Adaptive Ankle Resistance from a Wearable Robotic Device to Improve Muscle Recruitment in Cerebral Palsy
Individuals with cerebral palsy can have weak and poorly coordinated ankle plantar flexor muscles that contribute to inefficient walking patterns. Previous studies attempting to improve plantar flexor function have had inconsistent effects on mobility, likely due to a lack of task-specificity. The g...
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| Veröffentlicht in: | Annals of biomedical engineering 2020-04, Vol.48 (4), p.1309-1321 |
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| description | Individuals with cerebral palsy can have weak and poorly coordinated ankle plantar flexor muscles that contribute to inefficient walking patterns. Previous studies attempting to improve plantar flexor function have had inconsistent effects on mobility, likely due to a lack of task-specificity. The goal of this study was to develop, validate, and test the feasibility and neuromuscular response of a novel wearable adaptive resistance platform to increase activity of the plantar flexors during the propulsive phase of gait. We recruited eight individuals with spastic cerebral palsy to walk with adaptive plantar flexor resistance provided from an untethered exoskeleton. The resistance system and protocol was safe and feasible for all of our participants. Controller validation demonstrated our ability to provide resistance that proportionally- and instantaneously-adapted to the biological ankle moment (
R
= 0.92 ± 0.04). Following acclimation to resistance (0.16 ± 0.02 Nm/kg), more-affected limbs exhibited a 45 ± 35% increase in plantar flexor activity (
p
= 0.02), a 26 ± 24% decrease in dorsiflexor activity (
p
|
| doi_str_mv | 10.1007/s10439-020-02454-8 |
| format | Article |
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R
= 0.92 ± 0.04). Following acclimation to resistance (0.16 ± 0.02 Nm/kg), more-affected limbs exhibited a 45 ± 35% increase in plantar flexor activity (
p
= 0.02), a 26 ± 24% decrease in dorsiflexor activity (
p
< 0.05), and a 46 ± 25% decrease in co-contraction (tibialis anterior and soleus) (
p
= 0.02) during the stance phase. This adaptive resistance system warrants further investigation for use in a longitudinal intervention study.</description><identifier>ISSN: 0090-6964</identifier><identifier>EISSN: 1573-9686</identifier><identifier>DOI: 10.1007/s10439-020-02454-8</identifier><identifier>PMID: 31950309</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Acclimation ; Acclimatization ; Adolescent ; Ankle ; Ankle - physiology ; Ankle Joint - physiology ; Biochemistry ; Biological and Medical Physics ; Biomechanical Phenomena ; Biomedical and Life Sciences ; Biomedical Engineering and Bioengineering ; Biomedicine ; Biophysics ; Cerebral palsy ; Cerebral Palsy - physiopathology ; Child ; Classical Mechanics ; Contraction ; Exoskeleton ; Exoskeletons ; Feasibility ; Female ; Flexors ; Gait ; Humans ; Male ; Muscle, Skeletal - physiopathology ; Muscles ; Original Article ; Paralysis ; Robotics ; Walking ; Walking - physiology ; Wear resistance ; Wearable Electronic Devices ; Wearable technology</subject><ispartof>Annals of biomedical engineering, 2020-04, Vol.48 (4), p.1309-1321</ispartof><rights>Biomedical Engineering Society 2020</rights><rights>Annals of Biomedical Engineering is a copyright of Springer, (2020). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c522t-cbc08ec4fc6b95c24cbbc7100225e16d40099a9475a0b722cd8c972ad23a9333</citedby><cites>FETCH-LOGICAL-c522t-cbc08ec4fc6b95c24cbbc7100225e16d40099a9475a0b722cd8c972ad23a9333</cites><orcidid>0000-0002-7359-436X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10439-020-02454-8$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10439-020-02454-8$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,780,784,885,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31950309$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Conner, Benjamin C.</creatorcontrib><creatorcontrib>Luque, Jason</creatorcontrib><creatorcontrib>Lerner, Zachary F.</creatorcontrib><title>Adaptive Ankle Resistance from a Wearable Robotic Device to Improve Muscle Recruitment in Cerebral Palsy</title><title>Annals of biomedical engineering</title><addtitle>Ann Biomed Eng</addtitle><addtitle>Ann Biomed Eng</addtitle><description>Individuals with cerebral palsy can have weak and poorly coordinated ankle plantar flexor muscles that contribute to inefficient walking patterns. Previous studies attempting to improve plantar flexor function have had inconsistent effects on mobility, likely due to a lack of task-specificity. The goal of this study was to develop, validate, and test the feasibility and neuromuscular response of a novel wearable adaptive resistance platform to increase activity of the plantar flexors during the propulsive phase of gait. We recruited eight individuals with spastic cerebral palsy to walk with adaptive plantar flexor resistance provided from an untethered exoskeleton. The resistance system and protocol was safe and feasible for all of our participants. Controller validation demonstrated our ability to provide resistance that proportionally- and instantaneously-adapted to the biological ankle moment (
R
= 0.92 ± 0.04). Following acclimation to resistance (0.16 ± 0.02 Nm/kg), more-affected limbs exhibited a 45 ± 35% increase in plantar flexor activity (
p
= 0.02), a 26 ± 24% decrease in dorsiflexor activity (
p
< 0.05), and a 46 ± 25% decrease in co-contraction (tibialis anterior and soleus) (
p
= 0.02) during the stance phase. This adaptive resistance system warrants further investigation for use in a longitudinal intervention study.</description><subject>Acclimation</subject><subject>Acclimatization</subject><subject>Adolescent</subject><subject>Ankle</subject><subject>Ankle - physiology</subject><subject>Ankle Joint - physiology</subject><subject>Biochemistry</subject><subject>Biological and Medical Physics</subject><subject>Biomechanical Phenomena</subject><subject>Biomedical and Life Sciences</subject><subject>Biomedical Engineering and Bioengineering</subject><subject>Biomedicine</subject><subject>Biophysics</subject><subject>Cerebral palsy</subject><subject>Cerebral Palsy - physiopathology</subject><subject>Child</subject><subject>Classical Mechanics</subject><subject>Contraction</subject><subject>Exoskeleton</subject><subject>Exoskeletons</subject><subject>Feasibility</subject><subject>Female</subject><subject>Flexors</subject><subject>Gait</subject><subject>Humans</subject><subject>Male</subject><subject>Muscle, Skeletal - physiopathology</subject><subject>Muscles</subject><subject>Original Article</subject><subject>Paralysis</subject><subject>Robotics</subject><subject>Walking</subject><subject>Walking - physiology</subject><subject>Wear resistance</subject><subject>Wearable Electronic Devices</subject><subject>Wearable 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Mechanics</topic><topic>Contraction</topic><topic>Exoskeleton</topic><topic>Exoskeletons</topic><topic>Feasibility</topic><topic>Female</topic><topic>Flexors</topic><topic>Gait</topic><topic>Humans</topic><topic>Male</topic><topic>Muscle, Skeletal - physiopathology</topic><topic>Muscles</topic><topic>Original Article</topic><topic>Paralysis</topic><topic>Robotics</topic><topic>Walking</topic><topic>Walking - physiology</topic><topic>Wear resistance</topic><topic>Wearable Electronic Devices</topic><topic>Wearable technology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Conner, Benjamin C.</creatorcontrib><creatorcontrib>Luque, Jason</creatorcontrib><creatorcontrib>Lerner, Zachary F.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE 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Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Conner, Benjamin C.</au><au>Luque, Jason</au><au>Lerner, Zachary F.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Adaptive Ankle Resistance from a Wearable Robotic Device to Improve Muscle Recruitment in Cerebral Palsy</atitle><jtitle>Annals of biomedical engineering</jtitle><stitle>Ann Biomed Eng</stitle><addtitle>Ann Biomed Eng</addtitle><date>2020-04-01</date><risdate>2020</risdate><volume>48</volume><issue>4</issue><spage>1309</spage><epage>1321</epage><pages>1309-1321</pages><issn>0090-6964</issn><eissn>1573-9686</eissn><abstract>Individuals with cerebral palsy can have weak and poorly coordinated ankle plantar flexor muscles that contribute to inefficient walking patterns. Previous studies attempting to improve plantar flexor function have had inconsistent effects on mobility, likely due to a lack of task-specificity. The goal of this study was to develop, validate, and test the feasibility and neuromuscular response of a novel wearable adaptive resistance platform to increase activity of the plantar flexors during the propulsive phase of gait. We recruited eight individuals with spastic cerebral palsy to walk with adaptive plantar flexor resistance provided from an untethered exoskeleton. The resistance system and protocol was safe and feasible for all of our participants. Controller validation demonstrated our ability to provide resistance that proportionally- and instantaneously-adapted to the biological ankle moment (
R
= 0.92 ± 0.04). Following acclimation to resistance (0.16 ± 0.02 Nm/kg), more-affected limbs exhibited a 45 ± 35% increase in plantar flexor activity (
p
= 0.02), a 26 ± 24% decrease in dorsiflexor activity (
p
< 0.05), and a 46 ± 25% decrease in co-contraction (tibialis anterior and soleus) (
p
= 0.02) during the stance phase. This adaptive resistance system warrants further investigation for use in a longitudinal intervention study.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>31950309</pmid><doi>10.1007/s10439-020-02454-8</doi><tpages>13</tpages><orcidid>https://orcid.org/0000-0002-7359-436X</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Acclimation Acclimatization Adolescent Ankle Ankle - physiology Ankle Joint - physiology Biochemistry Biological and Medical Physics Biomechanical Phenomena Biomedical and Life Sciences Biomedical Engineering and Bioengineering Biomedicine Biophysics Cerebral palsy Cerebral Palsy - physiopathology Child Classical Mechanics Contraction Exoskeleton Exoskeletons Feasibility Female Flexors Gait Humans Male Muscle, Skeletal - physiopathology Muscles Original Article Paralysis Robotics Walking Walking - physiology Wear resistance Wearable Electronic Devices Wearable technology |
| title | Adaptive Ankle Resistance from a Wearable Robotic Device to Improve Muscle Recruitment in Cerebral Palsy |
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