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Innovative gait robot for the repetitive practice of floor walking and stair climbing up and down in stroke patients.

Hesse S, Waldner A, Tomelleri C - J Neuroeng Rehabil (2010)

Bottom Line: To enable wheelchair-dependent patients the repetitive practice of this task, a novel gait robot, G-EO-Systems (EO, Lat: I walk), based on the end-effector principle, has been designed.The severely affected subject regained walking and stair climbing ability.The lower limb muscle activation patterns were comparable, a training thus feasible, and the positive case report warrants further clinical studies.

View Article: PubMed Central - HTML - PubMed

Affiliation: Medical Park Humboldtmühle Berlin, Department Neurological Rehabilitation Charité, University Medicine, 13507 Berlin, Germany. s.hesse@medicalpark.de

ABSTRACT

Background: Stair climbing up and down is an essential part of everyday's mobility. To enable wheelchair-dependent patients the repetitive practice of this task, a novel gait robot, G-EO-Systems (EO, Lat: I walk), based on the end-effector principle, has been designed. The trajectories of the foot plates are freely programmable enabling not only the practice of simulated floor walking but also stair climbing up and down. The article intended to compare lower limb muscle activation patterns of hemiparetic subjects during real floor walking and stairs climbing up, and during the corresponding simulated conditions on the machine, and secondly to demonstrate gait improvement on single case after training on the machine.

Methods: The muscle activation pattern of seven lower limb muscles of six hemiparetic patients during free and simulated walking on the floor and stair climbing was measured via dynamic electromyography. A non-ambulatory, sub-acute stroke patient additionally trained on the G-EO-Systems every workday for five weeks.

Results: The muscle activation patterns were comparable during the real and simulated conditions, both on the floor and during stair climbing up. Minor differences, concerning the real and simulated floor walking conditions, were a delayed (prolonged) onset (duration) of the thigh muscle activation on the machine across all subjects. Concerning stair climbing conditions, the shank muscle activation was more phasic and timely correct in selected patients on the device. The severely affected subject regained walking and stair climbing ability.

Conclusions: The G-EO-Systems is an interesting new option in gait rehabilitation after stroke. The lower limb muscle activation patterns were comparable, a training thus feasible, and the positive case report warrants further clinical studies.

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Related in: MedlinePlus

The G-EO-Systems Robot. A three-dimensional view of the new gait robot with freely programmable foot plates, the patient lifter, body weight support system, handrails and the ramp.
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Figure 2: The G-EO-Systems Robot. A three-dimensional view of the new gait robot with freely programmable foot plates, the patient lifter, body weight support system, handrails and the ramp.

Mentions: The device (Figure 2) followed the end effector principle. The harness secured patient stood on two foot plates, whose trajectories were completely programmable. The two foot plates were connected each by a pivoting arm to two moving sledges. The foot's forward motion was given by the movement of the principal sledge, which was connected to the transmission belt of the linear guide (Figure 3). The transmission belt was driven by a 1.500 W servomotor fixed to the back end of the linear guide. The forward and backward excursion of the principal sledge ensured the control of the step length. The mechanic design for the control of the step height was realized implementing the scissor principle. The second sledge on the linear guide moved relatively to the principal sledge. A rod ensured the connection of the relative sledge to the pivoting arm. Nearing the relative sledge to the principal sledge closed the scissor, providing the pivoting arm to get lifted, and vice versa. The servomotor responsible for the relative motion was fixed under the relative sledge and connected to the principal sledge by a screw axle. A third completely programmable 400 W drive was fixed on the arm and transferred the rotation through a transmission belt to an external axle, which was aligned to the ankle, controlling the plantar- and dorsiflexion during the steps.


Innovative gait robot for the repetitive practice of floor walking and stair climbing up and down in stroke patients.

Hesse S, Waldner A, Tomelleri C - J Neuroeng Rehabil (2010)

The G-EO-Systems Robot. A three-dimensional view of the new gait robot with freely programmable foot plates, the patient lifter, body weight support system, handrails and the ramp.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2914004&req=5

Figure 2: The G-EO-Systems Robot. A three-dimensional view of the new gait robot with freely programmable foot plates, the patient lifter, body weight support system, handrails and the ramp.
Mentions: The device (Figure 2) followed the end effector principle. The harness secured patient stood on two foot plates, whose trajectories were completely programmable. The two foot plates were connected each by a pivoting arm to two moving sledges. The foot's forward motion was given by the movement of the principal sledge, which was connected to the transmission belt of the linear guide (Figure 3). The transmission belt was driven by a 1.500 W servomotor fixed to the back end of the linear guide. The forward and backward excursion of the principal sledge ensured the control of the step length. The mechanic design for the control of the step height was realized implementing the scissor principle. The second sledge on the linear guide moved relatively to the principal sledge. A rod ensured the connection of the relative sledge to the pivoting arm. Nearing the relative sledge to the principal sledge closed the scissor, providing the pivoting arm to get lifted, and vice versa. The servomotor responsible for the relative motion was fixed under the relative sledge and connected to the principal sledge by a screw axle. A third completely programmable 400 W drive was fixed on the arm and transferred the rotation through a transmission belt to an external axle, which was aligned to the ankle, controlling the plantar- and dorsiflexion during the steps.

Bottom Line: To enable wheelchair-dependent patients the repetitive practice of this task, a novel gait robot, G-EO-Systems (EO, Lat: I walk), based on the end-effector principle, has been designed.The severely affected subject regained walking and stair climbing ability.The lower limb muscle activation patterns were comparable, a training thus feasible, and the positive case report warrants further clinical studies.

View Article: PubMed Central - HTML - PubMed

Affiliation: Medical Park Humboldtmühle Berlin, Department Neurological Rehabilitation Charité, University Medicine, 13507 Berlin, Germany. s.hesse@medicalpark.de

ABSTRACT

Background: Stair climbing up and down is an essential part of everyday's mobility. To enable wheelchair-dependent patients the repetitive practice of this task, a novel gait robot, G-EO-Systems (EO, Lat: I walk), based on the end-effector principle, has been designed. The trajectories of the foot plates are freely programmable enabling not only the practice of simulated floor walking but also stair climbing up and down. The article intended to compare lower limb muscle activation patterns of hemiparetic subjects during real floor walking and stairs climbing up, and during the corresponding simulated conditions on the machine, and secondly to demonstrate gait improvement on single case after training on the machine.

Methods: The muscle activation pattern of seven lower limb muscles of six hemiparetic patients during free and simulated walking on the floor and stair climbing was measured via dynamic electromyography. A non-ambulatory, sub-acute stroke patient additionally trained on the G-EO-Systems every workday for five weeks.

Results: The muscle activation patterns were comparable during the real and simulated conditions, both on the floor and during stair climbing up. Minor differences, concerning the real and simulated floor walking conditions, were a delayed (prolonged) onset (duration) of the thigh muscle activation on the machine across all subjects. Concerning stair climbing conditions, the shank muscle activation was more phasic and timely correct in selected patients on the device. The severely affected subject regained walking and stair climbing ability.

Conclusions: The G-EO-Systems is an interesting new option in gait rehabilitation after stroke. The lower limb muscle activation patterns were comparable, a training thus feasible, and the positive case report warrants further clinical studies.

Show MeSH
Related in: MedlinePlus