Gait Adaptation Using a Cable-Driven Active Leg Exoskeleton (C-ALEX) With Post-Stroke Participants

Individuals with chronic hemiparesis post-stroke exhibit gait impairments that require functional rehabilitation through training. Exoskeletal robotic assistive devices can provide a user with continuous assistance but impose movement restrictions. There are currently devices that allow unrestricted movement but provide assistance only intermittently at specific points of the gait cycle. Our design, a cable-driven active leg exoskeleton (C-ALEX), allows the user both unrestricted movement and continuous force assistance throughout the gait cycle to assist the user in new walking patterns. In this study, we assessed the ability of C-ALEX to induce a change in the walking patterns of ten post-stroke participants using a single-session training protocol. The ability of C-ALEX to accurately provide forces and torques in the desired directions was also evaluated to compare its design performance to traditional rigid-link designs. Participants were able to reach 91% ± 12% of their target step length and 89% ± 13% of their target step height. The achieved step parameters differed significantly from participant baselines (p <; 0.05). To quantify the performance, the forces in each cable's out of the plane movements were evaluated relative to the in-plane desired cable tension magnitudes. This corresponded to an error of under 2Nm in the desired controlled joint torques. This error magnitude is low compared to the system command torques and typical adult biological torques during walking (2-4%). These results point to the utility of using non-restrictive cable-driven architectures in gait retraining, in which future focus can be on rehabilitating gait pathologies seen in stroke survivors.