Abstract
Background
Locomat(sic)
is a robotic exoskeleton providing guidance force and bodyweight
support to facilitate intensive walking training for people with stroke.
Although the Locomat has been reported to be effective in improving
walking performance, the effects of training parameters on the
neuromuscular control remain unclear. This study aimed to compare the
muscle activities between Locomat walking and treadmill walking at a
normal speed, as well as to investigate the effects of varying
bodyweight support and guidance force on muscle activation patterns
during Locomat walking in people with stroke.
Methods
A
cross-sectional study design was employed. Participants first performed
an unrestrained walking on a treadmill and then walked in the Locomat
with different levels of bodyweight support (30% or 50%) and guidance
force (40% or 70%) at the same speed (1.2 m/s). Surface electromyography
(sEMG) of seven muscles of the affected leg was recorded. The sEMG
envelope was time-normalised and averaged over gait cycles. Mean sEMG
amplitude was then calculated by normalising the sEMG amplitude with
respect to the peak amplitude during treadmill walking for statistical
analysis. A series of Non-parametric test and post hoc analysis were
performed with a significance level of 0.05.
Results
Fourteen participants with stroke were recruited at the Yangzhi Affiliated Rehabilitation Hospital of Tongji University (female n = 1;
mean age 46.1 ± 11.1 years). Only the mean sEMG amplitude of vastus
medialis oblique during Locomat walking (50% bodyweight support and 70%
guidance force) was significantly lower than that during treadmill
walking. Reducing both bodyweight and guidance increased muscle activity
of gluteus medius and tibialis anterior. Activity of vastus medialis
oblique muscle increased as bodyweight support reduced, while that of
rectus femoris increased as guidance force decreased.
Conclusions
The
effects of Locomat on reducing muscle activity in people with stroke
were minimized when walking at a normal speed. Reducing bodyweight
support and guidance force increased the activity of specific muscles
during Locomat walking. Effects of bodyweight support, guidance force
and speed should be taken into account when developing individualized
Locomat training protocols for clients with stroke.
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