Sierra M Sergio D, Garcia A Daniel E, Otálora Sophia, Arias-Castro María Camila, Gómez-Rodas Alejandro, Múnera Marcela, Cifuentes Carlos A
Department of Biomedical Engineering, Colombian School of Engineering Julio Garavito, Bogotá, Colombia.
Programa de Fisioterapia, Fundación Universitaria del Área Andina, Pereira, Colombia.
Front Neurorobot. 2021 Dec 14;15:742281. doi: 10.3389/fnbot.2021.742281. eCollection 2021.
The constant growth of the population with mobility impairments, such as older adults and people suffering from neurological pathologies like Parkinson's disease (PD), has encouraged the development of multiple devices for gait assistance. Robotic walkers have emerged, improving physical stability and balance and providing cognitive aid in rehabilitation scenarios. Different studies evaluated human gait behavior with passive and active walkers to understand such rehabilitation processes. However, there is no evidence in the literature of studies with robotic walkers in daily living scenarios with older adults with Parkinson's disease. This study presents the assessment of the AGoRA Smart Walker using Ramps Tests and Timed Up and Go Test (TUGT). Ten older adults participated in the study, four had PD, and the remaining six had underlying conditions and fractures. Each of them underwent a physical assessment (i.e., Senior Fitness, hip, and knee strength tests) and then interacted with the AGoRA SW. Kinematic and physical interaction data were collected through the AGoRA walker's sensory interface. It was found that for lower limb strength tests, older adults with PD had increases of at least 15% in all parameters assessed. For the Sit to Stand Test, the Parkinson's group evidenced an increase of 23%, while for the Chair Sit and Reach Test (CSRT), this same group was only 0.04 m away from reaching the target. For the Ramp Up Test (RUT), the subjects had to make a greater effort, and significant differences ( = 0.04) were evidenced in the force they applied to the device. For the Ramp Down Test (RDT), the Parkinson's group exhibited a decrease in torque, and there were statistically significant differences ( = 0.01) due to the increase in the complexity of the task. In the Timed Up and Go Test (TUGT), the subjects presented significant differences in torque ( of 0.05) but not in force ( of 0.22) due to the effect of the admittance controller implemented in the study. Finally, the results suggested that the walker, represents a valuable tool for assisting people with gait motor deficits in tasks that demanded more physical effort adapting its behavior to the specific needs of each user.
行动不便人群数量持续增长，例如老年人以及患有帕金森病（PD）等神经病理学疾病的人群，这推动了多种步态辅助设备的研发。机器人助行器应运而生，可改善身体稳定性和平衡能力，并在康复场景中提供认知辅助。不同研究通过被动和主动助行器评估人类步态行为，以了解此类康复过程。然而，文献中尚无关于在帕金森病老年患者日常生活场景中使用机器人助行器的研究证据。本研究介绍了使用坡道测试和定时起立行走测试（TUGT）对AGoRA智能助行器进行的评估。十名老年人参与了该研究，其中四名患有帕金森病，其余六名有基础疾病和骨折。他们每人都接受了身体评估（即老年人健身、髋部和膝部力量测试），然后与AGoRA智能助行器进行交互。通过AGoRA助行器的传感界面收集运动学和身体交互数据。研究发现，在下肢力量测试中，患有帕金森病的老年人所有评估参数至少提高了15%。在坐立测试中，帕金森病组的表现提高了23%，而在椅子坐位体前屈测试（CSRT）中，该组距离达到目标仅差0.04米。在爬坡测试（RUT）中，受试者必须付出更大努力，并且在他们施加于设备的力方面存在显著差异（P = 0.04）。在下坡测试（RDT）中，帕金森病组的扭矩降低，由于任务复杂性增加，存在统计学显著差异（P = 0.01）。在定时起立行走测试（TUGT）中，由于研究中实施的导纳控制器的作用，受试者在扭矩方面存在显著差异（P = 0.05），但在力方面不存在显著差异（P = 0.22）。最后，结果表明，该助行器是一种有价值的工具，可协助步态运动功能有缺陷的人完成需要更多体力的任务，并使其行为适应每个用户的特定需求。
