A neuromechanics-based powered ankle exoskeleton to assist walking post-stroke: a feasibility study.
A neuromechanics-based powered ankle exoskeleton to assist walking post-stroke: a feasibility study.
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DOI：
10.1186/s12984-015-0015-7
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发表时间：
2015-02-25
影响因子：
5.1
通讯作者：
Sawicki GS
中科院分区：
文献类型：
--
作者：
Takahashi KZ;Lewek MD;Sawicki GS
中风后，踝关节功能减弱可导致步态推进力不足。针对麻痹性踝关节损伤，我们开发了一种基于神经力学的动力踝关节外骨骼。具体来说，这种外骨骼仅在站立肢体受到前向地面反作用力（GRF）时的步态阶段提供与使用者的轻瘫比目鱼肌电图（EMG）振幅成比例的跖屈辅助。这项可行性研究的目的是研究动力踝关节外骨骼对步态力学和能量学的短期影响。五名中风患者在麻痹的肢体上用动力踝外骨骼行走三次，每次5分钟。我们分析了疲劳踝关节的最大跖屈力矩、疲劳踝关节正功、GRF推进脉冲的对称性和净代谢力。在有动力行走试验中，外骨骼比无辅助行走条件下增加了16%的足跖屈曲力矩（p < 0.05）。尽管有这种增强的麻痹性踝关节力矩，但在动力辅助下，麻痹性踝关节正功没有显著增加，也没有任何其他机械变量的变化。每重复5分钟，外骨骼辅助似乎逐渐降低净代谢力，但没有发现统计学意义。在三名受试者中，与无辅助行走相比，在有动力辅助时，站立推进阶段的paretic比目鱼肌激活减少（在第三次有动力辅助时，综合肌电图幅度减少35%）。该可行性研究表明，外骨骼可以增强麻痹性踝关节力矩。未来的研究需要更大的样本量和更长的时间来评估动力踝关节外骨骼对中风后患者整体步态结果的影响。本文的在线版本（doi:10.1186/s12984-015-0015-7）包含补充材料，仅供授权用户使用。
In persons post-stroke, diminished ankle joint function can contribute to inadequate gait propulsion. To target paretic ankle impairments, we developed a neuromechanics-based powered ankle exoskeleton. Specifically, this exoskeleton supplies plantarflexion assistance that is proportional to the user’s paretic soleus electromyography (EMG) amplitude only during a phase of gait when the stance limb is subjected to an anteriorly directed ground reaction force (GRF). The purpose of this feasibility study was to examine the short-term effects of the powered ankle exoskeleton on the mechanics and energetics of gait. Five subjects with stroke walked with a powered ankle exoskeleton on the paretic limb for three 5 minute sessions. We analyzed the peak paretic ankle plantarflexion moment, paretic ankle positive work, symmetry of GRF propulsion impulse, and net metabolic power. The exoskeleton increased the paretic plantarflexion moment by 16% during the powered walking trials relative to unassisted walking condition (p < .05). Despite this enhanced paretic ankle moment, there was no significant increase in paretic ankle positive work, or changes in any other mechanical variables with the powered assistance. The exoskeleton assistance appeared to reduce the net metabolic power gradually with each 5 minute repetition, though no statistical significance was found. In three of the subjects, the paretic soleus activation during the propulsion phase of stance was reduced during the powered assistance compared to unassisted walking (35% reduction in the integrated EMG amplitude during the third powered session). This feasibility study demonstrated that the exoskeleton can enhance paretic ankle moment. Future studies with greater sample size and prolonged sessions are warranted to evaluate the effects of the powered ankle exoskeleton on overall gait outcomes in persons post-stroke. The online version of this article (doi:10.1186/s12984-015-0015-7) contains supplementary material, which is available to authorized users.
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影响因子：
2.4
作者：
Gordon, Keith E.;Sawicki, Gregory S.;Ferris, Daniel P.
通讯作者：
Ferris, Daniel P.
影响因子：
0.9
作者：
Huang, Stephanie;Wensman, Jeffrey P.;Ferris, Daniel P.
通讯作者：
Ferris, Daniel P.
影响因子：
8.3
作者：
Bowden, MG;Balasubramanian, CK;Kautz, SA
通讯作者：
Kautz, SA
DOI：
10.1109/tnsre.2011.2120623
发表时间：
2011-06
期刊：
IEEE transactions on neural systems and rehabilitation engineering : a publication of the IEEE Engineering in Medicine and Biology Society
影响因子：
--
作者：
Feasel J;Whitton MC;Kassler L;Brooks FP;Lewek MD
通讯作者：
Lewek MD
DOI：
10.1109/tnsre.2007.903930
发表时间：
2007-09-01
影响因子：
4.9
作者：
Agrawal, Sunil K.;Banala, Sai K.;Hsu, Wei-Li
通讯作者：
Hsu, Wei-Li