A robotic exoskeleton helps kids learn to walk better outside the clinical setting

2022

Challenge

Movement disorders such as cerebral palsy, spina bifida, and muscular dystrophy often cause affected children to have difficulty walking. These children will likely benefit from physical therapy to improve how they walk using wearable robotic devices called exoskeletons. Unfortunately, currently available devices are not flexible enough to match each individual’s specific difficulties and are unable to train them at high enough intensities to be effective. Further, most interventions have been designed for high-functioning children and there are few options for those with the most severe movements problems. These children are at the highest risk for loss of their mobility and therefore stand to benefit the most.

Advance

IRP researchers led by Thomas C. Bulea, Ph.D., developed a new robotic exoskeleton specifically for children with more severe walking difficulties who require the use of other mobility aids such as crutches or walkers. The exoskeleton, which is essentially a wearable robotic brace, trains users to move differently. This new device provides variable, on-demand assistance and physical resistance to challenge the user as they walk, providing a unique form of strength training that can be adapted to the user’s capabilities over time. Additionally, the technology is robust enough for use in multiple settings, enabling users to undergo intensive training sessions at home daily.

Impact

The robotic exoskeleton developed at the NIH Clinical Center builds on fundamental rehabilitation and neuroscience principles in a way prior approaches have not. Initial testing in clinical populations has shown short term improvement in both walking function and muscle activity. Based on those promising results, a randomized interventional study is now underway to evaluate the feasibility and effectiveness of this intervention when delivered outside the clinic. The results from this study will also inform other device-based therapies.

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