John A. Paulson School of Engineering and Applied Sciences, Harvard University, Boston, MA, USA.
Department of Physical Therapy, Boston University, Boston, MA, USA.
Nat Med. 2024 Jan;30(1):177-185. doi: 10.1038/s41591-023-02731-8. Epub 2024 Jan 5.
Freezing of gait (FoG) is a profoundly disruptive gait disturbance in Parkinson's disease, causing unintended stops while walking. Therapies for FoG reveal modest and transient effects, resulting in a lack of effective treatments. Here we show proof of concept that FoG can be averted using soft robotic apparel that augments hip flexion. The wearable garment uses cable-driven actuators and sensors, generating assistive moments in concert with biological muscles. In this n-of-1 trial with five repeated measurements spanning 6 months, a 73-year-old male with Parkinson's disease and substantial FoG demonstrated a robust response to robotic apparel. With assistance, FoG was instantaneously eliminated during indoor walking (0% versus 39 ± 16% time spent freezing when unassisted), accompanied by 49 ± 11 m (+55%) farther walking compared to unassisted walking, faster speeds (+0.18 m s) and improved gait quality (-25% in gait variability). FoG-targeting effects were repeatable across multiple days, provoking conditions and environment contexts, demonstrating potential for community use. This study demonstrated that FoG was averted using soft robotic apparel in an individual with Parkinson's disease, serving as an impetus for technological advancements in response to this serious yet unmet need.
冻结步态（Freezing of gait，FoG）是一种严重破坏帕金森病患者行走能力的步态障碍，导致行走过程中出现非预期的停顿。针对 FoG 的治疗方法仅显示出适度且短暂的效果，导致缺乏有效的治疗方法。在这里，我们展示了一个概念验证，即通过增强髋关节弯曲的软机器人服装可以避免 FoG。这款可穿戴服装使用电缆驱动的执行器和传感器，与生物肌肉协同产生辅助力矩。在这项针对一名患者的 n-of-1 试验中，有五次重复测量，跨度为 6 个月，一名 73 岁的男性帕金森病患者和严重的 FoG 对机器人服装表现出了强烈的反应。在室内行走时，有辅助时 FoG 立即消除（辅助时无冻结的时间占比为 0%，而无辅助时为 39%±16%），与无辅助行走相比，行走距离增加了 49%±11%（增加了 55%），速度更快（速度增加了 0.18m/s），步态质量也得到改善（步态变异性降低了 25%）。在多天、多种诱发条件和环境背景下，FoG 的靶向作用具有可重复性，为在社区中使用提供了潜力。这项研究表明，在帕金森病患者中，使用软机器人服装可以避免 FoG，这为应对这一严重但尚未满足的需求的技术进步提供了动力。
