BACKGROUND Locomat 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.

中文翻译：

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体重支撑和引导力对中风患者 Locomat 行走期间肌肉激活的影响：一项横断面研究。

背景技术Locomat是一种机器人外骨骼，提供引导力和体重支撑，以促进中风患者的强化步行训练。尽管据报道 Locomat 可有效改善步行表现，但训练参数对神经肌肉控制的影响仍不清楚。本研究旨在比较 Locomat 行走和跑步机上正常速度行走的肌肉活动，并研究不同体重支撑和引导力对中风患者 Locomat 行走期间肌肉激活模式的影响。方法 采用横断面研究设计。参与者首先在跑步机上进行无限制行走，然后在不同程度的体重支撑（30%或50%）和引导力（40%或70%）的Locomat中以相同的速度（1.2 m/s）行走。记录受影响腿部七块肌肉的表面肌电图（sEMG）。sEMG 包络经过时间归一化并在步态周期内进行平均。然后通过将 sEMG 振幅相对于跑步机行走期间的峰值振幅归一化来计算平均 sEMG 振幅，以进行统计分析。进行了一系列非参数检验和事后分析，显着性水平为0.05。结果 同济大学杨志附属康复医院招募了 14 名脑卒中参与者（女性 n = 1；平均年龄 46.1 ± 11.1 岁）。仅Locomat行走（50%体重支撑和70%引导力）时股内侧斜肌平均sEMG振幅显着低于跑步机行走时。减轻体重和引导会增加臀中肌和胫骨前肌的肌肉活动。股内侧斜肌的活动随着体重支撑的减少而增加，而股直肌的活动随着引导力的减少而增加。结论 当以正常速度行走时，Locomat 对减少中风患者肌肉活动的影响最小化。减少体重支撑和引导力会增加 Locomat 行走过程中特定肌肉的活动。在为中风患者制定个性化 Locomat 训练方案时，应考虑体重支撑、引导力和速度的影响。