(Kiosk 1) Movement Therapy with Lightweight Wearable Robot in a Post-heart Transplant Stroke Patient: A Case Study

Case Diagnosis: Movement Therapy with Lightweight Wearable Robot in a Post-Heart Transplant Stroke Patient

Case Description or Program Description: Early mobilization following heart transplants and stroke is essential to improve patient outcomes. Previous studies have shown the viability of wearable robotic exoskeletons (WRE) in individual cases of lung transplants, strokes, and heart disease. To our knowledge, there is no literature on robot-assisted mobilization of post-heart-transplant, stroke patients. Our patient was intensely rehabilitated with WRE over 14 sessions after suffering a stroke 2 weeks prior to a scheduled heart transplant. This case study provides a novel direction for WRE, explores potential complications and clinical concerns, and evaluates the lessons learned in hopes that unique patient populations can receive the benefits of WRE.

Setting: Outpatient rehabilitation

Assessment/Results: Pre-WRE assessments provided a baseline of the patient’s balance, mobility, sensation, and motor function via 10-meter walk test and 6-minute walk test. Blood pressure (BP), heart rate (HR), total steps, walk time, uptime, adverse events, and pain level was meticulously measured throughout the sessions. Post-WRE assessments remeasured pre-WRE assessments and included via 10-meter walk test and 6-minute walk test with WRE. Pre-WRE balance, mobility, sensation, and motor function were improved, showing potential for improvement in distance and duration.

Discussion (relevance): WRE was utilized because it provided consistent gait-training intensity in the setting of a heart transplant, which regular non-WRE therapies may not sufficiently provide. There was one adverse event related to harness/heart rate monitor placement. BP and HR varied throughout rehabilitation but never reached parameters set by the cardiothoracic teams. Pain was well-controlled. The patient tolerated rehabilitation and is doing well.

Conclusions: Robotic exoskeleton-assisted mobilization is safe, feasible, well-tolerated, and well-accepted by our patient. Further studies are encouraged to expand on this foundational case report to assess the potential advantages of WRE in this unique patient population in comparison to existing therapies.