Individuals with cerebral palsy can have weak and poorly coordinated ankle plantar flexor muscles that contribute to inefficient walking patterns. Previous studies attempting to improve plantar flexor function have had inconsistent effects on mobility, likely due to a lack of task-specificity. The goal of this study was to develop, validate, and test the feasibility and neuromuscular response of a novel wearable adaptive resistance platform to increase activity of the plantar flexors during the propulsive phase of gait. We recruited eight individuals with spastic cerebral palsy to walk with adaptive plantar flexor resistance provided from an untethered exoskeleton. The resistance system and protocol was safe and feasible for all of our participants. Controller validation demonstrated our ability to provide resistance that proportionally- and instantaneously-adapted to the biological ankle moment (R = 0.92 ± 0.04). Following acclimation to resistance (0.16 ± 0.02 Nm/kg), more-affected limbs exhibited a 45 ± 35% increase in plantar flexor activity (p = 0.02), a 26 ± 24% decrease in dorsiflexor activity (p < 0.05), and a 46 ± 25% decrease in co-contraction (tibialis anterior and soleus) (p = 0.02) during the stance phase. This adaptive resistance system warrants further investigation for use in a longitudinal intervention study.

中文翻译：

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来自可穿戴机器人设备的自适应脚踝阻力，可改善脑瘫的肌肉吸收。

脑瘫患者的脚踝plant屈肌无力且协调不力，导致步行模式无效。先前尝试改善足底屈肌功能的研究对运动能力的影响不一致，这很可能是由于缺乏任务特异性所致。本研究的目的是开发，验证和测试新型可穿戴自适应阻力平台在步态推进阶段增加increase屈的活动的可行性和神经肌肉反应。我们招募了八名痉挛性脑瘫患者，以不受束缚的外骨骼提供的适应性足底屈肌阻力行走。抵抗系统和协议对我们所有参与者都是安全可行的。控制器验证表明，我们能够提供与生物踝关节力矩成比例和瞬时适应的阻力（R = 0.92±0.04）。适应阻力后（0.16±0.02 Nm / kg），患病较严重的肢体的plant屈活动度增加了45±35％（p = 0.02），背屈活动度减少了26±24％（p <0.05），并且在站立阶段，共收缩（胫前肌和比目鱼肌）减少46±25％（p = 0.02）。这种适应性抵抗系统值得进一步研究，以用于纵向干预研究。05），而在站立阶段，共同收缩（胫前肌和比目鱼肌）减少46±25％（p = 0.02）。这种适应性抵抗系统值得进一步研究，以用于纵向干预研究。05），而在站立阶段，共同收缩（胫前肌和比目鱼肌）减少46±25％（p = 0.02）。这种适应性抵抗系统值得进一步研究，以用于纵向干预研究。