Safety, not walking speed, is the priority for any Indego User. However, gait speed and the ability to control one’s speed is important in home and community environments. Walking speed requirements for persons with neurological injury (spinal cord injury or stroke) have been cited in the literature as approximately 0.2 m/s for indoor walking, 0.2 - 0.4 m/s for outdoor or limited community walking, and 0.4 m/s – 0.8 m/s to cross a two-way street and for outdoor community walking.1-4
What is Advanced Gait (AG)?
Advanced Gait is an Indego® software suite option which allows Users to walk with a more continuous stepping motion. A posture based “lean forward walk forward” approach to trigger steps remains, but the pause between steps is eliminated.
Who is appropriate for Advanced Gait?
Indego Users who have mastered walking in Standard Gait and wish to be able to walk at faster speeds. In previous Indego studies, average walking speed in Standard Gait during 10 Meter Walk Test was about 0.4 m/s.5,6
What are the benefits of Advanced Gait?
- Allows for a smooth, efficient gait pattern more closely aligned with “normal” walking behavior.
- Continuous motion means that every phase of the Indego gait cycle is utilized to keep both the User and device moving forward, allowing for smoother steps and dramatic increases in overground gait speed.
- Provides safe transitions into and out of faster walking speeds without having to stop and change walk settings.
- For Indego Personal Users AG offers the ability to achieve faster walking speeds when compared to Standard Gait, which is important for more advanced community ambulation.
- Increases challenges for persons in a rehabilitation setting working on gait re-training in either indoor or outdoor environments. Faster walking can equate to higher number of steps per session.
Does a User have to stop and change walk settings to speed up or slow down?
No. In a recent clinical study, Indego Users could safely control transitions between Standard Gait and Advanced Gait. One subject demonstrated changes in walking speed from 0.24 m/s to 0.78 m/s along a 40 Meter track through postural changes only.7 Subject number was low (5) and training sessions were limited (3 each). Thus, with continued practice, it is reasonable to assume speeds of 1.0 m/s and greater would be safe and achievable.
If you are interested in learning more about the Indego exoskeleton, please visit our website or give us a call at 1-844-846-3346.
- Andrews AW, Chinworth SA, Bourassa M, Garvin M,Benton D, Tanner S. Update on distance and velocity requirements for community ambulation. J Geriatr Phys Ther. 2010: 33: 128-134.
- Lapointe R, Lajoie Y, Serresse O, Barbeau H. Functional community ambulation requirements in incomplete spinal cord–injured subjects. Spinal Cord. 2001; 39: 327-335.
- Perry J, Garrett M, Gronley JK, Mulroy SJ. Classification of walking handicap in subjects in the stroke population. Stroke. 1995; 26: 982-989.
- Hubertus J. A. van Hedel, PhD, PT, for the EMSCI Study Group Gait Speed in Relation to Categories of Functional Ambulation After Spinal Cord Injury. Neurorehabiliation and neural Repair Vol 23 Number 4 May 2009 343-350.
- C. Hartigan, C. Kandilakis, S. Dalley, M. Clausen, E. Wilson, S. Morrison, S. Etheridge, and R. Farris. Mobility outcomes following five training sessions with a powered exoskeleton. Topics in Spinal Cord Injury Rehabilitation. 2015; 21: 93-99.
- Multi-Site Clinical Trial Outcomes from Parker Hannifin 510 K Application 2015.
- Dalley S, Hartigan C, Kandilakis C, and Farris R.J, Member, On the Use of Continuous Joint Motion to Increase Walking Speed and Speed Control in Exoskeleton Enabled Gait. Publication pending IEE.
This article was contributed by Clare Hartigan, PT, MPT. Clare is the Program Manager for Lower Extremity Robotics at The Virginia C Crawford Research Institute, Shepherd Center. Clare received her Bachelor of Science in Biology, Cum Laude, from Bucknell University in 1986 and a Master in Physical Therapy, Highest Honor, from Emory University in 1989. She has been working in the field of neurologic rehabilitation her entire career. Since 1991, she has been employed at Shepherd Center and served multiple roles as a clinician, supervisor/manager and researcher. Her work with exoskeletons began in 2010 trialing patients with Esko, ReWalk and Indego exoskeletons. Clare has conducted Indego research from 2010 to the present. Currently as a Certified Indego Instructor, Clare has travelled across the world educating and teaching others about exoskeleton technology. Clare is a member of the American Physical Therapy Association and the Neurologic Section.
Shepherd Center, located in Atlanta, Georgia, is a 152 bed, private, not-for-profit hospital specializing in medical treatment, research and rehabilitation for people with spinal cord injury, brain injury and multiple sclerosis.