Shaping neuroplasticity by using powered exoskeletons in patients with stroke: a randomized clinical trial.
Rocco Salvatore Calabrò, Antonino Naro, Margherita Russo and 7 others
PMID 29695280WHAT IT FOUND
Adding 45 minutes of Ekso exoskeleton gait training to conventional physiotherapy let all 20 patients reach the primary mobility target, unlike adding conventional overground walking to the same physiotherapy.
Key findings
01Adding 45 minutes of Ekso gait training to conventional physiotherapy resulted in all 20 Ekso patients meeting the composite primary outcome, while the conventional overground group did not.
02As an add-on to conventional physiotherapy, the Ekso group changed more than the overground group on the three primary mobility measures, with effect sizes of 0.9 for the 10-m walk test, 0.5 for the timed up and go test, and 0.6 for the Rivermead Mobility Index.
03No significant adverse events occurred, except mild skin erythema at thigh and shank strap sites in seven Ekso patients.
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 40 patients from a local neurorobotic rehabilitation unit, so the result may not apply to other services. There was no long-term follow-up, so it is unknown whether gains persisted. Both groups received conventional physiotherapy, so the trial cannot separate the effect of Ekso from the background physiotherapy. Only outcome assessors and data analysts were blinded to allocation; the paper does not describe patients or training therapists as blinded. The authors note the high dose of therapy could be a confounding factor when comparing protocols. The paper does not report how many overground patients met the composite primary outcome.
Declared interests
No funding or conflict-of-interest declaration appears in the supplied text.
The easy way to misread this
Do not conclude that Ekso alone caused the gains. Both groups received conventional physiotherapy, and the trial compared adding Ekso training with adding conventional overground walking, so the contribution of Ekso cannot be separated from the background physiotherapy.