Adaptive ankle exoskeleton gait training demonstrates acute neuromuscular and spatiotemporal benefits for individuals with cerebral palsy: A pilot study.
Ying Fang, Greg Orekhov, Zachary F Lerner
PMID 33248858WHAT IT FOUND
Six people with cerebral palsy walked faster and took longer steps after training with an ankle exoskeleton.
These improvements remained when walking without the device, suggesting the training helped them learn a more efficient pattern rather than just relying on the machine.
Key findings
01All participants increased walking speed and stride length after training, even when walking without the exoskeleton.
02Muscle activity became more consistent from step to step, particularly in the soleus, indicating more repeatable motor control.
03The study was a small pilot with only six participants, so these results cannot confirm efficacy or generalise to the wider CP population.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
Very small sample size (n=6) limits statistical power and generalisability. No control group or randomisation; improvements could be due to practice or natural variability. Short duration of training (4 sessions) and immediate post-test assessment; long-term retention is unknown. Could not isolate the effect of plantar-flexor assistance from the dorsi-flexor assistance or the training itself. Oval track design introduced turning, which may confound straight-line gait metrics. Potential conflict of interest: one author is a co-founder of a company commercialising the device.
Declared interests
One author (ZFL) is a named inventor on patents for the exoskeleton and a co-founder of a company seeking to commercialise the device.
The easy way to misread this
Do not assume the exoskeleton is the sole cause of improvement. The study lacked a control group, so the observed gains in walking speed and stride length could also result from the structured walking practice itself. Additionally, the sample size of six is too small to generalise these findings to all individuals with cerebral palsy.