Emphasizing the active use of the arms and coordinating them with the stepping motion of the legs may promote walking recovery in patients with impaired lower limb function. Yet, most approaches use seated devices to allow coupled arm and leg movements. To provide an option during treadmill walking, we designed a rope-pulley system that physically links the arms and legs. This arm-leg pulley system was grounded to the floor and made of commercially available slotted square tubing, solid strut channels, and low-friction pulleys that allowed us to use a rope to connect the subject’s wrist to the ipsilateral foot. This set-up was based on our idea that during walking the arm could generate an assistive force during arm swing retraction and, therefore, aid in leg swing. To test this idea, we compared the mechanical, muscular, and metabolic effects between normal walking and walking with the arm-leg pulley system. We measured rope and ground reaction forces, electromyographic signals of key arm and leg muscles, and rates of metabolic energy consumption while healthy, young subjects walked at 1.25 m/s on a dual-belt instrumented treadmill (n = 8). With our arm-leg pulley system, we found that an assistive force could be generated, reaching peak values of 7% body weight on average. Contrary to our expectation, the force mainly coincided with the propulsive phase of walking and not leg swing. Our findings suggest that subjects actively used their arms to harness the energy from the moving treadmill belt, which helped to propel the whole body via the arm-leg rope linkage. This effectively decreased the muscular and mechanical demands placed on the legs, reducing the propulsive impulse by 43% (p < 0.001), which led to a 17% net reduction in the metabolic power required for walking (p = 0.001). These findings provide the biomechanical and energetic basis for how we might reimagine the use of the arms in gait rehabilitation, opening the opportunity to explore if such a method could help patients regain their walking ability. Trial registration: Study registered on 09/29/2018 in ClinicalTrials.gov (ID—NCT03689647).

中文翻译：

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使用简单的绳轮系统将手臂、腿和跑步机机械连接起来，降低步行的代谢成本

强调手臂的积极使用，并与腿部的步进运动协调，可以促进下肢功能受损患者的步行恢复。然而，大多数方法使用坐式装置来允许手臂和腿部运动。为了在跑步机行走过程中提供一个选择，我们设计了一个绳索滑轮系统，将手臂和腿部物理连接起来。这个臂腿滑轮系统接地，由市售的开槽方管、实心支柱通道和低摩擦滑轮制成，使我们能够使用绳索将受试者的手腕连接到同侧脚。这种设置基于我们的想法，即在行走过程中，手臂可以在手臂摆动收缩期间产生辅助力，因此有助于腿部摆动。为了测试这个想法，我们比较了机械、肌肉、正常行走和使用臂腿滑轮系统行走之间的代谢效应。我们测量了绳索和地面反作用力、关键手臂和腿部肌肉的肌电信号，以及健康的年轻受试者在双带仪器跑步机（n = 8）上以 1.25 m/s 的速度行走时的代谢能量消耗率。通过我们的臂腿滑轮系统，我们发现可以产生辅助力，平均达到 7% 体重的峰值。与我们的预期相反，该力主要与行走的推进阶段相吻合，而不是腿部摆动。我们的研究结果表明，受试者积极地使用他们的手臂来利用移动跑步机皮带的能量，这有助于通过臂-腿绳索连接推动整个身体。这有效地减少了对腿部肌肉和机械的要求，将推进冲动减少 43% (p < 0.001)，这导致步行所需的代谢能力净减少 17% (p = 0.001)。这些发现为我们如何重新构想在步态康复中使用手臂提供了生物力学和能量基础，为探索这种方法是否可以帮助患者恢复步行能力提供了机会。试验注册：研究于 2018 年 9 月 29 日在 ClinicalTrials.gov 注册（ID-NCT03689647）。