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This study evaluates the immediate effects of walking with a lightweight soft exosuit providing mechanical assistance during plantarflexion and dorsiflexion of the paretic limb with individuals in the chronic phase of stroke recovery. For the primary analysis in this study, nine individuals with chronic stroke participated in bouts of walking on an instrumented treadmill with a tethered exosuit connected to an off-board actuation unit. Biomechanical analysis was performed at the participant’s preferred overground walking speed under two conditions – with the exosuit providing mechanical assistance during plantarflexion and dorsiflexion (powered) and with the suit not transmitting any forces to the wearer (unpowered). Compared to walking without assistance from the exosuit, study participants increased paretic ankle dorsiflexion by 5.33 ± 0.91° during the swing phase and improved paretic propulsion by 11 ± 3% (P < 0.05). These improvements contributed to an overall 20 ± 4% reduction in propulsion asymmetry and a 32 ± 9% reduction in the metabolic burden of post-stroke walking. Two complementary studies are also described in supplementary sections: a passive exosuit study and a study of overground gait assistance with an untethered (body-mounted) version of the exosuit. The authors suggest that exosuit-induced improvements in post-stroke walking function may increase the opportunity for walking practice with higher intensity and variability, and the ability to facilitate walking practice with more normal gait mechanics also has the potential to promote locomotor restoration instead of compensation.
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