A Battery-Powered Ankle Exoskeleton Improves Gait Mechanics in a Feasibility Study of Individuals with Cerebral Palsy
A Battery-Powered Ankle Exoskeleton Improves Gait Mechanics in a Feasibility Study of Individuals with Cerebral Palsy
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DOI：
10.1007/s10439-019-02237-w
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发表时间：
2019-06-01
影响因子：
3.8
通讯作者：
Lawson, Jennifer L.
中科院分区：
文献类型：
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作者：
Lerner, Zachary F.;Harvey, Taryn A.;Lawson, Jennifer L.
与脑瘫（CP）相关的神经肌肉损伤通常会导致终身步行障碍。我们的目标是评估一种新型无系绳可穿戴踝关节外骨骼的能力，以减少CP的步态病理的严重程度。在这项对5名CP患者的临床可行性研究中，我们使用仪器步态分析来量化动力足底屈肌辅助如何影响多次访视适应后的步态力学。与每个参与者正常行走的方式相比，使用无系绳外骨骼辅助行走导致踝关节跖屈和膝关节伸展改善;下肢残余屈曲畸形改善了14.4度（p=0.022）。动力跖屈肌辅助使平均总正踝关节动力增加44%（p=0.037），平均负生物踝关节动力减少30%（p=0.004），平均正髋关节动力减少29%（p=0.009）。这些研究结果表明，动力踝关节辅助增强，而不是简单地取代，生物功能，以产生更有效的步态模式，这是由运输代谢成本的19%的改善证实（p=0.011）。这项研究提供了证据，支持在该患者人群的活动和康复干预踝关节援助的持续调查。
Neuromuscular impairment associated with cerebral palsy (CP) often leads to life-long walking deficits. Our goal was to evaluate the ability of a novel untethered wearable ankle exoskeleton to reduce the severity of gait pathology from CP. In this clinical feasibility study of five individuals with CP, we used instrumented gait analysis to quantify how powered plantar-flexor assistance affected gait mechanics following multi-visit acclimation. Compared to how each participant walked normally, walking with untethered exoskeleton assistance resulted in improved ankle plantar-flexion and knee extension; residual flexion deformity across the lower-extremity improved by a clinically significant 14.4 degrees (p=0.022). Powered plantar-flexor assistance increased average total positive ankle power by 44% (p=0.037), and resulted in a 30% reduction in average negative biological ankle power (p=0.004) and a 29% reduction in average positive hip power (p=0.009). These findings suggest that powered ankle assistance augmented, rather than simply replaced, biological function to produce a more efficient gait pattern, which was corroborated by a 19% improvement in metabolic cost of transport (p=0.011). This study provides evidence in support of the continued investigation of ankle assistance in mobility and rehabilitation interventions for this patient population.