O 089 - A soft robotic exosuit assisting the paretic ankle in patients post-stroke: Effect on muscle activation during overground walking

Author(s):  
L. Sloot ◽  
J. Bae ◽  
L. Baker ◽  
K. O’Donnell ◽  
N. Menard ◽  
...  
2021 ◽  
Vol 11 (4) ◽  
pp. 448
Author(s):  
Francesco Infarinato ◽  
Paola Romano ◽  
Michela Goffredo ◽  
Marco Ottaviani ◽  
Daniele Galafate ◽  
...  

Background: Overground Robot-Assisted Gait Training (o-RAGT) appears to be a promising stroke rehabilitation in terms of clinical outcomes. The literature on surface ElectroMyoGraphy (sEMG) assessment in o-RAGT is limited. This paper aimed to assess muscle activation patterns with sEMG in subjects subacute post stroke after training with o-RAGT and conventional therapy. Methods: An observational preliminary study was carried out with subjects subacute post stroke who received 15 sessions of o-RAGT (5 sessions/week; 60 min) in combination with conventional therapy. The subjects were assessed with both clinical and instrumental evaluations. Gait kinematics and sEMG data were acquired before (T1) and after (T2) the period of treatment (during ecological gait), and during the first session of o-RAGT (o-RAGT1). An eight-channel wireless sEMG device acquired in sEMG signals. Significant differences in sEMG outcomes were found in the BS of TA between T1 and T2. There were no other significant correlations between the sEMG outcomes and the clinical results between T1 and T2. Conclusions: There were significant functional gains in gait after complex intensive clinical rehabilitation with o-RAGT and conventional therapy. In addition, there was a significant increase in bilateral symmetry of the Tibialis Anterior muscles. At this stage of the signals from the tibialis anterior (TA), gastrocnemius medialis (GM), rectus femoris (RF), and biceps femoris caput longus (BF) muscles of each lower extremity. sEMG data processing extracted the Bilateral Symmetry (BS), the Co-Contraction (CC), and the Root Mean Square (RMS) coefficients. Results: Eight of 22 subjects in the subacute stage post stroke agreed to participate in this sEMG study. This subsample demonstrated a significant improvement in the motricity index of the affected lower limb and functional ambulation. The heterogeneity of the subjects’ characteristics and the small number of subjects was associated with high variability research, functional gait recovery was associated with minimal change in muscle activation patterns.


Sensors ◽  
2020 ◽  
Vol 20 (9) ◽  
pp. 2452
Author(s):  
Ana Cecilia Villa-Parra ◽  
Jessica Lima ◽  
Denis Delisle-Rodriguez ◽  
Laura Vargas-Valencia ◽  
Anselmo Frizera-Neto ◽  
...  

The goal of this study is the assessment of an assistive control approach applied to an active knee orthosis plus a walker for gait rehabilitation. The study evaluates post-stroke patients and healthy subjects (control group) in terms of kinematics, kinetics, and muscle activity. Muscle and gait information of interest were acquired from their lower limbs and trunk, and a comparison was conducted between patients and control group. Signals from plantar pressure, gait phase, and knee angle and torque were acquired during gait, which allowed us to verify that the stance control strategy proposed here was efficient at improving the patients’ gaits (comparing their results to the control group), without the necessity of imposing a fixed knee trajectory. An innovative evaluation of trunk muscles related to the maintenance of dynamic postural equilibrium during gait assisted by our active knee orthosis plus walker was also conducted through inertial sensors. An increase in gait cycle (stance phase) was also observed when comparing the results of this study to our previous work. Regarding the kinematics, the maximum knee torque was lower for patients when compared to the control group, which implies that our orthosis did not demand from the patients a knee torque greater than that for healthy subjects. Through surface electromyography (sEMG) analysis, a significant reduction in trunk muscle activation and fatigability, before and during the use of our orthosis by patients, was also observed. This suggest that our orthosis, together with the assistive control approach proposed here, is promising and could be considered to complement post-stroke patient gait rehabilitation.


Author(s):  
Geng Li ◽  
Mohammad S. Shourijeh ◽  
Di Ao ◽  
Carolynn Patten ◽  
Benjamin J. Fregly

Muscle co-contraction generates joint stiffness to improve stability and accuracy during limb movement but at the expense of higher energetic cost. However, quantification of joint stiffness is difficult using either experimental or computational means. In contrast, quantification of muscle co-contraction using an EMG-based Co-Contraction Index (CCI) is easier and may offer an alternative for estimating joint stiffness. This study investigated the feasibility of using two common CCIs to approximate lower limb joint stiffness trends during gait. Calibrated EMG-driven lower extremity musculoskeletal models constructed for two individuals post-stroke were used to generate the quantities required for CCI calculations and model-based estimation of joint stiffness. CCIs were calculated for various combinations of antagonist muscle pairs based on two common CCI formulations: Rudolph et al. (2000) (CCI1) and Falconer and Winter (1985) (CCI2). CCI1 measures antagonist muscle activation relative to not only total activation of agonist plus antagonist muscles but also agonist muscle activation, while CCI2 measures antagonist muscle activation relative to only total muscle activation. We computed the correlation between these two CCIs and model-based estimates of sagittal plane joint stiffness for the hip, knee, and ankle of both legs. Although we observed moderate to strong correlations between some CCI formulations and corresponding joint stiffness, these associations were highly dependent on the methodological choices made for CCI computation. Specifically, we found that: (1) CCI1 was generally more correlated with joint stiffness than was CCI2, (2) CCI calculation using EMG signals with calibrated electromechanical delay generally yielded the best correlations with joint stiffness, and (3) choice of antagonist muscle pairs significantly influenced CCI correlation with joint stiffness. By providing guidance on how methodological choices influence CCI correlation with joint stiffness trends, this study may facilitate a simpler alternate approach for studying joint stiffness during human movement.


2019 ◽  
Vol 42 (6) ◽  
pp. 779-787 ◽  
Author(s):  
Hanneke van der Krogt ◽  
Ingrid Kouwijzer ◽  
Asbjørn Klomp ◽  
Carel G.M. Meskers ◽  
J. Hans Arendzen ◽  
...  

2015 ◽  
Vol 47 ◽  
pp. 318
Author(s):  
Brenda Jeng ◽  
Taeyou Jung ◽  
Teri Todd ◽  
Konstantinos Vrongistinos ◽  
Mai Narasaki-Jara ◽  
...  

Author(s):  
Richard W. Nuckols ◽  
Franchino Porciuncula ◽  
Chih-Kang Chang ◽  
Teresa C. Baker ◽  
Dorothy Orzel ◽  
...  

Author(s):  
Vinayak Vijayan ◽  
Shanpu Fang ◽  
Timothy Reissman ◽  
Allison L. Kinney ◽  
Megan E. Reissman

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