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Lower Extremity Flexible Assist Devices for Locomotion

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Neurorehabilitation Technology

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Abstract

A cable-driven locomotor training system (CaLT) has been developed to improve locomotor function in individuals following hemispheric stroke or spinal cord injury (SCI). A key component of this new system is that it is highly backdrivable, which allows for variation to occur in the trajectory of the gait pattern. The new robotic trainer uses a lightweight cable driven with controlled forces applied to the leg (rather than a controlled trajectory). The refore, the CaLT is compliant, and gives patients the freedom to voluntarily move their legs in a natural gait pattern while providing controlled assistance/resistance forces during body weight supported treadmill training (BWSTT).

Fourteen individuals poststroke and nine patients with SCI were recruited to participate in this pilot study to test the feasibility of using the CaLT for gait training. For our stroke survivors, locomotor training was provided using robotic-assisted, body weight supported treadmill training three times a week for 6 weeks. Single training sessions lasted up to 45 min with body weight support provided as necessary. The treadmill speed was consistent with the subject’s maximum comfortable speed. Primary outcome measures were evaluated for each participant prior to training, after 6 weeks of training, and at 8 weeks after training was completed. Primary measures were participant self-selected and fast overground walking velocity, collected on a 10-m instrumented walkway, and walking distance assessed through the 6-min walk. Secondary measures included clinical assessments of balance, muscle tone, and strength. A similar protocol was used for patients with SCI, but locomotor training was provided three times a week for 8 weeks, and outcome measures and clinical assessments were evaluated prior to training, and after 4 and 8 weeks of training. Results from this study indicate that locomotor gait training using the CaLT resulted in a significant improvement in walking function in individuals poststroke or with SCI. Thus, it is feasible to use a flexible cable-driven robotic system, i.e., CaLT, to improve locomotor function in individuals poststroke or with SCI.

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Acknowledgment

These studies were supported by NIH/NICHD, R21HD058267 (Wu), and PVA, #2552 (Wu). We thank Dr. Schmit, BD, Dr. Hornby, TG, Dr. Rymer, WZ, Dr. Yen, SC, Ms. Rafferty M, and Mrs. Zhang YH for their assistance.

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  1. Sensor Motor Performance Program, Rehabilitation Institute of Chicago, 345 E. Superior St., Room 1406, Chicago, IL, 60611, USA

    Ming Wu & Jill M. Landry

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  1. Ming Wu
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  2. Jill M. Landry
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Correspondence to Ming Wu .

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Editors and Affiliations

  1. Uniklinik Balgrist, Forchstr. 340, Zürich, 8008, Switzerland

    Volker Dietz

  2. , ARTORG Center for Biomedical Engineering, Universität Bern, Murtenstrasse 21, Bern, CH-3010, Switzerland

    Tobias Nef

  3. Rehabilitation Institute of Chicago, Illinois, 60611, USA

    William Zev Rymer

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Wu, M., Landry, J.M. (2012). Lower Extremity Flexible Assist Devices for Locomotion. In: Dietz, V., Nef, T., Rymer, W. (eds) Neurorehabilitation Technology. Springer, London. https://doi.org/10.1007/978-1-4471-2277-7_20

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  • DOI: https://doi.org/10.1007/978-1-4471-2277-7_20

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