PTOtherJournal of neuroengineering and rehabilitation2019

Increased gait variability during robot-assisted walking is accompanied by increased sensorimotor brain activity in healthy people.

Alisa Berger, Fabian Horst, Fabian Steinberg and 4 others

PMID 31882008

WHAT IT FOUND

Overall sensorimotor brain activity did not differ between robot-assisted and unassisted walking in 12 healthy adults.

Robot-assisted walking changed gait with lower forces, slower cadence and more variability; the brain-gait link was not clear.

Key findings

01The walking condition itself did not significantly change cortical oxygenated hemoglobin, but gait variability and sensorimotor cortex oxygenated hemoglobin were positively associated during robot-assisted walking (p = 0.052, r = 0.570).

02Robot-assisted walking increased intraindividual gait variability from 5.8% to 7.9% and interindividual variability from 7.0% to 15.7%, compared with unassisted walking.

03Robot-assisted walking changed gait timing and force patterns: vertical ground reaction force peaks were lower, the first peak appeared earlier, the second peak appeared later, and cadence was lower.

STILL TO COME

How it was doneWhat they foundWhat it means for PTs

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What it does not show

The study was done in 12 healthy young adults with no gait problems, so it does not show what robot-assisted walking does for patients with neurological disease. The sample was small, and the brain-gait correlation had p = 0.052, which did not meet the study's p <= 0.05 threshold. Only cortical regions over the motor areas were measured, so subcortical or wider brain network effects were not captured. The robot was set to 30% body-weight support and 100% guidance, with a fixed pelvis and foot straps, so the findings may not apply to other robot settings or clinical setups. The outcomes were gait force patterns and brain oxygenation during a single session, not walking recovery, falls, or function over time.

The easy way to misread this

Do not conclude that robot-assisted walking improves gait or brain recovery in patients. The study was done in 12 healthy young adults, not patients, and the brain-gait correlation did not meet the p <= 0.05 threshold.

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