Effects of a soft robotic exosuit on the quality and speed of overground walking depends on walking ability after stroke.
Lizeth H Sloot, Lauren M Baker, Jaehyun Bae and 11 others
PMID 37658408WHAT IT FOUND
A soft robotic exosuit increased walking speed in slower walkers poststroke but not in faster walkers.
It improved propulsion and foot landing without increasing energy cost or reducing muscle activity. These were immediate, single-session effects, not evidence of long-term recovery.
Key findings
01Walking speed increased by 6.7% overall, driven by limited ambulators who improved by 12.7%, while full ambulators showed no change.
02The exosuit improved propulsion and ground clearance without reducing paretic plantarflexor muscle activity, maintaining patient engagement.
03Energy cost of transport and walking stability did not change, indicating the device did not add metabolic burden or destabilize gait.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study measured immediate effects in a single 5-minute session; it does not show whether these benefits persist or lead to long-term recovery with repeated training. The sample was small (19 participants), and the subgroup split (limited vs. full ambulators) was based on a specific speed cutoff (0.93 m/s), which may not generalize to all patients. There was no 'sham' condition where the exosuit was worn but inactive, so the effect of the device's weight and bulk cannot be fully separated from the mechanical assistance. Most participants requiring a cane were in the limited ambulator group, and the authors could not exclude that cane use altered the exosuit's effectiveness.
Declared interests
The authors declared no competing interests. The study was supported by the NIH, NSF, American Heart Association, Rolex Award for Enterprise, and the Wyss Institute.
The easy way to misread this
Do not assume this device improves walking for all stroke survivors. The benefit was concentrated in slower walkers (limited ambulators); faster walkers (full community ambulators) showed no improvement in walking speed. Additionally, these were immediate, single-session effects, not evidence of long-term rehabilitation gains.