Development of a Prototype Overground Pelvic Obliquity Support Robot for Rehabilitation of Hemiplegia Gait

Effect of exoskeleton-assisted Body Weight-Supported Treadmill Training on gait function for patients with chronic stroke: a scoping review

BACKGROUND

Therapeutic exercise for gait function using an exoskeleton-assisted Body Weight Supported Treadmill Training (BWSTT) has been identified as a potential intervention that allows for task-based repetitive training with appropriate kinematics while adjusting the amount of body weight support (BWS). Nonetheless, its effect on gait in patients with stroke in the chronic phase are yet to be clarified. The primary aim of this scoping review was to present the status of effectiveness of exoskeleton-assisted BWSTT in patients with chronic stroke. The secondary aims were to summarise intervention protocols, types and functions of BWSTT exoskeletal robotic devices currently used clinically.

METHOD AND RESULTS

Articles were accessed and collected from PubMed, Ovid MEDLINE, Cochrane Central Register of Controlled Trials, and Web of Science databases, which were completed in October 2020. Articles were included if the subjects were adults with stroke in the chronic phase (onset ≥ 6 months) and if they utilised a robotic exoskeleton with treadmill and body weight support and investigated the efficacy of gait exercise. A total of 721 studies were identified, of which 11 randomised controlled trials were selected. All included studies were published from 2008 to 2020. Overall, 309 subjects were enrolled; of these, 241 (156 males, 85 females) participated. Walking outcome measures were used more often to evaluate the functional aspects of gait than to evaluate gait independence. In 10 of 11 studies, showed the effectiveness of exoskeleton robot-assisted BWSTT in terms of outcomes contributing to improved gait function. Two studies reported that exoskeleton-assisted BWSTT with combination therapy was significantly more effective in improving than exoskeleton-assisted BWSTT alone. However, no significant difference was identified between the groups; compared with therapist-assisted BWSTT groups, exoskeleton-assisted BWSTT groups did not exhibit significant change.

CONCLUSION

This review suggests that exoskeleton-assisted BWSTT for patients with chronic stroke may be effective in improving walking function. However, the potential may be "to assist" and not because of using the robot. Further studies are required to verify its efficacy and strengthen evidence on intervention protocols.

Model Analysis and Experimental Study of Lower Limb Rehabilitation Training Device Based on Gravity Balance

More hemiplegia patients tend to use equipment for rehabilitation training due to the lack of physical therapists and the low effect of manual training. Nowadays, lower limb rehabilitation training devices for patients in grade 2 of the Medical Research Council (MRC-2) scale are still scarce and have some issues of poor autonomy and cannot relieve the muscle weakness of patients. To address these problems, a prototype based on gravity balance was designed with the combination of springs and linkages to enable patients to passively experience the rehabilitation training in the state of balancing the gravity of lower limbs. The motion of the mechanism was analyzed to obtain the functional relation between the motor rotation angle and the joints’ angle. Based on the principle of constant potential energy, a gravity balance mathematical model of the device was established, analyzed, and simulated. Moreover, through the training experiment, the results show that when subjects in three different weights were trained under the rehabilitation device with and without gravity balance, the required torques of the motor and EMG signal strength of the knee and hip joints decreased by a degree of significance, which verified the effectiveness of the device’s gravity balancing characteristics for MRC-2 patients.