OBJECTIVE To examine the immediate effects of a hip-assistive wearable robotic exoskeleton on clinical walking performance, walking energetics, gait kinematics, and corticomotor excitability in individuals with stroke. DESIGN Randomized cross-over trial. SETTING Research laboratory of a rehabilitation hospital. PARTICIPANTS Twelve individuals (4F/8M, mean age 57.8±7.2) with chronic hemiparetic stroke. INTERVENTIONS Honda's Stride Management Assist (SMA) exoskeleton, which provides torque-based flexion and extension assistance at the hip joints during walking. MAIN OUTCOME MEASURES The primary outcome measure was change in self-selected walking speed with the device off vs. with the device on. Secondary outcome measures included changes in clinical endurance, energy expenditure, kinematics, and corticomotor excitability of lower limb muscles. RESULTS In a single session using the device, participants exhibited adaptations over most outcome measures. Self-selected walking speed and peak treadmill speed increased, while oxygen consumption rate decreased during overground and treadmill endurance tests. More symmetric walking patterns were observed during treadmill walking. Changes in corticomotor excitability were highly variable among participants, with a non-significant increase in excitability for the paretic rectus femoris. CONCLUSIONS The SMA hip exoskeleton causes immediate positive adaptations in walking performance in individuals with stroke when the device is in use.

中文翻译：

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使用可穿戴机器人外骨骼立即适应中风后步行表现

目的检查髋关节辅助可穿戴机器人外骨骼对中风患者的临床步行表现、步行能量学、步态运动学和皮质运动兴奋性的直接影响。设计 随机交叉试验。设置 康复医院的研究实验室。参与者 12 名慢性偏瘫患者（4F/8M，平均年龄 57.8±7.2）。干预措施 本田的步幅管理辅助 (SMA) 外骨骼，在行走过程中为髋关节提供基于扭矩的屈伸辅助。主要结果测量主要结果测量是设备关闭与设备开启时自选步行速度的变化。次要结果测量包括临床耐力、能量消耗、运动学和下肢肌肉皮质运动兴奋性的变化。结果 在使用该设备的单次会议中，参与者表现出对大多数结果测量的适应性。自行选择的步行速度和跑步机峰值速度增加，而在地上和跑步机耐力测试中耗氧率下降。在跑步机行走期间观察到更对称的行走模式。参与者之间皮质运动兴奋性的变化差异很大，麻痹性股直肌的兴奋性没有显着增加。结论 SMA 髋关节外骨骼在使用该设备时会立即使中风患者的步行表现产生积极的适应。而在地上和跑步机耐力测试中，耗氧率下降。在跑步机行走期间观察到更对称的行走模式。参与者之间皮质运动兴奋性的变化差异很大，麻痹性股直肌的兴奋性没有显着增加。结论 SMA 髋关节外骨骼在使用该设备时会立即使中风患者的步行表现产生积极的适应。而在地面和跑步机耐力测试中耗氧率下降。在跑步机行走期间观察到更对称的行走模式。参与者之间皮质运动兴奋性的变化差异很大，麻痹性股直肌的兴奋性没有显着增加。结论 SMA 髋关节外骨骼在使用该设备时会立即使中风患者的步行表现产生积极的适应。