Individuals with neuromuscular impairment from conditions like cerebral palsy face reduced quality of life due to diminishing mobility and independence. Lower-limb exoskeletons have potential to aid mobility, yet few studies have investigated their use during over-ground walking - an exercise that may contribute to our understanding of potential benefit in free-living settings. The goal of this study was to determine the potential for adaptive plantar-flexor assistance from an untethered ankle exoskeleton to improve over-ground walking economy and speed. Six individuals with cerebral palsy completed three consecutive daily over-ground training sessions to acclimate to, and tune, assistance. During a final assessment visit, metabolic cost, walking speed, and soleus electromyography were collected for baseline, unpowered, low, training-tuned, and high assistance conditions. Compared to each participant's baseline condition, we observed a 3.9 ± 1.9% (p = 0.050) increase in walking speed and a 22.0 ± 4.5% (p = 0.002) reduction in soleus activity with training-tuned assistance; metabolic cost of transport was unchanged (p = 0.130). High assistance resulted in an 8.5 ± 4.0% (p = 0.042) reduction in metabolic cost of transport, a 6.3 ± 2.6% (p = 0.029) increase in walking speed, and a 25.0 ± 4.0% (p < 0.001) reduction in soleus activity. Improvement in exoskeleton-assisted walking economy was related to pre-training baseline walking speed ( [Formula: see text], p = 0.001); the slower and more impaired participants improved the most. Energy cost and preferred walking speed remained generally unchanged for the faster and less impaired participants. These findings demonstrate that powered ankle exoskeletons have the potential to improve mobility-related outcomes for some people with cerebral palsy.

中文翻译：

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踝关节外骨骼协助可以改善脑瘫患者的地面行走经济性。

由于行动不便和独立性下降，患有神经性肌肉疾病（例如脑瘫）的人的生活质量下降。下肢外骨骼具有帮助行动的潜力，但很少有研究调查其在地面行走过程中的使用-这种锻炼可能有助于我们了解自由生活环境的潜在益处。这项研究的目的是确定不受束缚的脚踝外骨骼适应性足底屈肌辅助的潜力，以改善地面行走的经济性和速度。六名脑瘫患者完成了连续三天的每日地面训练，以适应和调整帮助。在最终评估访视期间，收集了代谢成本，步行速度和比目鱼肌电描记图，用于基线，无动力，低，经训练调整的，和高辅助条件。与每个参与者的基线状况相比，我们观察到在训练调整的辅助下，比目鱼活动的步行速度增加3.9±1.9％（p = 0.050），而比目鱼活动减少22.0±4.5％（p = 0.002）。代谢的运输成本没有变化（p = 0.130）。高度的协助可以使运输的新陈代谢成本降低8.5±4.0％（p = 0.042），步行速度提高6.3±2.6％（p = 0.029），比目鱼肌降低25.0±4.0％（p <0.001）活动。外骨骼辅助步行经济的改善与训练前的基线步行速度有关（[公式：见正文]，p = 0.001）；较慢和较障碍的参与者进步最大。对于速度更快，障碍较少的参与者，能量成本和首选步行速度通常保持不变。