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

机器人脚踝可恢复对称性并降低中风后行走的能量成本

基本信息

批准号：
8921240
负责人：
Gregory Stephen Sawicki
金额：
$ 18.22万
依托单位：
NORTH CAROLINA STATE UNIVERSITY RALEIGH
依托单位国家：
美国
项目类别：
财政年份：
2014
资助国家：
美国
起止时间：
2014-09-05 至 2017-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8921240
关键词：
Activities of Daily Living Age Aging Ankle Automobile Driving Body Weight Cerebral Palsy Characteristics Chronic Clinic Clinical Communities Consumption Energy Metabolism Equilibrium Financial compensation Gait Health Hemiplegia Hip region structure Impairment Intervention Joints Knee Lead Limb structure Locomotion Lower Extremity Mechanics Metabolic Muscle Muscle Weakness Musculoskeletal Outcome Output Paresis Patients Phase Play Population Power Walking Production Public Health Quality of life Recruitment Activity Research Risk Factors Robot Robotics Role Secondary to Side Societies Speed Spinal cord injury Stroke Sum Survivors Tendon structure Testing Translating Traumatic Brain Injury United States Walking Work ankle joint chronic stroke cost design disability exhaust exoskeleton falls gait symmetry hemiparesis improved intervention effect post stroke robot assistance robotic device therapy design

项目摘要

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.

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例新发病例。在慢性中风患者中，缓慢、疲惫的行走是限制日常生活活动的主要有害结果。此外，行走障碍可能导致继发性损伤，如肌肉无力和平衡差，这两个风险因素福尔斯。因此，旨在改善中风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。在健康步行中，脚踝伸肌在关键步行子任务中发挥着重要作用，包括（1）推进（2）体重支撑和（3）挥杆启动。慢性中风患者通常在这些子任务中的每一个方面都有问题，这可能是由于他们的瘫痪肢体中的踝关节机械功能薄弱和不协调。单侧踝关节功能受损会导致步态高度不对称，限制最高步行速度并增加代谢能量消耗。该研究的主要目的是使用可穿戴机器人设备来帮助中风后偏瘫患者的瘫痪肢体，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，并为他们的瘫痪肢体构建轻型机器人踝关节外骨骼。然后，我们将测试机器人辅助踝关节伸展是否可以改善瘫痪肢体功能-将其推向大小/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在多个尺度的肌肉骨骼组织（从四肢到下肢关节）中恢复步态对称性，并降低中风后行走的代谢成本。如果机器人踝关节外骨骼可以恢复正常的行走力学并降低代谢成本，然后中风后有严重损伤的人可以从便携式版本中受益，作为社区康复期间的永久辅助。