Use of Atalante Self-balancing Exoskeleton in Neurological Rehabilitation: Insights from Real-world Data Across Europe and the United States

Research Objectives: To analyze real-word evidence data on populations, verticalization and walking performances, and the duration of rehabilitation programs with Atalante, a self-balanced powered exoskeleton - incorporated into patients’ standard healthcare routine.

Design: Real-world evidence through anonymized metrics collection.

Setting: Atalante is used by 34 rehabilitation institutions across Europe and United-States in their clinical routine.

Participants: The study included 820 patients who underwent a rehabilitation program with Atalante from February 2021 until November 2023.

Interventions: Observational study.

Main Outcome Measures: Patient pathologies distribution, number of sessions, verticalization duration, average step count, and the variety of exercises executed using Atalante. Data were automatically and anonymously tracked through the tablet application of the device.

Results: Among Atalante users, hemiplegia was the most prevalent condition (N=320), followed by paraplegia (N=235) and tetraplegia (N=100). The primary associated diagnosis were stroke (N=110) and spinal cord injuries (N=98). Other frequently reported diagnosis included Multiple Sclerosis (N=67), Guillain Barré (N=19), neuromuscular diseases (N=19), coordination disorders (N=18), cerebral palsy (N=17), and acquired or traumatic brain injuries (N=17). Paraplegic and tetraplegic patients averaged 10 rehabilitation sessions, while hemiplegic patients seven sessions. Paraplegic patients performed the highest average step count per session (533.4 steps), followed by hemiplegic (461.3 steps) and tetraplegic (455.6 steps) patients. The mean verticalization time during a session for these three populations is 30.6 min (SD=12.5 min), 24.5 min (SD=10.2 min), 28.1 min (SD=12.2 min), respectively. Motor complete paraplegic and tetraplegic patients primarily engage in walking with full device assistance, whereas motor incomplete paraplegic, tetraplegic, and hemiplegic patients tend to reduce their reliance on the device. All groups engage in weight-shifting and upper-body exercises while standing in the exoskeleton.

Conclusions: Real-world data support the effectiveness of Atalante in standing and walking with adjustable assistance for patients with hemiplegia, paraplegia, and tetraplegia across various neurological conditions.

Author(s) Disclosures: Authors are Wandercraft employees involved in the device design, data collection and interpretation.