Evaluation of a passive pediatric leg exoskeleton during gait.
Jessica Zistatsis, Keshia M Peters, Daniel Ballesteros and 3 others
PMID 33094685WHAT IT FOUND
Four children walked in a passive leg exoskeleton.
Two with hemiparesis showed improved joint symmetry and variable speed changes, while two typically developing children were largely unaffected. The small sample size means this device is not yet proven to help.
Key findings
01In the two children with hemiparesis, the exoskeleton improved symmetry at specific joints, such as increasing ankle symmetry for one child and knee and ankle symmetry for the other.
02Walking speed responses were highly variable: one typically developing child slowed down, one sped up, and the two children with hemiparesis showed different patterns across stiffness levels.
03The device did not substantially change muscle activity in the children, despite the theoretical aim of reducing energy cost.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study included only four children, making it impossible to determine which patients might benefit or how common those benefits are. The walking conditions were not randomized, so any improvements seen later in the session might be due to practice or acclimation rather than the device itself. The acclimation period was short (2-5 minutes), which may have led to the initial decrease in walking speed observed in some participants. Participants did not wear their prescribed ankle-foot orthoses (AFOs) during the study, so the device's effect compared to standard care is unknown.
Declared interests
The authors declare no conflict of interest.
The easy way to misread this
Do not assume this device will improve walking speed or reduce effort for your patients. The study was a small case series with non-randomized trials, and speed changes were inconsistent, with some children actually slowing down. The primary finding was potential improvement in joint symmetry, not functional mobility.