Immediate kinematic and muscle activity changes after a single robotic exoskeleton walking session post-stroke. Issue 7 (2nd October 2020)

• Record Type: Journal Article
• Authors: Swank, Chad; Almutairi, Sattam; Wang-Price, Sharon; Gao, Fan
• Is Part Of: Topics in stroke rehabilitation. Volume 27:Issue 7(2020)
• Page Start: 503
• Page End: 515
• Publication Date: 2020-10-02
• Subjects: Cerebrovascular disease -- robotics -- electromyography -- gait -- temporospatial -- mobility -- biomechanics; Cerebrovascular disease -- Patients -- Rehabilitation -- Periodicals; Cerebrovascular disease -- Periodicals; 616.810305
• DOI: 10.1080/10749357.2020.1728954
• Languages: English
• ISSNs: 1074-9357

Abstract

ABSTRACT: Background : Robotic Exoskeletons (EKSO) are novel technology for retraining common gait dysfunction in people post-stroke. EKSO's capability to influence gait characteristics post-stroke is unknown. Objectives : To compare temporospatial, kinematic, and muscle activity gait characteristics before and after a single EKSO session and examine kinematic symmetry between involved and uninvolved limbs. Methods : Participants post-stroke walked under two conditions: pre-EKSO, and immediately post-EKSO. A 10-camera motion capture system synchronized with 6 force plates was used to obtain temporospatial and kinematic gait characteristics from 5 walking trials of 9 meters at a self-selected speed. Surface EMG activity was obtained from bilateral gluteus medius, rectus femoris, medial hamstrings, tibialis anterior, and soleus muscles. Wilcoxon Signed Rank tests were used to analyze differences pre- and post-EKSO. Single EKSO session consisted of 22.3±6.8 minutes total time (walk time=7.2±1.5 minutes) with 250±40 steps. Results : Six ambulatory (Functional Ambulation Category, range=4-5) adults (3 female; 44.7±14.6 years) with chronic stroke (4.5±1.9 years post-stroke) participated. No significant differences were observed for temporospatial gait characteristics. Muscle activity was significantly less post-EKSO in the involved leg rectus femoris during swing phase ( p =0.028). Ankle dorsiflexion range of motion on the involved leg post-EKSO was significantly less during stance phase ( p =0.046). Differences between involved and uninvolved joint range of motion symmetry were found pre-EKSO but not post-EKSO in swing phase hip flexion and stance phase knee flexion and knee extension. Conclusions : EKSO training appears capable of altering gait in people with chronic stroke and a viable intervention to reduce gait dysfunction post-stroke.