McGrath Robert L, Sergi Fabrizio
IEEE Int Conf Rehabil Robot. 2019 Jun;2019:874-879. doi: 10.1109/ICORR.2019.8779426.
Robot assisted gait retraining is an increasingly common method for supporting restoration of walking function after neurological injury. Gait speed, an indicator of walking function, is correlated with propulsive force, a measure modulated by the posture of the trailing limb at push-off. With the ultimate goal of improving efficacy of robot assisted gait retraining, we sought to directly target gait propulsion, by exposing subjects to pulses of joint torque applied at the hip and knee joints to modulate push-off posture. In this work, we utilized a robotic exoskeleton to apply pulses of torque to the hip and knee joints, during individual strides, of 16 healthy control subjects, and quantified the effects of this intervention on hip extension and propulsive impulse during and after application of these pulses. We observed significant effects in the outcome measures primarily at the stride of pulse application and generally no after effects in the following strides. Specifically, when pulses were applied at late stance, we observed a significant increase in propulsive impulse when knee and/or hip flexion pulses were applied and a significant increase in hip extension angle when hip extension torque pulses were applied. When pulses were applied at early stance, we observed a significant increase in propulsive impulse associated with hip extension torque.
机器人辅助步态再训练是一种越来越常见的方法,用于支持神经损伤后步行功能的恢复。步态速度是步行功能的一个指标,与推进力相关,推进力是一种由蹬离时后肢姿势调节的测量值。为了提高机器人辅助步态再训练的效果,我们试图通过让受试者暴露于在髋关节和膝关节施加的关节扭矩脉冲来调节蹬离姿势,从而直接针对步态推进。在这项工作中,我们利用机器人外骨骼在16名健康对照受试者的单个步幅期间,向髋关节和膝关节施加扭矩脉冲,并量化了这种干预对这些脉冲施加期间和之后的髋关节伸展和推进冲量的影响。我们观察到主要在脉冲施加的步幅时,结果测量有显著影响,而在随后的步幅中通常没有后续影响。具体而言,当在站立后期施加脉冲时,当施加膝关节和/或髋关节屈曲脉冲时,我们观察到推进冲量显著增加,当施加髋关节伸展扭矩脉冲时,髋关节伸展角度显著增加。当在站立早期施加脉冲时,我们观察到与髋关节伸展扭矩相关的推进冲量显著增加。