Adapted assistance and resistance training with a knee exoskeleton after stroke

Studies on robotic interventions for gait rehabilitation after stroke require: (i) rigorous performance evidence; (ii) systematic procedures to tune the control parameters; and (iii) combination of control modes. In this study, we investigated how stroke individuals responded to training for two wee...

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Autores: Miguel Fernández, Jesús de, Rey Prieto, Marta, Salazar del Río, Miguel Antonio, López Matas, Helena, Guirao Cano, Lluís, Font Llagunes, Josep Maria|||0000-0002-7192-2980, Lobo Prat, Joan
Formato: artículo
Fecha de publicación:2023
País:España
Recursos:Universitat Politècnica de Catalunya (UPC)
Repositorio:UPCommons. Portal del coneixement obert de la UPC
Idioma:inglés
OAI Identifier:oai:upcommons.upc.edu:2117/393988
Acesso em linha:https://hdl.handle.net/2117/393988
https://dx.doi.org/10.1109/TNSRE.2023.3303777
Access Level:acceso abierto
Palavra-chave:Artificial knee
Artificial joints
Rehabilitation robotics
Prosthetics and Exoskeletons
Wearable robotics
Genolls artificials
Articulacions artificials
Àrees temàtiques de la UPC::Enginyeria mecànica::Fabricació::Disseny i accionaments de robots
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oai_identifier_str oai:upcommons.upc.edu:2117/393988
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spelling Adapted assistance and resistance training with a knee exoskeleton after strokeMiguel Fernández, Jesús deRey Prieto, MartaSalazar del Río, Miguel AntonioLópez Matas, HelenaGuirao Cano, LluísFont Llagunes, Josep Maria|||0000-0002-7192-2980Lobo Prat, JoanArtificial kneeArtificial jointsRehabilitation roboticsProsthetics and ExoskeletonsWearable roboticsGenolls artificialsArticulacions artificialsÀrees temàtiques de la UPC::Enginyeria mecànica::Fabricació::Disseny i accionaments de robotsStudies on robotic interventions for gait rehabilitation after stroke require: (i) rigorous performance evidence; (ii) systematic procedures to tune the control parameters; and (iii) combination of control modes. In this study, we investigated how stroke individuals responded to training for two weeks with a knee exoskeleton (ABLE-KS) using both Assistance and Resistance training modes together with auditory feedback to train peak knee flexion angle. During the training, the torque provided by the ABLE-KS and the biofeedback were systematically adapted based on the subject’s performance and perceived exertion level. We carried out a comprehensive experimental analysis that evaluated a wide range of biomechanical metrics, together with usability and users’ perception metrics. We found significant improvements in peak knee flexion ( p=0.0016 ), minimum knee angle during stance ( p=0.0053 ), paretic single support time ( p=0.0087 ) and gait endurance ( p=0.022 ) when walking without the exoskeleton after the two weeks of training. Participants significantly ( p<0.00025 ) improved the knee angle during the stance and swing phases when walking with the exoskeleton powered in the high Assistance mode in comparison to the No Exo and the Unpowered conditions. No clinically relevant differences were found between Assistance and Resistance training sessions. Participants improved their performance with the exoskeleton (24-55 %) for the peak knee flexion angle throughout the training sessions. Moreover, participants showed a high level of acceptability of the ABLE-KS (QUEST 2.0 score: 4.5 ± 0.3 out of 5). Our preliminary findings suggest that the proposed training approach can produce similar or larger improvements in post-stroke individuals than other studies with knee exoskeletons that used higher training intensities.This work was supported in part by the Agency for Management of University and Research Grants (AGAUR) along with the Secretariat of Universities and Research of the Catalan Ministry of Research and Universities and the European Social Fund (ESF) under Grant 2020 FI_B 00331, in part by the Spanish Ministry of Science and Innovation (MCI)—Agencia Estatal de Investigación (AEI) under Grant PTQ2018-010227, in part by “La Caixa” Foundation under Grant LCF/TR/CC20/52480002, and in part by the Eurostars-3 Joint Program with co-financing from CDTI and the European Union’s Horizon Europe Research and Innovation Framework Program under Eureka Application Number 1789 under Grant CIIP-20221022Peer Reviewed20232023-08-0920232023-09-25journal articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://hdl.handle.net/2117/393988https://dx.doi.org/10.1109/TNSRE.2023.3303777reponame:UPCommons. Portal del coneixement obert de la UPCinstname:Universitat Politècnica de Catalunya (UPC)Inglésengopen accesshttp://purl.org/coar/access_right/c_abf2Attribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:upcommons.upc.edu:2117/3939882026-05-27T15:37:01Z
dc.title.none.fl_str_mv Adapted assistance and resistance training with a knee exoskeleton after stroke
title Adapted assistance and resistance training with a knee exoskeleton after stroke
spellingShingle Adapted assistance and resistance training with a knee exoskeleton after stroke
Miguel Fernández, Jesús de
Artificial knee
Artificial joints
Rehabilitation robotics
Prosthetics and Exoskeletons
Wearable robotics
Genolls artificials
Articulacions artificials
Àrees temàtiques de la UPC::Enginyeria mecànica::Fabricació::Disseny i accionaments de robots
title_short Adapted assistance and resistance training with a knee exoskeleton after stroke
title_full Adapted assistance and resistance training with a knee exoskeleton after stroke
title_fullStr Adapted assistance and resistance training with a knee exoskeleton after stroke
title_full_unstemmed Adapted assistance and resistance training with a knee exoskeleton after stroke
title_sort Adapted assistance and resistance training with a knee exoskeleton after stroke
dc.creator.none.fl_str_mv Miguel Fernández, Jesús de
Rey Prieto, Marta
Salazar del Río, Miguel Antonio
López Matas, Helena
Guirao Cano, Lluís
Font Llagunes, Josep Maria|||0000-0002-7192-2980
Lobo Prat, Joan
author Miguel Fernández, Jesús de
author_facet Miguel Fernández, Jesús de
Rey Prieto, Marta
Salazar del Río, Miguel Antonio
López Matas, Helena
Guirao Cano, Lluís
Font Llagunes, Josep Maria|||0000-0002-7192-2980
Lobo Prat, Joan
author_role author
author2 Rey Prieto, Marta
Salazar del Río, Miguel Antonio
López Matas, Helena
Guirao Cano, Lluís
Font Llagunes, Josep Maria|||0000-0002-7192-2980
Lobo Prat, Joan
author2_role author
author
author
author
author
author
dc.subject.none.fl_str_mv Artificial knee
Artificial joints
Rehabilitation robotics
Prosthetics and Exoskeletons
Wearable robotics
Genolls artificials
Articulacions artificials
Àrees temàtiques de la UPC::Enginyeria mecànica::Fabricació::Disseny i accionaments de robots
topic Artificial knee
Artificial joints
Rehabilitation robotics
Prosthetics and Exoskeletons
Wearable robotics
Genolls artificials
Articulacions artificials
Àrees temàtiques de la UPC::Enginyeria mecànica::Fabricació::Disseny i accionaments de robots
description Studies on robotic interventions for gait rehabilitation after stroke require: (i) rigorous performance evidence; (ii) systematic procedures to tune the control parameters; and (iii) combination of control modes. In this study, we investigated how stroke individuals responded to training for two weeks with a knee exoskeleton (ABLE-KS) using both Assistance and Resistance training modes together with auditory feedback to train peak knee flexion angle. During the training, the torque provided by the ABLE-KS and the biofeedback were systematically adapted based on the subject’s performance and perceived exertion level. We carried out a comprehensive experimental analysis that evaluated a wide range of biomechanical metrics, together with usability and users’ perception metrics. We found significant improvements in peak knee flexion ( p=0.0016 ), minimum knee angle during stance ( p=0.0053 ), paretic single support time ( p=0.0087 ) and gait endurance ( p=0.022 ) when walking without the exoskeleton after the two weeks of training. Participants significantly ( p<0.00025 ) improved the knee angle during the stance and swing phases when walking with the exoskeleton powered in the high Assistance mode in comparison to the No Exo and the Unpowered conditions. No clinically relevant differences were found between Assistance and Resistance training sessions. Participants improved their performance with the exoskeleton (24-55 %) for the peak knee flexion angle throughout the training sessions. Moreover, participants showed a high level of acceptability of the ABLE-KS (QUEST 2.0 score: 4.5 ± 0.3 out of 5). Our preliminary findings suggest that the proposed training approach can produce similar or larger improvements in post-stroke individuals than other studies with knee exoskeletons that used higher training intensities.
publishDate 2023
dc.date.none.fl_str_mv 2023
2023-08-09
2023
2023-09-25
dc.type.none.fl_str_mv journal article
http://purl.org/coar/resource_type/c_6501
VoR
http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://hdl.handle.net/2117/393988
https://dx.doi.org/10.1109/TNSRE.2023.3303777
url https://hdl.handle.net/2117/393988
https://dx.doi.org/10.1109/TNSRE.2023.3303777
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:UPCommons. Portal del coneixement obert de la UPC
instname:Universitat Politècnica de Catalunya (UPC)
instname_str Universitat Politècnica de Catalunya (UPC)
reponame_str UPCommons. Portal del coneixement obert de la UPC
collection UPCommons. Portal del coneixement obert de la UPC
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,301629

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