Walking with and without a robotic exoskeleton in people with incomplete spinal cord injury compared to a typical gait pattern

Sattam Almutairi; Chad Swank; Sharon Wang-Price; Fan Gao; Ann Medley

doi:10.3233/NRE-210187

Walking with and without a robotic exoskeleton in people with incomplete spinal cord injury compared to a typical gait pattern

Sattam Almutairi, Chad Swank, Sharon Wang-Price, Fan Gao, Ann Medley

Research output: Contribution to journal › Article › peer-review

Abstract

BACKGROUND: Robotic exoskeleton (RE) enables individuals with lower extremity weakness or paralysis to stand and walk in a stereotypical pattern. OBJECTIVE: Examine whether people with chronic incomplete spinal cord injury (SCI) demonstrate a more typical gait pattern when walking overground in a RE than when walking without. METHODS: Motion analysis system synchronized with a surface electromyographic (EMG) was used to obtain temporospatial gait parameters, lower extremity kinematics, and muscle activity in ambulatory individuals with SCI and healthy adults. RESULTS: Temporospatial parameters and kinematics for participants with SCI (n = 12; age 41.4±12.5 years) with and without RE were significantly different than a typical gait (healthy adults: n = 15; age 26.2±8.3 years). EMG amplitudes during the stance phase of a typical gait were similar to those with SCI with and without RE, except the right rectus femoris (p = 0.005) and left gluteus medius (p = 0.014) when participants with SCI walked with RE. EMG amplitudes of participants with SCI during the swing phase were significantly greater compared to those of a typical gait, except for left medial hamstring with (p = 0.025) and without (p = 0.196) RE. CONCLUSIONS: First-time walking in a RE does not appear to produce a typical gait pattern in people with incomplete SCI.

Original language	English
Pages (from-to)	585-596
Number of pages	12
Journal	NeuroRehabilitation
Volume	49
Issue number	4
DOIs	https://doi.org/10.3233/NRE-210187
State	Published - 2021

Bibliographical note

Funding Information:
This project was partially funded by Texas Woman’s University Research Enhancement Program.

Funding Information:
For our participants with SCI, walking in a robotic exoskeleton for a first time did not approximate the gait pattern of a healthy adult. Although mechanical and software constraints of the robotic exoskeleton design may have limitations, characteristics inherent to the individual with SCI such as poor muscle coordination and co-contractions must The authors wish to thank the assistance of Alyssa Breslin, Anna Lovotti, Kathryn Seeber, and Holly Bednarz for their contributions to this project. This project was supported by the Texas Woman’s University Research Enhancement Program. The researchers would like to thank the Deanship of Scientific Research, Qassim University for funding the publication of this project.

Publisher Copyright:
© 2021-IOS Press. All rights reserved.

Keywords

Bionics
Kinematics
Muscle activity
Rehabilitation
Spinal cord disorder
Walking

ASJC Scopus subject areas

Physical Therapy, Sports Therapy and Rehabilitation
Rehabilitation
Clinical Neurology

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10.3233/NRE-210187

Cite this

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title = "Walking with and without a robotic exoskeleton in people with incomplete spinal cord injury compared to a typical gait pattern",

abstract = "BACKGROUND: Robotic exoskeleton (RE) enables individuals with lower extremity weakness or paralysis to stand and walk in a stereotypical pattern. OBJECTIVE: Examine whether people with chronic incomplete spinal cord injury (SCI) demonstrate a more typical gait pattern when walking overground in a RE than when walking without. METHODS: Motion analysis system synchronized with a surface electromyographic (EMG) was used to obtain temporospatial gait parameters, lower extremity kinematics, and muscle activity in ambulatory individuals with SCI and healthy adults. RESULTS: Temporospatial parameters and kinematics for participants with SCI (n = 12; age 41.4±12.5 years) with and without RE were significantly different than a typical gait (healthy adults: n = 15; age 26.2±8.3 years). EMG amplitudes during the stance phase of a typical gait were similar to those with SCI with and without RE, except the right rectus femoris (p = 0.005) and left gluteus medius (p = 0.014) when participants with SCI walked with RE. EMG amplitudes of participants with SCI during the swing phase were significantly greater compared to those of a typical gait, except for left medial hamstring with (p = 0.025) and without (p = 0.196) RE. CONCLUSIONS: First-time walking in a RE does not appear to produce a typical gait pattern in people with incomplete SCI. ",

keywords = "Bionics, Kinematics, Muscle activity, Rehabilitation, Spinal cord disorder, Walking",

author = "Sattam Almutairi and Chad Swank and Sharon Wang-Price and Fan Gao and Ann Medley",

note = "Funding Information: This project was partially funded by Texas Woman{\textquoteright}s University Research Enhancement Program. Funding Information: For our participants with SCI, walking in a robotic exoskeleton for a first time did not approximate the gait pattern of a healthy adult. Although mechanical and software constraints of the robotic exoskeleton design may have limitations, characteristics inherent to the individual with SCI such as poor muscle coordination and co-contractions must The authors wish to thank the assistance of Alyssa Breslin, Anna Lovotti, Kathryn Seeber, and Holly Bednarz for their contributions to this project. This project was supported by the Texas Woman{\textquoteright}s University Research Enhancement Program. The researchers would like to thank the Deanship of Scientific Research, Qassim University for funding the publication of this project. Publisher Copyright: {\textcopyright} 2021-IOS Press. All rights reserved.",

year = "2021",

doi = "10.3233/NRE-210187",

language = "English",

volume = "49",

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T1 - Walking with and without a robotic exoskeleton in people with incomplete spinal cord injury compared to a typical gait pattern

AU - Almutairi, Sattam

AU - Swank, Chad

AU - Wang-Price, Sharon

AU - Gao, Fan

AU - Medley, Ann

N1 - Funding Information: This project was partially funded by Texas Woman’s University Research Enhancement Program. Funding Information: For our participants with SCI, walking in a robotic exoskeleton for a first time did not approximate the gait pattern of a healthy adult. Although mechanical and software constraints of the robotic exoskeleton design may have limitations, characteristics inherent to the individual with SCI such as poor muscle coordination and co-contractions must The authors wish to thank the assistance of Alyssa Breslin, Anna Lovotti, Kathryn Seeber, and Holly Bednarz for their contributions to this project. This project was supported by the Texas Woman’s University Research Enhancement Program. The researchers would like to thank the Deanship of Scientific Research, Qassim University for funding the publication of this project. Publisher Copyright: © 2021-IOS Press. All rights reserved.

PY - 2021

Y1 - 2021

N2 - BACKGROUND: Robotic exoskeleton (RE) enables individuals with lower extremity weakness or paralysis to stand and walk in a stereotypical pattern. OBJECTIVE: Examine whether people with chronic incomplete spinal cord injury (SCI) demonstrate a more typical gait pattern when walking overground in a RE than when walking without. METHODS: Motion analysis system synchronized with a surface electromyographic (EMG) was used to obtain temporospatial gait parameters, lower extremity kinematics, and muscle activity in ambulatory individuals with SCI and healthy adults. RESULTS: Temporospatial parameters and kinematics for participants with SCI (n = 12; age 41.4±12.5 years) with and without RE were significantly different than a typical gait (healthy adults: n = 15; age 26.2±8.3 years). EMG amplitudes during the stance phase of a typical gait were similar to those with SCI with and without RE, except the right rectus femoris (p = 0.005) and left gluteus medius (p = 0.014) when participants with SCI walked with RE. EMG amplitudes of participants with SCI during the swing phase were significantly greater compared to those of a typical gait, except for left medial hamstring with (p = 0.025) and without (p = 0.196) RE. CONCLUSIONS: First-time walking in a RE does not appear to produce a typical gait pattern in people with incomplete SCI.

AB - BACKGROUND: Robotic exoskeleton (RE) enables individuals with lower extremity weakness or paralysis to stand and walk in a stereotypical pattern. OBJECTIVE: Examine whether people with chronic incomplete spinal cord injury (SCI) demonstrate a more typical gait pattern when walking overground in a RE than when walking without. METHODS: Motion analysis system synchronized with a surface electromyographic (EMG) was used to obtain temporospatial gait parameters, lower extremity kinematics, and muscle activity in ambulatory individuals with SCI and healthy adults. RESULTS: Temporospatial parameters and kinematics for participants with SCI (n = 12; age 41.4±12.5 years) with and without RE were significantly different than a typical gait (healthy adults: n = 15; age 26.2±8.3 years). EMG amplitudes during the stance phase of a typical gait were similar to those with SCI with and without RE, except the right rectus femoris (p = 0.005) and left gluteus medius (p = 0.014) when participants with SCI walked with RE. EMG amplitudes of participants with SCI during the swing phase were significantly greater compared to those of a typical gait, except for left medial hamstring with (p = 0.025) and without (p = 0.196) RE. CONCLUSIONS: First-time walking in a RE does not appear to produce a typical gait pattern in people with incomplete SCI.

KW - Bionics

KW - Kinematics

KW - Muscle activity

KW - Rehabilitation

KW - Spinal cord disorder

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Walking with and without a robotic exoskeleton in people with incomplete spinal cord injury compared to a typical gait pattern

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

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