Effect of robotic knee extension assistance during walking on muscle activity in children with cerebral palsy

Crouch gait, a common gait deviation in cerebral palsy (CP), is energetically costly and associated with increased fatigue, joint pain, and reduced activity. Crouch contributes to gait deterioration and even cessation in adults with CP. Current treatments, e.g. surgery, toxin injections, orthoses, and strengthening may temporarily reduce crouch but long term solutions remain elusive. We designed a pediatric exoskeleton for progressive crouch reduction in CP. Rather than guide limbs along a pre-specified trajectory, this wearable rehabilitation device provides bursts of knee extension assistance during stance and/or late swing to facilitate improved posture while maintaining users' muscle activity, with the ultimate goal of training them to walk more upright without the device. The objective here was to examine changes in posture and muscle activity during walking with our exoskeleton.