Ankle-Foot-Orthosis "Hermes" compensates pathological ankle stiffness of chronic stroke - A proof of concept
Individuals with an upper motor neuron syndrome, e.g., stroke survivors, may have a pathological increase of passive ankle stiffness due to spasticity, that impairs ankle function and activities such as walking. To improve mobility, walking aids such as ankle-foot orthoses and orthopaedic shoes are...
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| Veröffentlicht in: | IEEE transactions on neural systems and rehabilitation engineering 2023-01, Vol.31, p.1-1 |
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| creator | Rodriguez Hernandez, Karen E. De Groot, Jurriaan H. Baas, Frank Stijntjes, Marjon Grootendorst-Heemskerk, Eveline R.M. Schiemanck, Sven K. Van der Helm, Frans C.T. Van der Kooij, Herman Mugge, Winfred |
| description | Individuals with an upper motor neuron syndrome, e.g., stroke survivors, may have a pathological increase of passive ankle stiffness due to spasticity, that impairs ankle function and activities such as walking. To improve mobility, walking aids such as ankle-foot orthoses and orthopaedic shoes are prescribed. However, these walking aids generally limit the range of motion (ROM) of the foot and may therewith negatively influence activities that require a larger ROM. Here we present a new ankle-foot orthosis "Hermes", and its first experimental results from four hemiparetic chronic stroke patients. Hermes was designed to facilitate active ankle dorsiflexion by mechanically compensating the passive ankle stiffness using a negative-stiffness mechanism. Four levels of the Hermes' stiffness compensation (0%, 35%, 70% and 100%) were applied to evaluate active ROM in a robotic ankle manipulator and to test walking feasibility on an instrumented treadmill, in a single session. The robotic tests showed that Hermes successfully compensated the ankle joint stiffness in all four patients and improved the active dorsiflexion ROM in three patients. Three patients were able to walk with Hermes at one or more Hermes' stiffness compensation levels and without reducing their preferred walking speeds compared to those with their own walking aids. Despite a small sample size, the results show that Hermes holds great promise to support voluntary ankle function and to benefit walking and daily activities. |
| doi_str_mv | 10.1109/TNSRE.2023.3310337 |
| format | Article |
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To improve mobility, walking aids such as ankle-foot orthoses and orthopaedic shoes are prescribed. However, these walking aids generally limit the range of motion (ROM) of the foot and may therewith negatively influence activities that require a larger ROM. Here we present a new ankle-foot orthosis "Hermes", and its first experimental results from four hemiparetic chronic stroke patients. Hermes was designed to facilitate active ankle dorsiflexion by mechanically compensating the passive ankle stiffness using a negative-stiffness mechanism. Four levels of the Hermes' stiffness compensation (0%, 35%, 70% and 100%) were applied to evaluate active ROM in a robotic ankle manipulator and to test walking feasibility on an instrumented treadmill, in a single session. The robotic tests showed that Hermes successfully compensated the ankle joint stiffness in all four patients and improved the active dorsiflexion ROM in three patients. Three patients were able to walk with Hermes at one or more Hermes' stiffness compensation levels and without reducing their preferred walking speeds compared to those with their own walking aids. Despite a small sample size, the results show that Hermes holds great promise to support voluntary ankle function and to benefit walking and daily activities.</description><identifier>ISSN: 1534-4320</identifier><identifier>EISSN: 1558-0210</identifier><identifier>DOI: 10.1109/TNSRE.2023.3310337</identifier><identifier>CODEN: ITNSB3</identifier><language>eng</language><publisher>New York: IEEE</publisher><subject>Aids ; Ankle ; Clinical and Translational Impact Statement—In this early clinical research study ; Compensation ; Equinus deformity ; Feet ; Footwear ; joint range of motion ; Legged locomotion ; Manipulators ; Motion control ; muscle spasticity ; Orthopedic apparatus ; Orthopedics ; Orthoses ; orthotic devices ; Read only memory ; Robot arms ; Shoes ; Spasticity ; Stiffness ; Stroke ; Torque ; Torque measurement ; Walking</subject><ispartof>IEEE transactions on neural systems and rehabilitation engineering, 2023-01, Vol.31, p.1-1</ispartof><rights>Copyright The Institute of Electrical and Electronics Engineers, Inc. (IEEE) 2023</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c390t-71d3b8335525aa37a56cb39bac05cb84990acd4e68680b5a0588da0f3a26f0c23</cites><orcidid>0000-0002-7926-3262 ; 0000-0001-6292-774X ; 0000-0002-6071-6401 ; 0000-0002-7828-8863 ; 0000-0002-8215-9204</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,860,2096,27901,27902</link.rule.ids></links><search><creatorcontrib>Rodriguez Hernandez, Karen E.</creatorcontrib><creatorcontrib>De Groot, Jurriaan H.</creatorcontrib><creatorcontrib>Baas, Frank</creatorcontrib><creatorcontrib>Stijntjes, Marjon</creatorcontrib><creatorcontrib>Grootendorst-Heemskerk, Eveline R.M.</creatorcontrib><creatorcontrib>Schiemanck, Sven K.</creatorcontrib><creatorcontrib>Van der Helm, Frans C.T.</creatorcontrib><creatorcontrib>Van der Kooij, Herman</creatorcontrib><creatorcontrib>Mugge, Winfred</creatorcontrib><title>Ankle-Foot-Orthosis "Hermes" compensates pathological ankle stiffness of chronic stroke - A proof of concept</title><title>IEEE transactions on neural systems and rehabilitation engineering</title><addtitle>TNSRE</addtitle><description>Individuals with an upper motor neuron syndrome, e.g., stroke survivors, may have a pathological increase of passive ankle stiffness due to spasticity, that impairs ankle function and activities such as walking. To improve mobility, walking aids such as ankle-foot orthoses and orthopaedic shoes are prescribed. However, these walking aids generally limit the range of motion (ROM) of the foot and may therewith negatively influence activities that require a larger ROM. Here we present a new ankle-foot orthosis "Hermes", and its first experimental results from four hemiparetic chronic stroke patients. Hermes was designed to facilitate active ankle dorsiflexion by mechanically compensating the passive ankle stiffness using a negative-stiffness mechanism. Four levels of the Hermes' stiffness compensation (0%, 35%, 70% and 100%) were applied to evaluate active ROM in a robotic ankle manipulator and to test walking feasibility on an instrumented treadmill, in a single session. The robotic tests showed that Hermes successfully compensated the ankle joint stiffness in all four patients and improved the active dorsiflexion ROM in three patients. Three patients were able to walk with Hermes at one or more Hermes' stiffness compensation levels and without reducing their preferred walking speeds compared to those with their own walking aids. Despite a small sample size, the results show that Hermes holds great promise to support voluntary ankle function and to benefit walking and daily activities.</description><subject>Aids</subject><subject>Ankle</subject><subject>Clinical and Translational Impact Statement—In this early clinical research study</subject><subject>Compensation</subject><subject>Equinus deformity</subject><subject>Feet</subject><subject>Footwear</subject><subject>joint range of motion</subject><subject>Legged locomotion</subject><subject>Manipulators</subject><subject>Motion control</subject><subject>muscle spasticity</subject><subject>Orthopedic apparatus</subject><subject>Orthopedics</subject><subject>Orthoses</subject><subject>orthotic devices</subject><subject>Read only memory</subject><subject>Robot arms</subject><subject>Shoes</subject><subject>Spasticity</subject><subject>Stiffness</subject><subject>Stroke</subject><subject>Torque</subject><subject>Torque measurement</subject><subject>Walking</subject><issn>1534-4320</issn><issn>1558-0210</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>ESBDL</sourceid><sourceid>RIE</sourceid><sourceid>DOA</sourceid><recordid>eNpdUU1v1DAQjRBIlMIfQByscuGSZeyJHee4qlpaqaISlLM1cSZtttk42NlD_z1Ot0KI04zmfWieXlF8lLCREpqvd99__rjYKFC4QZSAWL8qTqTWtgQl4fW6Y1VWqOBt8S6lHYCsja5PinE7PY5cXoawlLdxeQhpSOLsiuOe05nwYT_zlGjhJGbK6BjuB0-joFUl0jL0_cQpidAL_xDDNPh8jOGRRSm2Yo4hAysWJs_z8r5409OY-MPLPC1-XV7cnV-VN7ffrs-3N6XHBpaylh22FlFrpYmwJm18i01LHrRvbdU0QL6r2FhjodUE2tqOoEdSpgev8LS4Pvp2gXZujsOe4pMLNLjnQ4j3juIy-JEdSTZc60Z1aKteW9KKsTeq7yrD3kL2-nL0ymF-Hzgtbj8kz-NIE4dDcsrqxgDWIDP183_UXTjEKSfNLKOMzIl0Zqkjy8eQUuT-74MS3Fqmey7TrWW6lzKz6NNRNDDzPwKFla4t_gHpPpqI</recordid><startdate>20230101</startdate><enddate>20230101</enddate><creator>Rodriguez Hernandez, Karen E.</creator><creator>De Groot, Jurriaan H.</creator><creator>Baas, Frank</creator><creator>Stijntjes, Marjon</creator><creator>Grootendorst-Heemskerk, Eveline R.M.</creator><creator>Schiemanck, Sven K.</creator><creator>Van der Helm, Frans C.T.</creator><creator>Van der Kooij, Herman</creator><creator>Mugge, Winfred</creator><general>IEEE</general><general>The Institute of Electrical and Electronics Engineers, Inc. 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De Groot, Jurriaan H. ; Baas, Frank ; Stijntjes, Marjon ; Grootendorst-Heemskerk, Eveline R.M. ; Schiemanck, Sven K. ; Van der Helm, Frans C.T. ; Van der Kooij, Herman ; Mugge, Winfred</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c390t-71d3b8335525aa37a56cb39bac05cb84990acd4e68680b5a0588da0f3a26f0c23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Aids</topic><topic>Ankle</topic><topic>Clinical and Translational Impact Statement—In this early clinical research study</topic><topic>Compensation</topic><topic>Equinus deformity</topic><topic>Feet</topic><topic>Footwear</topic><topic>joint range of motion</topic><topic>Legged locomotion</topic><topic>Manipulators</topic><topic>Motion control</topic><topic>muscle spasticity</topic><topic>Orthopedic apparatus</topic><topic>Orthopedics</topic><topic>Orthoses</topic><topic>orthotic devices</topic><topic>Read only memory</topic><topic>Robot arms</topic><topic>Shoes</topic><topic>Spasticity</topic><topic>Stiffness</topic><topic>Stroke</topic><topic>Torque</topic><topic>Torque measurement</topic><topic>Walking</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rodriguez Hernandez, Karen E.</creatorcontrib><creatorcontrib>De Groot, Jurriaan H.</creatorcontrib><creatorcontrib>Baas, Frank</creatorcontrib><creatorcontrib>Stijntjes, Marjon</creatorcontrib><creatorcontrib>Grootendorst-Heemskerk, Eveline R.M.</creatorcontrib><creatorcontrib>Schiemanck, Sven K.</creatorcontrib><creatorcontrib>Van der Helm, Frans C.T.</creatorcontrib><creatorcontrib>Van der Kooij, Herman</creatorcontrib><creatorcontrib>Mugge, Winfred</creatorcontrib><collection>IEEE All-Society Periodicals Package (ASPP) 2005-present</collection><collection>IEEE Open Access Journals</collection><collection>IEEE All-Society Periodicals Package (ASPP) 1998-Present</collection><collection>IEEE Electronic Library (IEL)</collection><collection>CrossRef</collection><collection>Aluminium Industry Abstracts</collection><collection>Biotechnology Research Abstracts</collection><collection>Ceramic Abstracts</collection><collection>Computer and Information Systems Abstracts</collection><collection>Corrosion Abstracts</collection><collection>Electronics & Communications Abstracts</collection><collection>Engineered Materials Abstracts</collection><collection>Materials Business File</collection><collection>Mechanical & Transportation Engineering Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Solid State and Superconductivity Abstracts</collection><collection>METADEX</collection><collection>Technology Research Database</collection><collection>ANTE: Abstracts in New Technology & Engineering</collection><collection>Engineering Research Database</collection><collection>Aerospace Database</collection><collection>Materials Research Database</collection><collection>ProQuest Computer Science Collection</collection><collection>Civil Engineering Abstracts</collection><collection>Advanced Technologies Database with Aerospace</collection><collection>Computer and Information Systems Abstracts Academic</collection><collection>Computer and Information Systems Abstracts Professional</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>IEEE transactions on neural systems and rehabilitation engineering</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rodriguez Hernandez, Karen E.</au><au>De Groot, Jurriaan H.</au><au>Baas, Frank</au><au>Stijntjes, Marjon</au><au>Grootendorst-Heemskerk, Eveline R.M.</au><au>Schiemanck, Sven K.</au><au>Van der Helm, Frans C.T.</au><au>Van der Kooij, Herman</au><au>Mugge, Winfred</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Ankle-Foot-Orthosis "Hermes" compensates pathological ankle stiffness of chronic stroke - A proof of concept</atitle><jtitle>IEEE transactions on neural systems and rehabilitation engineering</jtitle><stitle>TNSRE</stitle><date>2023-01-01</date><risdate>2023</risdate><volume>31</volume><spage>1</spage><epage>1</epage><pages>1-1</pages><issn>1534-4320</issn><eissn>1558-0210</eissn><coden>ITNSB3</coden><abstract>Individuals with an upper motor neuron syndrome, e.g., stroke survivors, may have a pathological increase of passive ankle stiffness due to spasticity, that impairs ankle function and activities such as walking. To improve mobility, walking aids such as ankle-foot orthoses and orthopaedic shoes are prescribed. However, these walking aids generally limit the range of motion (ROM) of the foot and may therewith negatively influence activities that require a larger ROM. Here we present a new ankle-foot orthosis "Hermes", and its first experimental results from four hemiparetic chronic stroke patients. Hermes was designed to facilitate active ankle dorsiflexion by mechanically compensating the passive ankle stiffness using a negative-stiffness mechanism. Four levels of the Hermes' stiffness compensation (0%, 35%, 70% and 100%) were applied to evaluate active ROM in a robotic ankle manipulator and to test walking feasibility on an instrumented treadmill, in a single session. The robotic tests showed that Hermes successfully compensated the ankle joint stiffness in all four patients and improved the active dorsiflexion ROM in three patients. Three patients were able to walk with Hermes at one or more Hermes' stiffness compensation levels and without reducing their preferred walking speeds compared to those with their own walking aids. Despite a small sample size, the results show that Hermes holds great promise to support voluntary ankle function and to benefit walking and daily activities.</abstract><cop>New York</cop><pub>IEEE</pub><doi>10.1109/TNSRE.2023.3310337</doi><tpages>1</tpages><orcidid>https://orcid.org/0000-0002-7926-3262</orcidid><orcidid>https://orcid.org/0000-0001-6292-774X</orcidid><orcidid>https://orcid.org/0000-0002-6071-6401</orcidid><orcidid>https://orcid.org/0000-0002-7828-8863</orcidid><orcidid>https://orcid.org/0000-0002-8215-9204</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Aids Ankle Clinical and Translational Impact Statement—In this early clinical research study Compensation Equinus deformity Feet Footwear joint range of motion Legged locomotion Manipulators Motion control muscle spasticity Orthopedic apparatus Orthopedics Orthoses orthotic devices Read only memory Robot arms Shoes Spasticity Stiffness Stroke Torque Torque measurement Walking |
| title | Ankle-Foot-Orthosis "Hermes" compensates pathological ankle stiffness of chronic stroke - A proof of concept |
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