IEEE Trans Neural Syst Rehabil Eng. 2024;32:442-451. doi: 10.1109/TNSRE.2024.3354851. Epub 2024 Jan 24.
Entraining human gait with a periodic mechanical perturbation has been proposed as a potentially effective strategy for gait rehabilitation, but the related studies have mostly depended on the use of a fixed-speed treadmill (FST) due to various practical constraints. However, imposing a constant treadmill speed on participants becomes a critical problem because this speed constraint prohibits the participants from adjusting the gait speed, resulting in significant alterations in natural biomechanics as the entrainment alters the stride frequency. In this study, we hypothesized that the use of a variable-speed treadmill (VST), which enables the participants to continuously adjust their speed, can improve the success rate of gait entrainment and preserve natural gait biomechanics. To test this hypothesis, we recruited 15 young and healthy adults and let them walk on a conventional FST and a self-paced VST while wearing a soft robotic hip exosuit, which applied hip flexion perturbations at various frequencies, ranging from the preferred walking frequency to a 30% increased value. Kinematics and kinetics of the participants' walking under the two treadmill conditions were measured on two separate days. Experimental results demonstrated a higher success rate of entrainment during VST walking compared to FST walking, particularly at faster perturbation frequencies. Furthermore, walking on VST facilitated the maintenance of natural biomechanics, such as stride length and normalized propulsive impulse, better than walking on FST. The observed improvement, primarily attributed to allowing an increase in walking speed following the increase in the perturbation frequency, suggests that using a self-paced VST is a viable method for exploiting the potentially beneficial therapeutic effects of entrainment in gait rehabilitation.
用周期性机械扰动来诱发人体步态已被提出作为一种潜在有效的步态康复策略,但由于各种实际限制,相关研究大多依赖于使用固定速度跑步机(FST)。然而,对参与者施加恒定的跑步机速度成为一个关键问题,因为这种速度限制使得参与者无法调整步态速度,从而导致在诱发改变步频时,自然生物力学发生显著变化。在这项研究中,我们假设使用可变速度跑步机(VST),使参与者能够持续调整他们的速度,可以提高步态诱发的成功率并保持自然步态生物力学。为了验证这一假设,我们招募了 15 名年轻健康的成年人,让他们穿着软机器人髋关节外骨骼在传统的 FST 和自定速度的 VST 上行走,外骨骼以从偏好的步行频率到增加 30%的各种频率施加髋关节屈曲扰动。参与者在两种跑步机条件下行走的运动学和动力学在两天内进行了测量。实验结果表明,VST 行走时的诱发成功率高于 FST 行走时的成功率,尤其是在较快的扰动频率下。此外,与在 FST 上行走相比,在 VST 上行走更有利于维持自然生物力学,例如步长和归一化推进冲量。观察到的改善主要归因于允许在扰动频率增加时增加行走速度,这表明使用自定速度的 VST 是一种可行的方法,可以利用诱发在步态康复中的潜在有益治疗效果。