Robotic body weight support enables safe stair negotiation in compliance with basic locomotor principles

Journal of NeuroEngineering and Rehabilitation, 2019 · DOI: https://doi.org/10.1186/s12984-019-0631-8 · Published: December 11, 2019

Rehabilitation Biomedical Biomechanics

Simple Explanation

This study examines how body weight support (BWS) affects stair climbing, a challenging task, by analyzing movement and muscle activity. It explores if using BWS allows people to perform natural movements with minimal compensation. Seventeen healthy individuals were tested while ascending and descending stairs with varying levels of BWS (0-50%). The study looked at their speed, joint movements, forces exerted on the ground, and muscle activity. The research found that BWS does impact several factors during stair climbing, but these changes are small when using up to 30% body weight support, allowing for functional movement patterns. Thus, BWS is potentially useful for early stair training.

Study Duration

Not specified

Participants

17 able-bodied volunteers (9 female and 8 male)

Evidence Level

Not specified

Key Findings

1
Unloading affected walking velocity, joint ranges of motion, vertical ground reaction force parameters and myoelectric activity in all investigated muscles for stair ascent and descent.
2
A reduction with increasing levels of body weight support was seen in walking velocity (0.07–0.12 m/s), ranges of motion of the knee and hip (2–10°), vertical ground reaction force peaks (10–70%) and myoelectric activity (17–70%).
3
Up to 30% body weight support these changes are small, and no dysfunctional patterns are introduced.

Research Summary

The study investigated the effects of body weight support (BWS) on stair negotiation in able-bodied individuals, examining spatio-temporal parameters, joint kinematics, ground reaction forces, and myoelectric activity during stair ascent and descent with varying levels of BWS. Results indicated that while BWS affected several parameters, changes were minimal and did not introduce dysfunctional patterns up to 30% BWS, suggesting its suitability for early stair negotiation training. The findings support the potential use of BWS in rehabilitation settings to facilitate safe and physiological stair negotiation training for patients with neurological conditions, especially early in their rehabilitation process.

Practical Implications

Rehabilitation Tool

BWS can be used as a tool for early stair negotiation training in patients with neurological injuries, allowing them to train longer and start earlier.

Safety Enhancement

BWS provides a safe and permissive environment for patients with impaired lower limb coordination or balance impairments to train stair negotiation patterns without fear of falling.

Reduced Neuromuscular Demand

BWS reduces the neuromuscular demand during stair negotiation, making it achievable for patients with reduced physical strength.

Study Limitations

1
It was not possible to investigated unloading effects down to 10% BWS due to slow upward acceleration of the BWS system’s end-effector at this unloading level during ascent.
2
Reductions in walking speed, joint ROMs at substantial unloading and compensatory activation of TA could maybe be lessened by adding forward forces to the vertical BWS.
3
Measurements with patients with various gait dysfunctions are required to show how well different patients can harness the permissive environment created by the BWS system.

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