PDF(Pubmed)
Abstract：
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.
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.
摘要：
背景：在住院康复期间，物理治疗师(PT)通常需要手动推进患者的四肢，增加PT的身体负担，影响步态再训练质量。不同的机电设备通过帮助患者的肢体前进和支撑他们的体重来减轻这种负担。然而,当患者不再需要体重支持，但在恢复时继续需要肢体前移的帮助时，它们对于神经肌肉参与不太理想。这项研究的目的是确定在中风后的住院康复过程中使用髋关节屈曲机械护甲来帮助瘫痪肢体前移的可行性。
方法：除标准的住院康复护理外，十四名中风后患者在一到两周内接受了3到7个1小时的机械护甲步行训练。机械护甲辅助由PT触发或基于身体穿戴传感器检测到的步态事件。我们评估了临床(距离，速度)和时空(节奏，步幅长度,摆动时间对称）在2分钟和10米步行测试中，有和没有机械服辅助的步态测量。会议按PT所需的援助进行分组(肢体推进和平衡支持，仅支持平衡，或没有)没有机器护甲援助。
结果：PT在97％的时间内成功操作了机械护甲，其中70％的辅助时间是PT触发的，以适应非典型步态。Exosuit辅助消除了对PT的手动肢体前移的需要。在与需要肢体进步和平衡支持的参与者的会议中，在2分钟步行试验期间,在机械护甲辅助下,平均距离和步频增加2.2±3.1米和3.4±1.9步/分钟,分别(p<0.017)。在仅需要平衡支持的参与者的会议中，10米步行试验的平均速度随机械护甲增加0.07±0.12m/s(p=0.042)。有和没有机械护甲的独立救护车的临床和时空测量相似（p>0.339）。
结论：我们在不同程度的损伤患者的住院卒中康复中纳入了单侧髋关节屈曲机械护甲。机械护甲的辅助消除了PT上手动肢体前移的负担，并在某些情况下改善了步态措施。未来的工作将了解如何为该人群优化控制器和辅助配置文件。
方法：除标准的住院康复护理外，十四名中风后患者在一到两周内接受了3到7个1小时的机械护甲步行训练。机械护甲辅助由PT触发或基于身体穿戴传感器检测到的步态事件。我们评估了临床(距离，速度)和时空(节奏，步幅长度,摆动时间对称）在2分钟和10米步行测试中，有和没有机械服辅助的步态测量。会议按PT所需的援助进行分组(肢体推进和平衡支持，仅支持平衡，或没有)没有机器护甲援助。
结果：PT在97％的时间内成功操作了机械护甲，其中70％的辅助时间是PT触发的，以适应非典型步态。Exosuit辅助消除了对PT的手动肢体前移的需要。在与需要肢体进步和平衡支持的参与者的会议中，在2分钟步行试验期间,在机械护甲辅助下,平均距离和步频增加2.2±3.1米和3.4±1.9步/分钟,分别(p<0.017)。在仅需要平衡支持的参与者的会议中，10米步行试验的平均速度随机械护甲增加0.07±0.12m/s(p=0.042)。有和没有机械护甲的独立救护车的临床和时空测量相似（p>0.339）。
结论：我们在不同程度的损伤患者的住院卒中康复中纳入了单侧髋关节屈曲机械护甲。机械护甲的辅助消除了PT上手动肢体前移的负担，并在某些情况下改善了步态措施。未来的工作将了解如何为该人群优化控制器和辅助配置文件。
