflexion (pushing off) actions of the ankle, which are crucial for ground clearance and propulsion during walking. By synchronising its assistance with the patient’s own movement, it helps retrain proper gait mechanics.

A multi-site clinical trial found that after just five days of training with the ReStore, participants saw clinically meaningful increases in both their device-assisted and unassisted walking speeds. Some patients achieved even larger gains in a short period. The trial also confirmed the exosuit’s safety and reliability when used under the supervision of a physical therapist. No device-related falls or serious adverse events were reported, and users reported high satisfaction with the device.

The ReStore’s active assistive approach can probably offer a more advanced solution compared to passive devices like AFOs. It helps retrain and re-engage muscles, rather than simply bracing the ankle.

Ref: Awad, L.N., Esquenazi, A., Francisco, G.E. et al. The ReWalk ReStore™ soft robotic exosuit: a multi-site clinical trial of the safety, reliability, and feasibility of exosuit-augmented post-stroke gait rehabilitation. J NeuroEngineering Rehabil 17, 80 (2020).

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