Factors influencing neuromuscular responses to gait training with a robotic ankle exoskeleton in cerebral palsy

Benjamin C. Conner, Alyssa M. Spomer, Katherine M. Steele, Zachary F. Lerner

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

A current limitation in the development of robotic gait training interventions is understanding the factors that predict responses to treatment. The purpose of this study was to explore the application of an interpretable machine learning method, Bayesian Additive Regression Trees (BART), to identify factors influencing neuromuscular responses to a resistive ankle exoskeleton in individuals with cerebral palsy (CP). Eight individuals with CP (GMFCS levels I–III, ages 12–18 years) walked with a resistive ankle exoskeleton over seven visits while we measured soleus activation. A BART model was developed using a predictor set of kinematic, device, study, and participant metrics that were hypothesized to influence soleus activation. The model (R 2 = 0.94) found that kinematics had the largest influence on soleus activation, but the magnitude of exoskeleton resistance, amount of gait training practice with the device, and participant-level parameters also had substantial effects. To optimize neuromuscular engagement during exoskeleton training in individuals with CP, our analysis highlights the importance of monitoring the user’s kinematic response, in particular, peak stance phase hip flexion and ankle dorsiflexion. We demonstrate the utility of machine learning techniques for enhancing our understanding of robotic gait training outcomes, seeking to improve the efficacy of future interventions.

Original languageEnglish (US)
Pages (from-to)463-470
Number of pages8
JournalAssistive Technology
Volume35
Issue number6
DOIs
StatePublished - 2023
Externally publishedYes

Keywords

  • Bayesian additive regression tree
  • cerebral palsy
  • device engagement
  • exoskeleton
  • neurorehabilitation

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation

Fingerprint

Dive into the research topics of 'Factors influencing neuromuscular responses to gait training with a robotic ankle exoskeleton in cerebral palsy'. Together they form a unique fingerprint.

Cite this