Using gait robotics to improve symptoms of parkinson's disease: an open-label, pilot randomized controlled trial

BACKGROUND: People with Parkinson's Disease (PD) have difficulty participating in exercise.AIM: The primary objective of this pilot randomized controlled trial (RCT) was to determine if 8 weeks (2x per week) of bilateral exoskeleton (Exo) exercise results in positive changes in cognition and participation in adults with PD compared to exercising without an exoskeleton (Nxo) or wait-list control (Con).DESIGN: Open-label, parallel, pilot randomized controlled trial.SETTING: Neurorehabilitation clinic in a large urban center. POPULATION: Adults 50-85 years old with a confirmed diagnosis of PD.METHODS: Eight weeks of twice-weekly combined aerobic, strength and mobility exercise or wait-list control. Participants were randomly assigned to exercise with no exoskeleton (Nxo), exercise with the exoskeleton (Exo), or waitlist control (Con). Primary endpoints were change in cognitive function (SCOPA-COG) and mood. Secondary endpoints were change in gait speed, six-minute walk test (6MWT), freezing of gait, balance, and PD-specific health and quality of life outcomes. Safety endpoint was analysis of adverse events (AE).RESULTS: Forty participated in the trial (Exo, N.=13; Nxo, N.=14; Con, N.=13). Significant improvement in the Memory & Learning domain of the SCOPA-COG (P=0.014) and 6MWT (P=0.008) were detected for the Exo group compared to the Nxo and/or Con group. No other statisti-cally significant between-groups effects were found. There were no serious or unanticipated AE.CONCLUSIONS: Functional exercise with a low-profile overground exoskeleton showed promising results for improving memory and gait endurance in people with pD across HY stages I-IV.CLINICAL REHABILITATION IMPACT: Exoskeletons can improve participation in high-intensity exercise.

Automated summary

This pilot randomized controlled trial aimed to determine whether 8 weeks of bilateral exoskeleton exercise could lead to positive changes in cognition and participation in adults with PD, compared to exercising without an exoskeleton or wait-list control. The results showed significant improvement in memory and gait endurance for the Exo group.