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The increase in the number of people with walking disabilities caused by aging, accidental injuries and diseases is an important social problem. Therefore, based on the center of gravity control theory, a plantar hydraulic weight loss walking training device with flexible elements is proposed, which helps patients achieve walking rehabilitation training through a cooperative weight loss method combining passive suspension and active center of gravity control. Firstly, the structure of the device is designed and the dynamic model is established. Then, the constitutive model of the flexible element is determined by uniaxial tensile test. Then, based on the hyper-elastic finite element simulation results of the plantar flexible element, combined with the constant load pressure test, the correctness of the experimental data and the feasibility of the plantar hydraulic control device scheme are verified. Finally, the landing buffer and weight loss gait experiments were carried out. The results show that the plantar flexible element has a buffering effect at the moment of heel touching the ground, and the unloading force fluctuation of the two gaits under the single support phase of the human body is weakened. [ABSTRACT FROM AUTHOR]

The structural characteristics of a Body Weight Support System (BWSS) significantly influence the rehabilitation effect and control system of a lower-limb robot. This study considers vibration characteristics to design and optimize a BWSS. First, the design principles of the BWSS are formulated, and the force of the system during the rehabilitation training process is analyzed. Second, the BWSS optimization model is established by considering the vibration characteristics, including the design object, selected materials, design variables, optimization objective functions and constraints in static and dynamic analyses. Third, a hybrid multi-objective optimization method combining the finite element method, Kriging metamodel and Multi-Objective Genetic Algorithm (MOGA) is proposed. After performing optimization, the Kriging metamodel is discussed, and the final design parameters of a single-arm support structure are obtained by the MOGA. Finally, different MOGA parameters and the screening algorithm are compared and analyzed. Simultaneously, the experimental vibration acceleration data and the shock data of the actual original rehabilitation robot are compared with the numerical results of the optimized design. The numerical results indicate that the proposed hybrid multi-objective optimization method is reliable in terms of designing the BWSS, and the vibration characteristics of the designed BWSS are improved over those of the actual original BWSS. [ABSTRACT FROM AUTHOR]

Parkinson's disease (PD) is a neurodegenerative disorder characterized by motor and non-motor alterations. Typical motor symptoms include resting tremors, bradykinesia (hypokinesia or akinesia), muscular stiffness, gait alterations, and postural instability. In this context, neurorehabilitation may have a pivotal role in slowing the progression of PD, using both conventional and innovative rehabilitation approaches. Thirty patients (15 males and 15 females) affected by PD were enrolled in our study. We randomly divided the patients into two groups, an experimental group (EG) and a control group (CG). In particular, the EG performed gait and balance training using the Rysen system, which is an innovative body weight support (BWS) system, whilst the CG received conventional physiotherapy. Both groups underwent 20 sessions, five times weekly, with each session lasting about 40 min. At the end of the training sessions (T1), we found that both groups (EG and CG) achieved clinical improvements, although the EG showed better scores for post-treatment regarding global motor functioning and postural stability compared to the CG. In conclusion, our results suggest that the Rysen system, which is an innovative BWS tool, could be considered a valid device for improving postural control and global motor functions, when compared to conventional gait training, in patients affected by PD. [ABSTRACT FROM AUTHOR]

Parkinson’s disease (PD) is a neurodegenerative disorder characterized by motor and non-motor alterations. Typical motor symptoms include resting tremors, bradykinesia (hypokinesia or akinesia), muscular stiffness, gait alterations, and postural instability. In this context, neurorehabilitation may have a pivotal role in slowing the progression of PD, using both conventional and innovative rehabilitation approaches. Thirty patients (15 males and 15 females) affected by PD were enrolled in our study. We randomly divided the patients into two groups, an experimental group (EG) and a control group (CG). In particular, the EG performed gait and balance training using the Rysen system, which is an innovative body weight support (BWS) system, whilst the CG received conventional physiotherapy. Both groups underwent 20 sessions, five times weekly, with each session lasting about 40 min. At the end of the training sessions (T1), we found that both groups (EG and CG) achieved clinical improvements, although the EG showed better scores for post-treatment regarding global motor functioning and postural stability compared to the CG. In conclusion, our results suggest that the Rysen system, which is an innovative BWS tool, could be considered a valid device for improving postural control and global motor functions, when compared to conventional gait training, in patients affected by PD.

In recent years, the Body Weight Support system has been considered to be an indispensable component in gait training systems, which be used to improve the ability to walk of hemiplegic, stroke, and spinal cord injury patients. Previous studies investigated the influence of the Body Weight Support system on gait parameters were based on the implementation with healthy subjects or patients with high assistance. Consequently, the influences of the Body Weight Support systems on gait rehabilitation in clinical practice are still unclear and need further investigation. In this study, we investigated the effects of the two Body Weight Support systems, the active body weight support system and the Counter Weight system, on an abnormal gait, which was generated by restriction of the right knee joint and 3 kg-weight on the right ankle joint. Both Body Weight Support systems improve the gait parameters of the abnormal gait such as the center of mass, the center of pressure, margin of stability, and step parameters. The active Body Weight Support system with the unloading force modulation showed more advanced and better behavior in comparison with the Counter Weight system. The results suggested the applicability of two Body Weight Support systems in clinical practice as a recovered gait intervention. [ABSTRACT FROM AUTHOR]

We designed and manufactured a pneumatic-driven robotic passive gait training system (PRPGTS), providing the functions of body-weight support, postural support, and gait orthosis for patients who suffer from weakened lower limbs. The PRPGTS was designed as a soft-joint gait training rehabilitation system. The soft joints provide passive safety for patients. The PRPGTS features three subsystems: a pneumatic body weight support system, a pneumatic postural support system, and a pneumatic gait orthosis system. The dynamic behavior of these three subsystems are all involved in the PRPGTS, causing an extremely complicated dynamic behavior; therefore, this paper applies five individual interval type-2 fuzzy sliding controllers (IT2FSC) to compensate for the system uncertainties and disturbances in the PRGTS. The IT2FSCs can provide accurate and correct positional trajectories under passive safety protection. The feasibility of weight reduction and gait training with the PRPGTS using the IT2FSCs is demonstrated with a healthy person, and the experimental results show that the PRPGTS is stable and provides a high-trajectory tracking performance.

Abstract Background To provide body weight support during walking and balance training, one can employ two distinct embodiments: support through a harness hanging from an overhead system or support through a saddle/seat type. This paper presents a comparison of these two approaches. Ultimately, this comparison determined our selection of the body weight support system employed in the MIT-Skywalker, a robotic device developed for the rehabilitation/habilitation of gait and balance after a neurological injury. Method Here we will summarize our results with eight healthy subjects walking on the treadmill without any support, with 30% unloading supported by a harness hanging from an overhead system, and with a saddle/seat-like support system. We compared the center of mass as well as vertical and mediolateral trunk displacements across different walking speeds and support. Results The bicycle/saddle system had the highest values for the mediolateral inclination, while the overhead harness body weight support showed the lowest values at all speeds. The differences were statistically significant. Conclusion We selected the bicycle/saddle system for the MIT-Skywalker. It allows faster don-and-doff, better centers the patient to the split treadmill, and allows all forms of training. The overhead harness body weight support might be adequate for rhythmic walking training but limits any potential for balance training.

In recent years, the Body Weight Support system has been considered to be an indispensable component in gait training systems, which be used to improve the ability to walk of hemiplegic, stroke, and spinal cord injury patients. Previous studies investigated the influence of the Body Weight Support system on gait parameters were based on the implementation with healthy subjects or patients with high assistance. Consequently, the influences of the Body Weight Support systems on gait rehabilitation in clinical practice are still unclear and need further investigation. In this study, we investigated the effects of the two Body Weight Support systems, the active body weight support system and the Counter Weight system, on an abnormal gait, which was generated by restriction of the right knee joint and 3 kg-weight on the right ankle joint. Both Body Weight Support systems improve the gait parameters of the abnormal gait such as the center of mass, the center of pressure, margin of stability, and step parameters. The active Body Weight Support system with the unloading force modulation showed more advanced and better behavior in comparison with the Counter Weight system. The results suggested the applicability of two Body Weight Support systems in clinical practice as a recovered gait intervention.

• A novel weight support and trunk motor assistance system for post-stroke rehabilitation is proposed. • This paper collects and analyzes the muscle activation modalities of normal individuals under different conditions of weight support and assistance, and analyzes the muscle activation in different gait phases to help rehabilitation patients to better perform rehabilitation. • This paper analyzes the trends of joint angle changes and gait frequency changes of lower limb movements with weight support and trunk assistance to provide quantitative reference indicators for optimizing rehabilitation treatment tasks. Bipedal gait is one of the most important forms of human movement. However, every year many people lose their ability to walk due to disease. Weight support systems that reduce or even eliminate the effect of upper body mass loading on the lower limbs are among the most commonly used devices in gait rehabilitation. The designed weight support system provides body support while innovatively proposing a torso motion assist function. In this paper, walking experiments were performed on normal healthy subjects under five different weight-supported conditions, and motor and surface electromyography (sEMG) signals of the lower limb muscles were collected and analyzed. The results showed a slight decrease in joint motion of the lower extremities in the reference (free walking) and weight-supported-only assisted conditions, while there was no change in the joint angle curve waveform. In contrast, there was a significant change in the joint angle waveform between weight support plus trunk transfer and free walking. Different muscles differ in the significance of feature changes under different auxiliary conditions. By studying the changes in motor and muscle activation levels in the human lower extremity under the weight support system, it can be used as an indicator to assess specific gait indicators and muscle activity during the rehabilitation of the lower extremity in rehabilitated patients. [ABSTRACT FROM AUTHOR]

Background: To provide body weight support during walking and balance training, one can employ two distinct embodiments: support through a harness hanging from an overhead system or support through a saddle/seat type. This paper presents a comparison of these two approaches. Ultimately, this comparison determined our selection of the body weight support system employed in the MIT-Skywalker, a robotic device developed for the rehabilitation/habilitation of gait and balance after a neurological injury.Method: Here we will summarize our results with eight healthy subjects walking on the treadmill without any support, with 30% unloading supported by a harness hanging from an overhead system, and with a saddle/seat-like support system. We compared the center of mass as well as vertical and mediolateral trunk displacements across different walking speeds and support.Results: The bicycle/saddle system had the highest values for the mediolateral inclination, while the overhead harness body weight support showed the lowest values at all speeds. The differences were statistically significant.Conclusion: We selected the bicycle/saddle system for the MIT-Skywalker. It allows faster don-and-doff, better centers the patient to the split treadmill, and allows all forms of training. The overhead harness body weight support might be adequate for rhythmic walking training but limits any potential for balance training. [ABSTRACT FROM AUTHOR]

Body weight support (BWS) has become a typical strategy for gait training, in special with children with cerebral palsy (CP). Although several findings have been reported in the literature, it remains uncertain how different types of surfaces and gradual amount of BWS can facilitate the mobility of children with CP. The aim of this study was to investigate gait kinematic parameters of children with CP by manipulating BWS and two different types of ground surfaces. Ten children (7.7 ± 2.1 years old) diagnosed with spastic CP and GMFCS classification between levels II and IV were asked to walk on a treadmill and over the ground. In both conditions, BWS was manipulated to minimize gravitational effects and spatial–temporal gait parameters and lower limb joints were analyzed. The results revealed that the type of ground surface causes greater impact on the gait pattern of children with CP as compared to body weight unloading. This finding may provide new insights into the behavioral heterogeneity of children with CP, and offers critical information to be considered on interventional programs specifically designed to improve mobility on this population. [ABSTRACT FROM AUTHOR]

Background: Impaired balance regulation after stroke puts patients and therapists at risk of injury during rehabilitation. Body weight support systems (BWSSs) minimize this risk and allow patients to safely practice balance activities during therapy. Treadmill-based balance perturbation systems with BWSSs are known to improve balance in patients with age- or disease-related impairments. However, these stationary systems are unable to accommodate complex exercises that require more freedom of movement., Objective: This study aims to evaluate the effect of a new balance perturbation module, which is directly integrated into a track-mounted BWSS, on balance impairments secondary to acute stroke., Methods: This unblinded quasi-randomized controlled preliminary study was conducted in a rehabilitation-focused long-term acute care hospital. Participants were recruited from stroke rehabilitation inpatients with an admission Berg Balance Scale (BBS) score of 21 (out of 56) or greater. Over a 2-week period, consented participants completed 8 BWSS or BWSS with perturbation (BWSS-P) treatment sessions; study activities were incorporated into regular treatment to avoid disruption of their normal care. Although both groups conducted the same balance and gait activities during their treatment sessions, the BWSS-P sessions included lateral, anterior, and posterior balance perturbations. Pre- and postintervention BBS and Activities-Specific Balance Confidence (ABC) assessments were the primary outcome measures collected. Institutional BBS data from the year before installation of the track-mounted BWSS were retrospectively included as a post hoc historical standard of care comparison., Results: The improved postintervention BBS and ABC assessment scores showed that all participants benefited from therapy (P<.001 for all pre- and postintervention comparisons). The average BBS percent change for the BWSS-P sample (n=14) was 66.95% (SD 43.78%) and that for the BWSS control sample (n=15) was 53.29% (SD 24.13%). These values were greater than those for the standard of care group (n=30; mean 28.31%, SD 17.25%; P=.02 and P=.005 respectively), with no difference among the BWSS groups (P=.67). ABC score changes were also similar among the preintervention and postintervention BWSS groups (P=.94 and P=.92, respectively)., Conclusions: Both BWSS groups demonstrated similar BBS and ABC score improvements, indicating that balance perturbations were not detrimental to postacute stroke rehabilitation and were safe to use. These data provide strong rationale and baseline data for conducting a larger follow-up study to further assess if this new perturbation system provides additional benefit to the rehabilitation of gait and balance impairments following stroke., Trial Registration: ClinicalTrials.gov NCT04919161; https://clinicaltrials.gov/ct2/show/NCT04919161., (©Amanda Meyer, Henry Charles Hrdlicka, Erica Cutler, Jill Hellstrand, Emily Meise, Kaitlyn Rudolf, Pete Grevelding, Matthew Nankin. Originally published in JMIR Rehabilitation and Assistive Technology (https://rehab.jmir.org), 01.03.2022.)

We designed and manufactured a pneumatic-driven robotic passive gait training system (PRPGTS), providing the functions of body-weight support, postural support, and gait orthosis for patients who suffer from weakened lower limbs. The PRPGTS was designed as a soft-joint gait training rehabilitation system. The soft joints provide passive safety for patients. The PRPGTS features three subsystems: a pneumatic body weight support system, a pneumatic postural support system, and a pneumatic gait orthosis system. The dynamic behavior of these three subsystems are all involved in the PRPGTS, causing an extremely complicated dynamic behavior; therefore, this paper applies five individual interval type-2 fuzzy sliding controllers (IT2FSC) to compensate for the system uncertainties and disturbances in the PRGTS. The IT2FSCs can provide accurate and correct positional trajectories under passive safety protection. The feasibility of weight reduction and gait training with the PRPGTS using the IT2FSCs is demonstrated with a healthy person, and the experimental results show that the PRPGTS is stable and provides a high-trajectory tracking performance. [ABSTRACT FROM AUTHOR]

Background: To provide body weight support during walking and balance training, one can employ two distinct embodiments: support through a harness hanging from an overhead system or support through a saddle/seat type. This paper presents a comparison of these two approaches. Ultimately, this comparison determined our selection of the body weight support system employed in the MIT-Skywalker, a robotic device developed for the rehabilitation/habilitation of gait and balance after a neurological injury., Method: Here we will summarize our results with eight healthy subjects walking on the treadmill without any support, with 30% unloading supported by a harness hanging from an overhead system, and with a saddle/seat-like support system. We compared the center of mass as well as vertical and mediolateral trunk displacements across different walking speeds and support., Results: The bicycle/saddle system had the highest values for the mediolateral inclination, while the overhead harness body weight support showed the lowest values at all speeds. The differences were statistically significant., Conclusion: We selected the bicycle/saddle system for the MIT-Skywalker. It allows faster don-and-doff, better centers the patient to the split treadmill, and allows all forms of training. The overhead harness body weight support might be adequate for rhythmic walking training but limits any potential for balance training.