基于垂直地面反作用力的运动完全性截瘫患者在动力外骨骼辅助下行走的分析
Vertical ground reaction force-based analysis of powered exoskeleton-assisted walking in persons with motor-complete paraplegia.
作者信息
Fineberg Drew B, Asselin Pierre, Harel Noam Y, Agranova-Breyter Irina, Kornfeld Stephen D, Bauman William A, Spungen Ann M
机构信息
James J Peters VA Medical Center, Bronx, NY, USA.
出版信息
J Spinal Cord Med. 2013 Jul;36(4):313-21. doi: 10.1179/2045772313Y.0000000126.
OBJECTIVE
To use vertical ground reaction force (vGRF) to show the magnitude and pattern of mechanical loading in persons with spinal cord injury (SCI) during powered exoskeleton-assisted walking.
RESEARCH DESIGN
A cross-sectional study was performed to analyze vGRF during powered exoskeleton-assisted walking (ReWalk™: Argo Medical Technologies, Inc, Marlborough, MA, USA) compared with vGRF of able-bodied gait.
SETTING
Veterans Affairs Medical Center.
PARTICIPANTS
Six persons with thoracic motor-complete SCI (T1-T11 AIS A/B) and three age-, height-, weight- and gender-matched able-bodied volunteers participated.
INTERVENTIONS
SCI participants were trained to ambulate over ground using a ReWalk™. vGRF was recorded using the F-Scan™ system (TekScan, Boston, MA, USA).
OUTCOME MEASURES
Peak stance average (PSA) was computed from vGRF and normalized across all participants by percent body weight. Peak vGRF was determined for heel strike, mid-stance, and toe-off. Relative linear impulse and harmonic analysis provided quantitative support for analysis of powered exoskeletal gait.
RESULTS
Participants with motor-complete SCI, ambulating independently with a ReWalk™, demonstrated mechanical loading magnitudes and patterns similar to able-bodied gait. Harmonic analysis of PSA profile by Fourier transform contrasted frequency of stance phase gait components between able-bodied and powered exoskeleton-assisted walking.
CONCLUSION
Powered exoskeleton-assisted walking in persons with motor-complete SCI generated vGRF similar in magnitude and pattern to that of able-bodied walking. This suggests the potential for powered exoskeleton-assisted walking to provide a mechanism for mechanical loading to the lower extremities. vGRF profile can be used to examine both magnitude of loading and gait mechanics of powered exoskeleton-assisted walking among participants of different weight, gait speed, and level of assist.
目的
利用垂直地面反作用力（vGRF）来展示脊髓损伤（SCI）患者在动力外骨骼辅助行走过程中的机械负荷大小和模式。
研究设计
进行了一项横断面研究，以分析动力外骨骼辅助行走（ReWalk™：美国马萨诸塞州马尔伯勒市的阿戈医疗技术公司）过程中的vGRF，并与健全人步态的vGRF进行比较。
研究地点
退伍军人事务医疗中心。
参与者
6名胸段运动完全性SCI（T1 - T11美国脊髓损伤协会分级A/B级）患者以及3名年龄、身高、体重和性别匹配的健全志愿者参与。
干预措施
SCI患者接受使用ReWalk™在地面行走的训练。使用F - Scan™系统（美国马萨诸塞州波士顿市的TekScan公司）记录vGRF。
观察指标
根据vGRF计算峰值站立平均力（PSA），并以体重百分比对所有参与者进行标准化。确定足跟触地、站立中期和足趾离地时的峰值vGRF。相对线性冲量和谐波分析为动力外骨骼步态分析提供了定量支持。
结果
运动完全性SCI患者在使用ReWalk™独立行走时，表现出与健全人步态相似的机械负荷大小和模式。通过傅里叶变换对PSA曲线进行谐波分析，对比了健全人和动力外骨骼辅助行走时站立相步态成分的频率。
结论
运动完全性SCI患者在动力外骨骼辅助下行走产生的vGRF在大小和模式上与健全人行走相似。这表明动力外骨骼辅助行走有可能为下肢提供一种机械负荷机制。vGRF曲线可用于检查不同体重、步态速度和辅助水平的参与者在动力外骨骼辅助行走过程中的负荷大小和步态力学。
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