The effects of unilaterally compliant terrain on human gait: toward robot-assisted model-informed post-stroke gait rehabilitation
Date
2024
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Publisher
University of Delaware
Abstract
Post-stroke gait dysfunction affects millions every year. Due to hemiplegia, this dysfunctional gait normally presents itself in some form of asymmetry that impacts an individual's ability to walk quickly, independently, and safely. While there are common trends seen among stroke subjects, stroke does affect gait uniquely for each individual. Current rehabilitation protocols, including treadmill walking and more conventional therapy, are effective to varying degrees. Still, the majority of stroke survivors are left walking in a far less effective and safe manner than they were pre-stroke. Recently, robot-assisted rehabilitation has shown much promise, although it has not been adequately investigated. This dissertation examines the use of a specific type of robotic treadmill, the Variable Stiffness Treadmill (VST) 1 and 2, as a rehabilitation tool. The VST 1 and 2 are able to create unilaterally compliant terrain that perturbs the subject in a distinctive manner, uniquely disturbing neurological pathways. Additionally, this dissertation investigates modeling the human response to the environment created by the VST 1 and 2 using the neuro-muscular-skeletal (NMS) gait model. The results of this dissertation show that using unilaterally compliant terrain as an intervention creates useful and lasting aftereffects in both healthy and stroke subjects. These aftereffects push stroke subjects towards a more symmetric gait and increase vertical push-off force, both of which combat common post-stroke gait dysfunction issues. Furthermore, the NMS model is validated as an accurate representation of human gait for both a single step and continuous walking on unilaterally compliant terrain. This thesis suggests that unilaterally compliant terrain may engage stroke subjects in a manner that has a valuable neuroplastic effect. Interventions of this kind, along with using the NMS model predictively to test new experimental protocols, may allow for more effective, patient-specific, post-stroke gait rehabilitation.
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Keywords
Gait, Rehabilitation, Stroke, Treadmill, Neuro-muscular-skeletal gait