A novel robotic walker for gait training in cerebellar ataxia: crossover design with treadmill therapy

Background Cerebellar Ataxia (CA) is a condition that impairs motor control, leading to difficulties in gait and balance. Robot-Assisted Gait Training (RAGT) has been used for rehabilitation, but most studies focus on wearable devices and are retrospective, single-arm studies, or case reports. This study evaluates the rehabilitative effects of WALKit Smart Walker, a multifunctional robotic assistive device, compared to Treadmill-Assisted Gait Training (TAGT) in CA patients. Methods A crossover study was conducted with seven participants diagnosed with acquired or hereditary CA, out of nine assessed for eligibility. Two blocks of 15 sessions (30 min each) were completed. Functional assessments, namely SARA, 10-MWT, and TUG, were performed before and after each block. Spatiotemporal gait parameters and inter-limb symmetry ratios were analyzed in four participants. Results Six participants completed the study. While SARA scale alone was insufficient to compare both interventions, improvements in 10-MWT, TUG, and gait speed were observed for both treatments, with slightly better and more consistent results after RAGT, especially in TUG test. WALKit Smart Walker may enhance gait quality, as most participants improved or maintained inter-limb symmetry ratio of step excursion and time while increasing gait speed. Stance and swing inter-limb symmetry ratio did not benefit from increased speed in either intervention. Usability of WALKit Smart Walker was rated favorably (average SUS > 75 points), indicating technology acceptance. Conclusion WALKit Smart Walker shows potential for improving gait speed and inter-limb symmetry ratio of step excursion and time compared to TAGT. Further research with a larger, more homogeneous sample is needed to confirm these findings.