Robotic exoskeleton helps with mobilization in patients with heart failure

The use of a robotic exoskeleton is a feasible intervention to assist mobilization in patients with advanced heart failure, according to a recent study.

“None of the participants terminated the mobilization protocols early, which we interpreted as additional evidence for the safety and acceptability of the Myosuit,” the researchers said. “However, the walked distances did not increase when comparing intraindividual assisted and nonassisted walks. This might be due to a lack of adaption or familiarization to the device.”

Twenty patients (mean age 49.4 years, 80 percent men) participated in the study, all of whom had functional New York Heart Association class III.

Patients performed activities of daily life (ADL; n=10) or completed a single standardized 60-minute rehabilitation exercise unit (REU; n=10) with and without the Myosuit, a wearable robotic exoskeleton designed to support the synergistic extension of hip and knee joints.

The main outcomes of interest included the rates of perceived exertion (RPE) and dyspnoea (RPD), ability to perform ADL and REU, individual acceptability of the device, and adverse events.

Overall, the researchers deemed Myosuit to be a feasible intervention. With or without the robotic device, ADLs were completed independently or with minor support (ie, walking stick, using handrails when climbing stairs). All participants were able to complete REUs independently. [ESC Heart Fail 2022;doi:10.1002/ehf2.13903]

The mean total walk distance without device assistance was 325.2 m, which increased to 364.0 m when wearing the Myosuit. The median difference value of 26.5 m was not statistically significant (p=0.241). The exoskeleton was also safe, inducing no concerning changes in vital parameters. No participant needed supplemental oxygen.

Participants who completed ADLs also found the intervention to be tolerable, with mean RPE values of 10.6 and 10.5 without and with the device, respectively (mean difference, –0.1; p=0.932). RPD was likewise statistically comparable in the respective scenarios (2.8 vs 1.8; mean difference, –0.95; p=0.141).

A similar effect was reported for REU participants. RPE at 15 minutes (mean difference, 0.6; p=0.404) and 30 minutes (mean difference, 1.1; p=0.201), and RPD at 15 minutes (mean difference, 0.5; p=0.435) and 30 minutes (mean difference, 0.5; p=0.435) were comparable when REU tasks were performed with vs without Myosuit.

A questionnaire was used to measure the acceptability of the Myosuit. Seventy-five percent of device-related statements, as well as all median ratings, were positive after a single session. In particular, most patients felt safe (80 percent) and said that controlling the Myosuit was easy (80 percent). Ninety-five percent of patients said they enjoyed the experience, and 85 percent expressed interest in conducting robot-assisted exercises regularly. On the other hand, 25 percent said the exoskeleton was too heavy.

“Based on these promising findings, we are currently initiating a randomized, controlled, clinical trial to investigate specific training effects in an 8-week Myosuit-assisted exercise program,” the researchers said.