| 제목 |
Effect of a Robotic Orthosis on gait in a child with incomplete paraplegia due to spina bifida |
| 소속 |
Yonsei University College of Medicine, Department and Research Institute of Rehabilitation Medicine1, SG Robotics Co., Ltd., SG Robotics Co., Ltd.2, Sogang University, Department of Mechanical Engineering3 |
| 저자 |
Dong-wook Rha1,2*†, Hyunjin Choi2, Byeonghun Na2, Dongho Park1, Beomki Yoo1, Solrim Kim2, Dongseok Kim2, Kyongchul Kong2,3, Young Chea Chang1, Yonghyun Lee1 |
Objectives: Gait function is important for the ability to perform activities of daily living in disabled persons. Recently, many research institutions and companies have developed various exoskeleton robots for enhancing gait function in persons with gait impairments and have reported several positive outcomes of exoskeleton robots assisting gait in adults with gait disabilities. However, there is limited evidence demonstrating the effect of exoskeleton robots on gait function in children with motor disability in lower extremities. Therefore, the aim of this study was to determine whether the robotic exoskeleton, a newly developed for assisting gait of children, improved gait function in a child with incomplete paraplegia caused by spina bifida.
Subjects: A 12-year-old girl with incomplete paraplegia caused by spina bifida who can walk shortly on the level floor only with solid AFO participated in this study.
Methods: The gait function of a participant was assessed during walking on the level floor for 6 minutes with a wheeled walker under two conditions; robotic exoskeleton gait (REG) and gait with AFO (AFO). The robotic exoskeleton provided powered hip and knee assistance in the form of extension torque assistance during stance phase and flexion torque assistance during swing phase rather than position-controlled limb guidance according to a determined joint trajectory. While a participant walked under each condition, the oxygen consumption and the heart rate were measured using a portable cardiopulmonary metabolic system (Cosmed K4b2, Rome, Italy) and a wearable heart rate monitor (Wahoo Fitness, Atlanta, USA), respectively. In addition, kinematic data of hip and knee joints was measured by encoders built into the joints of robotic exoskeleton under the REG condition and by 3D motion analysis system (Vicon T10s, Oxford, UK) under the AFO condition.
Results: During over-ground walking for 6 minutes, the mean of oxygen consumption per unit mass was 14.56 ml/min/kg under the REG condition and was 14.17 ml/min/kg under the AFO condition. The oxygen consumption in two conditions was not significantly different. The kinematic data showed that the range of motion of the hip joints were 32 degrees in average under the AFO condition and 48 degrees under the REG condition. The range of motion of the knee joints under AFO and REG conditions were 33 degrees and 46 degrees, respectively. The kinematic pattern of hip and knee joints on sagittal plane improved under REG condition compared to AFO condition.
Conclusions: This study demonstrated that the newly-developed robotic exoskeleton for a child can enhance gait function by assistive torque generation. Although the oxygen consumptions of the REG condition did not show significant change, the kinematics of gait improved only by torque assistance at hip and knee joints, not by joint position control. |
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Fig 1. The kinematic pattern of hip and knee joints on sagittal plane of (a) AFO gait and (b) robotic exoskeleton gait(REG).
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