Postural and Metabolic Benefits of Using a Forearm Support Walker in Older Adults With Impairments

Jayaraman, Chandrasekaran; Mummidisetty, Chaithanya K.; Loesch, Alexandra; Kaur, Sandi; Hoppe-Ludwig, Shenan; Staat, Manfred; Jayaraman, Arun

doi:10.1016/j.apmr.2018.10.001

Cited by 7 publications

(3 citation statements)

References 39 publications

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“…P3, P5, and P6 benefited the most from exoskeleton assistance because of slow baseline walking speeds and low metabolic detriments when wearing the device unpowered. More impaired participants could use an exoskeleton in conjunction with forearm support walkers for even greater improvement in metabolic cost of transport [37].…”

Section: Discussionmentioning

confidence: 99%

Ankle Exoskeleton Assistance Can Improve Over-Ground Walking Economy in Individuals With Cerebral Palsy

Orekhov

Fang

Luque

et al. 2020

IEEE Trans. Neural Syst. Rehabil. Eng.

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Individuals with neuromuscular impairment from conditions like cerebral palsy face reduced quality of life due to diminishing mobility and independence. Lower-limb exoskeletons have potential to aid mobility, yet few studies have investigated their use during over-ground walkingan exercise that may contribute to our understanding of potential benefit in free-living settings. The goal of this study was to determine the potential for adaptive plantar-flexor assistance from an untethered ankle exoskeleton to improve over-ground walking economy and speed. Six individuals with cerebral palsy completed three consecutive daily over-ground training sessions to acclimate to, and tune, assistance. During a final assessment visit, metabolic cost, walking speed, and soleus electromyography were collected for baseline, unpowered, low, training-tuned, and high assistance conditions. Compared to each participant's baseline condition, we observed a 3.9 ± 1.9% (p=0.050) increase in walking speed and a 22.0 ± 4.5% (p=0.002) reduction in soleus activity with training-tuned assistance; metabolic cost of transport was unchanged (p=0.130). High assistance resulted in an 8.5 ± 4.0% (p=0.042) reduction in metabolic cost of transport, a 6.3 ± 2.6% (p=0.029) increase in walking speed, and a 25.0 ± 4.0% (p<0.001) reduction in soleus activity. Improvement in exoskeleton-assisted walking economy was related to pre-training baseline walking speed (R 2 = 0.94, p=0.001); the slower and more impaired participants improved the most. Energy cost and preferred walking speed remained generally unchanged for the faster and less impaired participants. These findings demonstrate that powered ankle exoskeletons have the potential to improve mobility-related outcomes for some people with cerebral palsy.

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Section: Discussionmentioning

confidence: 99%

Ankle Exoskeleton Assistance Can Improve Over-Ground Walking Economy in Individuals With Cerebral Palsy

Orekhov

Fang

Luque

et al. 2020

IEEE Trans. Neural Syst. Rehabil. Eng.

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“…When individuals load walker forearm rests while walking, their trunk's anterior tilt increases with an increase in forearm loading [13], while their pelvic tilt decreases [14]. Jayaraman et al showed that utilizing forearm supports reduced anterior-posterior trunk sway, reduced erector spinae muscle activation, and improved gait efficiency measured by oxygen consumption [15]. To further this research, we will compare two different forearm positions with a traditional walker grip and investigate gait characteristics and muscle activations.…”

Section: Introductionmentioning

confidence: 99%

Evaluating Gait Stability and Muscle Activation in Different Hand Holding Conditions Using the Robotic Walker-mTPAD

Jacobs,

Stramel,

Shair

et al. 2023

Sensors

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While walkers are used as mobility aids for different gait impairments, little is known about the factors that affect the performance of such aids. Therefore, we investigated the impact of arm-holding conditions on gait stability and muscle activation. We used surface electromyography (sEMG) sensors on specific arm and leg muscles while the users took laps with a robotic walker, the mobile Tethered Pelvic Assist Device (mTPAD), on an instrumented mat. Eleven participants without gait disorders walked with and without a 10% body weight (BW) force applied on the pelvis in the following three configurations: (i) while gripping the walker’s frame, (ii) while using an armrest with their arms at a 90∘ angle, and (iii) while using an armrest with their arms at a 130∘ angle for 5 min each. Our results showed that when applying a force, the users changed their gait to increase stability. We also discovered differences in muscle activation based on the user’s specific arm conditions. Specifically, the 130∘ condition required the least muscle activation, while gripping the walker’s frame increased specific muscle activation compared to 90∘ and 130∘. This study is the first to evaluate how arm-holding and external loading conditions alter gait and muscle activations using the mTPAD.

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“…In this paper, we describe the development and evaluation of a low-fidelity force measurement glove for extended fieldbased data collections with manual wheelchair users. This glove was used in one previous study to measure hand contact forces while using a forearm support walker [11]. While the glove accuracy was deemed adequate in that loading scenario, it was unknown if the FSRs would be able to reliably measure hand contact forces in the relatively unconstrained loading scenarios of manual wheelchair propulsion and weight relief exercises.…”

Section: Introductionmentioning

confidence: 99%

Calibration and Evaluation of a Force Measurement Glove for Field-Based Monitoring of Manual Wheelchair Users

Anderson

Hooke

Jayaraman

et al. 2020

Preprint

Self Cite

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Manual wheelchair users exhibit pain related to repetitive and demanding shoulder activities of daily living. Wearable sensing systems like force measurement gloves can provide insights about upper extremity loading in the community and home environments. We calibrated and evaluated the accuracy of a novel force measurement glove with a body-worn data logger. The device was calibrated with loads of 0-800 N applied to the palmar surface of the glove. Calibration conditions were tested that varied the stiffness of the material in the glove, the temperature, and the curvature of the force applicator. Calibration equations from each condition were evaluated by comparing the glove’s force prediction with the output of an instrumented wheelchair rim during propulsion and weight relief exercises. The force measurement glove detected 72.7% of 355 propulsion peaks and had a strong linear correlation with the instrumented rim force measurements (r=0.80). The most accurate calibration equation was constructed using data from all conditions, with an RMS force measurement error of 64.7 N and 31.7 N for weight relief exercise and propulsion, respectively. The force measurement glove design described here may serve as a useful tool for detection of loading events and relative magnitude changes.

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Postural and Metabolic Benefits of Using a Forearm Support Walker in Older Adults With Impairments

Cited by 7 publications

References 39 publications

Ankle Exoskeleton Assistance Can Improve Over-Ground Walking Economy in Individuals With Cerebral Palsy

Ankle Exoskeleton Assistance Can Improve Over-Ground Walking Economy in Individuals With Cerebral Palsy

Evaluating Gait Stability and Muscle Activation in Different Hand Holding Conditions Using the Robotic Walker-mTPAD

Calibration and Evaluation of a Force Measurement Glove for Field-Based Monitoring of Manual Wheelchair Users

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