The use of a Robotic Exoskeleton in adjunct with Standard Overground Gait Training in a Patient with an Acute Stroke: A Case Report

Background: Standard therapy treatment for gait training requires intensive physical assistance during the acute time period for post-stroke patients. The purpose of this case report is to highlight the use of EKSO robotic exoskeleton in therapy for treatment of a patient with an acute stroke. Case Description: Our patient is an 84-year-old female admitted into the hospital in August with right sided weakness and facial droop. MRI confirmed a left basal ganglia stroke. Upon admittance, she was a moderate-max assist for functional mobility and not yet walking. On day of discharge, was able to ambulate 10 feet x 2 with use of small base quad cane. Intervention: The robotic exoskeleton is individually programmed to give lower body motor assistance to patients. The exoskeleton provides mechanical power to the hip and knee joints. The software of the robotic exoskeleton will be able to provide the appropriate assistance for the patient to ambulate with use of front wheeled walker. The Physical Therapist can create settings that will allow the robotic exoskeleton to assist in taking a step once the patient shifts enough weight on the contralateral leg. Discussion: Many articles show that when using robotic exoskeleton as an adjunct to standard of care gait training; you will find a strong correlation between number of robotic training sessions and the total distance walked during the episode of care. Increased total distance walked reinforces the principle of neuroplasticity. If you are able to increase the task specific walking dose then you will find a correlation of improved functional outcomes.