Immediate Effects of the Agilik™ Test Drive on Walking Performance in Adults With Neuromuscular Conditions: A Pilot Study

BACKGROUND: Neuromuscular deficiencies and disorders can affect gait and overall mobility. Recent advances have enhanced the use of Knee-Ankle-Foot Orthoses (KAFOs) for gait assistance through the integration of computer-controlled technologies. Microprocessor KAFOs (MPKAFOs) incorporate sensors and a microprocessor-based control system to monitor gait and adjust joint assistance, support or resistance in real-time according to gait phase. The Agilik™ is a motorized knee joint integrated into a KAFO providing powered resistance and assistance. Past studies have focused on long-term use of custom Agilik™ devices in pediatric crouch gait (flex knee gait) populations. As use of the Agilik™ Test Drive, an adjustable trial orthosis, has grown among a broader adult population, the immediate effects it produces, already used to support prescription decisions, remain poorly characterized. OBJECTIVE: To evaluate immediate changes in functional, objective, and participant-perceived gait outcomes when using the Agilik™ Test Drive under powered versus unpowered conditions. METHODOLOGY: This within-subject pilot study assessed functional walking performance using the Timed Up and Go (TUG), a 10-meter walk test (10MWT), and stair ascent and descent (based on clinical evaluation of safety and participants’ confidence) performed first without power then with power in the Agilik™ Test Drive. Participant-perceived Likert ratings of ease, safety, balance, and control were also collected in both conditions. RESULTS: Consistent directional improvement was observed across participants (n = 9) in powered versus unpowered conditions. TUG and 10MWT time decreased by mean individual percentage changes of 35.8% and 34.3%. Seven of the eight participants assessed for stairs improved their stepping technique. Mean participant-perceived ratings improved across all questionnaire items. CONCLUSION: These findings suggest that the Agilik™ Test Drive may provide immediate functional, objective and participant-perceived benefits to gait. Longitudinal research is needed to determine whether immediate Agilik™ Test Drive responses predict long-term outcomes with custom Agilik™ devices. Layman's Abstract Gait impairments can significantly affect mobility and quality of life. Knee-Ankle-Foot Orthoses (KAFOs) are prescribed devices that stabilize the leg during standing and walking and aid with motion control. Microprocessor-Knee-Ankle-Foot Orthoses (MPKAFOs) have enhanced these devices through the use of sensors and machine motion (motors or hydraulics) to support or regulate movement at different stages of walking. The Agilik™ is a smart, powered knee joint incorporated into a KAFO which offers active assistance and resistance to flex (bend) and extend (straighten) the knee. Past research on the Agilik™ has focused on long-term use of a constrained MPKAFO in a specific pediatric population. As use of the Agilik™ Test Drive, a fully adjustable leg orthosis with a motorized knee joint, is increasingly being used to determine device suitability in a wider population of individuals with nerves and muscles related conditions, studies are needed to formally characterize its efficacy. In an evaluation of nine participants using the Agilik™ Test Drive, participants demonstrated functional and objective walking improvement, including increased gait speed, improved stair ascent and descent stepping strategy, and improved participant-perceived outcomes with the device powered versus unpowered. These findings suggest that the Agilik™ Test Drive may reveal immediate walking and gait-related benefits. The improvements observed during the Agilik™ Test Drive may support its use as a clinical prescription tool. However, long-term research is needed to determine whether functional walking improvements and participant-reported outcomes during Test Drive trials predict long-term benefits with a custom Agilik™ KAFO. Article PDF Link: https://jps.library.utoronto.ca/index.php/cpoj/article/view/47893/35407 How To Cite: Sucharov-Gluck R, Adams S, Filice S, Hardy T, Anandashankar S, Grogan D. Immediate effects of the Agilik™ Test Drive on walking performance in adults with neuromuscular conditions: A pilot study. Can Prosthet Orthot J. 2026;9(2):7.https://doi.org/10.33137/cpoj.v9i2.47893 Corresponding Author: Rory Sucharov-Gluck, Affiliation: Bionic Power Inc., Toronto, Ontario, Canada.E-Mail: rory.sucharov-gluck@bionic-power.comORCID ID: https://orcid.org/0009-0000-2404-3425