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 language | English (US) |
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Article number | 1503050 |
Journal | Frontiers in Bioengineering and Biotechnology |
Volume | 12 |
DOIs | |
State | Published - 2024 |
Keywords
- cerebral palsy
- exoskeleton
- gait training
- low-frequency
- real-world
- spatiotemporal
ASJC Scopus subject areas
- Biotechnology
- Bioengineering
- Histology
- Biomedical Engineering