Effects of a soft robotic exosuit on the quality and speed of overground walking depends on walking ability after stroke.
Effects of a soft robotic exosuit on the quality and speed of overground walking depends on walking ability after stroke.
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DOI：
10.1186/s12984-023-01231-7
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发表时间：
2023-09-01
影响因子：
5.1
通讯作者：
Walsh, Conor J.
中科院分区：
文献类型：
--
作者：
Sloot, Lizeth H.;Baker, Lauren M.;Bae, Jaehyun;Porciuncula, Franchino;Clement, Blandine F.;Siviy, Christopher;Nuckols, Richard W.;Baker, Teresa;Sloutsky, Regina;Choe, Dabin K.;O'Donnell, Kathleen;Ellis, Terry D.;Awad, Louis N.;Walsh, Conor J.
柔软的机器人外骨骼可以提供部分背屈肌和跖屈肌的平行支持，以提高中风后的行走能力。先前的研究结果表明，基线行走能力可能会影响使用者利用外骨骼辅助的能力，而对持续行走、行走稳定性和肌肉松弛的影响尚未得到评估。在这里，我们评估了便携式踝外服对19名慢性偏瘫患者持续舒适地上行走的影响。我们还比较了两个基于速度的亚组（阈值：0.93 m/s），以解决卒中后异质性。我们改进了先前开发的便携式轻质软外套，以支持连续的地面行走。我们比较了在实验室中穿着外骨骼服连续行走五分钟和不穿外骨骼服行走五分钟在离地间隙、足部着地和推进力、运输能量成本、行走稳定性和跖屈肌松弛方面的差异。外服辅助与目标步态障碍的改善有关：摆动时离地间隙增加22%，初始接触时脚与地面的角度增加5°，推离时质心推进力增加22%。推进力和足部着地的改进使行走速度提高了6.7% (0.04 m/s) （R2 = 0.82）。这种步态功能的增强是在没有肌肉力量、稳定性或运输成本下降的情况下实现的。亚群分析显示，所有个体都受益于离地支持，但速度较慢的个体利用跖屈肌辅助将推进力提高35%，使行走速度快13%，而速度较快的个体也没有改变。在这里提出的外太空服的直接恢复效益强调其对中风后个体康复步态训练的承诺。在线版本包含补充材料，可在10.1186/s12984-023-01231-7获得。
Soft robotic exosuits can provide partial dorsiflexor and plantarflexor support in parallel with paretic muscles to improve poststroke walking capacity. Previous results indicate that baseline walking ability may impact a user’s ability to leverage the exosuit assistance, while the effects on continuous walking, walking stability, and muscle slacking have not been evaluated. Here we evaluated the effects of a portable ankle exosuit during continuous comfortable overground walking in 19 individuals with chronic hemiparesis. We also compared two speed-based subgroups (threshold: 0.93 m/s) to address poststroke heterogeneity. We refined a previously developed portable lightweight soft exosuit to support continuous overground walking. We compared five minutes of continuous walking in a laboratory with the exosuit to walking without the exosuit in terms of ground clearance, foot landing and propulsion, as well as the energy cost of transport, walking stability and plantarflexor muscle slacking. Exosuit assistance was associated with improvements in the targeted gait impairments: 22% increase in ground clearance during swing, 5° increase in foot-to-floor angle at initial contact, and 22% increase in the center-of-mass propulsion during push-off. The improvements in propulsion and foot landing contributed to a 6.7% (0.04 m/s) increase in walking speed (R2 = 0.82). This enhancement in gait function was achieved without deterioration in muscle effort, stability or cost of transport. Subgroup analyses revealed that all individuals profited from ground clearance support, but slower individuals leveraged plantarflexor assistance to improve propulsion by 35% to walk 13% faster, while faster individuals did not change either. The immediate restorative benefits of the exosuit presented here underline its promise for rehabilitative gait training in poststroke individuals. The online version contains supplementary material available at 10.1186/s12984-023-01231-7.
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影响因子：
4.2
作者：
Bowden, Mark G.;Balasubramanian, Chitralakshmi K.;Kautz, Steven A.
通讯作者：
Kautz, Steven A.
paretic推进和尾肢角是中风后长距离步行功能的关键决定因素。
影响因子：
4.2
作者：
Awad LN;Binder-Macleod SA;Pohlig RT;Reisman DS
通讯作者：
Reisman DS
DOI：
10.1109/tnsre.2003.823266
发表时间：
2004-03-01
影响因子：
4.9
作者：
Blaya, JA;Herr, H
通讯作者：
Herr, H
影响因子：
2.8
作者：
Bae, Jaehyun;Awad, Louis N.;Walsh, Conor J.
通讯作者：
Walsh, Conor J.
影响因子：
2.2
作者：
Hornby, T. George;Straube, Donald S.;Narducci, Elizabeth A.
通讯作者：
Narducci, Elizabeth A.