A multidirectional gravity-assist algorithm that enhances locomotor control in patients with stroke or spinal cord injury

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A multidirectional gravity-assist algorithm that enhances locomotor control in patients with stroke or spinal cord injury

Journal Article (2017)

Author(s)

Jean Baptiste Mignardot (École Polytechnique Fédérale de Lausanne, University Hospital of Vaud (CHUV))

Camille G. Le Goff (École Polytechnique Fédérale de Lausanne, University Hospital of Vaud (CHUV))

Rubia Van Den Brand (École Polytechnique Fédérale de Lausanne, University Hospital of Vaud (CHUV))

Marco Capogrosso (University Hospital of Vaud (CHUV), École Polytechnique Fédérale de Lausanne)

Nicolas Fumeaux (École Polytechnique Fédérale de Lausanne)

Heike Vallery (TU Delft - Biomechatronics & Human-Machine Control)

Selin Anil (École Polytechnique Fédérale de Lausanne)

Jessica Lanini (École Polytechnique Fédérale de Lausanne)

Isabelle Fodor (University Hospital of Vaud (CHUV))

Grégoire Eberle (University Hospital of Vaud (CHUV))

Auke J. Ijspeert (École Polytechnique Fédérale de Lausanne)

Brigitte Schurch (University Hospital of Vaud (CHUV))

Armin Curt (Universitat Zurich)

Stefano Carda (University Hospital of Vaud (CHUV))

Jocelyne Bloch (University Hospital of Vaud (CHUV))

Joachim Von Zitzewitz (École Polytechnique Fédérale de Lausanne)

Grégoire Courtine (University Hospital of Vaud (CHUV), École Polytechnique Fédérale de Lausanne)

Research Group

Biomechatronics & Human-Machine Control

DOI related publication

https://doi.org/10.1126/scitranslmed.aah3621

To reference this document use:

https://resolver.tudelft.nl/uuid:71dda22a-5759-4bf1-8249-505da591e87c

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Publication Year

2017

Language

English

Research Group

Biomechatronics & Human-Machine Control

Issue number

399

Volume number

9

Abstract

Gait recovery after neurological disorders requires remastering the interplay between body mechanics and gravitational forces. Despite the importance of gravity-dependent gait interactions and active participation for promoting this learning, these essential components of gait rehabilitation have received comparatively little attention. To address these issues, we developed an adaptive algorithm that personalizes multidirectional forces applied to the trunk based on patient-specific motor deficits. Implementation of this algorithm in a robotic interface reestablished gait dynamics during highly participative locomotion within a large and safe environment. This multidirectional gravity-assist enabled natural walking in nonambulatory individuals with spinal cord injury or stroke and enhanced skilled locomotor control in the less-impaired subjects. A 1-hour training session with multidirectional gravity-assist improved locomotor performance tested without robotic assistance immediately after training, whereas walking the same distance on a treadmill did not ameliorate gait. These results highlight the importance of precise trunk support to deliver gait rehabilitation protocols and establish a practical framework to apply these concepts in clinical routine.

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