A multidirectional gravity-assist algorithm that enhances locomotor control in patients with stroke or spinal cord injury.
- Mignardot JB Center for Neuroprosthetics and Brain Mind Institute, School of Life Sciences, Swiss Federal Institute of Technology Lausanne (EPFL), Lausanne, Switzerland.
- Le Goff CG Center for Neuroprosthetics and Brain Mind Institute, School of Life Sciences, Swiss Federal Institute of Technology Lausanne (EPFL), Lausanne, Switzerland.
- van den Brand R Center for Neuroprosthetics and Brain Mind Institute, School of Life Sciences, Swiss Federal Institute of Technology Lausanne (EPFL), Lausanne, Switzerland.
- Capogrosso M Center for Neuroprosthetics and Brain Mind Institute, School of Life Sciences, Swiss Federal Institute of Technology Lausanne (EPFL), Lausanne, Switzerland.
- Fumeaux N Center for Neuroprosthetics and Brain Mind Institute, School of Life Sciences, Swiss Federal Institute of Technology Lausanne (EPFL), Lausanne, Switzerland.
- Vallery H Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology, Delft, Netherlands.
- Anil S Center for Neuroprosthetics and Brain Mind Institute, School of Life Sciences, Swiss Federal Institute of Technology Lausanne (EPFL), Lausanne, Switzerland.
- Lanini J School of Engineering, EPFL, Lausanne, Switzerland.
- Fodor I Neurorehabilitation, CHUV, Lausanne, Switzerland.
- Eberle G Neurorehabilitation, CHUV, Lausanne, Switzerland.
- Ijspeert A School of Engineering, EPFL, Lausanne, Switzerland.
- Schurch B Neuro-urology, CHUV, Lausanne, Switzerland.
- Curt A Spinal Cord Injury Center, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.
- Carda S Clinical Neuroscience, University Hospital of Vaud (CHUV), Lausanne, Switzerland.
- Bloch J Clinical Neuroscience, University Hospital of Vaud (CHUV), Lausanne, Switzerland.
- von Zitzewitz J Center for Neuroprosthetics and Brain Mind Institute, School of Life Sciences, Swiss Federal Institute of Technology Lausanne (EPFL), Lausanne, Switzerland.
- Courtine G Center for Neuroprosthetics and Brain Mind Institute, School of Life Sciences, Swiss Federal Institute of Technology Lausanne (EPFL), Lausanne, Switzerland. gregoire.courtine@epfl.ch.
- 2017-07-21
Published in:
- Science translational medicine. - 2017
English
Gait recovery after neurological disorders requires remastering the interplay between body mechanics and gravitational forces. Despite the importance of gravity-dependent gait interactions and active participation for promoting this learning, these essential components of gait rehabilitation have received comparatively little attention. To address these issues, we developed an adaptive algorithm that personalizes multidirectional forces applied to the trunk based on patient-specific motor deficits. Implementation of this algorithm in a robotic interface reestablished gait dynamics during highly participative locomotion within a large and safe environment. This multidirectional gravity-assist enabled natural walking in nonambulatory individuals with spinal cord injury or stroke and enhanced skilled locomotor control in the less-impaired subjects. A 1-hour training session with multidirectional gravity-assist improved locomotor performance tested without robotic assistance immediately after training, whereas walking the same distance on a treadmill did not ameliorate gait. These results highlight the importance of precise trunk support to deliver gait rehabilitation protocols and establish a practical framework to apply these concepts in clinical routine.
- Language
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- English
- Open access status
- bronze
- Identifiers
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- DOI 10.1126/scitranslmed.aah3621
- PMID 28724575
- Persistent URL
- https://sonar.ch/global/documents/47622
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