Department and Research Institute of Rehabilitation Medicine, Severance Rehabilitation Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea.
Sensors (Basel). 2023 Jul 21;23(14):6579. doi: 10.3390/s23146579.
Cerebral palsy is a neurologic disorder caused by lesions on an immature brain, often resulting in spasticity and gait abnormality. This study aimed to compare the muscle activation patterns of real level and stair walking with those of simulated walking using an end-effector-type robot in children with spastic cerebral palsy. The electromyographic activities of the vastus lateralis, biceps femoris, tibialis anterior and medial gastrocnemius of nine children with spastic bilateral cerebral palsy were measured during gait using a wireless surface EMG device. Morning walk was used for the simulated gait. Differences in the muscle activation patterns between the real and simulated gait conditions were analyzed. In the loading response, all four muscles showed reduced activity during two simulated conditions. In mid-stance, mGCM showed reduced activity during simulated conditions, whereas BFem showed greater activity during simulated level walking. In the swing phase, BFem and TAnt activity was reduced during the simulated conditions. The onset-offset of the VLat, BFem and TAnt activity was significantly delayed during simulated versus real level walking. No differences in activity onset-offset were observed between the simulated level and stair conditions. In conclusion, the robot-simulated gait showed differences in its muscle activation patterns compared with the real gait conditions, which must be considered for gait training using an end-effector-type robot.
脑性瘫痪是一种由未成熟大脑的病变引起的神经障碍，常导致痉挛和步态异常。本研究旨在比较使用末端效应型机器人在痉挛性脑瘫儿童中真实水平和楼梯行走与模拟行走的肌肉激活模式。使用无线表面肌电图设备测量了 9 名双侧痉挛性脑瘫儿童在行走过程中股外侧肌、股二头肌、胫骨前肌和内侧腓肠肌的肌电图活动。晨练用于模拟行走。分析了真实和模拟行走条件下肌肉激活模式的差异。在负荷反应中，所有 4 块肌肉在两种模拟条件下的活动均减少。在中间站立阶段，mGCM 在模拟条件下的活动减少，而 BFem 在模拟水平行走时的活动增加。在摆动阶段，BFem 和 TAnt 的活动在模拟条件下减少。与真实水平行走相比，VLat、BFem 和 TAnt 的活动起始-结束时间明显延迟。模拟水平和楼梯条件下的活动起始-结束时间没有差异。结论：与真实步态条件相比，机器人模拟步态的肌肉激活模式存在差异，这在使用末端效应型机器人进行步态训练时必须加以考虑。
