A Lightweight and Efficient Portable Soft Exosuit for Paretic Ankle Assistance in Walking After Stroke

Bae, Jaehyun; Siviy, Christopher; Rouleau, Michael; Menard, Nicolas; O’Donnell, Kathleen; Geliana, Ignacio; Athanassiu, Maria; Ryan, Danielle Louise; Bibeau, Christine; Sloot, Lizeth H.; Kudzia, Pawel; Ellis, Terry; Awad, Louis N.; Walsh, Conor J.

doi:10.1109/icra.2018.8461046

Cited by 117 publications

(96 citation statements)

References 22 publications

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“…There have been efforts to develop portable rehabilitation devices (Handzic et al, 2011;Afzal et al, 2015;Lahiff et al, 2016;Calabrò et al, 2018) and assistive devices (Rao et al, 2008;Awad et al, 2017;Bae et al, 2018) to improve walking patterns in individuals with gait asymmetries, such as individuals poststroke. While these apparatus could reduce the metabolic cost associated to gait in this clinical population (Awad et al, 2017) and improve walking speed (Rao et al, 2008;Buesing et al, 2015;Calabrò et al, 2018), these devices were unsuccessful in modifying the step length asymmetry (Handzic et al, 2011), which is an important parameter in rehabilitation of post-stroke patients (Patterson et al, 2008(Patterson et al, , 2014.…”

Section: Study Implicationsmentioning

confidence: 99%

Motorized Shoes Induce Robust Sensorimotor Adaptation in Walking

Aucie

Zhang²,

Sargent

et al. 2020

Front. Neurosci.

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The motor system has the flexibility to update motor plans according to systematic changes in the environment or the body. This capacity is studied in the laboratory through sensorimotor adaptation paradigms imposing sustained and predictable motor demands specific to the task at hand. However, these studies are tied to the laboratory setting. Thus, we asked if a portable device could be used to elicit locomotor adaptation outside the laboratory. To this end, we tested the extent to which a pair of motorized shoes could induce similar locomotor adaptation to split-belt walking, which is a well-established sensorimotor adaptation paradigm in locomotion. We specifically compared the adaptation effects (i.e. after-effects) between two groups of young, healthy participants walking with the legs moving at different speeds by either a split-belt treadmill or a pair of motorized shoes. The speeds at which the legs moved in the splitbelt group was set by the belt speed under each foot, whereas in the motorized shoes group were set by the combined effect of the actuated shoes and the belts' moving at the same speed. We found that the adaptation of joint motions and measures of spatial and temporal asymmetry, which are commonly used to quantify sensorimotor adaptation in locomotion, were indistinguishable between groups. We only found small differences in the joint angle kinematics during baseline walking between the groupspotentially due to the weight and height of the motorized shoes. Our results indicate that robust sensorimotor adaptation in walking can be induced with a paired of motorized shoes, opening the exciting possibility to study sensorimotor adaptation during more realistic situations outside the laboratory.

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Section: Study Implicationsmentioning

confidence: 99%

Motorized Shoes Induce Robust Sensorimotor Adaptation in Walking

Aucie

Zhang²,

Sargent

et al. 2020

Front. Neurosci.

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“…Overall, the resistive nature and the duration of the applied forces on the ankle or hip joint separately induced a deviant gait in healthy participants. In contrast, the application of assistive forces at the ankle or hip joint during walking have been reported to improve the walking performance of individuals with a disability (Lewis and Ferris, 2008;Zhang et al, 2017;Bae et al, 2018;Ding et al, 2018). Importantly, the nature and duration of external forces applied to these joints during a robotic rehabilitation setting are crucial for effective gait training.…”

Section: Discussionmentioning

confidence: 99%

“…With the proposed controller to administer the gait phase adaptation during walking, the system can adapt to subject-specific gait frequency variations to apply the force at the desired point and during a desired phase of the gait cycle. Various studies in literature (Zhang et al, 2017;Bae et al, 2018;Ding et al, 2018) use the human-in-loop approach to adapt to subject-specific variations to provide suitable force intervention for gait assistance. In the current work, WeARS has been used to apply resistive force intervention at a single joint.…”

Section: Discussionmentioning

confidence: 99%

“…Alternatively, cable-driven systems that are lightweight, flexible, and do not interfere with the natural gait have been used to develop wearable systems for gait rehabilitation. Some of these systems include C-ALEX (Hidayah et al, 2018), A-TPAD (Vashista et al, 2014), and exosuits (Zhang et al, 2017;Bae et al, 2018;Kim et al, 2018) for lower limbs.…”

Section: Introductionmentioning

confidence: 99%

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Evolving Toward Subject-Specific Gait Rehabilitation Through Single-Joint Resistive Force Interventions

2020

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Walking is one of the most relevant tasks that a person performs in their daily routine. Despite its mechanical complexities, any change in the external conditions that applies some external perturbation, or in the human musculoskeletal system that limits an individual's movement, entails a motor response that can either be compensatory or adaptive in nature. Incidentally, with aging or due to the occurrence of a neuro-musculoskeletal disorder, a combination of such changes including reduced sensory perception, muscle weakness, spasticity, etc. has been reported, and this can significantly degrade the human walking performance. Various studies in gait rehabilitation literature have identified a need for the development of better rehabilitation paradigms and have implied that an efficient human robot interaction is critical. Understanding how humans respond to a particular gait alteration can be beneficial in designing an effective rehabilitation paradigm. In this context, the current work investigates human locomotor adaptation to resistive alteration to the hip and ankle strategies of walking. A cable-driven robotic system, which does not add mobility constraints, was used to implement resistive force interventions within the hip and ankle joints separately through two experiments with eight healthy adult participants in each. In both cases, the intervention was applied during the push-off phase of walking, i.e., from pre-swing to terminal swing. The results showed that subjects in both groups adopted a compensatory response to the applied intervention and demonstrated intralimb and interlimb adaptation. Overall, the participants demonstrated a deviant gait implying lower limb musculoskeletal adjustments as if to compensate for a hip or ankle abnormality.

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“…There have been efforts to develop portable rehabilitation devices (Afzal et al, 2015; Calabrò et al, 2018; Handzic et al, 2011; Lahiff et al, 2016) and assistive devices (Awad et al, 2017; Bae et al, 2018; Rao et al, 2008) to improve walking patterns in individuals with gait asymmetries, such as individuals post-stroke. While these apparatus could reduce the metabolic cost associated to gait in this clinical population (Awad et al, 2017) and improve walking speed (Buesing et al, 2015; Calabrò et al, 2018; Rao et al, 2008), these devices were unsuccessful in modifying the step length asymmetry (Handzic et al, 2011), which is an important parameter in rehabilitation of post-stroke patients (Patterson et al, 2008, 2014).…”

Section: Discussionmentioning

confidence: 99%