Department of Rehabilitation Research, Baylor Scott & White Institute for Rehabilitation , Dallas, TX, USA.
College of Medical Rehabilitation, Qassim University , Buraydah, Saudi Arabia.
Top Stroke Rehabil. 2020 Oct;27(7):503-515. doi: 10.1080/10749357.2020.1728954. Epub 2020 Feb 20.
: Robotic Exoskeletons (EKSO) are novel technology for retraining common gait dysfunction in people post-stroke. EKSO's capability to influence gait characteristics post-stroke is unknown. : To compare temporospatial, kinematic, and muscle activity gait characteristics before and after a single EKSO session and examine kinematic symmetry between involved and uninvolved limbs. : Participants post-stroke walked under two conditions: pre-EKSO, and immediately post-EKSO. A 10-camera motion capture system synchronized with 6 force plates was used to obtain temporospatial and kinematic gait characteristics from 5 walking trials of 9 meters at a self-selected speed. Surface EMG activity was obtained from bilateral gluteus medius, rectus femoris, medial hamstrings, tibialis anterior, and soleus muscles. Wilcoxon Signed Rank tests were used to analyze differences pre- and post-EKSO. Single EKSO session consisted of 22.3±6.8 minutes total time (walk time=7.2±1.5 minutes) with 250±40 steps. : Six ambulatory (Functional Ambulation Category, range=4-5) adults (3 female; 44.7±14.6 years) with chronic stroke (4.5±1.9 years post-stroke) participated. No significant differences were observed for temporospatial gait characteristics. Muscle activity was significantly less post-EKSO in the involved leg rectus femoris during swing phase (=0.028). Ankle dorsiflexion range of motion on the involved leg post-EKSO was significantly less during stance phase (=0.046). Differences between involved and uninvolved joint range of motion symmetry were found pre-EKSO but not post-EKSO in swing phase hip flexion and stance phase knee flexion and knee extension. : EKSO training appears capable of altering gait in people with chronic stroke and a viable intervention to reduce gait dysfunction post-stroke.
: 外骨骼机器人(EKSO)是一种用于重新训练脑卒中后常见步态障碍的新型技术。但 EKSO 对脑卒中后步态特征的影响尚不清楚。 : 本研究旨在对比脑卒中患者在 EKSO 治疗前后单次疗程中的时空、运动学和肌肉活动步态特征,并检查受累和未受累肢体的运动学对称性。 : 脑卒中患者在两种条件下行走:EKSO 治疗前和治疗后即刻。使用 10 个摄像机运动捕捉系统与 6 个力板同步,以获得 9 米、自我选择速度的 5 次步行试验中的时空和运动学步态特征。表面肌电图(sEMG)活性来自双侧臀中肌、股直肌、内侧腘绳肌、胫骨前肌和比目鱼肌。采用 Wilcoxon 符号秩检验分析 EKSO 治疗前后的差异。单次 EKSO 疗程总时长为 22.3±6.8 分钟(行走时间为 7.2±1.5 分钟),包含 250±40 步。 : 本研究共纳入 6 名(3 名女性;平均年龄 44.7±14.6 岁)慢性脑卒中(脑卒中后 4.5±1.9 年)、可独立行走(功能性步行分类,范围为 4-5)的成年人。治疗前后,时空步态特征无显著差异。治疗后,受累侧股直肌在摆动相的肌肉活动明显减少(=0.028)。受累侧踝关节背屈运动范围在站立相明显减少(=0.046)。治疗前后,摆动相髋关节屈曲、站立相膝关节屈曲和膝关节伸展时,受累和未受累关节运动学对称性存在差异,但 EKSO 治疗后无差异。 : EKSO 训练似乎能够改变慢性脑卒中患者的步态,是一种可行的脑卒中后减少步态障碍的干预措施。