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The Actuation System of the Ankle Exoskeleton T-FLEX: First Use Experimental Validation in People with Stroke

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Gomez Vargas, Daniel
Ballen Moreno, Felipe
Barria, Patricio
Aguilar, Rolando
Azorín, José M.
Múnera, Marcela
Cifuentes, Carlos A.
Abstract (Spanish)
Los dispositivos robóticos pueden proporcionar asistencia física a personas que han sufrido discapacidades neurológicas como un accidente cerebrovascular. Los trastornos neurológicos relacionados con esta afección inducen patrones de marcha anormales, que impiden la independencia para ejecutar diferentes actividades de la vida diaria (AVD). A partir del papel fundamental del tobillo en la marcha, se han desarrollado ortesis de tobillo y pie motorizadas (PAFO) para mejorar los patrones de marcha de los usuarios y, por lo tanto, su calidad de vida. Diez pacientes que sufrieron un accidente cerebrovascular utilizaron el sistema de actuación del exoesqueleto T-FLEX activado por un sensor inercial en la punta del pie. El sistema de captura VICONmotion registró la cinemática de los usuarios para las modalidades de marcha asistida y no asistida. El análisis biomecánico y la evaluación de usabilidad midieron el rendimiento de la actuación del sistema para los participantes en la marcha sobre el suelo. La evaluación biomecánica mostró cambios en el rango de movimiento de las articulaciones inferiores en el 70% de los sujetos. Además, la cinemática del tobillo mostró una correlación con la variación de otros movimientos analizados. Esta variación tuvo efectos positivos en el 70% de los participantes en al menos una articulación. El Índice de Desviación de la Marcha (GDI) presentó cambios significativos para el 30% de los miembros paréticos y el 40% de los no paréticos, donde la tendencia fue a disminuir. Los parámetros espacio-temporales no mostraron variaciones significativas entre modalidades, aunque la cadencia de los usuarios tuvo una disminución del 70% de los voluntarios. Por último, la satisfacción con el dispositivo fue positiva, siendo la comodidad el aspecto más seleccionado por los usuarios. En este artículo se presenta la evaluación del sistema de actuación T-FLEX en personas que sufrieron un ictus. Los resultados biomecánicos muestran una mejoría en la cinemática del tobillo y variaciones en el resto de articulaciones. En términos generales, el GDI no presenta incrementos significativos y el Perfil de Análisis del Movimiento (MAP) registra alteraciones en la marcha asistida con el dispositivo. Futuros trabajos deberían centrarse en evaluar la ortesis T-FLEX completa en una muestra más amplia de pacientes, incluyendo una etapa de entrenamiento.
Abstract (English)
Robotic devices can provide physical assistance to people who have suffered neurological impairments such as stroke. Neurological disorders related to this condition induce abnormal gait patterns, which impede the independence to execute different Activities of Daily Living (ADLs). From the fundamental role of the ankle in walking, Powered Ankle-Foot Orthoses (PAFOs) have been developed to enhance the users’ gait patterns, and hence their quality of life. Ten patients who suffered a stroke used the actuation system of the T-FLEX exoskeleton triggered by an inertial sensor on the foot tip. The VICONmotion capture system recorded the users’ kinematics for unassisted and assisted gait modalities. Biomechanical analysis and usability assessment measured the performance of the system actuation for the participants in overground walking. The biomechanical assessment exhibited changes in the lower joints’ range of motion for 70% of the subjects. Moreover, the ankle kinematics showed a correlation with the variation of other movements analyzed. This variation had positive effects on 70% of the participants in at least one joint. The Gait Deviation Index (GDI) presented significant changes for 30% of the paretic limbs and 40% of the non-paretic, where the tendency was to decrease. The spatiotemporal parameters did not show significant variations between modalities, although users’ cadence had a decrease of 70% of the volunteers. Lastly, the satisfaction with the device was positive, the comfort being the most user-selected aspect. This article presents the assessment of the T-FLEX actuation system in people who suffered a stroke. Biomechanical results show improvement in the ankle kinematics and variations in the other joints. In general terms, GDI does not exhibit significant increases, and the Movement Analysis Profile (MAP) registers alterations for the assisted gait with the device. Future works should focus on assessing the full T-FLEX orthosis in a larger sample of patients, including a stage of training
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URI: https://repositorio.escuelaing.edu.co/handle/001/3251
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