Assisting Limb Advancement During Walking After Stroke Using a Wearable Soft Hip Exosuit: A Proof-of-Concept

Porciuncula, Franchino; Nuckols, Richard W.; Karavas, Nikos; Chang, Chien-Chih; Baker, Teresa; Orzel, Dorothy; Perry, David; Ellis, Terry; Awad, Louis N.; Walsh, Conor J.

doi:10.1007/978-3-030-01845-0_63

Cited by 3 publications

(2 citation statements)

References 3 publications

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“…IMU-based gait analysis is an emerging subfield in biomechanics and movement science (see [11,35] for a review). Given the highly heterogeneous nature of gait deficits within and across neurological diagnostic groups, gait estimation methods developed for healthy walking need to be validated in target patient populations [11].…”

Section: Estimating Walking Speed and Stride Length Using Thigh Phase Portraitsmentioning

confidence: 99%

“…Indeed, for individuals with limited range of motion due to musculoskeletal [32,33] or neurological [34] conditions, IMUs worn proximally at the waist or on the thigh may be easier to self-manage than distally-worn IMUs. Relatedly, a thigh-worn IMU may be more desirable for embedded control of wearable robots and orthoses that do not extend below the knee [23,35,36]. Beyond usability, thigh-worn IMUs may be preferable to distally-worn IMUs from a measurement perspective.…”

Section: Introductionmentioning

confidence: 99%

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Estimation of Walking Speed and Its Spatiotemporal Determinants Using a Single Inertial Sensor Worn on the Thigh: From Healthy to Hemiparetic Walking

Revi

Rossi

Walsh

et al. 2021

Sensors

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We present the use of a single inertial measurement unit (IMU) worn on the thigh to produce stride-by-stride estimates of walking speed and its spatiotemporal determinants (i.e., stride time and stride length). Ten healthy and eight post-stroke individuals completed a 6-min walk test with an 18-camera motion capture system used for ground truth measurements. Subject-specific estimation models were trained to estimate walking speed using the polar radius extracted from phase portraits produced from the IMU-measured thigh angular position and velocity. Consecutive flexion peaks in the thigh angular position data were used to define each stride and compute stride times. Stride-by-stride estimates of walking speed and stride time were then used to compute stride length. In both the healthy and post-stroke cohorts, low error and high consistency were observed for the IMU estimates of walking speed (MAE < 0.035 m/s; ICC > 0.98), stride time (MAE < 30 ms; ICC > 0.97), and stride length (MAE < 0.037 m; ICC > 0.96). This study advances the use of a single wearable sensor to accurately estimate walking speed and its spatiotemporal determinants during both healthy and hemiparetic walking.

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Section: Estimating Walking Speed and Stride Length Using Thigh Phase Portraitsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Estimation of Walking Speed and Its Spatiotemporal Determinants Using a Single Inertial Sensor Worn on the Thigh: From Healthy to Hemiparetic Walking

Revi

Rossi

Walsh

et al. 2021

Sensors

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Reducing the metabolic rate of walking and running with a versatile, portable exosuit

Kim

Lee

Heimgartner

et al. 2019

Science

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357

256

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Walking and running have fundamentally different biomechanics, which makes developing devices that assist both gaits challenging. We show that a portable exosuit that assists hip extension can reduce the metabolic rate of treadmill walking at 1.5 meters per second by 9.3% and that of running at 2.5 meters per second by 4.0% compared with locomotion without the exosuit. These reduction magnitudes are comparable to the effects of taking off 7.4 and 5.7 kilograms during walking and running, respectively, and are in a range that has shown meaningful athletic performance changes. The exosuit automatically switches between actuation profiles for both gaits, on the basis of estimated potential energy fluctuations of the wearer’s center of mass. Single-participant experiments show that it is possible to reduce metabolic rates of different running speeds and uphill walking, further demonstrating the exosuit’s versatility.

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Implementation of a unilateral hip flexion exosuit to aid paretic limb advancement during inpatient gait retraining for individuals post-stroke: a feasibility study

Chang,

Lee,

Nuckols

et al. 2024

J NeuroEngineering Rehabil

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Background During inpatient rehabilitation, physical therapists (PTs) often need to manually advance patients’ limbs, adding physical burden to PTs and impacting gait retraining quality. Different electromechanical devices alleviate this burden by assisting a patient’s limb advancement and supporting their body weight. However, they are less ideal for neuromuscular engagement when patients no longer need body weight support but continue to require assistance with limb advancement as they recover. The objective of this study was to determine the feasibility of using a hip flexion exosuit to aid paretic limb advancement during inpatient rehabilitation post-stroke. Methods Fourteen individuals post-stroke received three to seven 1-hour walking sessions with the exosuit over one to two weeks in addition to standard care of inpatient rehabilitation. The exosuit assistance was either triggered by PTs or based on gait events detected by body-worn sensors. We evaluated clinical (distance, speed) and spatiotemporal (cadence, stride length, swing time symmetry) gait measures with and without exosuit assistance during 2-minute and 10-meter walk tests. Sessions were grouped by the assistance required from the PTs (limb advancement and balance support, balance support only, or none) without exosuit assistance. Results PTs successfully operated the exosuit in 97% of sessions, of which 70% assistance timing was PT-triggered to accommodate atypical gait. Exosuit assistance eliminated the need for manual limb advancement from PTs. In sessions with participants requiring limb advancement and balance support, the average distance and cadence during 2-minute walk test increased with exosuit assistance by 2.2 ± 3.1 m and 3.4 ± 1.9 steps/min, respectively (p < 0.017). In sessions with participants requiring balance support only, the average speed during 10-meter walk test increased with exosuit by 0.07 ± 0.12 m/s (p = 0.042). Clinical and spatiotemporal measures of independent ambulators were similar with and without exosuit (p > 0.339). Conclusions We incorporated a unilateral hip flexion exosuit into inpatient stroke rehabilitation in individuals with varying levels of impairments. The exosuit assistance removed the burden of manual limb advancement from the PTs and resulted in improved gait measures in some conditions. Future work will understand how to optimize controller and assistance profiles for this population.

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Assisting Limb Advancement During Walking After Stroke Using a Wearable Soft Hip Exosuit: A Proof-of-Concept

Cited by 3 publications

References 3 publications

Estimation of Walking Speed and Its Spatiotemporal Determinants Using a Single Inertial Sensor Worn on the Thigh: From Healthy to Hemiparetic Walking

Estimation of Walking Speed and Its Spatiotemporal Determinants Using a Single Inertial Sensor Worn on the Thigh: From Healthy to Hemiparetic Walking

Reducing the metabolic rate of walking and running with a versatile, portable exosuit

Implementation of a unilateral hip flexion exosuit to aid paretic limb advancement during inpatient gait retraining for individuals post-stroke: a feasibility study

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