背景:踝足矫形器(AFO)通常由脑瘫(CP)儿童使用,但是传统的解决方案无法解决CP儿童之间的异质性和不断变化的需求。一个关键的限制在于当前无源器件无法定制扭矩-角度关系,这对于使支持适应特定的个人需求至关重要。供电的替代品可以提供定制的行为,但经常面临可靠性的挑战,体重,和成本。总的来说,临床医生发现某些障碍阻碍他们的处方。在最近的工作中,开发了可变刚度矫形器(VSO),使刚度定制无需电机或复杂的控制。
方法:这项工作通过研究其对CP患儿步行表现的影响及其作为评估可变僵硬对病理性步态的影响的潜力来评估VSO(inGAIT-VSO)的儿科版本。收集了三个典型的发育中(TD)儿童和六个患有CP的儿科参与者的数据,这些参与者在两个疗程中涉及步行/平衡任务和问卷。
结果:inGAIT-VSO的传感器提供了有用的信息,以评估设备的影响。增加inGAIT-VSO的刚度显着降低了参与者的背屈和pi屈。尽管运动范围缩小,峰值恢复扭矩随刚度的增加而增加。总的来说,参与者的步态模式通过减少蹲下步态来改变,防止跌足和支撑体重。与正常情况(仅自己的AFO或鞋子)相比,使用inGAIT-VSO行走时,CP的参与者表现出明显更低的(p<0.05)生理成本。一般来说,与正常情况相比,该装置并未损害参与者的行走和平衡.根据问卷调查结果,inGAIT-VSO易于使用,参与者报告了积极的经历。
结论:inGAIT-VSO刚度显着影响参与者的前屈和背屈,并产生了有关病理性步态中步行表现的客观数据(例如,施加扭矩和恢复的辅助能量)。这些影响是由集成在设备中的传感器捕获的,而无需使用外部设备。inGAIT-VSO显示了定制AFO刚度并帮助临床医生基于客观指标选择个性化刚度的前景。
BACKGROUND: Ankle-foot orthoses (AFOs) are commonly used by children with cerebral palsy (CP), but traditional solutions are unable to address the heterogeneity and evolving needs amongst children with CP. One key limitation lies in the inability of current passive devices to customize the torque-angle relationship, which is essential to adapt the support to the specific individual needs. Powered alternatives can provide customized behavior, but often face challenges with reliability, weight, and cost. Overall, clinicians find certain barriers that hinder their prescription. In recent work, the Variable Stiffness Orthosis (VSO) was developed, enabling stiffness customization without the need for motors or sophisticated control.
METHODS: This work evaluates a pediatric version of the VSO (inGAIT-VSO) by investigating its impact on the walking performance of children with CP and its potential to be used as a tool for assessing the effect of variable stiffness on pathological gait. Data was collected for three typical developing (TD) children and six pediatric participants with CP over two sessions involving walking/balance tasks and questionnaires.
RESULTS: The sensors of the inGAIT-VSO provided useful information to assess the impact of the device. Increasing the stiffness of the inGAIT-VSO significantly reduced participants\' dorsiflexion and plantarflexion. Despite reduced range of motion, the peak restoring torque increased with stiffness. Overall the participants\' gait pattern was altered by reducing crouch gait, preventing drop-foot and supporting body weight. Participants with CP exhibited significantly lower (p < 0.05) physiological cost when walking with the inGAIT-VSO compared to normal condition (own AFO or shoes only). Generally, the device did not impair walking and balance of the participants compared to normal conditions. According to the questionnaire results, the inGAIT-VSO was easy to use and participants reported positive experiences.
CONCLUSIONS: The inGAIT-VSO stiffnesses significantly affected participants\' plantarflexion and dorsiflexion and yielded objective data regarding walking performance in pathological gait (e.g. ankle angle, exerted torque and restored assistive energy). These effects were captured by the sensors integrated in the device without using external equipment. The inGAIT-VSO shows promise for customizing AFO stiffness and aiding clinicians in selecting a personalized stiffness based on objective metrics.