Passive, yet not inactive: robotic exoskeleton walking increases cortical activation dependent on task.
Sue Peters, Shannon B Lim, Dennis R Louie and 2 others
PMID 32778109WHAT IT FOUND
Passive robotic exoskeleton walking triggered greater brain activation than active walking.
This happened in the parietal and frontal cortex, likely because the user had to actively inhibit their muscles to stay relaxed while the machine moved them.
Key findings
01Passive walking produced increased oxygenated hemoglobin in the right frontal cortex compared to active walking.
02Passive walking also showed increased deoxygenated hemoglobin in multiple bilateral parietal regions, suggesting higher neural demand in these areas.
03Muscle activity was significantly higher during the active condition, confirming participants successfully differentiated between being moved and moving with the device.
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
The study involved only healthy adults, so findings may not apply to individuals with neurological injuries like stroke or spinal cord injury. fNIRS can only detect activity in the outer layer of the brain (cortex), missing deeper structures involved in movement. A small but significant difference in left knee range of motion between conditions could have influenced brain activation, though the authors argue it may not be behaviourally meaningful. The sample size was small (n=14), and the authors note high variability in the data, which might mask other differences.
Declared interests
The authors declared no competing interests. Funding was provided by Canadian Institutes of Health Research, Canada Research Chairs, Michael Smith Foundation for Health Research, Vanier Graduate Scholarship Program, and University of British Columbia 4 Year Fellowship.
The easy way to misread this
Do not conclude that passive robotic walking is better for neuroplasticity or rehabilitation than active walking. This study measured immediate brain activation in healthy adults, not clinical outcomes or long-term recovery in patients.