Effect of exoskeletal joint constraint and passive resistance on metabolic energy expenditure: Implications for walking in paraplegia
An important consideration in the design of a practical system to restore walking in individuals with spinal cord injury is to minimize metabolic energy demand on the user. In this study, the effects of exoskeletal constraints on metabolic energy expenditure were evaluated in able-bodied volunteers...
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| description | An important consideration in the design of a practical system to restore walking in individuals with spinal cord injury is to minimize metabolic energy demand on the user. In this study, the effects of exoskeletal constraints on metabolic energy expenditure were evaluated in able-bodied volunteers to gain insight into the demands of walking with a hybrid neuroprosthesis after paralysis. The exoskeleton had a hydraulic mechanism to reciprocally couple hip flexion and extension, unlocked hydraulic stance controlled knee mechanisms, and ankles fixed at neutral by ankle-foot orthoses. These mechanisms added passive resistance to the hip (15 Nm) and knee (6 Nm) joints while the exoskeleton constrained joint motion to the sagittal plane. The average oxygen consumption when walking with the exoskeleton was 22.5 ± 3.4 ml O2/min/kg as compared to 11.7 ± 2.0 ml O2/min/kg when walking without the exoskeleton at a comparable speed. The heart rate and physiological cost index with the exoskeleton were at least 30% and 4.3 times higher, respectively, than walking without it. The maximum average speed achieved with the exoskeleton was 1.2 ± 0.2 m/s, at a cadence of 104 ± 11 steps/min, and step length of 70 ± 7 cm. Average peak hip joint angles (25 ± 7°) were within normal range, while average peak knee joint angles (40 ± 8°) were less than normal. Both hip and knee angular velocities were reduced with the exoskeleton as compared to normal. While the walking speed achieved with the exoskeleton could be sufficient for community ambulation, metabolic energy expenditure was significantly increased and unsustainable for such activities. This suggests that passive resistance, constraining leg motion to the sagittal plane, reciprocally coupling the hip joints, and weight of exoskeleton place considerable limitations on the utility of the device and need to be minimized in future designs of practical hybrid neuroprostheses for walking after paraplegia. |
| doi_str_mv | 10.1371/journal.pone.0183125 |
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In this study, the effects of exoskeletal constraints on metabolic energy expenditure were evaluated in able-bodied volunteers to gain insight into the demands of walking with a hybrid neuroprosthesis after paralysis. The exoskeleton had a hydraulic mechanism to reciprocally couple hip flexion and extension, unlocked hydraulic stance controlled knee mechanisms, and ankles fixed at neutral by ankle-foot orthoses. These mechanisms added passive resistance to the hip (15 Nm) and knee (6 Nm) joints while the exoskeleton constrained joint motion to the sagittal plane. The average oxygen consumption when walking with the exoskeleton was 22.5 ± 3.4 ml O2/min/kg as compared to 11.7 ± 2.0 ml O2/min/kg when walking without the exoskeleton at a comparable speed. The heart rate and physiological cost index with the exoskeleton were at least 30% and 4.3 times higher, respectively, than walking without it. The maximum average speed achieved with the exoskeleton was 1.2 ± 0.2 m/s, at a cadence of 104 ± 11 steps/min, and step length of 70 ± 7 cm. Average peak hip joint angles (25 ± 7°) were within normal range, while average peak knee joint angles (40 ± 8°) were less than normal. Both hip and knee angular velocities were reduced with the exoskeleton as compared to normal. While the walking speed achieved with the exoskeleton could be sufficient for community ambulation, metabolic energy expenditure was significantly increased and unsustainable for such activities. 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In this study, the effects of exoskeletal constraints on metabolic energy expenditure were evaluated in able-bodied volunteers to gain insight into the demands of walking with a hybrid neuroprosthesis after paralysis. The exoskeleton had a hydraulic mechanism to reciprocally couple hip flexion and extension, unlocked hydraulic stance controlled knee mechanisms, and ankles fixed at neutral by ankle-foot orthoses. These mechanisms added passive resistance to the hip (15 Nm) and knee (6 Nm) joints while the exoskeleton constrained joint motion to the sagittal plane. The average oxygen consumption when walking with the exoskeleton was 22.5 ± 3.4 ml O2/min/kg as compared to 11.7 ± 2.0 ml O2/min/kg when walking without the exoskeleton at a comparable speed. The heart rate and physiological cost index with the exoskeleton were at least 30% and 4.3 times higher, respectively, than walking without it. 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This suggests that passive resistance, constraining leg motion to the sagittal plane, reciprocally coupling the hip joints, and weight of exoskeleton place considerable limitations on the utility of the device and need to be minimized in future designs of practical hybrid neuroprostheses for walking after paraplegia.</description><subject>Adult</subject><subject>Analysis</subject><subject>Angular velocity</subject><subject>Ankle</subject><subject>Biology and Life Sciences</subject><subject>Biomechanics</subject><subject>Biomedical engineering</subject><subject>Care and treatment</subject><subject>Energy conservation</subject><subject>Energy demand</subject><subject>Energy expenditure</subject><subject>Energy Metabolism</subject><subject>Exoskeleton</subject><subject>Feet</subject><subject>Female</subject><subject>Health aspects</subject><subject>Heart rate</subject><subject>Hip</subject><subject>Humans</subject><subject>Joints - metabolism</subject><subject>Joints - physiopathology</subject><subject>Knee</subject><subject>Leg</subject><subject>Male</subject><subject>Medicine and Health Sciences</subject><subject>Metabolism</subject><subject>Middle Aged</subject><subject>Motional resistance</subject><subject>Neural prostheses</subject><subject>Orthoses</subject><subject>Oxygen</subject><subject>Oxygen consumption</subject><subject>Paralysis</subject><subject>Paraplegia</subject><subject>Paraplegia - metabolism</subject><subject>Paraplegia - physiopathology</subject><subject>Physiology</subject><subject>Prosthetics</subject><subject>Spinal cord</subject><subject>Spinal cord injuries</subject><subject>Spinal cord injury</subject><subject>Surgical implants</subject><subject>Veterans</subject><subject>Walking</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><sourceid>DOA</sourceid><recordid>eNqNk11rFDEUhgdRbK3-A9GAIHqxazKZr_VCKKXqQqHg1204kzmZZptNpkmmtj_A_222Oy1d6YXMxYTkeZ9MzuRk2UtG54zX7MPKjd6CmQ_O4pyyhrO8fJTtswXPZ1VO-eN7473sWQgrSkveVNXTbC9vGlbXlO1nf46VQhmJUwSvXDhHgxEMWTltI5HOhuhhMwTbkQFC0JdIPAYdIliJxFmyToHWGS0JWvT9dfIMaDsdR48fyXI9pCWIOqmIcp78BnOubU-0TT4Pg8Few_PsiQIT8MX0Psh-fj7-cfR1dnL6ZXl0eDKT1SKPMwl8wVWx4C3nRVO1HFreUEBeFYypGqoOFaUyx4J2lOYtl23XQZ7QRYk05Q6y11vvYFwQUwWDSHWiRcFqyhOx3BKdg5UYvF6DvxYOtLiZcL4X4KOWBgXFRi1UzaFUZUGRtVBy6BrAisu8KTauT9NuY7vGTqJNxTQ70t0Vq89E7y5FWVa04mUSvJsE3l2MGKJY6yDRGLDoxum7G8rKPKFv_kEfPt1E9ZAOoK1yaV-5kYrDkrK6opRtXPMHqPR0uNbpTqDSaX4n8H4nkJiIV7GHMQSx_P7t_9nTX7vs23vsGYKJZ8GZ8eY27YLFFpTeheBR3RWZUbHplttqiE23iKlbUuzV_R90F7ptD_4XA5cRYg</recordid><startdate>20170817</startdate><enddate>20170817</enddate><creator>Chang, Sarah R</creator><creator>Kobetic, Rudi</creator><creator>Triolo, Ronald J</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-2870-0055</orcidid></search><sort><creationdate>20170817</creationdate><title>Effect of exoskeletal joint constraint and passive resistance on metabolic energy expenditure: Implications for walking in paraplegia</title><author>Chang, Sarah R ; Kobetic, Rudi ; Triolo, Ronald J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-ca393f493b33486b3ab380ae36411f7a6def00c2e40d002b3cbdda248695e0493</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Analysis</topic><topic>Angular velocity</topic><topic>Ankle</topic><topic>Biology and Life Sciences</topic><topic>Biomechanics</topic><topic>Biomedical engineering</topic><topic>Care and treatment</topic><topic>Energy conservation</topic><topic>Energy demand</topic><topic>Energy expenditure</topic><topic>Energy Metabolism</topic><topic>Exoskeleton</topic><topic>Feet</topic><topic>Female</topic><topic>Health aspects</topic><topic>Heart rate</topic><topic>Hip</topic><topic>Humans</topic><topic>Joints - metabolism</topic><topic>Joints - physiopathology</topic><topic>Knee</topic><topic>Leg</topic><topic>Male</topic><topic>Medicine and Health Sciences</topic><topic>Metabolism</topic><topic>Middle Aged</topic><topic>Motional resistance</topic><topic>Neural prostheses</topic><topic>Orthoses</topic><topic>Oxygen</topic><topic>Oxygen consumption</topic><topic>Paralysis</topic><topic>Paraplegia</topic><topic>Paraplegia - metabolism</topic><topic>Paraplegia - physiopathology</topic><topic>Physiology</topic><topic>Prosthetics</topic><topic>Spinal cord</topic><topic>Spinal cord injuries</topic><topic>Spinal cord injury</topic><topic>Surgical implants</topic><topic>Veterans</topic><topic>Walking</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chang, Sarah R</creatorcontrib><creatorcontrib>Kobetic, Rudi</creatorcontrib><creatorcontrib>Triolo, Ronald J</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chang, Sarah R</au><au>Kobetic, Rudi</au><au>Triolo, Ronald J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effect of exoskeletal joint constraint and passive resistance on metabolic energy expenditure: Implications for walking in paraplegia</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2017-08-17</date><risdate>2017</risdate><volume>12</volume><issue>8</issue><spage>e0183125</spage><epage>e0183125</epage><pages>e0183125-e0183125</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>An important consideration in the design of a practical system to restore walking in individuals with spinal cord injury is to minimize metabolic energy demand on the user. In this study, the effects of exoskeletal constraints on metabolic energy expenditure were evaluated in able-bodied volunteers to gain insight into the demands of walking with a hybrid neuroprosthesis after paralysis. The exoskeleton had a hydraulic mechanism to reciprocally couple hip flexion and extension, unlocked hydraulic stance controlled knee mechanisms, and ankles fixed at neutral by ankle-foot orthoses. These mechanisms added passive resistance to the hip (15 Nm) and knee (6 Nm) joints while the exoskeleton constrained joint motion to the sagittal plane. The average oxygen consumption when walking with the exoskeleton was 22.5 ± 3.4 ml O2/min/kg as compared to 11.7 ± 2.0 ml O2/min/kg when walking without the exoskeleton at a comparable speed. The heart rate and physiological cost index with the exoskeleton were at least 30% and 4.3 times higher, respectively, than walking without it. The maximum average speed achieved with the exoskeleton was 1.2 ± 0.2 m/s, at a cadence of 104 ± 11 steps/min, and step length of 70 ± 7 cm. Average peak hip joint angles (25 ± 7°) were within normal range, while average peak knee joint angles (40 ± 8°) were less than normal. Both hip and knee angular velocities were reduced with the exoskeleton as compared to normal. While the walking speed achieved with the exoskeleton could be sufficient for community ambulation, metabolic energy expenditure was significantly increased and unsustainable for such activities. This suggests that passive resistance, constraining leg motion to the sagittal plane, reciprocally coupling the hip joints, and weight of exoskeleton place considerable limitations on the utility of the device and need to be minimized in future designs of practical hybrid neuroprostheses for walking after paraplegia.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>28817701</pmid><doi>10.1371/journal.pone.0183125</doi><tpages>e0183125</tpages><orcidid>https://orcid.org/0000-0002-2870-0055</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Analysis Angular velocity Ankle Biology and Life Sciences Biomechanics Biomedical engineering Care and treatment Energy conservation Energy demand Energy expenditure Energy Metabolism Exoskeleton Feet Female Health aspects Heart rate Hip Humans Joints - metabolism Joints - physiopathology Knee Leg Male Medicine and Health Sciences Metabolism Middle Aged Motional resistance Neural prostheses Orthoses Oxygen Oxygen consumption Paralysis Paraplegia Paraplegia - metabolism Paraplegia - physiopathology Physiology Prosthetics Spinal cord Spinal cord injuries Spinal cord injury Surgical implants Veterans Walking |
| title | Effect of exoskeletal joint constraint and passive resistance on metabolic energy expenditure: Implications for walking in paraplegia |
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