Many people who have experienced a stroke have deficits in their walking balance. The long-term goal of this research is to develop an exoskeleton that can effectively improve walking balance, thus improving functional mobility.
Walking balance is an important component of functional mobility, with post-stroke balance deficits contributing to a fall rate more than double that of age-matched controls. Unfortunately, traditional therapy approaches have not succeeded in addressing balance deficits or reducing fall risk, motivating the use of technology to fill this gap. Although assistive exoskeletons are a promising approach to improve post-stroke mobility, they have generally not been designed to control walking balance and agility. This limitation is a particular concern in the development of devices for people with stroke, as applying forces to "assist" some aspect of walking (including balance) can have unexpected negative effects. The project goal is to investigate the potential of exoskeleton assistance to improve walking balance that will be accepted by people with stroke. To this end, investigators will use a previously developed hip exoskeleton to quantify the effects of assisting gait stabilization.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
BASIC_SCIENCE
Masking
NONE
Enrollment
21
The participant will not wear an exoskeleton
The participant will wear an exoskeleton with zero impedance
The participant will wear an exoskeleton with low joint impedance
Medical University of South Carolina
Charleston, South Carolina, United States
RECRUITINGPartial correlation (rSW) between mediolateral pelvis displacement and step width during unperturbed walking
Mediolateral pelvis displacement will be quantified at the start of each step, and step width will be calculated at the end of each step. Across all steps, the partial correlation between these two metrics will be calculated - accounting for the mediolateral pelvis velocity. This will be done for steps taken with each leg independently.
Time frame: Visit 2, anticipated average 1 week
Partial correlation (rSW) between mediolateral pelvis displacement and step width during speed perturbations
Mediolateral pelvis displacement will be quantified at the start of each step, and step width will be calculated at the end of each step. Across all steps, the partial correlation between these two metrics will be calculated - accounting for the mediolateral pelvis velocity. This will be done for steps taken with each leg independently.
Time frame: Visit 4, anticipated average 1 year
Partial correlation (rSW) between mediolateral pelvis displacement and step width during vision perturbations
Mediolateral pelvis displacement will be quantified at the start of each step, and step width will be calculated at the end of each step. Across all steps, the partial correlation between these two metrics will be calculated - accounting for the mediolateral pelvis velocity. This will be done for steps taken with each leg independently.
Time frame: Visit 4, anticipated average 1 year
Partial correlation (rSW) between mediolateral pelvis displacement and step width during mediolateral pull perturbations
Mediolateral pelvis displacement will be quantified at the start of each step, and step width will be calculated at the end of each step. Across all steps, the partial correlation between these two metrics will be calculated - accounting for the mediolateral pelvis velocity. This will be done for steps taken with each leg independently.
Time frame: Visit 4, anticipated average 1 year
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The participant will wear an exoskeleton with medium joint impedance
The participant will wear an exoskeleton with high impedance
Partial correlation between mediolateral pelvis displacement and mediolateral foot placement (unperturbed walking)
Mediolateral pelvis displacement will be quantified at the start of each step, and mediolateral foot placement relative to the pelvis will be calculated at the end of each step. Across all steps, the partial correlation between these two metrics will be calculated - accounting for the mediolateral pelvis velocity. This will be done for steps taken with each leg independently.
Time frame: Visit 2, anticipated average 1 week
Average gluteus medius activity during stance phase (surface EMG) in unperturbed walking
Average gluteus medius EMG activity will be calculated during the stance phase of walking. This will be calculated for each leg independently.
Time frame: Visit 2, anticipated average 1 week
Average gluteus medius activity during swing phase (surface EMG) in unperturbed walking
Average gluteus medius EMG activity will be calculated during the swing phase of walking. This will be calculated for each leg independently.
Time frame: Visit 2, anticipated average 1 week
Rating of Perceived Stability (RPS) during unperturbed walking
This patient reported outcome measure uses a validated scale for participants to self-report their perceived balance while walking.
Time frame: Visit 2, anticipated average 1 week
Partial correlation between mediolateral pelvis displacement and mediolateral foot placement during speed perturbations
Mediolateral pelvis displacement will be quantified at the start of each step, and mediolateral foot placement relative to the pelvis will be calculated at the end of each step. Across all steps, the partial correlation between these two metrics will be calculated - accounting for the mediolateral pelvis velocity. This will be done for steps taken with each leg independently.
Time frame: Visit 4, anticipated average 1 year
Average gluteus medius activity during stance phase (surface EMG) with speed perturbations
Average gluteus medius EMG activity will be calculated during the stance phase of walking. This will be calculated for each leg independently.
Time frame: Visit 4, anticipated average 1 year
Average gluteus medius activity during swing phase (surface EMG) with speed perturbations
Average gluteus medius EMG activity will be calculated during the swing phase of walking. This will be calculated for each leg independently.
Time frame: Visit 4, anticipated average 1 year
Rating of Perceived Stability (RPS) with speed perturbations
This patient reported outcome measure uses a validated scale for participants to self-report their perceived balance while walking.
Time frame: Visit 4, anticipated average 1 year
Partial correlation between mediolateral pelvis displacement and mediolateral foot placement during vision perturbations
Mediolateral pelvis displacement will be quantified at the start of each step, and mediolateral foot placement relative to the pelvis will be calculated at the end of each step. Across all steps, the partial correlation between these two metrics will be calculated - accounting for the mediolateral pelvis velocity. This will be done for steps taken with each leg independently.
Time frame: Visit 4, anticipated average 1 year
Average gluteus medius activity during stance phase (surface EMG) with vision perturbations
Average gluteus medius EMG activity will be calculated during the stance phase of walking. This will be calculated for each leg independently.
Time frame: Visit 4, anticipated average 1 year
Average gluteus medius activity during swing phase (surface EMG) with vision perturbations
Average gluteus medius EMG activity will be calculated during the swing phase of walking. This will be calculated for each leg independently.
Time frame: Visit 4, anticipated average 1 year
Rating of Perceived Stability (RPS) with vision perturbations
This patient reported outcome measure uses a validated scale for participants to self-report their perceived balance while walking.
Time frame: Visit 4, anticipated average 1 year
Partial correlation between mediolateral pelvis displacement and mediolateral foot placement during mediolateral pull perturbations
Mediolateral pelvis displacement will be quantified at the start of each step, and mediolateral foot placement relative to the pelvis will be calculated at the end of each step. Across all steps, the partial correlation between these two metrics will be calculated - accounting for the mediolateral pelvis velocity. This will be done for steps taken with each leg independently.
Time frame: Visit 4, anticipated average 1 year
Average gluteus medius activity during stance phase (surface EMG) with mediolateral pull perturbations
Average gluteus medius EMG activity will be calculated during the stance phase of walking. This will be calculated for each leg independently.
Time frame: Visit 4, anticipated average 1 year
Average gluteus medius activity during swing phase (surface EMG) with mediolateral pull perturbations
Average gluteus medius EMG activity will be calculated during the swing phase of walking. This will be calculated for each leg independently.
Time frame: Visit 4, anticipated average 1 year
Rating of Perceived Stability (RPS) with mediolateral pull perturbations
This patient reported outcome measure uses a validated scale for participants to self-report their perceived balance while walking.
Time frame: Visit 4, anticipated average 1 year
Change in mediolateral foot placement (cm) during pull perturbations relative to unperturbed steps
The change in mediolateral foot placement locations between steps with and without pull perturbations will be calculated. This will be calculated separately for steps taken with each leg.
Time frame: Visit 4, anticipated average 1 year