Does Ankle Exoskeleton Assistance Impair Stability During Walking in Individuals with Cerebral Palsy?

Lower-limb exoskeletons have the potential to improve mobility in individuals with movement disabilities, such as cerebral palsy (CP). The goal of this study was to assess the impact of plantar-flexor assistance from an untethered ankle exoskeleton on dynamic stability during unperturbed and perturbed walking in individuals with CP. Seven participants with CP (Gross Motor Function Classification System levels I-III, ages 6–31 years) completed a treadmill walking protocol under their normal walking condition and while wearing an ankle exoskeleton that provided adaptive plantar-flexor assistance. Pseudo-randomized treadmill perturbations were delivered during stance phase by accelerating one side of a split-belt treadmill. Treadmill perturbations resulted in a significant decrease in anteroposterior minimum margin-of-stability (− 32.1%, p