Functional and Applied Biomechanics Section, Rehabilitation Medicine Department, National Institutes of Health, Bethesda, MD, USA.
Department of Mechanical Engineering, Northern Arizona University, Flagstaff, AZ, USA.
Sci Rep. 2017 Oct 18;7(1):13512. doi: 10.1038/s41598-017-13554-2.
Individuals with cerebral palsy often exhibit crouch gait, a debilitating and inefficient walking pattern marked by excessive knee flexion that worsens with age. To address the need for improved treatment, we sought to evaluate if providing external knee extension assistance could reduce the excessive burden placed on the knee extensor muscles as measured by knee moments. We evaluated a novel pediatric exoskeleton designed to provide appropriately-timed extensor torque to the knee joint during walking in a multi-week exploratory clinical study. Seven individuals (5-19 years) with mild-moderate crouch gait from cerebral palsy (GMFCS I-II) completed the study. For six participants, powered knee extension assistance favorably reduced the excessive stance-phase knee extensor moment present during crouch gait by a mean of 35% in early stance and 76% in late stance. Peak stance-phase knee and hip extension increased by 12° and 8°, respectively. Knee extensor muscle activity decreased slightly during exoskeleton-assisted walking compared to baseline, while knee flexor activity was elevated in some participants. These findings support the use of wearable exoskeletons for the management of crouch gait and provide insights into their future implementation.
脑瘫患者常表现出蹲伏步态，这是一种衰弱且低效的行走模式，其特征是膝关节过度弯曲，随着年龄的增长而恶化。为了解决治疗需求，我们试图评估提供膝关节伸展辅助是否可以通过测量膝关节力矩来减少膝关节伸肌承受的过度负荷。我们评估了一种新型儿科外骨骼，旨在为行走中的膝关节提供适时的伸肌扭矩，这是一项为期多周的探索性临床研究。7 名轻度至中度脑瘫蹲伏步态患者（GMFCS I-II）完成了这项研究。对于 6 名参与者，动力膝关节伸展辅助在早期站立和晚期站立时分别将蹲伏步态中存在的过度站立相膝关节伸肌力矩降低了 35%和 76%。峰值站立相膝关节和髋关节伸展增加了 12°和 8°。与基线相比，外骨骼辅助行走时膝关节伸肌活动略有减少，而一些参与者的膝关节屈肌活动升高。这些发现支持使用可穿戴外骨骼来管理蹲伏步态，并为其未来的实施提供了一些见解。
