Han Seung-Hyeon, Choi Sanguk, Ko Chanyoung, Weon Lee Jong, Kong Kyoungchul, Rha Dong-Wook, Kim Deog Young
IEEE Trans Neural Syst Rehabil Eng. 2025;33:2251-2262. doi: 10.1109/TNSRE.2025.3577600.
This study evaluates the effectiveness of a cable-driven soft wearable robot (SWR) in assisting hip flexion and extension in chronic stroke patients to improve gait performance, energy efficiency, and kinematic parameters. A randomized crossover trial assessed under three scenarios: no SWR, SWR without power, and SWR with active assistance. Nineteen patients with chronic stroke participated, showing substantial enhancements in gait performance, energy efficiency, and joint kinematics following SWR activation. Notable outcomes include a 14.9% reduction in oxygen cost during SWR-assisted walking compared to unassisted walking, underscoring its metabolic benefits. Gait performance improved, evidenced by a 0.11 m/s increase in self-selected walking speed and a 20.7-meter gain in the 6-minute walk test (6MWT) distance, exceeding the minimal clinically important difference (MCID) thresholds. Kinematic analysis disclosed significant improvements in paretic-side hip flexion angles, with a 39.4% increase at initial contact and a 41.1% increase during the swing phase. Moreover, reductions in compensatory movements such as hip hiking were noted. Despite these gains, gait asymmetry remained, highlighting the necessity for further enhancements in SWR design and control mechanisms to mitigate entrenched compensatory patterns in chronic stroke patients. The lightweight, body-adaptive design of the SWR added to user comfort and energy conservation, showcasing its potential for clinical use. This research highlights the potential of SWR technology to enhance functional mobility and autonomy in stroke survivors. Future investigations should focus on long-term impacts and real-world efficacy to refine rehabilitation approaches.
本研究评估了缆线驱动的软质可穿戴机器人（SWR）在协助慢性中风患者进行髋关节屈伸以改善步态表现、能量效率和运动学参数方面的有效性。一项随机交叉试验在三种情况下进行评估：不使用SWR、使用无动力的SWR以及使用主动辅助的SWR。19名慢性中风患者参与其中，结果显示激活SWR后，他们在步态表现、能量效率和关节运动学方面有显著改善。显著的结果包括，与无辅助行走相比，在SWR辅助行走过程中氧气消耗降低了14.9%，突出了其代谢益处。步态表现得到改善，自我选择步行速度提高了0.11米/秒，6分钟步行试验（6MWT）距离增加了20.7米，超过了最小临床重要差异（MCID）阈值，证明了这一点。运动学分析显示，患侧髋关节屈曲角度有显著改善，初始接触时增加了39.4%，摆动期增加了41.1%。此外，还注意到诸如提髋等代偿性动作减少。尽管有这些改善，但步态不对称仍然存在，这突出表明有必要进一步改进SWR的设计和控制机制，以减轻慢性中风患者根深蒂固的代偿模式。SWR的轻质、身体适应性设计增加了用户的舒适度并节省了能量，展示了其临床应用潜力。这项研究突出了SWR技术在增强中风幸存者功能移动性和自主性方面的潜力。未来的研究应关注长期影响和实际疗效，以完善康复方法。
