The evaluation of rehabilitation effects using exoskeleton EKSO GT in patients after stroke

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Limitations of independent walking after stroke and of functional status are serious problem for a growing group of patients. Restoration of walking abilities by various mechanical devices and locomotor training have been previously reported. Therapy for neurological recovery of walking may include locomotor training with the use of body weight supported treadmill training by either, a robotic training system or manual placement of the feet during the treadmill walking. The most technologically advanced devices for mechanical support of the gait are exoskeletons. An exoskeleton is a wearbale robot which support or, in some cases substitute for the user’s own movements. The aim of this study is the evaluation of the quality of ambulation and functional status of stroke survivors while using the robotic exoscelaton. This study will recruit individuals who have experienced an ischemic stroke. It will be focused on evaluation of the efficacy of new technology, a lower body exoskeleton EKSO GT with Variable Assist software extension(EKSO Bionics, Richmond, CA, USA), that allows ambulation of patients with various neurological disorders. The Variable Assist software feature allows the patients with hemiparesis to be trained only on the affected side, whilst the non-affected side works as a non-motorized support frame only. The other feature is the ability of adaptation of the level of force support given to the lower limbs by EKSO drives independently to each limb. Those two features might significantly improve the therapy outcomes made with the use of the EKSO system. Members of the research team will perform all of the evaluation listed in methods section on subjects, that have been qualified to EKSO training basing on inclusion and exclusion criteria provided by both Ekso Bionics (in terms of safe use of the device) and the lead researcher (to maintain the coherence of the research group). The Physical therapists conducting the training are certified EKSO Physical Therapist. The training of each evaluated individual will be made over the course of 4 weeks, 3-4 times a week. The subjects in control group will recieve a standard rehabilitation typical for stroke survivors. It wil include gait reeducation, neurorehabilitation with e.g PNF or Bobath methods. The rehabilitation will be administrated 3-4 times a week. Evaluation of the patients state will be made before the first training session and after last one.