Abstract
The conventional cane (single cane) is widely used to promote gait ability of stroke survivors as it provides postural stability by extending the base of support. However, its use can reduce muscle activity in the user's paretic side and cause upper limb neuropathies due to the intermittent and excessive loading of the upper limb. The provision of low magnitude support and speed regulation may result in collective improvement of gait parameters such as symmetry, balance and muscle activation. In this paper, we developed a robotic Haptic Cane (HC) that is composed of a tilted structure with motorized wheels and sensors to allow continuous haptic contact with the ground while moving at a regulated speed, and carried out gait experiments to compare the HC with an Instrumented conventional Cane (IC). The results show that use of the HC involved more continuous ground support force of a comparatively lesser magnitude than the IC, and resulted in greater improvements in the swing symmetry ratio and significant improvements in the step length symmetry ratio. Percentage of Non-Paretic Activity (%NPA) of paretic muscles (vastus medialis obliquus (VMO), semitendinosus (SMT), tibialis anterior (TBA) and gastrocnemius medialis (GCM)) in swing phase was significantly improved by the use of either device at fast speed. However, the use of HC improved %NPA of paretic VMO and SMT more than the use of IC at both preferred and fast speeds. It also significantly improved %NPA of paretic GCM in stance phase. Furthermore, comfortable speed with the HC was higher than with the IC and exhibited better RMS of anteroposterior (AP) tilt. Thus, the developed device with a simple and intuitive mechanism can provide efficient assistance for overground gait of stroke patients with a high possibility of widespread use.
Highlights
S TROKE typically leads to hemiplegia, and even 3 months after stroke, approximately 70% of the patients walk with reduced velocity and capacity [1]
In this paper we present the development of a robotic Haptic Cane (HC) for hemiplegic patients that induces fast overground walking with higher stability, and evaluate its effects on the gait, balance and muscle activation parameters of stroke survivors
It can be concluded from these results that at relatively lower gait speeds the HC can provide lesser magnitude more continuous support than the Instrumented Conventional Cane (IC), which may be more beneficial for stroke survivors
Summary
S TROKE typically leads to hemiplegia, and even 3 months after stroke, approximately 70% of the patients walk with reduced velocity and capacity [1]. Hemiplegia increases metabolic cost of transport [2]–[4], causes asymmetric gait, and reduces walking speed [5], [6]. Stroke survivors with balance control or sensorimotor deficiencies tend to exhibit problems associated with gait, including increased likelihood of falling and loss of independence [7], [8]. Since the causes and symptoms of gait disorders experienced by stroke survivors are diverse, measurable gait parameters such as gait speed and symmetry, which are closely related to balance and gait ability, are considered as appropriate evaluation indices [5], [10], [11]. Studies have shown that improvement of step length symmetry coincides with improvements in gait speed [6] and cost of transport [5], [12], [13]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callMore From: IEEE transactions on neural systems and rehabilitation engineering : a publication of the IEEE Engineering in Medicine and Biology Society
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
