Objective: To clarify the effect of a wearable exoskeleton stride management assist device (SMAD: Honda R and D Corporation, Japan) on gait in Parkinson’s disease (PD) patients.

Background: The SMAD increases step length and decreases spatial asymmetry when walking in post-stroke patients. There are few reports conducted about the effect of SMADs on mobility in PD patients.

Methods: We studied the direct effect when wearing SMAD and the indirect effect after rehabilitation using SMAD in PD patients. In the direct effect study, patients did 10 meters (m) and 3 minutes (min) walking wearing SMAD with and without stride assist six times on separate days and we estimated the velocity, distance, step length and cadence. In the indirect effect study, patients did step and walking rehabilitation 4 times / 3 weeks without SMAD (phase A1) and using SMAD (phase B1), without SMAD (phase A2) and using SMAD (phase B2). We used the following mode and the step mode of SMAD. We evaluated 10 m and 3 minutes of walking without SMAD, Timed Up and Go test (TUG), Berg Balance Scale (BBS), UPDRS part III, Freezing of Gait Questionnaire (FOG-Q) and PDQ-39 at the pre-intervention and each post-phase. The statistical analysis was done using the paired t-test in the direct study.

Results: 5 patients (4 females, mean age 75.8 y, disease duration 9.8 y, HY 2.5) were included and completed the direct study. Patient 1 (P1) finished the indirect study. In the direct study, the walking distance for 3 minutes of walking in P1 and P3 increased from 135.5 to 145.0 m (p = 0.013) and from 162.5 to 168.2 m (p = 0.000). The step length in 10 m of walking in P2 and P3 also rose from 37.5 to 40.3 cm (p = 0.010) and from 51.5 to 53.8 cm (p = 0.028). The step length in 3 min walking increased in P3, P4 and P5 from 48.5 to 50.3 cm (p = 0.012), from 43.7 to 49.8 cm (p=0.000) and from 59.2 to 61.2 cm (p=0.003). In the indirect study, P1 could walk a longer distance in 3 minutes than that before the intervention. (pre-A1 127 m; post-A1 147 m; post-B1 156 m; post-A2 162 m; post-B2 185 m (+45.7 %)). UPDRS item 26 (leg agility) and item 30 (posture), and MDS-UPDRS item 3.11 (freezing of gait) improved mildly.

Conclusions: This study showed that Honda SMAD could increase walking velocity and step length in PD patients. The SMAD could be a useful device to increase exercise capacity in PD patients. 

« Back to 2017 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/improvement-on-gait-in-parkinsons-disease-patients-using-honda-stride-management-assist-device/