TY - JOUR
T1 - A multidirectional gravity-assist algorithm that enhances locomotor control in patients with stroke or spinal cord injury
AU - Mignardot, Jean Baptiste
AU - Le Goff, Camille G.
AU - Van Den Brand, Rubia
AU - Capogrosso, Marco
AU - Fumeaux, Nicolas
AU - Vallery, Heike
AU - Anil, Selin
AU - Lanini, Jessica
AU - Fodor, Isabelle
AU - Eberle, Grégoire
AU - Ijspeert, Auke J.
AU - Schurch, Brigitte
AU - Curt, Armin
AU - Carda, Stefano
AU - Bloch, Jocelyne
AU - Von Zitzewitz, Joachim
AU - Courtine, Grégoire
PY - 2017
Y1 - 2017
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85025449430&partnerID=8YFLogxK
U2 - 10.1126/scitranslmed.aah3621
DO - 10.1126/scitranslmed.aah3621
M3 - Article
AN - SCOPUS:85025449430
SN - 1946-6234
VL - 9
JO - Science Translational Medicine
JF - Science Translational Medicine
IS - 399
M1 - eaah3621
ER -