Adapted Assistance and Resistance Training With a Knee Exoskeleton After Stroke
Por:
de Miguel-Fernández J, Rey-Prieto, Marta, Salazar-Del Rio, Miguel, Lopez-Matas, Helena, Guirao-Cano, Lluis, Font-Llagunes JM and Lobo-Prat, Joan
Publicada:
1 ene 2023
Ahead of Print:
18 ago 2023
Resumen:
Studies on robotic interventions for gait rehabilitation after stroke
require: (i) rigorous performance evidence; (ii) systematic procedures
to tune the control parameters; and (iii) combination of control modes.
In this study, we investigated how stroke individuals responded to
training for two weeks with a knee exoskeleton (ABLE-KS) using both
Assistance and Resistance training modes together with auditory feedback
to train peak knee flexion angle. During the training, the torque
provided by the ABLE-KS and the biofeedback were systematically adapted
based on the subject's performance and perceived exertion level. We
carried out a comprehensive experimental analysis that evaluated a wide
range of biomechanical metrics, together with usability and users'
perception metrics. We found significant improvements in peak knee
flexion (p = 0.0016), minimum knee angle during stance (p = 0.0053),
paretic single support time (p = 0.0087) and gait endurance (p = 0.022)
when walking without the exoskeleton after the two weeks of training.
Participants significantly (p < 0.00025) improved the knee angle during
the stance and swing phases when walking with the exoskeleton powered in
the high Assistance mode in comparison to the No Exo and the Unpowered
conditions. No clinically relevant differences were found between
Assistance and Resistance training sessions. Participants improved their
performance with the exoskeleton (24-55 %) for the peak knee flexion
angle throughout the training sessions. Moreover, participants showed a
high level of acceptability of the ABLE-KS (QUEST 2.0 score: 4.5 +/- 0.3
out of 5). Our preliminary findings suggest that the proposed training
approach can produce similar or larger improvements in post-stroke
individuals than other studies with knee exoskeletons that used higher
training intensities.
Filiaciones:
de Miguel-Fernández J:
Univ Politecn Cataluna, Dept Mech Engn, Biomech Engn Lab, Barcelona 08028, Spain
Univ Politecn Cataluna, Res Ctr Biomed Engn, Barcelona 08028, Spain
Inst Recerca St Joan Deu, Esplugas de Llobregat 08950, Spain
Rey-Prieto, Marta:
Univ Politecn Cataluna, Dept Mech Engn, Biomech Engn Lab, Barcelona 08028, Spain
Univ Politecn Cataluna, Res Ctr Biomed Engn, Barcelona 08028, Spain
Inst Recerca St Joan Deu, Esplugas de Llobregat 08950, Spain
Salazar-Del Rio, Miguel:
Univ Politecn Cataluna, Dept Mech Engn, Biomech Engn Lab, Barcelona 08028, Spain
Univ Politecn Cataluna, Res Ctr Biomed Engn, Barcelona 08028, Spain
Inst Recerca St Joan Deu, Esplugas de Llobregat 08950, Spain
Lopez-Matas, Helena:
ABLE Human Mot, Barcelona 08028, Spain
Guirao-Cano, Lluis:
Hosp Univ Mutua Terrassa, Terrassa 08221, Spain
Font-Llagunes JM:
Univ Politecn Cataluna, Dept Mech Engn, Biomech Engn Lab, Barcelona 08028, Spain
Univ Politecn Cataluna, Res Ctr Biomed Engn, Barcelona 08028, Spain
Inst Recerca St Joan Deu, Esplugas de Llobregat 08950, Spain
Lobo-Prat, Joan:
ABLE Human Mot, Barcelona 08028, Spain
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