Abstract

BackgroundWearable robots have been shown to improve the efficiency of walking in diverse scenarios. However, it is unclear how much practice is needed to fully adapt to robotic assistance, and which neuromotor processes underly this adaptation. Familiarization strategies for novice users, robotic optimization techniques (e.g. human-in-the-loop), and meaningful comparative assessments depend on this understanding.MethodsTo better understand the process of motor adaptation to robotic assistance, we analyzed the energy expenditure, gait kinematics, stride times, and muscle activities of eight naïve unimpaired participants across three 20-min sessions of robot-assisted walking. Experimental outcomes were analyzed with linear mixed effect models and statistical parametric mapping techniques.ResultsMost of the participants’ kinematic and muscular adaptation occurred within the first minute of assisted walking. After ten minutes, or 880 steps, the energetic benefits of assistance were realized (an average of 5.1% (SD 2.4%) reduction in energy expenditure compared to unassisted walking). Motor adaptation was likely driven by the formation of an internal model for feedforward motor control as evidenced by the reduction of burst-like muscle activity at the cyclic end of robotic assistance and an increase in arm-swing asymmetry previously associated with increased cognitive load.ConclusionHumans appear to adapt to walking assistance from a wearable robot over 880 steps by forming an internal model for feedforward control. The observed adaptation to the wearable robot is well-described by existing three-stage models that start from a cognitive stage, continue with an associative stage, and end in autonomous task execution.Trial registration Not applicable.

Highlights

  • Wearable robots have been shown to improve the efficiency of walking in diverse scenarios

  • We aimed to investigate how naïve individuals adapt to walking assistance from a wearable robot, using the Myosuit as model device

  • Participants reduced the amplitude of their right-arm swing when initially exposed to Myosuit assistance in During the part of the stance phase in which the Myosuit provided assistance, we found a reduction of the EMG activities of gluteus maximus (GMAX) ( t(417) = −10, p < 0.001 ), rectus femoris (RF)

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Summary

Introduction

Wearable robots have been shown to improve the efficiency of walking in diverse scenarios It is unclear how much practice is needed to fully adapt to robotic assistance, and which neuromotor processes underly this adaptation. Haufe et al J NeuroEngineering Rehabil (2021) 18:157 address the needs of individuals with a gait disorder, have successfully reduced the mobility impairment associated with stroke [13] or incomplete spinal cord injury [14]. These achievements depend on the users’ ability to integrate the robotic assistance into their movements, or in other words: learn to walk with a wearable robot. There is compelling evidence that locomotor adaptation is accompanied by an improvement in the economy of walking [17,18,19]

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