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The study aimed to evaluate the effectiveness of functional and motor activity restoration, including the walking function, in patients after an ischemic stroke using the ExoAtlet lower limb exoskeleton. Patients and methods. A clinical study was carried out on 42 patients who had undergone a cerebral infarction in the mid cerebral artery system with a post-stroke paresis of the leg, and who had undergone a rehabilitation course in a round-theclock hospital during the early recovery period. Patients were randomized into two equal groups comparable in terms of the stroke severity: the patients in group 1 were receiving a standard rehabilitation program (control group), the patients in group 2 were additionally receiving a course of gait rehabilitation using the ExoAtlet exoskeleton - 10 sessions, 5 sessions per week for 14 days. Results. The study demonstrated the effectiveness of the ExoAtlet exoskeleton used in the rehabilitation of stroke patients over the standard course of rehabilitation. The advantages include a decrease in the hemiparesis degree, an increase in the muscle strength of the paretic limb, an improvement in balance, an improvement and acceleration of the walking process. The obtained results of the instrumental study confirmed the benefits of physical training on the Exoskeleton, which was demonstrated through an increase in stability and balance, as well as through a decrease in the energy consumption index for maintaining the stable verticalization. Conclusion. The usage of the ExoAtlet exoskeleton increases the effectiveness of rehabilitation measures and improves motor and functional activities of patients who have suffered a cerebral stroke.

The main functions of a method of functional electrical stimulation of muscles (FES) are described: diagnostic, prognostic, and therapeutic. The main indication for using the FES method is a deficiency of muscle function, which may be organic (due to lesions to neuromuscular structures) or functional (associated with relaxation of the muscular apparatus). The five most significant functions of the FES method were established: 1) identification of correctable movements and stimulable muscles; 2) identification of the amplitude and time program for stimulation; 3) stimulation regimes for pathological gaits; 4) stimulation parameters; 5) positioning of skin electrodes on the human body. Using the example of two severe central nervous system pathologies (spinal cord lesions in the lumbosacral area and hemiparesis of cerebral origin), the positive effects of FES on the process of motor rehabilitation of this category of patients were demonstrated.

Good tolerability of workload within 30-40 min. was observed. The improvement in the EDSS was detected in 9 patients, in whole, a significant positive trend (p<0.01) was shown. The study of the biomechanics of the walk showed its significant impairment compared to healthy individuals: reduction of parameters of rate, speed and step length, significant instability, pronounced asymmetry, the decrease in support and shock lower limb function, high coefficient of variability of the parameters, the phenomenon of recurrence of the vertical component of support reactions. After a course of exercise of walking in the exoskeleton, the walking speed and stability increased, oscillation of the body decreased, support function increased, the phenomenon of cyclical changes of the vertical component of support reactions reduced. The results of the pilot study showed promising future research opportunities for robotic-assisted walking and maintenance of the vertical posture with the help of the exoskeleton ExoAtlet to restore the abilities of movement in MS patients with locomotor disorders.

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Aim. To identify the features of changes in the energy parameters of walking in patients with multiple sclerosis (MS) and their correction under the influence of the of the exoskeleton training course. Material and methods. Authors of this article investigated electrical activity of two symmetrical thigh muscles – both m. rectus femoris and both m. biceps femoris during walking at different cadences – the slowest one, slow, decelerated, voluntary and fast in 3 patients with multiple sclerosis (MS). In addition to these parameters, the energy parameters of walking were also studied, namely, the average electrical activity of the muscles, equivalent to the power of the muscles, and the total integral for 10 m of the path, equivalent to the work of the muscles, taking into account both the pace and the length of the step. Results. The authors revealed the characteristic features of the energy parameters of walking in patients with multiple sclerosis, namely, a very slight increase in muscle power with an increase of walking velovity and the absence of the parabola second branch in the curve of the total integral for the distance of 10 m. On the basis of the received data authors make conclusion, that rezonance pnenomena are considerably diminished in patients with MS. The training exoskeleton walking method was developed, which includes the total training time, net walking time (walking time without rest), speed, pace and step length when walking in an exoskeleton, the number of steps taken by patients during the session and for the entire course. Remarkable improvement of the innervative structure of walking takes place after the course of training in the exoskeleton, that is revealed in considerable activity maximuma growth and in a number of cases – in apperance of these maxima, in concentration of these maxima in the locomotor cycle adequate phases, in appearance of the second maximum of activity in rectus femoris muscle and biceps femoris muscle in the swing phase of the locomotor cycle. Conclusion. All these positive changes were accompanied by an increase in the random walking speed and remarkable improvement of the energy walking parameters, namely, by considerable increase of the average electrical muscle activity and appearance of two parabola branches in the curve of the summary integral for the distance of 10 m, what points to appearance of the rezonance phenomena during walking in this patient.

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