Exoskeleton gait training on real-world terrain improves spatiotemporal performance in cerebral palsy

Emmanuella A. Tagoe, Ying Fang, Jack R. Williams, Julie L. Stone, Zachary F. Lerner

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: Walking is essential for daily life but poses a significant challenge for many individuals with neurological conditions like cerebral palsy (CP), which is the leading cause of childhood walking disability. Although lower-limb exoskeletons show promise in improving walking ability in laboratory and controlled overground settings, it remains unknown whether these benefits translate to real-world environments, where they could have the greatest impact. Methods: This feasibility study evaluated whether an untethered ankle exoskeleton with an adaptable controller can improve spatiotemporal outcomes in eight individuals with CP after low-frequency exoskeleton-assisted gait training on real-world terrain. Results: Comparing post- and pre-assessment, assisted walking speed increased by 11% and cadence by 7% (p = 0.003; p = 0.006), while unassisted walking speed increased by 8% and cadence by 5% (p = 0.009; p = 0.012). In the post-assessment, assisted walking speed increased by 9% and stride length by 8% relative to unassisted walking (p < 0.001; p < 0.001). Improvements in walking speed were more strongly associated with longer strides than higher cadence (R2 = 0.92; R2 = 0.68). Muscle activity outcomes, including co-contraction of the soleus and tibialis anterior, did not significantly change after training. Discussion: These findings highlight the spatiotemporal benefits of an adaptive ankle exoskeleton for individuals with CP in real-world settings after short-term training.

Original languageEnglish (US)
Article number1503050
JournalFrontiers in Bioengineering and Biotechnology
Volume12
DOIs
StatePublished - 2024

Keywords

  • cerebral palsy
  • exoskeleton
  • gait training
  • low-frequency
  • real-world
  • spatiotemporal

ASJC Scopus subject areas

  • Biotechnology
  • Bioengineering
  • Histology
  • Biomedical Engineering

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