Exoskeleton Assistance Improves Crouch during Overground Walking with Forearm Crutches: A Case Study

Area of Science:

• Biomedical Engineering
• Rehabilitation Robotics
• Pediatric Neurology

Background:

• Wearable robotic exoskeletons are increasingly used for gait training in children with movement disorders.
• Existing devices cater to either highly functional or non-ambulatory individuals.
• Optimal gait training strategies for children with moderate mobility impairments (GMFCS III) remain unclear.

Purpose of the Study:

• To investigate the efficacy of a wearable robotic exoskeleton for overground walking in a child with cerebral palsy (CP) classified as GMFCS III.
• To assess the exoskeleton's ability to synchronize assistance with gait phases and improve mobility.
• To evaluate the impact of robotic assistance on knee extension and muscle activity.

Main Methods:

• A case study was conducted on a child with CP (GMFCS III) using a newly developed wearable robotic exoskeleton.
• The exoskeleton provided synchronized assistance to five discrete phases of the gait cycle during overground walking with forearm crutches.
• Gait parameters, including peak knee extension and muscle activity, were measured with and without exoskeleton assistance.

Main Results:

• The wearable robotic exoskeleton successfully synchronized assistance with the gait cycle during overground walking.
• Peak knee extension improved by an average of 10 degrees (right leg) and 7 degrees (left leg) with exoskeleton assistance.
• Improvements in knee extension were observed during early stance, mid-stance, and late swing phases without a reduction in muscle activity.

Conclusions:

• State-based control for robotic extension assistance in wearable exoskeletons shows promise for children with CP and crouch gait who use assistive devices.
• This technology warrants further investigation as a potential rehabilitation strategy to enhance gait and prevent mobility loss in this population.