A multisite clinical trial has shown a soft exosuit to be a safe and potentially effective tool for lower limb rehabilitation. Photo by Rob DelGaudio

After a stroke, it can take survivors months or years to walk again, leaving them with mobility limitations that negatively affect their health and quality of life. Many come to rely on assistive devices like canes or walkers that, while helpful for getting around safely, don’t actively advance their recovery. A soft, wearable exosuit, codeveloped by physical therapy researchers at Sargent College, could change that. In a major multisite clinical trial, the suit—made of cables, straps, and computer-controlled motors—was shown to be a safe and potentially effective tool for lower limb rehabilitation.

Lou Awad and his colleagues are studying whether a robotic exosuit could help with lower back pain. Read more about their work in “Pain Relief You Can Wear.”

The trial, which was co-led by Lou Awad, an assistant professor of physical therapy, included 44 stroke survivors with partial paralysis on one side of their body. Under the supervision of a physical therapist, each participant completed gait training while wearing the exosuit. After only five days, 64 percent of them increased their maximum walking speed both with and without the device, a key indicator of improved functional capacity. The findings, published in the June 2020 issue of the Journal of NeuroEngineering and Rehabilitation, represent the first independent study of soft exosuit technology for post-stroke rehabilitation, including its potential use by clinicians for patient rehabilitation.

Lou Awad co-led the first independent study of soft exosuit technology for post-stroke rehabilitation. Photo by Dave Green

“The translation of soft exosuit technology from the lab to the clinic has the potential to be transformative for the hundreds of thousands of people who survive a stroke each year,” says Awad, director of the Neuromotor Recovery Laboratory. “As an active assistive device, the exosuit offers new opportunities to retrain walking after a stroke. Physical therapists can use it to provide patients with targeted assistance for crucial walking subtasks often impaired after stroke, like propulsion and ground clearance. In turn, patients may be able to practice more and at a higher intensity—leading to better recovery outcomes.”

The trial was a collaboration between academia, industry, and five leading rehabilitation institutions: Spaulding Rehabilitation Hospital in Massachusetts, Kessler Rehabilitation Hospital in New Jersey, Shirley Ryan AbilityLab in Illinois, TIRR Memorial Hermann in Texas, and Moss Rehabilitation Hospital in Pennsylvania. ReWalk Robotics, the industry partner that began manufacturing the exosuit in 2017, sponsored the study, which follows the company’s successful 2019 application to the Food and Drug Administration for clearance to sell the exosuit to rehabilitation clinics.

Awad and a research team from BU, Harvard, and Spaulding are now preparing a new multisite trial—funded by the American Heart Association—to measure the exosuit’s therapeutic impact compared to existing treatment options.

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