scholarly journals Exoskeleton use in post-stroke gait rehabilitation: a qualitative study of the perspectives of persons post-stroke and physiotherapists

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Julie Vaughan-Graham ◽  
Dina Brooks ◽  
Lowell Rose ◽  
Goldie Nejat ◽  
Jose Pons ◽  
...  
Keyword(s):  
Lower Limb ◽  
Stakeholder Participation ◽  
Patient Characteristics ◽  
Evidence Base ◽  
End Users ◽  
Gait Rehabilitation ◽  
Walking Ability ◽  
Locomotor Training ◽  
Post Stroke ◽  
Single Use

Abstract Background Wearable powered exoskeletons are a new and emerging technology developed to provide sensory-guided motorized lower limb assistance enabling intensive task specific locomotor training utilizing typical lower limb movement patterns for persons with gait impairments. To ensure that devices meet end-user needs it is important to understand and incorporate end-users perspectives, however research in this area is extremely limited in the post-stroke population. The purpose of this study was to explore in-depth, end-users perspectives, persons with stroke and physiotherapists, following a single-use session with a H2 exoskeleton. Methods We used a qualitative interpretive description approach utilizing semi-structured face to face interviews, with persons post-stroke and physiotherapists, following a 1.5 h session with a H2 exoskeleton. Results Five persons post-stroke and 6 physiotherapists volunteered to participate in the study. Both participant groups provided insightful comments on their experience with the exoskeleton. Four themes were developed from the persons with stroke participant data: (1) Adopting technology; (2) Device concerns; (3) Developing walking ability; and, (4) Integrating exoskeleton use. Five themes were developed from the physiotherapist participant data: (1) Developer-user collaboration; (2) Device specific concerns; (3) Device programming; (4) Patient characteristics requiring consideration; and, (5) Indications for use. Conclusions This study provides an interpretive understanding of end-users perspectives, persons with stroke and neurological physiotherapists, following a single-use experience with a H2 exoskeleton. The findings from both stakeholder groups overlap such that four over-arching concepts were identified including: (i) Stakeholder participation; (ii) Augmentation vs. autonomous robot; (iii) Exoskeleton usability; and (iv) Device specific concerns. The end users provided valuable perspectives on the use and design of the H2 exoskeleton, identifying needs specific to post-stroke gait rehabilitation, the need for a robust evidence base, whilst also highlighting that there is significant interest in this technology throughout the continuum of stroke rehabilitation.

Simulation Lower Limb Muscle Activation Patterns on Gait Rehabilitation Robot Device

2015 ◽  
Vol 649 ◽  
pp. 60-65
Author(s):  
Pi Ying Cheng ◽  
Po Ying Lai ◽  
Cheng Li Hsieh ◽  
Wei I Lun
Keyword(s):  
Lower Limb ◽  
Muscle Activation ◽  
Rectus Femoris ◽  
Gait Rehabilitation ◽  
Walking Ability ◽  
Rehabilitation Robot ◽  
Technical Improvement ◽  
End Effector ◽  
Muscle Activation Patterns ◽  
Rehabilitation Robots

Rehabilitation robot is usefully to improves walking ability on patients with gait disorders. Over the last decade, rehabilitation robot device replaced the training of overground and treadmill. The purpose of this study was to compare the differences in muscles activities of simulated human leg while walking on two gait rehabilitation robots: the exoskeleton rehabilitation robot and the end-effector rehabilitation robot. We have built models of simulated human leg, exoskeleton rehabilitation robot and end-effector rehabilitation robot. The results showed that rectus femoris and tibialis anterior muscles of the simulated human leg were more active while walking on the exoskeleton rehabilitation robot. The results of this study may provide technical improvement for gait rehabilitation robots, so that lower limb muscles movement can be more correctly achieved for normal individuals during gait rehabilitation training.

Over-ground robotic lower limb exoskeleton in neurological gait rehabilitation: User experiences and effects on walking ability

2020 ◽  
pp. 1-11
Author(s):  
Taina Jyräkoski ◽  
Sari Merilampi ◽  
Juha Puustinen ◽  
Anne Kärki
Keyword(s):  
User Experience ◽  
Lower Limb ◽  
Chronic Phase ◽  
Training Intervention ◽  
Gait Rehabilitation ◽  
Walking Ability ◽  
User Experiences ◽  
Lower Limb Exoskeleton ◽  
Cord Injury ◽  
Post Test

BACKGROUND: Over-ground robotic lower limb exoskeletons are safe and feasible in rehabilitation with individuals with spinal cord injury (SCI) and stroke. Information about effects on stroke rehabilitees is scarce and descriptions of learning process and user experience is lacking. OBJECTIVE: The objectives of this study were to describe how rehabilitees learn exoskeleton use, to study effects of exoskeleton assisted walking (EAW) training, and to study rehabilitees’ user experiences. METHODS: One-group pre-test post-test pre-experimental study involved five rehabilitees with stroke or traumatic brain injury (TBI). Participants in chronic phase underwent twice a week an 8-week training intervention with Indego exoskeleton. Process of learning to walk and the level of assistance were documented. Outcome measurements were conducted with 6-minute and 10-meter walk tests (6 MWT, 10 mWT). User experience was assessed with a satisfaction questionnaire. RESULTS: Rehabilitees learnt to walk using the exoskeleton with the assistance from 2–3 therapists within two sessions and progressed individually. Three participants improved their results in 10 mWT, four in 6 MWT. The rehabilitees felt comfortable and safe when using and exercising with the device. CONCLUSION: Indego exoskeleton may be beneficial to gait rehabilitation with chronic stroke or TBI rehabilitees. The rehabilitees were satisfied with the exoskeleton as a rehabilitation device.

scholarly journals Long-Term Efficacy of Extracorporeal Shock Wave Therapy on Lower Limb Post-Stroke Spasticity: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2020 ◽  
Vol 10 (1) ◽  
pp. 86
Author(s):  
Emanuela Elena Mihai ◽  
Luminita Dumitru ◽  
Ilie Valentin Mihai ◽  
Mihai Berteanu
Keyword(s):  
Systematic Review ◽  
Lower Limb ◽  
Meta Analysis ◽  
Extracorporeal Shock Wave Therapy ◽  
Shock Wave Therapy ◽  
Post Stroke ◽  
Randomized Controlled ◽  
Term Efficacy ◽  
Extracorporeal Shock Wave

The purpose of this systematic review and meta-analysis is to evaluate the long-term efficacy of Extracorporeal Shock Wave Therapy (ESWT) on reducing lower limb post-stroke spasticity in adults. A systematic electronic search of PubMed/ MEDLINE, Physiotherapy Evidence Database (PEDro), Scopus, Ovid MEDLINE(R), and search engine of Google Scholar was performed. Publications that ranged from January 2010 to August 2020, published in English, French, Spanish, Portuguese, and Italian language and available as full texts were eligible for inclusion and they were searched without any restrictions of country. The study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines and followed the recommendations of the Cochrane Handbook for Systematic Reviews of Interventions. Two authors screened the references, extracted data, and assessed the risk of bias. The primary outcome was spasticity grade mainly assessed by the Modified Ashworth Scale (MAS). Secondary outcomes were passive range of motion (PROM), pain intensity, electrophysiological parameters, gait assessment, and adverse events. A total of seven recent randomized controlled trials (RCTs) were included in the systematic review and meta-analysis, and a beneficial effect on spasticity was found. The high level of evidence presented in this paper showed that ESWT ameliorates spasticity considering the parameters: MAS: standardized mean difference (SMD) = 0.53; 95% confidence interval (95% CI): (0.07–0.99); Modified Tardieu Scale (MTS): SMD = 0.56; 95% CI: (0.01–1.12); Visual Analogue Scale (VAS): SMD = 0.35; 95% CI: (−0.21–0.91); PROM: SMD = 0.69; 95% CI: (0.20–1.19). ESWT presented long-term efficacy on lower limb post-stroke spasticity, reduced pain intensity, and increased range of motion. The effect of this novel and non-invasive therapy was significant and the intervention did not present adverse events, proving a satisfactory safety profile.

scholarly journals Systematic review on wearable lower-limb exoskeletons for gait training in neuromuscular impairments

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Antonio Rodríguez-Fernández ◽  
Joan Lobo-Prat ◽  
Josep M. Font-Llagunes
Keyword(s):  
Systematic Review ◽  
Clinical Efficacy ◽  
Lower Limb ◽  
Gait Training ◽  
Health Conditions ◽  
Current Evidence ◽  
Clinical Aspects ◽  
Gait Rehabilitation ◽  
Comprehensive Overview ◽  
Walking Aids

AbstractGait disorders can reduce the quality of life for people with neuromuscular impairments. Therefore, walking recovery is one of the main priorities for counteracting sedentary lifestyle, reducing secondary health conditions and restoring legged mobility. At present, wearable powered lower-limb exoskeletons are emerging as a revolutionary technology for robotic gait rehabilitation. This systematic review provides a comprehensive overview on wearable lower-limb exoskeletons for people with neuromuscular impairments, addressing the following three questions: (1) what is the current technological status of wearable lower-limb exoskeletons for gait rehabilitation?, (2) what is the methodology used in the clinical validations of wearable lower-limb exoskeletons?, and (3) what are the benefits and current evidence on clinical efficacy of wearable lower-limb exoskeletons? We analyzed 87 clinical studies focusing on both device technology (e.g., actuators, sensors, structure) and clinical aspects (e.g., training protocol, outcome measures, patient impairments), and make available the database with all the compiled information. The results of the literature survey reveal that wearable exoskeletons have potential for a number of applications including early rehabilitation, promoting physical exercise, and carrying out daily living activities both at home and the community. Likewise, wearable exoskeletons may improve mobility and independence in non-ambulatory people, and may reduce secondary health conditions related to sedentariness, with all the advantages that this entails. However, the use of this technology is still limited by heavy and bulky devices, which require supervision and the use of walking aids. In addition, evidence supporting their benefits is still limited to short-intervention trials with few participants and diversity among their clinical protocols. Wearable lower-limb exoskeletons for gait rehabilitation are still in their early stages of development and randomized control trials are needed to demonstrate their clinical efficacy.

scholarly journals Powered Lower Limb Orthoses for Gait Rehabilitation

2005 ◽  
Vol 11 (2) ◽  
pp. 34-49 ◽  
Author(s):  
Daniel Ferris ◽  
Gregory Sawicki ◽  
Antoinette Domingo
Keyword(s):  
Lower Limb ◽  
Gait Rehabilitation

Modelling and Simulation of a Robotic System for Lower Limb Rehabilitation

2018 ◽  
Author(s):  
Bogdan Gherman ◽  
Iosif Birlescu ◽  
Paul Tucan ◽  
Calin Vaida ◽  
Adrian Pisla ◽  
...  
Keyword(s):  
Lower Limb ◽  
Parallel Robot ◽  
Gait Training ◽  
Singularity Analysis ◽  
Robotic System ◽  
Upper Limb Rehabilitation ◽  
Post Stroke ◽  
Kinematic Modelling ◽  
Limb Rehabilitation ◽  
Lower Limb Rehabilitation

As the life span increases and the availability of physicians becomes more and more scarce, robotic rehabilitation for post-stroke patients becomes more and more demanding, especially due to the repeatability character of the rehabilitation exercises. Both lower and upper limb rehabilitation using robotic systems have proved to be very successful in different stages of the rehabilitation process, but only a few address the immediate (critical) post-stroke phase, especially when the patient is hemiplegic and is unable to stand. The paper presents the kinematic modelling, singularity analysis and gait simulation for a new 4-DOF parallel robot named RECOVER used for lower limb rehabilitation for bedridden patients. The robotic system has been designed for the mobilization of the lower limb, namely the following motions: the hip and knee flexion and the plantar adduction/abduction and flexion/dorsiflexion. The kinematics has been studied and the singularity configurations have been determined to achieve a failsafe rehabilitation robot. Numerical simulations prove that the system can be used for gait training exercises in safe conditions.

scholarly journals Systematic Review on Wearable Lower-Limb Exoskeletons for Gait Training in Neuromuscular Impairments

2020 ◽  
Author(s):  
Antonio Rodríguez-Fernández ◽  
Joan Lobo-Prat ◽  
Josep M. Font-Llagunes
Keyword(s):  
Systematic Review ◽  
Clinical Efficacy ◽  
Lower Limb ◽  
Gait Training ◽  
Health Conditions ◽  
Current Evidence ◽  
Clinical Aspects ◽  
Gait Rehabilitation ◽  
Comprehensive Overview ◽  
Walking Aids

Abstract Gait disorders can reduce the quality of life for people with neuromuscular impairments. Therefore, walking recovery is one of the main priorities for counteracting sedentary lifestyle, reducing secondary health conditions and restoring legged mobility. At present, wearable powered lower-limb exoskeletons are emerging as a revolutionary technology for robotic gait rehabilitation. This systematic review provides a comprehensive overview on wearable lower-limb exoskeletons for people with neuromuscular impairments, addressing the following three questions: (1) what is the current technological status of wearable lower-limb exoskeletons for gait rehabilitation?, (2) what is the methodology used in the clinical validations of wearable lower-limb exoskeletons?, and (3) what are the benefits and current evidence on clinical efficacy of wearable lower-limb exoskeletons? We analyzed 87 clinical studies focusing on both device technology (e.g., actuators, sensors, structure) and clinical aspects (e.g., training protocol, outcome measures, patient impairments), and make available the database with all the compiled information. The results of the literature survey reveal that wearable exoskeletons have potential for a number of applications including early rehabilitation, promoting physical exercise, and carrying out daily living activities both at home and the community. Likewise, wearable exoskeletons may improve mobility and independence in non-ambulatory people, and may reduce secondary health conditions related to sedentariness, with all the advantages that this entails. However, the use of this technology is still limited by heavy and bulky devices, which require supervision and the use of walking aids. In addition, evidence supporting their benefits is still limited to short-intervention trials with few participants and diversity among their clinical protocols. Wearable lower-limb exoskeletons for gait rehabilitation are still in their early stages of development and randomized control trials are needed to demonstrate their clinical efficacy.

Sign in / Sign up

Export Citation Format

Share Document