NewGait: A Low-Cost Rehabilitation System to Improve Post-Stroke Gait

项目总结 在美国，每年有超过79.5万人患有中风，使中风成为主要原因 在美国和世界范围内，成年人的残疾问题。超过一半的中风幸存者表现出减少 中风相关步态障碍导致的独立性和功能活动能力。尽管取得了重大进步 在中风后的医疗护理和康复中，目前的治疗方法在最佳恢复步态方面并不成功 中风后的功能。众所周知，高强度、重复性、以任务为导向的康复干预是 对于诱导经验依赖性神经可塑性(定义为神经系统适应的能力)是必不可少的 并通过结构和功能变化优化其资源)--这是中风后步态的关键因素 恢复。因此，依赖专门步态训练设备的新治疗方法，如 跑步机、机器人设备和外衣都已经开发出来了。然而，这些设备通常很昂贵， 体积庞大，不适合家庭使用。此外，这些设备通常需要不间断的电源， 这是发展中国家农村社区面临的主要障碍。而一些重量轻、成本低的产品 商业设备是存在的，它们通常不是基于多用户反馈和强大的生物力学而设计的 数据及其临床效用尚未在中风幸存者中进行测试，因此限制了可用性和有效性。 因此，临床上对有效的、负担得起的和便携的步态活动/康复的需求还远远没有得到满足。 一种大多数中风幸存者都可以接触到的设备。精英运动员产品公司(EAP)设计了一种可穿戴的步态 专门针对这一临床需求的康复系统NewGait。在此阶段，EAP拥有 组建了一个跨学科团队，以追求以下具体目标：(1)确定最佳的新步态设计 基于最终用户反馈(设计冲刺)和肌肉骨骼建模，以满足中风的需求 修复，(2)使用从设计冲刺中收集的数据和大声思考技术来提炼当前的原型 并对最终原型进行台式测试以验证耐用性，以及(3)检查短期步态 对卒中幸存者进行对比临床可行性研究的适应性和临床可行性 中风幸存者建立NewGait设备与两种竞争设备的临床效用的比较 (TheraSuit和TheraTogs)。该项目结合了EAP在开发低成本神经康复方面的专业知识 具有我们大学学术伙伴的临床、生物力学和神经可塑性专业知识的设备 密歇根大学和韦恩州立大学。一期工程的顺利完成将为下一阶段的建设奠定基础 一种基于证据的低成本步态康复系统，可能对数百万中风患者的生活产生积极影响 生活在全球各地的幸存者。

PROJECT SUMMARY More than 795,000 individuals suffer from a stroke each year in the United States, making stroke a leading cause of adult disability in the United States and worldwide. More than half of stroke survivors exhibit reduced independence and functional mobility due to stroke-related gait impairments. Despite significant advancements in post-stroke medical care and rehabilitation, current treatments are not successful in optimally restoring gait function after stroke. It is well established that intense, repetitive task-oriented rehabilitation interventions are essential for inducing experience-dependent neuroplasticity (defined as the ability of the nervous system to adapt and optimize its resources through structural and functional changes)—which is a key factor for post-stroke gait recovery. Accordingly, new therapeutic approaches that rely on specialized gait training devices, such as treadmills, robotic devices, and exosuits have been developed. However, these devices are typically expensive, bulky, and not accessible for home use. Moreover, these devices often require uninterrupted power sources, which is a major barrier for rural communities in developing nations. While some lightweight and “low-cost” commercial devices exist, they are not often designed based on multi-user feedback and robust biomechanical data and their clinical utility have not been tested in stroke survivors, thereby limiting usability and effectiveness. Thus, there is a significant unmet clinical need for an effective, affordable, and portable gait mobility/rehabilitation device that is accessible for most stroke survivors. Elite Athlete Products (EAP) has designed a wearable gait rehabilitation system, NewGait, that specifically addresses this clinical need. In this Phase-I STTR, EAP has assembled an interdisciplinary team to pursue the following specific aims: (1) Identify an optimal NewGait design based on end-user feedback (design sprints) and musculoskeletal modeling to address the needs of stroke rehabilitation, (2) Refine the current prototype using data gathered from design sprints and think aloud technique and perform benchtop testing on the final prototype to validate durability, and (3) Examine short-term gait adaptations and clinical feasibility in stroke survivors by performing a comparative clinical feasibility study in stroke survivors to establish the clinical utility of the NewGait device in comparison with two competitive devices (TheraSuit and TheraTogs). This project combines EAP’s expertise in developing low-cost neurorehabilitation devices with the clinical, biomechanical, and neuroplasticity expertise of our academic partners at the University of Michigan and Wayne State University. The successful completion of this Phase-I STTR will lay the foundation for an evidence-based low-cost gait rehabilitation system that could positively affect the lives of millions of stroke survivors living across the globe.