Applying Hip Stiffness With an Exoskeleton to Compensate Gait Kinematics.

Abstract

Neurological disorders and aging induce impaired gait kinematics. Despite recent advances, effective methods using lower-limb exoskeleton robots to restore gait kinematics are as yet limited. In this study, applying virtual stiffness using a hip exoskeleton was investigated as a possible method to guide users to change their gait kinematics. With a view to applications in locomotor rehabilitation, either to provide assistance or promote recovery, this study assessed whether imposed stiffness induced changes in the gait pattern during walking; and whether any changes persisted upon removal of the intervention, which would indicate changes in central neuro-motor control. Both positive and negative stiffness induced immediate and persistent changes of gait kinematics. However, the results showed little behavioral evidence of persistent changes in neuro-motor control, not even short-lived aftereffects. In addition, stride duration was little affected, suggesting that at least two dissociable layers exist in the neuro-motor control of human walking. The lack of neuro-motor adaptation suggests that, within broad limits, the central nervous system is surprisingly indifferent to the details of lower limb kinematics. The lack of neuro-motor adaptation also suggests that alternative methods may be required to implement a therapeutic technology to promote recovery. However, the immediate, significant, and reproducible changes in kinematics suggest that applying hip stiffness with an exoskeleton may be an effective assistive technology for compensation.