The Effect of a Wearable Assistive Trunk Exoskeleton on the Motor Coordination of People with Cerebellar Ataxia

Author:

Tatarelli Antonella12ORCID,Babič Jan3ORCID,Casali Carlo4,Castiglia Stefano Filippo45ORCID,Chini Giorgia2ORCID,Ciancia Rosanna6,Cioffi Ettore14ORCID,Fiori Lorenzo27ORCID,Michieli Mariagrazia6,Montante Barbara6,Serrao Mariano4ORCID,Varrecchia Tiwana2,Ranavolo Alberto2ORCID

Affiliation:

1. Department of Human Neurosciences, Sapienza University of Rome, Viale dell’Università 30, 00185 Rome, Italy

2. Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Via Fontana Candida, 1, Monte Porzio Catone, 00078 Rome, Italy

3. Laboratory for Neuromechanics and Biorobotics, Department of Automatics, Biocybernetics and Robotics, Jožef Stefan Institute, SI-1000 Ljubljana, Slovenia

4. Department of Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome, Polo Pontino, Via Franco Faggiana 1668, 04100 Latina, Italy

5. Department of Brain and Behavioral Sciences, University of Pavia, Via A. Bassi 21, 27100 Pavia, Italy

6. Oncohematology and Cell Therapy Unit, Department of Medical Oncology, CRO Aviano, National Cancer Institute, IRCCS, SI-1000 Ljubljana, Slovenia

7. Behavioral Neuroscience PhD Program, Department of Physiology and Pharmacology, Sapienza University, Viale dell’Università 30, 00185 Rome, Italy

Abstract

The motor features of people with cerebellar ataxia suggest that locomotion is substantially impaired due to incoordination of the head, trunk, and limbs. The purpose of this study was to investigate how well a wearable soft passive exoskeleton worked for motor coordination in these patients. We used an optoelectronic system to examine the gait of nine ataxic people in three different conditions: without an exoskeleton and with two variants of the exoskeleton, one less and the other more flexible. We investigated kinematics using trunk ranges of motion, the displacement of the center of mass in the medio-lateral direction, and the parameters of mechanical energy consumption and recovery. Furthermore, we investigated the lower limb and trunk muscle coactivation. The results revealed a reduction of the medio-lateral sway of the center of mass, a more efficient behavior of the body in the antero-posterior direction, an energy expenditure optimization, a reduction of muscle coactivation and a better coordination between muscle activations. As a result, the findings laid the groundwork for the device to be used in the rehabilitation of individuals with cerebellar ataxia.

Publisher

MDPI AG

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