Ankle Exoskeleton Assistance Increases Six-Minute Walk Test Performance in Cerebral Palsy

Objective: To determine the effects of providing battery-powered ankle dorsiflexor and plantar flexor exoskeleton assistance on six-minute walk test performance and efficiency in children and young adults with cerebral palsy by comparing distance walked under exoskeleton assisted (Assisted) and no device (Shod) walking conditions, and explore the acclimation rate to maximal walking with ankle exoskeleton assistance. Results: Six-minute walk test performance significantly improved under the final Assisted condition test compared to the Shod condition (42 ± 27 m, p = 0.02), surpassing the minimum clinically important difference range for children and young adults with CP. There was no difference in walking efficiency (-0.06 ± 0.1, p = 0.3). Participants had an average acclimation rate of 19.6 m per session. Conclusions: Powered ankle assistance can significantly improve six-minute walk test performance in individuals with mild-to-moderate gait impairment from CP, supporting the use of this intervention to improve functional mobility and walking capacity in this patient population.