Unilateral non-electric assistive walking device helps neurological patients to improve gait patterns

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TITLE: Unilateral non-electric assistive walking device helps neurological patients to improve gait patterns INTRODUCTION: Pathological gait patterns are common in older adults and neurological patients and put them at high risk of falling, restricting autonomy and social participation. Novel assistive walking devices are designed to actively support the recovery and maintenance of physiological gait patterns by means of motor guidance and mechanical support of the lower limbs. This study aimed at investigating a non-electric assistive walking device powered by a cam spring mechanism (aLQ, imasen).RESEARCH QUESTION:Does the investigated assistive walking device improve dysfunctional gait patterns in neurological and orthopaedic patients?METHODS: A three-dimensional instrumented gait analysis was conducted on a treadmill using spatio-temporal, kinetic and kinematic data obtained from synchronized motion capturing, surface EMG (sEMG) and pressure distribution measurements. Eight high-speed motion capture cameras (Miqus3, Qualisys) were installed around a treadmill (quasar, hp cosmos) on which 40 adults with impaired walking were tested in a 2x2 within-subjects design (with/without aLQ device; at preferred/fast speed). Regarding the participants' medical condition, the volunteers were assigned either to the group with orthopaedic condition (n=20) or to the group with neurological condition (n=20).Applying the CAST marker model, 36 passive reflective markers were attached to anatomical landmarks of the lower body. Muscle activity of M. rectus femoris and M. gastrocnemius medialis was recorded using sEMG (Ultium, Noraxon). The wireless direct radio technology of the sEMG telemetry system sends the measurement signals directly from the derived muscle, allowing movements that are more natural. A pressure measurement platform installed underneath the treadmill's belt, allowed for the observation of the gait with a high number of step repetitions. The movement of the treadmill is compensated, so reliable gait and roll-off patterns can be analysed. Data was synced and analysed using Visual3D and MatLab.RESULTS: The most prominent gait parameters including step length, cadence and range of motion of the lower extremities approximate previously reported norms for the respective age group when using the device. With respect to participants’ medical condition, deviations from the norm at baseline appear to be larger in neurological patients. Thus, results indicate stronger improvements in this group.DISCUSSION: Research on unilateral non-electric assistive walking device for activities of daily living (ADLs) are sparse. In our study, participants seem to benefit from the aLQ assistive walking device regarding gait and movement patterns. Against the background of The International Classification of Functioning, Disability and Health (ICF) we conclude that the aLQ device might help to improve functional health status and quality of life especially but not exclusively for patients affected by neurological conditions and could decrease their incidence of falls. Further studies should focus on feasibility regarding the facilitation of ADLs using assistive walking devices and verifying long-term benefits in patients’ autonomy and social participation.
REFERENCES: Bertrand, K., Raymond, M.-H., Miller, W. C., Martin Ginis, K. A., & Demers, L. (2017). Walking Aids for Enabling Activity and Participation: A Systematic Review. American Journal of Physical Medicine & Rehabilitation, 96(12), 894–903. https://doi.org/10.1097/PHM.0000000000000836Chen, G., Chan, C. K., Guo, Z., & Yu, H. (2013). A Review of Lower Extremity Assistive Robotic Exoskeletons in Rehabilitation Therapy. Critical Reviews in Biomedical Engineering, 41(4-5), 343–363. https://doi.org/10.1615/CritRevBiomedEng.2014010453Cimolin, V., & Galli, M. (2014). Summary measures for clinical gait analysis: A literature review. Gait & Posture, 39(4), 1005–1010. https://doi.org/10.1016/j.gaitpost.2014.02.001
Original languageEnglish
Title of host publicationAbstract book : virtual ESMAC 2020
Number of pages2
Publication date17.09.2020
Publication statusPublished - 17.09.2020
EventAnnual Meeting of the European Society for Movement Analysis in Adults and Children - Virtual
Duration: 17.09.202018.09.2020
Conference number: 29

ID: 5448644



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