Modulation of anticipatory postural adjustments of gait using a portable powered ankle-foot orthosis

Matthew N. Petrucci, Colum D. Mackinnon, Elizabeth T. Hsiao-Wecksler

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Abstract

Prior to taking a step, properly coordinated anticipatory postural adjustments (APAs) are generated to control posture and balance as the body is propelled forward. External cues (audio, visual, somatosensory) have been shown to facilitate gait initiation by improving the magnitude and timing of APAs in Parkinson's disease (PD), but the efficacy of these cueing strategies has been limited by their inability to produce the forces required to generate an appropriate APA. To date, mechanical cueing paradigms have been relatively underexplored. Using healthy young adults, we investigated the use of a portable powered ankle-foot orthosis (PPAFO) to provide a modest torque at the ankle as a mechanical cue to initiate gait. Subjects were instructed to initiate gait in five test conditions: (1) self-initiated in running shoes [baseline-shoe], (2) self-initiated trial in unpowered passive PPAFO [baseline-passive], (3) with acoustic go-cue in passive PPAFO [acoustic-passive], (4) acoustic go-cue and simultaneous mechanical assist from powered PPAFO [acoustic-assist], and (5) mechanical assist cue only [assist]. APA characteristics were quantified using ground reaction force (GRF), center of pressure (COP), and electromyography (EMG) data. Mechanical cueing significantly increased medial-lateral COP and GRF peak amplitude, and decreased GRF time to peak amplitude, COP and GRF onset times, and time to toe off. Mechanical cueing conditions also demonstrated consistent bimodal EMG behaviors across all subjects. Overall, these data suggest that the mechanical assist from the PPAFO can significantly improve APA timing parameters and increase APA force production in healthy young adults.

Original languageEnglish (US)
Title of host publication2013 IEEE 13th International Conference on Rehabilitation Robotics, ICORR 2013
DOIs
StatePublished - 2013
Event2013 IEEE 13th International Conference on Rehabilitation Robotics, ICORR 2013 - Seattle, WA, United States
Duration: Jun 24 2013Jun 26 2013

Publication series

NameIEEE International Conference on Rehabilitation Robotics
ISSN (Print)1945-7898
ISSN (Electronic)1945-7901

Other

Other2013 IEEE 13th International Conference on Rehabilitation Robotics, ICORR 2013
CountryUnited States
CitySeattle, WA
Period6/24/136/26/13

Keywords

  • anticipatory postural adjustments
  • cueing
  • exoskeleton
  • gait initiation)
  • powered orthosis

ASJC Scopus subject areas

  • Control and Systems Engineering
  • Electrical and Electronic Engineering
  • Rehabilitation

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  • Cite this

    Petrucci, M. N., Mackinnon, C. D., & Hsiao-Wecksler, E. T. (2013). Modulation of anticipatory postural adjustments of gait using a portable powered ankle-foot orthosis. In 2013 IEEE 13th International Conference on Rehabilitation Robotics, ICORR 2013 [6650450] (IEEE International Conference on Rehabilitation Robotics). https://doi.org/10.1109/ICORR.2013.6650450