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Technical Brief

Design, Analysis, and Optimization of an Acute Stroke Gait Rehabilitation Device

[+] Author and Article Information
Kazuto Kora

Department of Mechanical Engineering,
The University of Auckland,
Private Bag 92019,
Auckland Mail Centre,
Auckland 1142, New Zealand
e-mail: kkor008@aucklanduni.ac.nz

James Stinear

Department of Exercise Sciences,
Faculty of Science,
The University of Auckland,
Private Bag 92019,
Auckland Mail Centre,
Auckland 1142, New Zealand
e-mail: j.stinear@auckland.ac.nz

Andrew McDaid

Mem. ASME
Department of Mechanical Engineering,
The University of Auckland,
Private Bag 92019,
Auckland Mail Centre,
Auckland 1142, New Zealand
e-mail: andrew.mcdaid@auckland.ac.nz

Manuscript received April 28, 2016; final manuscript received October 16, 2016; published online December 21, 2016. Assoc. Editor: Rita M. Patterson.

J. Med. Devices 11(1), 014503 (Dec 21, 2016) (6 pages) Paper No: MED-16-1216; doi: 10.1115/1.4035127 History: Received April 28, 2016; Revised October 16, 2016

Stroke is one of the leading causes of adult physical disability, and rehabilitation and hospitalization costs for stroke are among the highest for all injuries. Current rehabilitation techniques are labor intensive and time consuming for therapists and difficult to perform effectively. Research suggests that starting rehabilitation during the acute or subacute stage of recovery results in better outcomes than therapy delivered in the chronic stage. To improve the gait rehabilitation process, robot-assisted gait rehabilitation has gained much interest over the past years. However, many robot-assisted rehabilitation devices have limitations; one of which is being bulky and complex to handle. Large and expensive devices that require special training to operate are less attractive to clinics and therapists, and ultimately less likely to be available to patients especially at the early stage of stroke. To address these limitations, this research proposes a new gait rehabilitation device called the linkage design gait trainer (LGT). The device is based on a walking frame design with a simple four-bar linkage “end-effector” mechanism to generate normal gait trajectories during general walking and exercise. The design of the four-bar linkage mechanism was optimized for a particular gait pattern. A prototype of the device was developed and tested. The kinematics of the device itself and gait kinematics with and without assistance from the device were recorded and analyzed using an optical motion capture system. The results show the linkage mechanism is able to guide the leg of the user during over ground walking. There were some differences in the hip (20.5 deg RMS) and knee (14.8 deg RMS) trajectory between the person walking with and without the device assistance. The study demonstrated the concept and feasibility of this novel gait training device.

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Figures

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Fig. 1

Schematic of first frame design: (a) 2D side view and (b) 3D view

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Fig. 2

Design parameters of a crank-rocker mechanism

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Fig. 3

Prototype of linkage design gait trainer (LGT)

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Fig. 4

Ankle trajectories

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Fig. 5

Simulation of hip and knee angles of the participant walking with 60% scaled step length (dotted line) against the normative gait pattern (solid line with one standard deviation in dashed lines)

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Fig. 6

Simulation of hip and knee angles the participant walking with 60% scaled step length (dotted line) against hip and knee angles of the participant walking without the LGT (solid line with one standard deviation in dashed line)

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Fig. 7

Simulation of hip and knee angles the participant walking with 60% scaled step length (dotted line) against hip and knee angles of the participant with the LGT (solid line with one standard deviation in dashed line)

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Fig. 8

Hip and knee angles of the participant with the LGT (solid line) against hip and knee angles of the participant walking without the LGT (dotted line). Dashed lines show 1SD from both results.

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