Mobility Training for Patients Recovering from Neurological Injuries with Kickstart<sup>®</sup>: A Case Series

Case Series

Phys Med Rehabil Int. 2015; 2(8): 1062.

Mobility Training for Patients Recovering from Neurological Injuries with Kickstart®: A Case Series

Glaister BC¹*, Schoen JA¹, Kawahara C¹, Pacanowsky AD¹, Zachar ME CO² and Byl NN PT PhD³

¹Cadence Biomedical, Inc.; Seattle, WA 98115, USA

²Gary Berke Prosthetics; Redwood City, CA 94063, USA

³Department of Physical Therapy & Rehabilitation Science, University of California, San Francisco, CA94143, USA

*Corresponding author: Brian C Glaister, Cadence Biomedical, Inc.; Seattle, WA 98115, USA

Received: September 14, 2015; Accepted: October 07, 2015; Published: October 10, 2015


Despite numerous advances in rehabilitation techniques for people recovering from neurological injuries, many patients reach plateaus in their walking recovery and are unable to fully regain their independence. Technologies such as robotic exoskeletons seek to improve walking ability for neurological patients, but their cost severely limits widespread adoption. New affordable technologies that can accelerate neurological rehabilitation are needed. In this case series, we investigate a bio-inspired device called Kickstart with two chronic stroke survivors and one participant with a chronic incomplete spinal cord injury. Participants were assessed in terms of walking speed and walking endurance. All three participants demonstrated improved walking speed to reach elevated levels of community ambulation, and all three participants exhibited functional return in the form of less reliance on Kickstart. The results of this study suggest that Kickstart can be an effective tool in accelerating walking recovery for patients with chronic neurological injuries.

Keywords: Stroke; Spinal cord injury; Rehabilitation; Physical therapy; Neurorehabilitation; Exotendon


T-10: Tenth Thoracic Vertebrae; m: Meter; m/s: Meters per Second

Background and Purpose

To actively assist ambulation for persons with injuries and disabilities, much work has been done in the area of powered exoskeletons [1-4]. These devices consist of an external support structure with powered, articulated joints and are touted to provide unbridled potential as assistive devices for the mobility-impaired. However, the motors and control circuitry required to operate powered exoskeletons result in immense financial costs for the systems that limit their clinical adoption. New technologies that are affordable for widespread use are needed to accelerate walking recovery for patients with neurological injuries. For this case series, we investigated the use of Kickstart, a bio-inspired neurorehabilitation device, with three patients with chronic neurological injuries. Instead of electronics or stimulation, Kickstart utilizes an elastic based Exotendon™ technology inspired by the anatomy of horses. In the hind limbs of a horse, long tendons span multiple joints. During the stance phase of gait, the tendons stretch and store energy which is later returned to initiate swing phase with less work required from the muscles [5-13]. Kickstart’s Exotendon functions similarly by storing energy during the stance phase and slowing the progression of the tibia relative to the foot to provide a greater sense of stability and to promote a longer contra lateral step. Then, when the user shifts his/her weight to the contra lateral limb, the Exotendon returns energy to initiate the swing phase of gait (Figure 1). This is intended to enable users to perform the proper walking motions with better endurance which has been documented as key factors in bringing about therapeutic carryover following neurological injury [14]. We now present three clinical cases of patients with chronic neurological injuries using Kickstart.