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ORIGINAL ARTICLE   Open accessopen access

European Journal of Physical and Rehabilitation Medicine 2022 October;58(5):723-37

DOI: 10.23736/S1973-9087.22.07549-9

Copyright © 2022 THE AUTHORS

This is an open access article distributed under the terms of the CC BY-NC-ND 4.0 license which allows users to copy and distribute the manuscript, as long as this is not done for commercial purposes and further does not permit distribution of the manuscript if it is changed or edited in any way, and as long as the user gives appropriate credits to the original author(s) and the source (with a link to the formal publication through the relevant DOI) and provides a link to the license.

language: English

Using gait robotics to improve symptoms of Parkinson’s disease: an open-label, pilot randomized controlled trial

Pearl GRYFE 1, Andrew SEXTON 2, Chris A. MCGIBBON 2, 3

1 Assistive Technology Clinic, Toronto, ON, Canada; 2 Institute of Biomedical Engineering, University of New Brunswick, Fredericton, NB, Canada; 3 Faculty of Kinesiology, University of New Brunswick, Fredericton, NB, Canada



BACKGROUND: People with Parkinson’s Disease (PD) have difficulty participating in exercise.
AIM: The primary objective of this pilot randomized controlled trial (RCT) was to determine if 8 weeks (2x per week) of bilateral exoskeleton (Exo) exercise results in positive changes in cognition and participation in adults with PD compared to exercising without an exoskeleton (Nxo) or wait-list control (Con).
DESIGN: Open-label, parallel, pilot randomized controlled trial.
SETTING: Neurorehabilitation clinic in a large urban center.
POPULATION: Adults 50-85 years old with a confirmed diagnosis of PD.
METHODS: Eight weeks of twice-weekly combined aerobic, strength and mobility exercise or wait-list control. Participants were randomly assigned to exercise with no exoskeleton (Nxo), exercise with the exoskeleton (Exo), or waitlist control (Con). Primary endpoints were change in cognitive function (SCOPA-COG) and mood. Secondary endpoints were change in gait speed, six-minute walk test (6MWT), freezing of gait, balance, and PD-specific health and quality of life outcomes. Safety endpoint was analysis of adverse events (AE).
RESULTS: Forty participated in the trial (Exo, N.=13; Nxo, N.=14; Con, N.=13). Significant improvement in the Memory & Learning domain of the SCOPA-COG (P=0.014) and 6MWT (P=0.008) were detected for the Exo group compared to the Nxo and/or Con group. No other statistically significant between-groups effects were found. There were no serious or unanticipated AE.
CONCLUSIONS: Functional exercise with a low-profile overground exoskeleton showed promising results for improving memory and gait endurance in people with PD across HY stages I-IV.
CLINICAL REHABILITATION IMPACT: Exoskeletons can improve participation in high-intensity exercise.


KEY WORDS: Parkinson disease; Exercise; Robotics; Cognition; Gait

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