Unilateral changes in walking surface compliance evoke dorsiflexion in paretic leg of impaired walkers

Abstract

Introduction Gait impairments due to stroke impact millions of individuals throughout the world. Despite the growing interest in automating gait therapy with robotic devices, there is no clear evidence that robot-assisted gait therapy is superior to traditional treadmill-based therapy. Methods This work investigates the effect of perturbations to the compliance of the walking surface on the paretic leg of impaired walkers. Using a novel robotic device, the variable stiffness treadmill, we apply perturbations to the compliance of the walking surface underneath the non-paretic leg of two hemi-paretic walkers and analyze the kinematic and neuromuscular response of the contralateral (paretic) leg with motion capture and surface electromyography systems. Results We present results of evoked muscle activity (predominately tibialis anterior) and increased dorsiflexion in the paretic leg during the swing phase of gait at stiffness values of 60 kN/m and less for all subjects. Conclusions This work provides evidence for the first time of reducing the drop-foot effect in the impaired leg of hemiparetic walkers in response to unilateral perturbations to the compliance of the treadmill platform, thus providing direction for targeted robot-assisted gait rehabilitation.