Fang Ying, Lerner Zachary F
Mechanical Engineering Department, Northern Arizona University, Flagstaff, AZ 86011 USA.
Mechanical Engineering Department, Northern Arizona University, Flagstaff, AZ 86011 USA, and also with the Department of Orthopedics, The University of Arizona College of Medicine-Phoenix, Phoenix, AZ 85004 USA.
IEEE Robot Autom Lett. 2022 Apr;7(2):1246-1253. doi: 10.1109/lra.2021.3139540. Epub 2021 Dec 31.
People with lower-limb hemiparesis have impaired function on one side of the body that affects their walking ability. Wearable robotic assistance has been investigated to treat hemiparetic gait by applying assistance to the paretic limb. In this exploratory case series, we sought to compare the effects of bilateral vs. paretic-limb-only ankle exoskeleton assistance on walking performance in a case series of three heterogeneous presentations of lower-limb hemiparesis. A secondary goal was to validate the use of a real-time ankle-moment-adaptive exoskeleton control system for effectively assisting hemiparetic gait; the ankle moment controller accuracy ranged from 72 - 90% across all conditions and participants. Compared to walking without the device, both paretic-limb-only and bilateral assistance resulted in greater average total ankle power (up to 72%), improved treadmill walking efficiency (up to 28%), and increased over-ground walking distance (up to 41%). All participants achieved a more symmetrical, efficient gait pattern with bilateral assistance, indicating that assisting both limbs may be more beneficial than assisting only the paretic side in people with hemiparetic gait. The results of this case series are intended to inform future clinical studies and exoskeleton designs in a wide range of patient populations.
下肢偏瘫患者身体一侧功能受损，影响其行走能力。人们已对可穿戴机器人辅助设备进行研究，通过对瘫痪肢体提供辅助来治疗偏瘫步态。在这个探索性病例系列中，我们试图比较双侧与仅对瘫痪肢体使用踝关节外骨骼辅助对三种不同类型下肢偏瘫患者行走表现的影响。第二个目标是验证实时踝关节力矩自适应外骨骼控制系统对有效辅助偏瘫步态的作用；在所有情况和参与者中，踝关节力矩控制器的准确率在72%至90%之间。与不使用该设备行走相比，仅对瘫痪肢体提供辅助和双侧辅助均使平均总踝关节功率显著增加（高达72%），提高了跑步机行走效率（高达28%），并增加了地面行走距离（高达41%）。所有参与者在双侧辅助下都实现了更对称、高效的步态模式，这表明对于偏瘫步态患者，辅助双侧肢体可能比仅辅助瘫痪侧更有益。这个病例系列的结果旨在为未来针对广泛患者群体的临床研究和外骨骼设计提供参考。
