Ohata K1, Kawasaki S1, Watanabe S1, Nogi S1, Yusuke H2, Yoshida T3, Yokoyama A3
1Kyoto University Graduate School of Medicine, Human Health Sciences, Kyoto, Japan, 2HONDA R&D X, Wako, Japan, 3Kyoto University Graduate School of Medicine, Pediatrics, Kyoto, Japan
Background: In children with cerebral palsy (CP), improvement of gait function is one of the most important targets of rehabilitation. Recently, rehabilitation robots were used to improve the gait function, and many devices have been developed to improve the gait in individuals with neurological deficits. Honda Walking Assist (HWA), that is able to make the efficient gait kinematics and kinetics, is one of the most popular robots in Japan. However, it is not clear that changes with using this device in children with CP.
Purpose: We aimed to clarify the effect of gait kinetics and kinematics using the Honda Waking Assist in children with cerebral palsy.
Methods: The HWA is an automated stride assistance system, which applied robotic engineering to controlling hip movement and adding supporting power to the thigh during walking. The HWA assists both flexion and extension of the hip joints in a ballistic manner by means of electrical actuators.
Children with CP classified as GMFCS-Level I, II or III were recruited from Kyoto University Hospital. After providing informed consent, 10 children (11.1±2.3y) participated in this study. All procedures in this study were approved by the ethics committee of Kyoto University Graduate School and Faculty of Medicine (C1313) and were consistent with the Declaration of Helsinki. Children performed the two types of gait trainings (with or without the HWA) on different day in random order. In the training with the HWA, children walked for 30 seconds on treadmill at confortable speed. This gait trial were repeated 10 times with the assist using HWA and followed 5 times without the assist using HWA to assess the aftereffect. In another day, children walked 15 trials without the assist using HWA in same condition. The gait kinetics and kinematics were measured on over-ground walking before and after treadmill trials. The gait speed on 5.5m gait-way, peak hip and knee angle during gait using inertial sensor (X-sense), and peak vertical and horizontal force during gait using ground reaction force (AMTI) were measured as outcome measurement. From range of hip motion during first over-ground gait, kinetic and kinematic data was classified into large and small-moving side. 3-way ANOVA (before v.s. after trial, assist v.s. no assist, large- v.s. small-moving side) was used to analyze.
Results: There was no difference of gait speed between before and after gait training trials. Peak hip extension and flexion angle motion showed a significant interaction and peak hip flexion angle significantly increased only after training with assist. Moreover, asymmetry of hip motion during gait significantly improved in training with assist. In ground reaction force, peak propulsion force at 70-100% of stance phase on small-moving side was increased in after training with assist, and that on large-moving side was decreased in training without assist.
Conclusion(s): The HWA can induce the aftereffect for hip motion and ground reaction force. This device can reduce the gait asymmetry due to repetition of correct way of hip motion during gait.
Implications: Rehabilitation robot can improve the gait kinetics and kinematics in children with CP.
Keywords: Cerebral Palsy, Rehabilitation Robot, Gait kinetics
Funding acknowledgements: HONDA R&D X supported this study.
Purpose: We aimed to clarify the effect of gait kinetics and kinematics using the Honda Waking Assist in children with cerebral palsy.
Methods: The HWA is an automated stride assistance system, which applied robotic engineering to controlling hip movement and adding supporting power to the thigh during walking. The HWA assists both flexion and extension of the hip joints in a ballistic manner by means of electrical actuators.
Children with CP classified as GMFCS-Level I, II or III were recruited from Kyoto University Hospital. After providing informed consent, 10 children (11.1±2.3y) participated in this study. All procedures in this study were approved by the ethics committee of Kyoto University Graduate School and Faculty of Medicine (C1313) and were consistent with the Declaration of Helsinki. Children performed the two types of gait trainings (with or without the HWA) on different day in random order. In the training with the HWA, children walked for 30 seconds on treadmill at confortable speed. This gait trial were repeated 10 times with the assist using HWA and followed 5 times without the assist using HWA to assess the aftereffect. In another day, children walked 15 trials without the assist using HWA in same condition. The gait kinetics and kinematics were measured on over-ground walking before and after treadmill trials. The gait speed on 5.5m gait-way, peak hip and knee angle during gait using inertial sensor (X-sense), and peak vertical and horizontal force during gait using ground reaction force (AMTI) were measured as outcome measurement. From range of hip motion during first over-ground gait, kinetic and kinematic data was classified into large and small-moving side. 3-way ANOVA (before v.s. after trial, assist v.s. no assist, large- v.s. small-moving side) was used to analyze.
Results: There was no difference of gait speed between before and after gait training trials. Peak hip extension and flexion angle motion showed a significant interaction and peak hip flexion angle significantly increased only after training with assist. Moreover, asymmetry of hip motion during gait significantly improved in training with assist. In ground reaction force, peak propulsion force at 70-100% of stance phase on small-moving side was increased in after training with assist, and that on large-moving side was decreased in training without assist.
Conclusion(s): The HWA can induce the aftereffect for hip motion and ground reaction force. This device can reduce the gait asymmetry due to repetition of correct way of hip motion during gait.
Implications: Rehabilitation robot can improve the gait kinetics and kinematics in children with CP.
Keywords: Cerebral Palsy, Rehabilitation Robot, Gait kinetics
Funding acknowledgements: HONDA R&D X supported this study.
Topic: Robotics & technology; Paediatrics: cerebral palsy; Human movement analysis
Ethics approval required: Yes
Institution: Kyoto University
Ethics committee: Kyoto University Graduate school of Medicine Ethics Committee
Ethics number: C1313
All authors, affiliations and abstracts have been published as submitted.
