Robotic Ankle to Restore Symmetry and Reduce Energy Cost of Walking Post-Stroke

描述（由申请人提供）：中风是美国慢性残疾的主要原因，每年有近610,000例新病例。在慢性中风患者中，缓慢而疲惫的步行是限制日常生活活动的主要有害结果。此外，行走障碍会导致继发性损伤，如肌肉无力和平衡能力差，这两个都是跌倒的危险因素。因此，旨在改善卒中后行走功能的干预措施可能对数百万人的生活质量产生显著的积极影响。在健康的步行中，踝关节伸肌在关键的步行子任务中起着重要的作用，包括(1)推进力(2)体重支撑和(3)摇摆起始。慢性中风患者通常在这些子任务中都有问题，可能是由于他们的麻痹肢体的踝关节机械功能薄弱和不协调。单侧踝关节功能受损导致步态高度不对称，限制了最高步行速度并增加了代谢能量消耗。提出的研究的主要目的是使用可穿戴机器人设备来辅助中风后偏瘫患者的肢体麻痹，并改善步态对称性和经济性。我们将招募20名慢性中风患者，为他们的麻痹肢体构建轻型机器人踝关节外骨骼。然后，我们将测试专注于踝关节伸展的机器人辅助是否可以改善父母的肢体功能-将其推向体型/年龄配对的健康对照。我们假设，有针对性的单侧踝关节机械辅助将恢复多个肌肉骨骼组织（从四肢到下肢关节）的步态对称性，并降低中风后行走的代谢成本。如果

DESCRIPTION (provided by applicant): Stroke is a leading cause of chronic disability in the United States, with nearly 610,000 new cases annually. In chronic stroke patients, slow, exhausting walking is a primary deleterious outcome that limits activities of daily living. Furthermore, impaired walking can lead to secondary impairments such as muscle weakness and poor balance, both risk factors for falls. Therefore, interventions designed to improve walking function post-stroke could have significant positive impact on the quality of life of millions. In healthy walking, the ankle extensor muscles play a major role in key walking sub-tasks including (1) propulsion (2) body-weight support and (3) swing initiation. Chronic stroke patients typically have problems with each of these sub-tasks, likely due to weak and uncoordinated ankle mechanical function in their paretic limb. Impaired unilateral ankle function results in highly asymmetric gait that limits top walking speed and elevates metabolic energy expenditure. The primary objective of the proposed research is to use a wearable robotic device to assist the paretic limb in patients with post-stroke hemiplegia and improve both gait symmetry and economy. We will recruit 20 patients with chronic stroke and construct lightweight robotic ankle exoskeletons for their paretic limb. Then we will test whether robotic assistance focused on ankle joint extension can improve paretic limb function - driving it towards that of size/age paired healthy controls. We hypothesize that targeted, unilateral ankle joint mechanical assistance will restore gait symmetry across multiple scales of musculoskeletal organization - from limbs to lower-limb joints- and reduce the metabolic cost of walking in people post-stroke. If robotic ankle exoskeletons can restore normal walking mechanics and reduce metabolic cost, then people with severe impairments post-stroke could benefit from a portable version as a permanent aid during community ambulation.