Effects of a soft robotic exosuit on the quality and speed of overground walking depends on walking ability after stroke.

Autor: Sloot LH; Harvard John A. Paulson School of Engineering and Applied Sciences, Cambridge, MA, USA.; Wyss Institute for Biologically Inspired Engineering, Boston, MA, USA.; ZITI Institute of Computer Engineering, Heidelberg University, Heidelberg, Germany., Baker LM; Harvard John A. Paulson School of Engineering and Applied Sciences, Cambridge, MA, USA.; Wyss Institute for Biologically Inspired Engineering, Boston, MA, USA., Bae J; Harvard John A. Paulson School of Engineering and Applied Sciences, Cambridge, MA, USA.; Wyss Institute for Biologically Inspired Engineering, Boston, MA, USA., Porciuncula F; Harvard John A. Paulson School of Engineering and Applied Sciences, Cambridge, MA, USA.; Wyss Institute for Biologically Inspired Engineering, Boston, MA, USA., Clément BF; Harvard John A. Paulson School of Engineering and Applied Sciences, Cambridge, MA, USA.; Wyss Institute for Biologically Inspired Engineering, Boston, MA, USA.; Institute for Biomedical Engineering, ETH Zürich, Zürich, Schweiz., Siviy C; Harvard John A. Paulson School of Engineering and Applied Sciences, Cambridge, MA, USA.; Wyss Institute for Biologically Inspired Engineering, Boston, MA, USA., Nuckols RW; Harvard John A. Paulson School of Engineering and Applied Sciences, Cambridge, MA, USA.; Wyss Institute for Biologically Inspired Engineering, Boston, MA, USA., Baker T; Wyss Institute for Biologically Inspired Engineering, Boston, MA, USA.; Department of Physical Therapy, Boston University, Boston, MA, USA., Sloutsky R; Wyss Institute for Biologically Inspired Engineering, Boston, MA, USA.; Department of Physical Therapy, Boston University, Boston, MA, USA., Choe DK; Harvard John A. Paulson School of Engineering and Applied Sciences, Cambridge, MA, USA.; Wyss Institute for Biologically Inspired Engineering, Boston, MA, USA., O'Donnell K; Harvard John A. Paulson School of Engineering and Applied Sciences, Cambridge, MA, USA.; Wyss Institute for Biologically Inspired Engineering, Boston, MA, USA., Ellis TD; Department of Physical Therapy, Boston University, Boston, MA, USA., Awad LN; Wyss Institute for Biologically Inspired Engineering, Boston, MA, USA. louawad@bu.edu.; Department of Physical Therapy, Boston University, Boston, MA, USA. louawad@bu.edu., Walsh CJ; Harvard John A. Paulson School of Engineering and Applied Sciences, Cambridge, MA, USA. walsh@seas.harvard.edu.; Wyss Institute for Biologically Inspired Engineering, Boston, MA, USA. walsh@seas.harvard.edu.
Jazyk: angličtina
Zdroj: Journal of neuroengineering and rehabilitation [J Neuroeng Rehabil] 2023 Sep 01; Vol. 20 (1), pp. 113. Date of Electronic Publication: 2023 Sep 01.
DOI: 10.1186/s12984-023-01231-7
Abstrakt: Background: Soft robotic exosuits can provide partial dorsiflexor and plantarflexor support in parallel with paretic muscles to improve poststroke walking capacity. Previous results indicate that baseline walking ability may impact a user's ability to leverage the exosuit assistance, while the effects on continuous walking, walking stability, and muscle slacking have not been evaluated. Here we evaluated the effects of a portable ankle exosuit during continuous comfortable overground walking in 19 individuals with chronic hemiparesis. We also compared two speed-based subgroups (threshold: 0.93 m/s) to address poststroke heterogeneity.
Methods: We refined a previously developed portable lightweight soft exosuit to support continuous overground walking. We compared five minutes of continuous walking in a laboratory with the exosuit to walking without the exosuit in terms of ground clearance, foot landing and propulsion, as well as the energy cost of transport, walking stability and plantarflexor muscle slacking.
Results: Exosuit assistance was associated with improvements in the targeted gait impairments: 22% increase in ground clearance during swing, 5° increase in foot-to-floor angle at initial contact, and 22% increase in the center-of-mass propulsion during push-off. The improvements in propulsion and foot landing contributed to a 6.7% (0.04 m/s) increase in walking speed (R 2  = 0.82). This enhancement in gait function was achieved without deterioration in muscle effort, stability or cost of transport. Subgroup analyses revealed that all individuals profited from ground clearance support, but slower individuals leveraged plantarflexor assistance to improve propulsion by 35% to walk 13% faster, while faster individuals did not change either.
Conclusions: The immediate restorative benefits of the exosuit presented here underline its promise for rehabilitative gait training in poststroke individuals.
(© 2023. BioMed Central Ltd., part of Springer Nature.)
Databáze: MEDLINE
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