Wearable Hip-assist Robot Modulates Cortical Activation during Gait in Stroke Patients: A Functional Near-Infrared Spectroscopy Study

Lee, Suhyun; Lee, Hwang-Jae; Shim, Youngbo; Chang, Won Hyuk; Choi, Byung‐Ok; Ryu, Gyu Ha; Kim, Yun-Hee

doi:10.21203/rs.3.rs-23523/v2

Cited by 3 publications

(3 citation statements)

References 34 publications

(43 reference statements)

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“…Therefore, improvement in gait speed can partially explain the improvement in gait symmetry. In addition, in a study that analyzed the effects of wearable exoskeletons in stroke patients using functional near-infrared spectroscopy [29], symmetrical sensorimotor cortex activation was induced. Interestingly, it was confirmed that the oxyhemoglobin concentration decreased in the ipsilesional sensorimotor cortex and bilateral supplemental motor areas at the end of the training, resulting in a rhythmic efficient gait pattern with minimal cortical participation.…”

Section: Discussionmentioning

confidence: 99%

Effect of Robot-Assisted Wearable Exoskeleton on Gait Speed of Post-Stroke Patients: A Systematic Review and Meta-Analysis of a Randomized Controlled Trials

Kim

2022

Phys Ther Rehabil Sci

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The greatest motor impairment after stroke is a decreased ability to walk. Most stroke patients achieve independent gait, but approximately 70% do not reach normal speed, making it difficult to reach a standard of daily living. Therefore, a wearable exoskeleton is recommended for optimal independent gait because different residual disorders hinder motor function after stroke. This review synthesized the effect on gait speed in randomized controlled trials (RCTs) in which gait training using a wearable exoskeleton was performed on post-stroke patients for qualitative and quantitative analysis. Design: A systematic review and meta-analysis of a randomized controlled trials Methods: RCTs using wearable exoskeletons in robotic rehabilitation of post-stroke patients were extracted from an international electronic database. For quality assessment and quantitative analysis, RevMan 5.4 was used. Quantitative analysis was calculated as the standardized mean difference (SMD) and presented as a random effect model. Results: Five studies involving 197 post-stroke patients were included in this review. As a result of the analysis using a random effect model, gait training using a wearable exoskeleton in post-stroke patients showed a significant improvement in gait speed compared to the non-wearing exoskeleton (SMD＝1.15, 95% confidence interval: 0.52 to 1.78). Conclusions: This study concluded that a wearable exoskeleton was more effective than conventional gait training in improving the gait speed in post-stroke patients.

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Section: Discussionmentioning

confidence: 99%

Effect of Robot-Assisted Wearable Exoskeleton on Gait Speed of Post-Stroke Patients: A Systematic Review and Meta-Analysis of a Randomized Controlled Trials

Kim

2022

Phys Ther Rehabil Sci

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“…Corticomotor excitability (CME) corresponding to rectus femoris muscle in patients with chronic stroke augmented with hip exoskeleton compared with functional training (P 0.010). primary sensorimotor cortex (SMC) showed augmented activation in patients with stroke, as revealed by infrared spectroscopy [43].…”

Section: Muscle Activitymentioning

confidence: 99%

Powered Hip Exoskeletons for Gait Rehabilitation: A Systematic Review and Meta-analysis

Daliri

Ghorbani

Akbarzadeh

et al. 2023

Preprint

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Background: Gait disorders and as a consequence, robotic rehabilitation techniques are becoming increasingly prevalent as the population ages. In the area of rehabilitation robotics, using lightweight single hip joint exoskeletons are of significance. Considering no prior systematic review article on clinical outcomes, we aim to systematically review powered hip exoskeletons in terms of gait parameters and metabolic expenditure effects. Methods: Three databases of PubMed, Scopus, and Web of science were searched for clinical articles comparing outcomes of gait rehabilitation using hip motorized exoskeleton with conventional methods, on patients with gait disorder or healthy individuals. Of total number of 37 reviewed articles, 14 trials were quantitatively analyzed. Analyses performed in terms of gait spatiotemporal parameters like speed (self-speed and maximum speed), step length, stride length, cadence, and oxygen consumption. Results: Improved clinical outcomes of gait spatiotemporal parameters with hip joint exoskeletons are what our review's findings show. In terms of gait values, meta-analysis indicates that rehabilitation with single hip joint exoskeleton enhanced parameters of max speed (P = 0.018) and stride length (P = 0.01). Subgroup analysis showed that cadence improved among healthy elderly people (P = 0.050). For the remaining investigated gait parameters, no statistically significant difference was observed. Regarding metabolic parameters, oxygen consumption was lower in individuals treated with hip exoskeleton (P = 0.007). Conclusion: Although the analysis demonstrated improvement with just specific gait measures utilizing powered hip exoskeletons, the lack of improvement in all parameters is likely caused by the high patient condition heterogeneity among the evaluated articles. We also noted in patients who rehabilitated with the hip exoskeleton, the oxygen cost was lower. More randomized controlled trials are needed to verify both the short- and long-term clinical outcomes, including patient-reported measures. Level of evidence: Level I (systematic review and meta-analysis)

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“…Lee et al developed a smart wearable hip-assist robot for restoring the locomotor function, the Gait Enhancing and Motivating System (GEMS, Samsung Advanced Institute of Technology, Suwon, South Korea). GEMS is equipped with an assist-as-needed algorithm for delivering active-assistance in hip extension and flexion ( Lee et al, 2019 ; Lee et al, 2020 ) ( Figure 5 ).…”

Section: Home-based Rehabilitation Systemsmentioning

confidence: 99%

Robotic Home-Based Rehabilitation Systems Design: From a Literature Review to a Conceptual Framework for Community-Based Remote Therapy During COVID-19 Pandemic

2021

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During the COVID-19 pandemic, the higher susceptibility of post-stroke patients to infection calls for extra safety precautions. Despite the imposed restrictions, early neurorehabilitation cannot be postponed due to its paramount importance for improving motor and functional recovery chances. Utilizing accessible state-of-the-art technologies, home-based rehabilitation devices are proposed as a sustainable solution in the current crisis. In this paper, a comprehensive review on developed home-based rehabilitation technologies of the last 10 years (2011–2020), categorizing them into upper and lower limb devices and considering both commercialized and state-of-the-art realms. Mechatronic, control, and software aspects of the system are discussed to provide a classified roadmap for home-based systems development. Subsequently, a conceptual framework on the development of smart and intelligent community-based home rehabilitation systems based on novel mechatronic technologies is proposed. In this framework, each rehabilitation device acts as an agent in the network, using the internet of things (IoT) technologies, which facilitates learning from the recorded data of the other agents, as well as the tele-supervision of the treatment by an expert. The presented design paradigm based on the above-mentioned leading technologies could lead to the development of promising home rehabilitation systems, which encourage stroke survivors to engage in under-supervised or unsupervised therapeutic activities.

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Wearable Hip-assist Robot Modulates Cortical Activation during Gait in Stroke Patients: A Functional Near-Infrared Spectroscopy Study

Cited by 3 publications

References 34 publications

Effect of Robot-Assisted Wearable Exoskeleton on Gait Speed of Post-Stroke Patients: A Systematic Review and Meta-Analysis of a Randomized Controlled Trials

Effect of Robot-Assisted Wearable Exoskeleton on Gait Speed of Post-Stroke Patients: A Systematic Review and Meta-Analysis of a Randomized Controlled Trials

Powered Hip Exoskeletons for Gait Rehabilitation: A Systematic Review and Meta-analysis

Robotic Home-Based Rehabilitation Systems Design: From a Literature Review to a Conceptual Framework for Community-Based Remote Therapy During COVID-19 Pandemic

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