Eveld Maura E, King Shane T, Zelik Karl E, Goldfarb Michael
Department of Mechanical Engineering, Vanderbilt University, TN, USA.
Department of Physical Medicine & Rehabilitation, Vanderbilt University, TN, USA.
Wearable Technol. 2023 Sep 6;4:e22. doi: 10.1017/wtc.2023.17. eCollection 2023.
Falls due to stumbles are a major cause of injury for many populations, and as such interventions to reduce fall risk have been a key focus of rehabilitation research. However, dedicated stumble recovery assistance in a powered lower-limb exoskeleton has yet to be explored as a fall mitigation intervention. Thus young, healthy adults () were recruited for a stumble recovery experiment to test the efficacy of knee exoskeleton stumble recovery assistance in improving an impaired stumble recovery response (i.e., the elevating strategy response). Leg weights were attached unilaterally to each participant's shank to simulate walking and stumble recovery impairment, and a unilateral powered knee exoskeleton was worn on the same leg for walking and stumble recovery assistance. Ultimately, knee exoskeleton stumble recovery assistance served to improve participants' elevating limb kinematics (i.e., increase thigh and knee motion) and reduce overall fall risk (i.e., reduce trunk motion and improve foot placement) during responses relative to their impaired response (i.e., with the leg weights and no assistance), and relative to their response while receiving only walking assistance. This initial exploration provides a first indication that knee exoskeleton stumble recovery assistance is a viable approach to improving an impaired stumble recovery response, which could serve two important use cases: (1) a safety mechanism for existing exoskeleton wearers, who may be less capable of recovering from stumbles due to the added weight or joint impedance of the device; (2) an external stumble recovery aid for fall-prone populations, such as the elderly or stroke survivors.
绊倒导致的跌倒对许多人群来说是受伤的主要原因，因此，降低跌倒风险的干预措施一直是康复研究的重点。然而，动力下肢外骨骼中专门的绊倒恢复辅助作为一种跌倒缓解干预措施尚未得到探索。因此，招募了年轻健康的成年人（）进行绊倒恢复实验，以测试膝关节外骨骼绊倒恢复辅助在改善受损的绊倒恢复反应（即抬高策略反应）方面的效果。在每个参与者的小腿上单侧附加腿部重量，以模拟行走和绊倒恢复障碍，并在同一条腿上佩戴单侧动力膝关节外骨骼，用于行走和绊倒恢复辅助。最终，膝关节外骨骼绊倒恢复辅助有助于改善参与者抬高肢体的运动学（即增加大腿和膝关节的运动），并相对于其受损反应（即佩戴腿部重量且无辅助）以及仅接受行走辅助时的反应，降低整体跌倒风险（即减少躯干运动并改善足部着地）。这一初步探索首次表明，膝关节外骨骼绊倒恢复辅助是改善受损绊倒恢复反应的一种可行方法，可用于两个重要的应用场景：（1）作为现有外骨骼佩戴者的安全机制，由于设备增加的重量或关节阻抗，他们可能更难从绊倒中恢复；（2）作为易跌倒人群（如老年人或中风幸存者）的外部绊倒恢复辅助工具。
