Fig. 1

Study design and key elements of REAL and CONTROL gait training programs. (A) Staged clinical trial development approach used to develop and study the REAL gait training program. This trial is a stage 2, development-of-concept trial with (B) a crossover study design. (C) In addition to clinical outcomes of walking speed, as measured by the 10-meter walk test, and walking distance, as measured by the 6-minute walk test, biomechanical outcomes were evaluated at the pre- and post-training evaluation timepoints. (D) The key gait training elements for the REAL and CONTROL gait training programs. The programs were equivalent in terms of a progressive speed target provided within and across training visits, the provision of goal-directed feedback from a physical therapist, and training provided across settings. The programs differed in that the REAL gait program exploited the soft robotic exosuit to directly target propulsion impairment by way of intermittent (and continuous) gait assistance provided by the exosuit