期刊
JOURNAL OF SPINAL CORD MEDICINE
卷 36, 期 4, 页码 313-321出版社
MANEY PUBLISHING
DOI: 10.1179/2045772313Y.0000000126
关键词
Spinal cord injury; Paraplegia; Rehabilitation; ReWalk (TM); Assistive technology; Robotic-assisted exoskeletal device; Vertical ground reaction force; Mechanical loading; F-scan (TM) tekscan; Fourier series
资金
- Rehabilitation Medicine Service, Spinal Cord Injury Service, Prosthetics and Orthotics Service James J. Peters Veterans Affairs Medical Center, Department of Neurology
- Mount Sinai School of Medicine
- Department of Veterans Affairs Rehabilitation Research and Development Service [B9212-C]
Objective: To use vertical ground reaction force (vGRF) to show the magnitude and pattern of mechanical loading in persons with spinal cord injury (SCI) during powered exoskeleton-assisted walking. Research design: A cross-sectional study was performed to analyze vGRF during powered exoskeleton-assisted walking (ReWalk (TM): Argo Medical Technologies, Inc, Marlborough, MA, USA) compared with vGRF of able-bodied gait. Setting: Veterans Affairs Medical Center. Participants: Six persons with thoracic motor-complete SCI (T1-T11 AIS A/B) and three age-, height-, weight- and gender-matched able-bodied volunteers participated. Interventions: SCI participants were trained to ambulate over ground using a ReWalk (TM). vGRF was recorded using the F-Scan (TM) system (TekScan, Boston, MA, USA). Outcome measures: Peak stance average (PSA) was computed from vGRF and normalized across all participants by percent body weight. Peak vGRF was determined for heel strike, mid-stance, and toe-off. Relative linear impulse and harmonic analysis provided quantitative support for analysis of powered exoskeletal gait. Results: Participants with motor-complete SCI, ambulating independently with a ReWalk (TM), demonstrated mechanical loading magnitudes and patterns similar to able-bodied gait. Harmonic analysis of PSA profile by Fourier transform contrasted frequency of stance phase gait components between able-bodied and powered exoskeleton-assisted walking. Conclusion: Powered exoskeleton-assisted walking in persons with motor-complete SCI generated vGRF similar in magnitude and pattern to that of able-bodied walking. This suggests the potential for powered exoskeleton-assisted walking to provide a mechanism for mechanical loading to the lower extremities. vGRF profile can be used to examine both magnitude of loading and gait mechanics of powered exoskeleton-assisted walking among participants of different weight, gait speed, and level of assist.
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