Enhancing Walking Performance With a Bilateral Hip Exoskeleton Assistance in Individuals With Above-Knee Amputation.

Area of Science:

• Biomedical Engineering
• Rehabilitation Science
• Biomechanics

Background:

• Transfemoral amputation causes significant mobility limitations and secondary health issues.
• Current prosthetics fail to restore efficient and functional gait.
• Assisting the residual hip with energy injection is a novel strategy to improve gait.

Purpose of the Study:

• To evaluate the effectiveness of a portable, powered hip exoskeleton in reducing walking energy expenditure in individuals with above-knee amputation.
• To assess the impact of the exoskeleton on gait stability, comfort, and confidence.

Main Methods:

• Four individuals with above-knee amputation participated in the study.
• The Physiological Cost Index (PCI) was used to quantify walking energy expenditure.
• Participants walked with and without the hip exoskeleton at self-selected comfortable and fast speeds.

Main Results:

• A reduction in walking energy expenditure was observed in all participants, ranging from -10% to -17% compared to unassisted walking.
• Three out of four participants showed a reduction between -2% and -24% compared to walking without the device.
• Participants reported comfortable and confident overground walking with the exoskeleton at various speeds, with no gait stability issues.

Conclusions:

• A powered hip exoskeleton is a promising approach for individuals with transfemoral amputation.
• Energy injection at the hip level can reduce walking energy expenditure and improve gait.
• This technology may enhance mobility, improve locomotor training, and positively impact the quality of life for amputees.