Enhancing Neuroplasticity in the Chronic Phase After Stroke: Effects of a Soft Robotic Exosuit on Training Intensity and Brain-Derived Neurotrophic Factor

Enhancing Neuroplasticity in the Chronic Phase After Stroke: Effects of a Soft Robotic Exosuit on Training Intensity and Brain-Derived Neurotrophic Factor

<italic>Objective:</italic> High intensity training may enhance neuroplasticity after stroke; however, gait deficits limit the ability to achieve and sustain high walking training intensities. We hypothesize that soft robotic exosuits can facilitate speed-based gait training at higher in...

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Bibliographic Details
Main Authors: Anna V. Roto Cataldo, Ashley N. Collimore, Johanna Spangler, Lillian Ribeirinha-Braga, Karen Hutchinson, Qing Mei Wang, LaDora Thompson, Louis N. Awad
Format: Article
Language:English
Published: IEEE 2023-01-01
Series:IEEE Open Journal of Engineering in Medicine and Biology
Subjects:
Brain-derived neurotrophic factor
neuroplasticity
soft robotic exosuit
stroke
walking
Online Access:https://ieeexplore.ieee.org/document/10244088/
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Summary:<italic>Objective:</italic> High intensity training may enhance neuroplasticity after stroke; however, gait deficits limit the ability to achieve and sustain high walking training intensities. We hypothesize that soft robotic exosuits can facilitate speed-based gait training at higher intensities and longer durations, resulting in a corresponding increase in circulating brain-derived neurotrophic factor (BDNF). <italic>Results:</italic> Eleven individuals &gt;6-mo post-stroke completed a two-session, pilot randomized crossover trial (NCT05138016). Maximum training speed (&#x0394;: 0.07 &#x00B1; 0.03 m&#x002F;s), duration (&#x0394;: 2.07 &#x00B1; 0.88 min), and intensity (VO<sub>2</sub> peak, &#x0394;: 1.75 &#x00B1; 0.60 ml-O<sub>2</sub>&#x002F;kg&#x002F;min) significantly increased (p &lt; 0.05) during exosuit-augmented training compared to no-exosuit training. Post-session increases in BDNF (&#x0394;: 5.96 &#x00B1; 2.27 ng&#x002F;ml, p &#x003D; 0.03) were observed only after exosuit-augmented training. Biomechanical changes were not observed after exosuit-augmented training; however, a deterioration in gait propulsion symmetry (&#x0025;&#x0394;: &#x2212;5 &#x00B1; 2 &#x0025;) and an increase in nonparetic propulsion (&#x0394;: 0.9 &#x00B1; 0.3 &#x0025;bw) were observed (p &lt; 0.05) after no-exosuit training. <italic>Conclusion:</italic> Soft robotic exosuits facilitate faster, longer duration, and higher intensity walking training associated with enhanced neuroplasticity.
ISSN:2644-1276

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