Lerner Zachary F, Damiano Diane L, Bulea Thomas C
Annu Int Conf IEEE Eng Med Biol Soc. 2016 Aug;2016:2214-2217. doi: 10.1109/EMBC.2016.7591169.
A robotic exoskeleton was designed for individuals with crouch gait caused by cerebral palsy with the intent to supplement existing muscle function during walking. The aim of this study was to evaluate how powered knee extension assistance provided during stance and swing phases of the gait cycle affect knee kinematics, and knee flexor and extensor muscle activity. Muscle activity and kinematic data were collected from four individuals with crouch gait from cerebral palsy during their normal walking condition and while walking with the exoskeleton under stance, swing, and stance & swing assistance. The exoskeleton was effective in reducing crouch by an average of 13.8° in three of the four participants when assistance was provided during the stance phase; assistance during the swing phase alone was ineffective. Peak knee extensor activity was maintained for all of the conditions during the stance and swing phases. Integrated (i.e. area under the curve) knee extensor activity decreased in two of the subjects indicating a more well-modulated activation pattern. Modest increases in peak and integrated antagonist knee flexor activity were exhibited in all participants; the subject without kinematic improvement had the greatest increase. While the exoskeleton was well tolerated, additional training with a focus on reducing knee flexor activity may lead to further improvements in crouch gait reduction.
设计了一种机器人外骨骼，用于帮助患有脑性瘫痪导致蹲伏步态的个体在行走过程中补充现有的肌肉功能。本研究的目的是评估在步态周期的支撑期和摆动期提供的动力膝关节伸展辅助如何影响膝关节运动学以及膝关节屈肌和伸肌的活动。在四名患有脑性瘫痪蹲伏步态的个体正常行走时以及穿着外骨骼在支撑期、摆动期和支撑期与摆动期辅助下行走时，收集了肌肉活动和运动学数据。当在支撑期提供辅助时，外骨骼在四名参与者中的三名中有效降低了平均13.8°的蹲伏角度；仅在摆动期提供辅助则无效。在支撑期和摆动期的所有情况下，膝关节伸肌活动峰值均得以维持。两名受试者的膝关节伸肌综合（即曲线下面积）活动减少，表明激活模式得到了更好的调节。所有参与者的膝关节屈肌峰值和综合活动均有适度增加；运动学无改善的受试者增加幅度最大。虽然外骨骼耐受性良好，但专注于减少膝关节屈肌活动的额外训练可能会进一步改善蹲伏步态。
