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

项目说明/摘要 在美国，中风是慢性残疾的主要原因，每年有近61万新病例。在……里面 慢性中风患者，缓慢、疲惫的步行是限制日常活动的主要有害结果 活着。此外，行走障碍会导致继发性损伤，如肌肉无力和虚弱。 平衡，这两个因素都是跌倒的风险因素。因此，旨在改善中风后步行功能的干预措施 可能会对数百万人的生活质量产生重大积极影响。 在健康的步行中，脚踝伸肌在关键的步行子任务中起着主要作用，包括(1) 推进(2)重量支撑；(3)摆动启动。慢性中风患者通常有以下问题 这些子任务中的每一个，很可能是由于他们瘫痪肢体的踝关节机械功能薄弱和不协调所致。 单侧踝关节功能受损导致高度不对称步态，限制了最高行走速度并抬高了 代谢能量消耗。 这项拟议的研究的主要目标是使用可穿戴的机器人设备来帮助瘫痪患者 改善中风后偏瘫患者的肢体，改善步态对称性和经济性。 我们将招募20名慢性中风患者，并为他们的患者构建轻型机器人脚踝外骨骼 偏瘫的肢体。然后，我们将测试以踝关节伸展为重点的机器人辅助是否可以改善偏瘫 肢体功能--将其推向尺寸/年龄配对的健康对照组。我们假设目标是， 单侧踝关节机械辅助将恢复多尺度肌肉骨骼的步态对称性 组织-从四肢到下肢关节-并降低中风后患者步行的新陈代谢成本。 如果机器人脚踝外骨骼可以恢复正常的行走机制，降低新陈代谢成本，那么人类 有严重损伤的中风后患者可以受益于便携式版本，作为社区期间的永久援助 走动。

PROJECT DESCRIPTION / ABSTRACT 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.