Using robot-assisted stiffness perturbations to evoke aftereffects useful to post-stroke gait rehabilitation.
Using robot-assisted stiffness perturbations to evoke aftereffects useful to post-stroke gait rehabilitation.
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DOI：
10.3389/frobt.2022.1073746
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发表时间：
2022
影响因子：
3.4
通讯作者：
Artemiadis, Panagiotis
中科院分区：
文献类型：
--
作者：
Chambers, Vaughn;Artemiadis, Panagiotis
中风是一个重大的全球性问题，每年影响数百万人。当中风发生时，幸存者往往会出现身体残疾或困难，通常表现为步态异常。中风后步态通常表现为单侧步长缩短、摆动期背屈减少和行走速度降低中的一种或组合。这些因素会导致跌倒的可能性增加，并且由于依靠自己的力量快速安全地移动的能力下降，导致生活质量整体下降。目前的许多康复技术未能显示出持久的结果，表明有可能产生永久性的改变。随着技术的进步，机器人辅助康复似乎具有明显的优势，因为这种干预的精确度和可重复性是传统的人工治疗无法比拟的。本文进一步研究了可变刚度跑步机 (VST)（一种独特的机器人跑步机）在步态康复中的可能作用。 VST 是一款分体式皮带跑步机，可以降低其中一条皮带的垂直刚度，而另一条皮带则保持刚性。在这项工作中，我们表明，该设备产生的重复单侧刚度扰动会引起步长增加的后遗症，在单次 10 分钟的干预后，健康受试者的超过 575 个步态周期中就会出现这种情况。据我们所知，这些长期的后遗症目前在文献中是无与伦比的。这种步长的增加伴随着运动学和肌肉活动后遗症，有助于解释功能变化，并且在考虑中风后步态特征时具有自己的独立价值。这些结果表明，重复的单侧僵硬扰动可能是中风后步态康复的一种有用形式。
Stroke is a major global issue, affecting millions every year. When a stroke occurs, survivors are often left with physical disabilities or difficulties, frequently marked by abnormal gait. Post-stroke gait normally presents as one of or a combination of unilaterally shortened step length, decreased dorsiflexion during swing phase, and decreased walking speed. These factors lead to an increased chance of falling and an overall decrease in quality of life due to a reduced ability to locomote quickly and safely under one’s own power. Many current rehabilitation techniques fail to show lasting results that suggest the potential for producing permanent changes. As technology has advanced, robot-assisted rehabilitation appears to have a distinct advantage, as the precision and repeatability of such an intervention are not matched by conventional human-administered therapy. The possible role in gait rehabilitation of the Variable Stiffness Treadmill (VST), a unique, robotic treadmill, is further investigated in this paper. The VST is a split-belt treadmill that can reduce the vertical stiffness of one of the belts, while the other belt remains rigid. In this work, we show that the repeated unilateral stiffness perturbations created by this device elicit an aftereffect of increased step length that is seen for over 575 gait cycles with healthy subjects after a single 10-min intervention. These long aftereffects are currently unmatched in the literature according to our knowledge. This step length increase is accompanied by kinematics and muscle activity aftereffects that help explain functional changes and have their own independent value when considering the characteristics of post-stroke gait. These results suggest that repeated unilateral stiffness perturbations could possibly be a useful form of post-stroke gait rehabilitation.