Robot-Assisted Overground Walking: Physiological Responses and Perceived Exertion in Nonambulatory Stroke Survivors

Robot-assisted overground walking (RAOW) may facilitate walking aerobic exercise in nonambulatory stroke survivors. The aims of this study were to investigate the physiological responses and perceived exertion during RAOW in persons with stroke and to compare the exercise intensity to aerobic exercise guidelines for stroke survivors. Ten nonambulatory stroke survivors (50% male, median age of 72 years old, and median time poststroke of 40 days) walked 20 minutes overground wearing a lower limb exoskeleton (Ekso GT) with full bilateral assistance. Breath-by-breath gas exchange and heart rate were monitored continuously. The rating of perceived exertion (RPE) on a 6-20 scale was assessed at the end of rest and every 5 min during walking. Net values were obtained by subtracting gross values from resting values. The net heart rate and net RPE significantly increased between minute 5 [median: 8 beats/min; interquartile range (IQR): 10 beats/min; median: 2; IQR: 5] and minute 20 (median: 17 beats/min; IQR: 17 beats/min; median: 6; IQR: 5).