TY - GEN
T1 - Improving Ankle Muscle Recruitment via Plantar Pressure Biofeedback during Robot Resisted Gait Training in Cerebral Palsy
AU - Conner, Benjamin C.
AU - Lerner, Zachary F.
N1 - Publisher Copyright:
© 2022 IEEE.
PY - 2022
Y1 - 2022
N2 - Neurological impairment from stroke or cerebral palsy often presents with diminished ankle plantar flexor function during the propulsive phase of gait. This deficit often results in slow, energy-expensive walking patterns that limit community mobility. Robotic gait training interventions may prove effective in improving functional outcomes, including exoskeleton resistance used to provide targeted neuromuscular recruitment. However, these interventions to date have required regular verbal cues and coaching for proper plantar flexor engagement with resistance, particularly for pediatric applications. In this validation study, we sought to address the need for automating and improving the effectiveness of facilitating user engagement with robotic resistance. Specifically, our main goal was to compare changes in plantar flexor activity between walking with plantar flexor resistance alone vs plantar flexor resistance combined with plantar pressure biofeedback in individuals with cerebral palsy. We recruited 8 ambulatory adolescents with cerebral palsy between the ages of 11-18 years old to participate in this cross-sectional feasibility study. Supporting our hypothesis, we observed a 36 ± 36% and 46 ± 39% increase in mean and peak soleus activity, respectively, between resistance plus biofeedback vs resistance alone (both p < 0.05). Compared to other biofeedback sensing modalities like assessment of muscle activity via surface electrodes, integrating the plantar pressure-based system within the wearable robotic devices minimizes barriers to clinical implementation by reducing cost, complexity, and setup time. With these positive feasibility results, our future work will explore longer-term training effects of ankle resistance combined with plantar pressure biofeedback.
AB - Neurological impairment from stroke or cerebral palsy often presents with diminished ankle plantar flexor function during the propulsive phase of gait. This deficit often results in slow, energy-expensive walking patterns that limit community mobility. Robotic gait training interventions may prove effective in improving functional outcomes, including exoskeleton resistance used to provide targeted neuromuscular recruitment. However, these interventions to date have required regular verbal cues and coaching for proper plantar flexor engagement with resistance, particularly for pediatric applications. In this validation study, we sought to address the need for automating and improving the effectiveness of facilitating user engagement with robotic resistance. Specifically, our main goal was to compare changes in plantar flexor activity between walking with plantar flexor resistance alone vs plantar flexor resistance combined with plantar pressure biofeedback in individuals with cerebral palsy. We recruited 8 ambulatory adolescents with cerebral palsy between the ages of 11-18 years old to participate in this cross-sectional feasibility study. Supporting our hypothesis, we observed a 36 ± 36% and 46 ± 39% increase in mean and peak soleus activity, respectively, between resistance plus biofeedback vs resistance alone (both p < 0.05). Compared to other biofeedback sensing modalities like assessment of muscle activity via surface electrodes, integrating the plantar pressure-based system within the wearable robotic devices minimizes barriers to clinical implementation by reducing cost, complexity, and setup time. With these positive feasibility results, our future work will explore longer-term training effects of ankle resistance combined with plantar pressure biofeedback.
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U2 - 10.1109/ICORR55369.2022.9896581
DO - 10.1109/ICORR55369.2022.9896581
M3 - Conference contribution
C2 - 36176108
AN - SCOPUS:85138901861
T3 - IEEE International Conference on Rehabilitation Robotics
BT - 2022 International Conference on Rehabilitation Robotics, ICORR 2022
PB - IEEE Computer Society
T2 - 2022 International Conference on Rehabilitation Robotics, ICORR 2022
Y2 - 25 July 2022 through 29 July 2022
ER -