BACKGROUND After a neurological injury, mobility focused rehabilitation programs intensively train walking on treadmills or overground. However, after discharge, quite a few patients are not able to independently negotiate stairs, a real-world task with high physical and psychological demands and a high injury risk. To decrease fall risk and improve patients' capacity to navigate typical environments, early stair negotiation training can help restore competence and confidence in safe stair negotiation. One way to enable early training in a safe and permissive environment is to unload the patient with a body weight support system. We here investigated if unloaded stair negotiation complies with basic locomotor principles, in terms of enabling performance of a physiological movement pattern with minimal compensation. METHODS Seventeen able-bodied participants were unloaded with 0-50% bodyweight during self-paced ascent and descent of a 4-tread staircase. Spatio-temporal parameters, joint ranges of motion, ground reaction forces and myoelectric activity in the main lower limb muscles of participants were compared between unloading levels. Likelihood ratio tests of separated linear mixed models of the investigated outcomes assessed if unloading affects the parameters in general. Subsequent post-hoc testing revealed which levels of unloading differed from unsupported stair negotiation. RESULTS Unloading affected walking velocity, joint ranges of motion, vertical ground reaction force parameters and myoelectric activity in all investigated muscles for stair ascent and descent while step width and single support duration were only affected during ascent. A reduction with increasing levels of body weight support was seen in walking velocity (0.07-0.12 m/s), ranges of motion of the knee and hip (2-10°), vertical ground reaction force peaks (10-70%) and myoelectric activity (17-70%). An increase with unloading was only seen during ascent for ankle range of motion and tibialis anterior activity at substantial unloading. CONCLUSIONS Body weight support facilitates stair negotiation by providing safety and support against gravity. Although unloading effects are present in most parameters, up to 30% body weight support these changes are small, and no dysfunctional patterns are introduced. Body weight support therefore fulfills all the necessary requirements for early stair negotiation training.

中文翻译：

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机器人体重支撑可以根据基本运动原理实现安全的楼梯通过。

背景技术神经损伤后，以活动能力为重点的康复计划会集中训练在跑步机或地上行走。然而，出院后，相当多的患者无法独立爬楼梯，这是一项对身体和心理要求较高、受伤风险较高的现实任务。为了降低跌倒风险并提高患者应对典型环境的能力，早期的楼梯谈判训练可以帮助恢复安全楼梯谈判的能力和信心。在安全和宽松的环境中进行早期训练的一种方法是用体重支撑系统减轻患者的负担。我们在这里调查了卸载楼梯谈判是否符合基本运动原理，即以最小的补偿实现生理运动模式。方法 17 名身体健全的参与者在 4 级楼梯的自控上升和下降过程中以 0-50% 体重卸载。比较不同卸载水平下参与者的时空参数、关节活动范围、地面反作用力和主要下肢肌肉的肌电活动。如果卸载影响一般参数，则评估所研究结果的分离线性混合模型的似然比测试。随后的事后测试揭示了哪些级别的卸载与无支撑的楼梯谈判不同。结果卸载影响了上楼梯和下楼梯时所有研究肌肉的步行速度、关节运动范围、垂直地面反作用力参数和肌电活动，而步宽和单次支撑持续时间仅在上楼梯期间受到影响。随着体重支撑水平的增加，步行速度（0.07-0.12 m/s）、膝盖和臀部的运动范围（2-10°）、垂直地面反作用力峰值（10-70%）和肌电活动（17-70%）。仅在上升过程中观察到在大量卸载时踝关节运动范围和胫骨前肌活动随着卸载而增加。结论 体重支撑通过提供安全性和对抗重力的支撑来促进楼梯通过。尽管大多数参数都存在卸载效应，但高达 30% 的体重支持这些变化很小，并且不会引入功能失调模式。因此，体重支撑满足早期楼梯谈判训练的所有必要要求。