Department of Mechanical Engineering, Northern Arizona University, Flagstaff, AZ, United States.
Department of Mechanical Engineering, Northern Arizona University, Flagstaff, AZ, United States; College of Medicine - Phoenix, University of Arizona, Phoenix, AZ, United States.
J Biomech. 2024 Oct;175:112282. doi: 10.1016/j.jbiomech.2024.112282. Epub 2024 Aug 16.
Individuals with diminished walking performance caused by neuromuscular impairments often lack plantar flexion muscle activity. Robotic devices have been developed to address these issues and increase walking performance. While these devices have shown promise in their ability to increase musculature engagement of the lower limbs when used on a treadmill, most have not been developed or validated for overground walking and community use. Overground walking may limit the effectiveness of robotic devices due to differences in gait characteristics between walking terrains and reduced user engagement. The purpose of this study was to validate our multimodal robotic gait training system for overground walking in individuals with neuromuscular gait impairments. This untethered wearable robotic device can provide an ankle resistive torque proportional to the users' biological ankle torque. The device can also provide audio biofeedback based on users' plantar pressure intending to increase ankle power and muscle activity of the plantar flexors. Seven individuals with cerebral palsy participated. Participants walked overground and on a treadmill with our robotic gait training system in a single testing session. Results showed all seven participants to increase peak plantar flexor muscle activity, 10.3% on average, when walking with the gait trainer overground compared to treadmill. When compared to typical baseline overground walking, overground gait trainer use caused individuals to have slightly less knee joint excursion (3°) and moderately more ankle joint excursion (7°). This work supports our vision of using the wearable robotic device as a gait aid and rehabilitation tool in the home and community settings.
由于神经肌肉损伤而导致行走能力下降的个体通常缺乏跖屈肌活动。已经开发出机器人设备来解决这些问题并提高行走能力。虽然这些设备在跑步机上使用时显示出增加下肢肌肉参与的潜力，但大多数设备尚未开发或验证用于地面行走和社区使用。由于行走地形之间的步态特征差异以及用户参与度降低，地面行走可能会限制机器人设备的有效性。本研究的目的是验证我们用于神经肌肉步态障碍个体地面行走的多模态机器人步态训练系统。这款无绳可穿戴机器人设备可以提供与用户生物踝关节扭矩成比例的踝关节阻力扭矩。该设备还可以根据用户的足底压力提供音频生物反馈，旨在增加踝关节力量和跖屈肌的肌肉活动。七名脑瘫患者参与了研究。参与者在单次测试中同时使用我们的机器人步态训练系统在地面和跑步机上行走。结果表明，与在跑步机上行走相比，当使用步态训练器在地面上行走时，所有七名参与者的峰值跖屈肌肌肉活动平均增加了 10.3%。与典型的基线地面行走相比，使用地面步态训练器使个体的膝关节活动度略小（3°），踝关节活动度略大（7°）。这项工作支持了我们的愿景，即使用可穿戴机器人设备作为家庭和社区环境中的步态辅助和康复工具。
