Biomechanical differences between able-bodied and spinal cord injured individuals walking in an overground robotic exoskeleton.
Biomechanical differences between able-bodied and spinal cord injured individuals walking in an overground robotic exoskeleton.
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DOI：
10.1371/journal.pone.0262915
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发表时间：
2022
期刊：
影响因子：
3.7
通讯作者：
Vanicek N
中科院分区：
文献类型：
--
作者：
Hayes SC;White M;Wilcox CRJ;White HSF;Vanicek N
机器人辅助步态训练（RAGT）使用动力外骨骼来支撑个人的身体并移动他们的肢体，目的是激活存储在下脊髓中的潜在的、预先存在的运动模式，称为中央模式发生器（CPG），以促进步进。应针对直接刺激步进CPG（髋关节伸展和同侧足部卸载）的参数，以最大限度地提高这些器械的康复益处。比较ReWalkTM动力外骨骼内脊髓损伤（SCI）患者和身体健全者的生物力学特征，并将用户的特征与外骨骼进行对比。八名身体健全的人和四名SCI患者穿着ReWalkTM，使用肘部拐杖沿着12米长的人行道行走。采集了用户和ReWalkTM的全身运动学，沿着GRF和时空特征。使用Kruskall-Wallis H和Dunn事后分析对离散运动学值进行分析。采用Mann-Whitney U检验分析上身差异、GRF和时空特征（P <0.05）。步行速度范围为0.32 - 0.39m/s。髋关节外展，峰值膝关节屈曲和踝关节背屈的SCI和健全的组与ReWalkTM的显着差异。除额面髋关节ROM外，健全组的所有运动学变量与ReWalkTM相比均存在显著差异（P = 0.093，δ =-0.56）。SCI患者的骨盆和躯干运动范围明显大于健全患者（分别为P = 0.004，δ =-1; P = 0.008，δ =-0.94）。SCI组的后制动力显著更大（P = 0.004，δ =-1）。SCI组使用的不同躯干运动以及用户关节角度超过设备的能力表明，生物力学特征因用户组而异。然而，使用ReWalkTM设备直立行走可传递适当的传入刺激以激活CPG，因为两个用户组之间的关键生物力学参数没有差异。
Robotic assisted gait training (RAGT) uses a powered exoskeleton to support an individual’s body and move their limbs, with the aim of activating latent, pre-existing movement patterns stored in the lower spinal cord called central pattern generators (CPGs) to facilitate stepping. The parameters that directly stimulate the stepping CPGs (hip extension and ipsilateral foot unloading) should be targeted to maximise the rehabilitation benefits of these devices. To compare the biomechanical profiles of individuals with a spinal cord injury (SCI) and able-bodied individuals inside the ReWalkTM powered exoskeleton and to contrast the users’ profiles with the exoskeleton. Eight able-bodied and four SCI individuals donned a ReWalkTM and walked along a 12-meter walkway, using elbow crutches. Whole-body kinematics of the users and the ReWalkTM were captured, along with GRF and temporal-spatial characteristics. Discreet kinematic values were analysed using a Kruskall-Wallis H and Dunn’s post-hoc analysis. Upper-body differences, GRF and temporal-spatial characteristics were analysed using a Mann-Whitney U test (P<0.05). Walking speed ranged from 0.32–0.39m/s. Hip abduction, peak knee flexion and ankle dorsiflexion for both the SCI and able-bodied groups presented with significant differences to the ReWalkTM. The able-bodied group presented significant differences to the ReWalkTM for all kinematic variables except frontal plane hip ROM (P = 0.093,δ = -0.56). Sagittal plane pelvic and trunk ROM were significantly greater in the SCI vs. able-bodied (P = 0.004,δ = -1; P = 0.008,δ = -0.94, respectively). Posterior braking force was significantly greater in the SCI group (P = 0.004, δ = -1). The different trunk movements used by the SCI group and the capacity for the users’ joint angles to exceed those of the device suggest that biomechanical profiles varied according to the user group. However, upright stepping with the ReWalkTM device delivered the appropriate afferent stimulus to activate CPGs as there were no differences in key biomechanical parameters between the two user groups.
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影响因子：
5.1
作者：
Louie DR;Eng JJ;Lam T;Spinal Cord Injury Research Evidence (SCIRE) Research Team
通讯作者：
Spinal Cord Injury Research Evidence (SCIRE) Research Team
影响因子：
1.8
作者：
Masani, Kei;Sin, Vivian W.;Popovic, Milos R.
通讯作者：
Popovic, Milos R.
影响因子：
2.4
作者：
Donelan, JM;Shipman, DW;Kuo, AD
通讯作者：
Kuo, AD
影响因子：
1.8
作者：
CAPPOZZO, A;CATANI, F;LEARDINI, A
通讯作者：
LEARDINI, A
影响因子：
2.2
作者：
Hornby, T. George;Straube, Donald S.;Narducci, Elizabeth A.
通讯作者：
Narducci, Elizabeth A.