Muscle activation of stroke patients during stair climbing in robot assisted gait training

For central nervous system (CNS) impaired patients, e.g. after stroke, the achievement of an independent, stable gait function and endurance in walking is essential for independent mobility in daily life. Modern concepts of rehabilitation favor a task specific repetitive training, that facilitates natural motion and muscle activation patterns, i.e. in addition to commonly practiced floor walking other gait motions of daily living (ADL), such as stair climbing, should be trained. In gait rehabilitation of severely affected non-ambulatory patients, a guided training must be applied as no or only little voluntary motor control is left in the affected side. The rehabilitation robot HapticWalker is the first device that allows for robot assisted guided training of arbitrary foot trajectories, e.g. also stair climbing. The goal of this study was to assess the effect of guided training in stair climbing condition on the HapticWalker on the movement and muscle activation patterns of stroke patients. Generally rhythmic and phasic muscle activation patterns were observed, which is an important factor in gait rehabilitation. The training of stair climbing condition on the HapticWalker also facilitated body weight shift in all patients and proper activation of weight bearing muscles. The HapticWalker currently lacks a lateral hip guidance facility, hence individual differences in the ability of controlling hip movement and body weight shift depending on the level of gait ability were observed.