PTPilotJournal of neuroengineering and rehabilitation2019

Relearning functional and symmetric walking after stroke using a wearable device: a feasibility study.

Seok Hun Kim, David E Huizenga, Ismet Handzic and 6 others

PMID 31455358

WHAT IT FOUND

Six people with chronic stroke who wore a passive shoe that moves the unaffected foot backward during walking all showed better step length symmetry and faster walking after 12 sessions.

No control group, so this is feasibility, not proof.

Key findings

01Six individuals with chronic stroke used the passive shoe for 12 sessions over four weeks in this feasibility study.

02All six participants improved step length symmetry; four improved double limb support symmetry; and four improved stance phase symmetry, though the stance changes were small.

03All participants improved gait velocity, and five improved beyond at least one meaningful change or minimal detectable change threshold.

STILL TO COME

How it was doneWhat they foundWhat it means for PTs

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What it does not show

Only six participants were studied, so the results cannot show how likely the changes are in a broader stroke population. There was no matched control group receiving standard physical therapy or walking alone, so the changes cannot be compared with usual recovery or exercise. The device was worn together with a height and weight matched shoe on the paretic foot and with physical therapist supervision, so the contribution of the shoe alone cannot be separated. One participant did not complete the follow-up Timed Up and Go and 6-minute walk tests. The gait velocity meaningful change thresholds were based on people 30 to 150 days post stroke, while all participants were more than one year post stroke. The 6-minute walk improvements did not surpass the 34 m minimal clinically important difference, and the four-week training had only 6 hours total walk time.

Declared interests

Funding was named as Moterum Technologies, Inc. and Florida High Tech Corridor.

The easy way to misread this

Do not read the improvements as proof that the shoe causes recovery. The study had six participants, no matched control group, and the shoe was used with a matched shoe on the other foot and with physical therapist supervision.

Read it on PubMed →