Wearable hip-assist robot modulates cortical activation during gait in stroke patients: a functional near-infrared spectroscopy study

Journal of NeuroEngineering and Rehabilitation

Gyu-Ha Ryu¹  Byung-Ok Choi²  Su-Hyun Lee³  Won Hyuk Chang³  Hwang-Jae Lee⁴  Yun-Hee Kim⁴  Youngbo Shim⁵ 

[1] Department of Medical Device Management and Research, SAIHST, Sungkyunkwan University School of Medicine, Irwon-ro 81, Gangnam-gu, 06351, Seoul, Republic of Korea;The Office of R&D Strategy & Planning, Samsung Medical Center, Irwon-ro 81, Gangnam-gu, 06351, Seoul, Republic of Korea;Department of Neurology, Neuroscience Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon-ro 81, Gangnam-gu, 06351, Seoul, Republic of Korea;Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon-ro 115, Gangnam-gu, 06355, Seoul, Republic of Korea;Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon-ro 115, Gangnam-gu, 06355, Seoul, Republic of Korea;Department of Health Sciences and Technology, Department of Medical Device Management and Research, Department of Digital Health, SAIHST, Sungkyunkwan University, Irwon-ro 81, Gangnam-gu, 06351, Seoul, Republic of Korea;Samsung Research, Samsung Electronics, 56, Seongchon-gil, Seocho-gu, 06756, Seoul, Republic of Korea;

关键词: Wearable hip-assist robot;    Stroke;    Functional near infrared spectroscopy;    Cortical activation;   

DOI  :  10.1186/s12984-020-00777-0

来源: Springer

【 摘 要 】

BackgroundGait dysfunction is common in post-stroke patients as a result of impairment in cerebral gait mechanism. Powered robotic exoskeletons are promising tools to maximize neural recovery by delivering repetitive walking practice.ObjectivesThe purpose of this study was to investigate the modulating effect of the Gait Enhancing and Motivating System-Hip (GEMS-H) on cortical activation during gait in patients with chronic stroke. Methods. Twenty chronic stroke patients performed treadmill walking at a self-selected speed either with assistance of GEMS-H (GEMS-H) or without assistance of GEMS-H (NoGEMS-H). Changes in oxygenated hemoglobin (oxyHb) concentration in the bilateral primary sensorimotor cortex (SMC), premotor cortices (PMC), supplemental motor areas (SMA), and prefrontal cortices (PFC) were recorded using functional near infrared spectroscopy.ResultsWalking with the GEMS-H promoted symmetrical SMC activation, with more activation in the affected hemisphere than in NoGEMS-H conditions. GEMS-H also decreased oxyHb concentration in the late phase over the ipsilesional SMC and bilateral SMA (P < 0.05).ConclusionsThe results of the present study reveal that the GEMS-H promoted more SMC activation and a balanced activation pattern that helped to restore gait function. Less activation in the late phase over SMC and SMA during gait with GEMS-H indicates that GEMS-H reduces the cortical participation of stroke gait by producing rhythmic hip flexion and extension movement and allows a more coordinate and efficient gait patterns.Trial registration NCT03048968. Registered 06 Feb 2017

【 授权许可】

CC BY