Engineering Application of Lower Limb Exoskeleton System in Clinical Rehabilitation
DOI:
https://doi.org/10.54097/kazp0b49Keywords:
Exoskeleton, gait rehabilitation, limber.Abstract
Spinal cord injuries and strokes can severely affect the function of the lower limbs, which in turn reduces people's quality of life. Lower limb function is an important part of daily life, and therefore, clinical treatment of these disorders is aimed at restoring the patient's ability to walk normally. Due to the great potential of lower limb exoskeletons in the clinical rehabilitation of these diseases, the number of studies on lower limb exoskeletons has increased a lot in recent years. However, there are some gaps between the current research and clinical practice of lower limb exoskeletons in the laboratory, and this paper provides some lower limb exoskeletons based on clinical rehabilitation practice to bridge the gap between theory and practice. This review article mentions the advantages and disadvantages of several different driving modes of lower limb exoskeletons, and focuses on the design of rigid electric drive lower limb exoskeletons and their role in clinical rehabilitation. This article compares the rehabilitation methods involved in the lower extremity exoskeleton with traditional treatment methods, and illustrates that the lower extremity exoskeleton can better assist patients in gait recovery in some cases.
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[1] Li S, Francisco GE, Zhou P. Post-stroke Hemiplegic Gait: New Perspective and Insights. Front Physiol. 2018, 9:1021. DOI: https://doi.org/10.3389/fphys.2018.01021
[2] Wu CH, Mao HF, Hu JS, Wang TY, Tsai YJ, Hsu WL. The effects of gait training using powered lower limb exoskeleton robot on individuals with complete spinal cord injury. J Neuroeng Rehabil. 2018; 15(1):14. DOI: https://doi.org/10.1186/s12984-018-0355-1
[3] Bortole M, Venkatakrishnan A, Zhu F, Moreno JC, Francisco GE, Pons JL, Contreras-Vidal JL. The H2 robotic exoskeleton for gait rehabilitation after stroke: early findings from a clinical study. J Neuroeng Rehabil. 2015, 12:54. DOI: https://doi.org/10.1186/s12984-015-0048-y
[4] He Y, Xu Y, Hai M, Feng Y, Liu P, Chen Z, Duan W. Exoskeleton-Assisted Rehabilitation and Neuroplasticity in Spinal Cord Injury. World Neurosurg. 2024, 185:45-54. DOI: https://doi.org/10.1016/j.wneu.2024.01.167
[5] Louie DR, Mortenson WB, Durocher M, Teasell R, Yao J, Eng JJ. Exoskeleton for post-stroke recovery of ambulation (ExStRA): study protocol for a mixed-methods study investigating the efficacy and acceptance of an exoskeleton-based physical therapy program during stroke inpatient rehabilitation. BMC Neurol. 2020,2 0(1):35. DOI: https://doi.org/10.1186/s12883-020-1617-7
[6] Morioka H, Hirayama T, Sugisawa T, Murata K, Shibukawa M, Ebina J, Sawada M, Hanashiro S, Nagasawa J, Yanagihashi M, Uchi M, Kawabe K, Washizawa N, Ebihara S, Nakajima T, Kano O. Robot-assisted training using hybrid assistive limb ameliorates gait ability in patients with amyotrophic lateral sclerosis. J Clin Neurosci. 2022, 99:158-163. DOI: https://doi.org/10.1016/j.jocn.2022.02.032
[7] Shihomi K, Koji O, Tadao T, Yuichi S, Yoshiyuki H. Development of new rehabilitation robot device that can be attached to the conventional Knee-Ankle-Foot-Orthosis for controlling the knee in individuals after stroke. IEEE Int Conf Rehabil Robot. 2017, 2017:304-307.
[8] Buesing C, Fisch G, O'Donnell M, Shahidi I, Thomas L, Mummidisetty CK, Williams KJ, Takahashi H, Rymer WZ, Jayaraman A. Effects of a wearable exoskeleton stride management assist system (SMA®) on spatiotemporal gait characteristics in individuals after stroke: a randomized controlled trial. J Neuroeng Rehabil. 2015, 12:69. DOI: https://doi.org/10.1186/s12984-015-0062-0
[9] Yeung LF, Ockenfeld C, Pang MK, Wai HW, Soo OY, Li SW, Tong KY. Design of an exoskeleton ankle robot for robot-assisted gait training of stroke patients. IEEE Int Conf Rehabil Robot. 2017, 2017:211-215. DOI: https://doi.org/10.1109/ICORR.2017.8009248
[10] Birch N, Graham J, Priestley T, Heywood C, Sakel M, Gall A, Nunn A, Signal N. Results of the first interim analysis of the RAPPER II trial in patients with spinal cord injury: ambulation and functional exercise programs in the REX powered walking aid. J Neuroeng Rehabil. 2017, 14(1):60. DOI: https://doi.org/10.1186/s12984-017-0274-6
[11] Tsukahara A, Yoshida K, Matsushima A, Ajima K, Kuroda C, Mizukami N, Hashimoto M. Effects of gait support in patients with spinocerebellar degeneration by a wearable robot based on synchronization control. J Neuroeng Rehabil. 2018, 15(1):84. DOI: https://doi.org/10.1186/s12984-018-0425-4
[12] Miller EL, Murray L, Richards L, Zorowitz RD, Bakas T, Clark P, Billinger SA; American Heart Association Council on Cardiovascular Nursing and the Stroke Council. Comprehensive overview of nursing and interdisciplinary rehabilitation care of the stroke patient: a scientific statement from the American Heart Association. Stroke. 2010, 41(10):2402-48. DOI: https://doi.org/10.1161/STR.0b013e3181e7512b
[13] Mangold S, Keller T, Curt A, Dietz V. Transcutaneous functional electrical stimulation for grasping in subjects with cervical spinal cord injury. Spinal Cord. 2005, 43(1):1-13. DOI: https://doi.org/10.1038/sj.sc.3101644
[14] Esquenazi A, Talaty M, Packel A, Saulino M. The ReWalk powered exoskeleton to restore ambulatory function to individuals with thoracic-level motor-complete spinal cord injury. Am J Phys Med Rehabil. 2012, 91(11):911-21. DOI: https://doi.org/10.1097/PHM.0b013e318269d9a3
[15] Porciuncula F, Roto AV, Kumar D, Davis I, Roy S, Walsh CJ, Awad LN. Wearable Movement Sensors for Rehabilitation: A Focused Review of Technological and Clinical Advances. PM R. 2018, 10(9 Suppl 2):S220-S232. DOI: https://doi.org/10.1016/j.pmrj.2018.06.013
[16] Mehrholz J, Platz T, Kugler J, Pohl M. Electromechanical and robot-assisted arm training for improving arm function and activities of daily living after stroke. Cochrane Database Syst Rev. 2008 Oct 8;(4):CD006876. doi: 10.1002/14651858.CD006876.pub2. Update in: Cochrane Database Syst Rev. 2012, 6:CD006876. DOI: https://doi.org/10.1002/14651858.CD006876.pub2
[17] Felix M. Escalante, Juan C. Pérez-Ibarra, Jonathan C. Jaimes, Adriano A. G. Siqueira, Marco H. Terra. Robust Markovian Impedance Control applied to a Modular Knee-Exoskeleton. IFAC PapersOnLine 2020, 53:10141-10147 DOI: https://doi.org/10.1016/j.ifacol.2020.12.2740
[18] Rosales-Luengas Y, Espinosa-Espejel KI, Lopéz-Gutiérrez R, Salazar S, Lozano R. Lower Limb Exoskeleton for Rehabilitation with Flexible Joints and Movement Routines Commanded by Electromyography and Baropodometry Sensors. Sensors (Basel). 2023, 23(11):5252. DOI: https://doi.org/10.3390/s23115252
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