Exoskeleton for Gait Rehabilitation: Effects of Assistance, Mechanical Structure, and Walking Aids on Muscle Activations
Several exoskeletons have been developed and increasingly used in clinical settings for training and assisting locomotion. These devices allow people with severe motor deficits to regain mobility and sustain intense and repetitive gait training. However, three factors might affect normal muscle acti...
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doaj-f468d8be43b744eda3a75f72dc861da22020-11-24T22:11:20ZengMDPI AGApplied Sciences2076-34172019-07-01914286810.3390/app9142868app9142868Exoskeleton for Gait Rehabilitation: Effects of Assistance, Mechanical Structure, and Walking Aids on Muscle ActivationsAlice De Luca0Amy Bellitto1Sergio Mandraccia2Giorgia Marchesi3Laura Pellegrino4Martina Coscia5Clara Leoncini6Laura Rossi7Simona Gamba8Antonino Massone9Maura Casadio10Department of Informatics, Bioengineering, Robotics and System Engineering, University of Genoa, 13-16145 Genoa, ItalyDepartment of Informatics, Bioengineering, Robotics and System Engineering, University of Genoa, 13-16145 Genoa, ItalySpinal Cord Unit, Santa Corona Hospital, ASL2 Savonese, 38-17027 Pietra Ligure (SV), ItalyDepartment of Informatics, Bioengineering, Robotics and System Engineering, University of Genoa, 13-16145 Genoa, ItalyDepartment of Informatics, Bioengineering, Robotics and System Engineering, University of Genoa, 13-16145 Genoa, ItalyWyss Center for Bio- and Neuroengineering, CH-1202 Geneva, SwitzerlandSpinal Cord Unit, Santa Corona Hospital, ASL2 Savonese, 38-17027 Pietra Ligure (SV), ItalySpinal Cord Unit, Santa Corona Hospital, ASL2 Savonese, 38-17027 Pietra Ligure (SV), ItalySpinal Cord Unit, Santa Corona Hospital, ASL2 Savonese, 38-17027 Pietra Ligure (SV), ItalySpinal Cord Unit, Santa Corona Hospital, ASL2 Savonese, 38-17027 Pietra Ligure (SV), ItalyDepartment of Informatics, Bioengineering, Robotics and System Engineering, University of Genoa, 13-16145 Genoa, ItalySeveral exoskeletons have been developed and increasingly used in clinical settings for training and assisting locomotion. These devices allow people with severe motor deficits to regain mobility and sustain intense and repetitive gait training. However, three factors might affect normal muscle activations during walking: the assistive forces that are provided during walking, the crutches or walker that are always used in combination with the device, and the mechanical structure of the device itself. To investigate these effects, we evaluated eight healthy volunteers walking with the Ekso, which is a battery-powered, wearable exoskeleton. They walked supported by either crutches or a walker under five different assistance modalities: bilateral maximum assistance, no assistance, bilateral adaptive assistance, and unilateral adaptive assistance on each leg. Participants also walked overground without the exoskeleton. Surface electromyography was recorded bilaterally, and the statistical parametric mapping approach and muscle synergies analysis were used to investigate differences in muscular activity across different walking conditions. The lower limb muscle activations while walking with the Ekso were not influenced by the use of crutches or walker aids. Compared to normal walking without robotic assistance, the Ekso reduced the amplitude of activation for the distal lower limb muscles while changing the timing for the others. This depended mainly on the structure of the device, and not on the type or level of assistance. In fact, the presence of assistance did not change the timing of the muscle activations, but instead mainly had the effect of increasing the level of activation of the proximal lower limb muscles. Surprisingly, we found no significant changes in the adaptive control with respect to a maximal fixed assistance that did not account for subjects’ performance. These are important effects to take into careful considerations in clinics where these devices are used for gait rehabilitation in people with neurological diseases.https://www.mdpi.com/2076-3417/9/14/2868exoskeletonassisted gaitmuscle activationswalking aidsmuscle synergies |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Alice De Luca Amy Bellitto Sergio Mandraccia Giorgia Marchesi Laura Pellegrino Martina Coscia Clara Leoncini Laura Rossi Simona Gamba Antonino Massone Maura Casadio |
spellingShingle |
Alice De Luca Amy Bellitto Sergio Mandraccia Giorgia Marchesi Laura Pellegrino Martina Coscia Clara Leoncini Laura Rossi Simona Gamba Antonino Massone Maura Casadio Exoskeleton for Gait Rehabilitation: Effects of Assistance, Mechanical Structure, and Walking Aids on Muscle Activations Applied Sciences exoskeleton assisted gait muscle activations walking aids muscle synergies |
author_facet |
Alice De Luca Amy Bellitto Sergio Mandraccia Giorgia Marchesi Laura Pellegrino Martina Coscia Clara Leoncini Laura Rossi Simona Gamba Antonino Massone Maura Casadio |
author_sort |
Alice De Luca |
title |
Exoskeleton for Gait Rehabilitation: Effects of Assistance, Mechanical Structure, and Walking Aids on Muscle Activations |
title_short |
Exoskeleton for Gait Rehabilitation: Effects of Assistance, Mechanical Structure, and Walking Aids on Muscle Activations |
title_full |
Exoskeleton for Gait Rehabilitation: Effects of Assistance, Mechanical Structure, and Walking Aids on Muscle Activations |
title_fullStr |
Exoskeleton for Gait Rehabilitation: Effects of Assistance, Mechanical Structure, and Walking Aids on Muscle Activations |
title_full_unstemmed |
Exoskeleton for Gait Rehabilitation: Effects of Assistance, Mechanical Structure, and Walking Aids on Muscle Activations |
title_sort |
exoskeleton for gait rehabilitation: effects of assistance, mechanical structure, and walking aids on muscle activations |
publisher |
MDPI AG |
series |
Applied Sciences |
issn |
2076-3417 |
publishDate |
2019-07-01 |
description |
Several exoskeletons have been developed and increasingly used in clinical settings for training and assisting locomotion. These devices allow people with severe motor deficits to regain mobility and sustain intense and repetitive gait training. However, three factors might affect normal muscle activations during walking: the assistive forces that are provided during walking, the crutches or walker that are always used in combination with the device, and the mechanical structure of the device itself. To investigate these effects, we evaluated eight healthy volunteers walking with the Ekso, which is a battery-powered, wearable exoskeleton. They walked supported by either crutches or a walker under five different assistance modalities: bilateral maximum assistance, no assistance, bilateral adaptive assistance, and unilateral adaptive assistance on each leg. Participants also walked overground without the exoskeleton. Surface electromyography was recorded bilaterally, and the statistical parametric mapping approach and muscle synergies analysis were used to investigate differences in muscular activity across different walking conditions. The lower limb muscle activations while walking with the Ekso were not influenced by the use of crutches or walker aids. Compared to normal walking without robotic assistance, the Ekso reduced the amplitude of activation for the distal lower limb muscles while changing the timing for the others. This depended mainly on the structure of the device, and not on the type or level of assistance. In fact, the presence of assistance did not change the timing of the muscle activations, but instead mainly had the effect of increasing the level of activation of the proximal lower limb muscles. Surprisingly, we found no significant changes in the adaptive control with respect to a maximal fixed assistance that did not account for subjects’ performance. These are important effects to take into careful considerations in clinics where these devices are used for gait rehabilitation in people with neurological diseases. |
topic |
exoskeleton assisted gait muscle activations walking aids muscle synergies |
url |
https://www.mdpi.com/2076-3417/9/14/2868 |
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