IEEE Trans Neural Syst Rehabil Eng. 2020 Sep;28(9):1984-1993. doi: 10.1109/TNSRE.2020.3009317. Epub 2020 Jul 14.
Individuals with chronic hemiparesis post-stroke exhibit gait impairments that require functional rehabilitation through training. Exoskeletal robotic assistive devices can provide a user with continuous assistance but impose movement restrictions. There are currently devices that allow unrestricted movement but provide assistance only intermittently at specific points of the gait cycle. Our design, a cable-driven active leg exoskeleton (C-ALEX), allows the user both unrestricted movement and continuous force assistance throughout the gait cycle to assist the user in new walking patterns. In this study, we assessed the ability of C-ALEX to induce a change in the walking patterns of ten post-stroke participants using a single-session training protocol. The ability of C-ALEX to accurately provide forces and torques in the desired directions was also evaluated to compare its design performance to traditional rigid-link designs. Participants were able to reach 91% ± 12% of their target step length and 89% ± 13% of their target step height. The achieved step parameters differed significantly from participant baselines ( ). To quantify the performance, the forces in each cable's out of the plane movements were evaluated relative to the in-plane desired cable tension magnitudes. This corresponded to an error of under 2Nm in the desired controlled joint torques. This error magnitude is low compared to the system command torques and typical adult biological torques during walking (2-4%). These results point to the utility of using non-restrictive cable-driven architectures in gait retraining, in which future focus can be on rehabilitating gait pathologies seen in stroke survivors.
中风后慢性偏瘫患者表现出需要通过训练进行功能康复的步态障碍。外骨骼机器人辅助设备可以为用户提供持续的辅助,但会限制运动。目前有一些设备可以允许不受限制的运动,但仅在步态周期的特定点间歇性地提供辅助。我们的设计,一种缆索驱动的主动腿部外骨骼(C-ALEX),允许用户在整个步态周期内不受限制地运动并持续提供力辅助,以帮助用户形成新的行走模式。在这项研究中,我们使用单次训练方案评估了 C-ALEX 改变十名中风后参与者行走模式的能力。我们还评估了 C-ALEX 准确提供所需方向的力和扭矩的能力,以将其设计性能与传统的刚性连杆设计进行比较。参与者能够达到目标步长的 91%±12%和目标步高的 89%±13%。所达到的步长参数与参与者的基线有显著差异()。为了量化性能,评估了每个缆索出线运动的力与平面内所需缆索张力的大小。这对应于期望控制关节扭矩的误差小于 2Nm。与系统命令扭矩和典型成年人在行走时的生物扭矩(2-4%)相比,这个误差幅度很小。这些结果表明,在步态再训练中使用非限制性缆索驱动架构的有效性,未来的重点可以放在康复中风幸存者中出现的步态病理上。