Robotic Walking Device to Improve Mobility in Parkinson's Disease

Difficulties with walking in people with Parkinson's disease contribute to injurious falls
and decreased quality of life. The Honda Walking Assist (HWA) robotic device is designed to
assist individuals with gait impairments to take longer strides and walk faster. This study
will investigate the impact of HWA usage on mobility in the home and community in individuals
with PD. It will also examine feasibility and safety of HWA usage in the PD population.
Specific Aim 1: Determine the short-term impact of mechanical gait assistance on efficiency
and ease of walking in individuals with PD. With disease progression, individuals with PD
develop gait impairments (e.g., slower gait velocity, shorter step lengths, increased
step-to-step variability, and freezing of gait), that interfere with their abilities to
perform daily living tasks and participate in work, home, and social activities and
predispose them to falls. The investigators hypothesize that wearing the HWA device will
improve gait efficiency, gait parameters, and perceived ease of walking in individuals with
PD compared to unassisted walking over a one session period. Specific Aim 2: Determine the
effect of long-term HWA device usage on the ease and ability to walk unassisted in the home
and community in individuals with PD. Angular sensors embedded in the HWA monitor the
cadence, angular velocity, and degree of hip extension and flexion of the device user. When
the user initiates walking, the HWA automatically adjusts leg movements to reach target walk
ratios (step length/cadence) by increasing the amount of hip flexion and/or extension using
power supplied by the device. Thus, the HWA applies continuous, step-by-step cueing to
individuals with PD to take bigger and more symmetrical steps, thereby producing a faster and
more efficient walking pattern. By wearing the HWA device over an extended period of time,
individuals with PD will repetitively practice walking with a more "normal" gait pattern,
possibly driving neuroplastic changes that will translate to improve unassisted walking. The
investigators hypothesize that an 8-week intervention of HWA device usage will improve gait
efficiency, gait parameters, perceived ease of walking, self-confidence, and daily physical
activity in the home and community in individuals with PD with and without the use of the
device.

Inclusion Criteria:

- Diagnosis of idiopathic Parkinson's disease

- Age 50-80 years

- Able to ambulate without assistance (Hoehn & Yahr stages 1-3)

- On stable doses of Parkinson's medications for at least 4 weeks prior to the study.

Exclusion Criteria:

- Presence of other significant cardiac, neurological or orthopedic problems that affect
gait

- Weight more than 220 pounds and height greater than 6'8"

- Electronic medical devices embedded in the body

- Participating in any physical therapy

- Inability to understand instructions required by the study.