Bilateral vs. Paretic-Limb-Only Ankle Exoskeleton Assistance for Improving Hemiparetic Gait: A Case Series

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5 Scopus citations


People with lower-limb hemiparesis have impaired function on one side of the body that affects their walking ability. Wearable robotic assistance has been investigated to treat hemiparetic gait by applying assistance to the paretic limb. In this exploratory case series, we sought to compare the effects of bilateral vs. paretic-limb-only ankle exoskeleton assistance on walking performance in a case series of three heterogeneous presentations of lower-limb hemiparesis. A secondary goal was to validate the use of a real-time ankle-moment-adaptive exoskeleton control system for effectively assisting hemiparetic gait; the ankle moment controller accuracy ranged from 72-90% across all conditions and participants. Compared to walking without the device, both paretic-limb-only and bilateral assistance resulted in greater average total ankle power (up to 72%), improved treadmill walking efficiency (up to 28%), and increased over-ground walking distance (up to 41%). All participants achieved a more symmetrical, efficient gait pattern with bilateral assistance, indicating that assisting both limbs may be more beneficial than assisting only the paretic side in people with hemiparetic gait. The results of this case series are intended to inform future clinical studies and exoskeleton designs in a wide range of patient populations.

Original languageEnglish (US)
Pages (from-to)1246-1253
Number of pages8
JournalIEEE Robotics and Automation Letters
Issue number2
StatePublished - Apr 1 2022
Externally publishedYes


  • Adaptive control
  • prosthetics and exoskeletons rehabilitation robotics

ASJC Scopus subject areas

  • Control and Systems Engineering
  • Biomedical Engineering
  • Human-Computer Interaction
  • Mechanical Engineering
  • Computer Vision and Pattern Recognition
  • Computer Science Applications
  • Control and Optimization
  • Artificial Intelligence


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