Effects of Bilateral Assistance for Hemiparetic Gait Post-Stroke Using a Powered Hip Exoskeleton

• Type of Material: Article
• Authors: Yi-Tsen Pan, Georgia Institute of Technology; Inseung Kang, Georgia Institute of Technology; James Joh, Georgia Institute of Technology; Patrick Kim, Georgia Institute of Technology; Kinsey R Herrin, Georgia Institute of Technology; Trisha Kesar, Emory University; Gregory S Sawicki, Georgia Institute of Technology; Aaron J Young, Georgia Institute of Technology
• Language: English
• Date: 2022-08-13
• Publisher: SPRINGER
• Publication Version: Final Published Version
• Copyright Statement: © The Author(s) 2022
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1007/s10439-022-03041-9
• Title of Journal or Parent Work: ANNALS OF BIOMEDICAL ENGINEERING
• Volume: 51
• Issue: 2
• Start Page: 410
• End Page: 421
• Grant/Funding Information: Open Access funding provided by the MIT Libraries. Funding was provided by National Institutes of Health (Grant No. R03HD097740-01).
• Keywords: Science & Technology; Engineering, Biomedical; Hip assistance; PHASE; SPEED; PERFORMANCE; INTERLIMB COORDINATION; STROKE; Biomechanics; WALKING; Engineering; PEOPLE; Technology; Stroke gait; ROBOT; AMBULATION; Powered exoskeleton; RECOVERY; Walking speed
• Research Categories: Engineering, Mechanical

Abstract

Hemiparetic gait due to stroke is characterized by an asymmetric gait due to weakness in the paretic lower limb. These inter-limb asymmetries increase the biomechanical demand and reduce walking speed, leading to reduced community mobility and quality of life. With recent progress in the field of wearable technologies, powered exoskeletons have shown great promise as a potential solution for improving gait post-stroke. While previous studies have adopted different exoskeleton control methodologies for restoring gait post-stroke, the results are highly variable due to limited understanding of the biomechanical effect of exoskeletons on hemiparetic gait. In this study, we investigated the effect of different hip exoskeleton assistance strategies on gait function and gait biomechanics of individuals post-stroke. We found that, compared to walking without a device, powered assistance from hip exoskeletons improved stroke participants’ self-selected overground walking speed by 17.6 ± 2.5% and 11.1 ± 2.7% with a bilateral and unilateral assistance strategy, respectively (p < 0.05). Furthermore, both bilateral and unilateral assistance strategies significantly increased the paretic and non-paretic step length (p < 0.05). Our findings suggest that powered assistance from hip exoskeletons is an effective means to increase walking speed post-stroke and tuning the balance of assistance between non-paretic and paretic limbs (i.e., a bilateral strategy) may be most effective to maximize performance gains.