Applying elastic resistance bands for gait training: A simulation-based study to determine how band configuration affects gait biomechanics and muscle activation

Abstract

BackgroundWearable robotic exoskeletons and leg braces are desirable for gait rehabilitation because they can apply loads directly to an affected joint. Yet, they are not widely used in clinics because they are costly and complex to set up. Conversely, tethered devices, such as elastic resistance bands, are widely available in clinics, are low-cost, and are quick to set up. However, resistance bands will affect walking differently based on how they are configured to pull on the leg (e.g., pulling forward or backward). Research questionHow can a resistance band be configured to alter muscle activation and gait biomechanics based on the segment it is attached to and the angle with which it attaches? MethodsWe used an open-source musculoskeletal modeling platform to emulate several configurations of an elastic band pulling on the ankle, calf, and thigh at various angles during non-pathological walking. We evaluated gait biomechanics and simulated muscle activation using computed muscle control (CMC) and identified a subset of four configurations with potential applications for gait training. Eight non-pathological participants then walked on a treadmill under these configurations to verify how these configurations altered muscle activation. ResultsWe found that muscle activity greatly varied based on the location where the elastic band is attached and the angle with which the elastic band pulls on the leg. Notably, specific angles can be used to pull on the legs to elicit an increase or decrease in muscle activation. SignificanceThis study provides insight into how tethered devices can be configured to provide assistance or resistance during gait training. This information can be applied when developing low-cost gait training solutions for addressing individuals’ impairments.