Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 May 23;8(2):213.
doi: 10.3390/biomimetics8020213.

Changes in Distance between a Wearable Robotic Exoskeleton User and Four-Wheeled Walker during Gait in Level and Slope Conditions: Implications for Fall Prevention Systems

Koki Tan  1 , Soichiro Koyama  1   2 , Hiroaki Sakurai  1   2 , Yoshikiyo Kanada  1   2 , Shigeo Tanabe  1   2
Affiliations

Changes in Distance between a Wearable Robotic Exoskeleton User and Four-Wheeled Walker during Gait in Level and Slope Conditions: Implications for Fall Prevention Systems

Koki Tan et al. Biomimetics (Basel). .

Abstract

When walking with wearable robotic exoskeletons (WRE) in people with spinal cord injury, the distance between the user and the walker is one of the most important perspectives for ensuring safety. The purpose of this study was to clarify the distance between WRE users and four-wheeled walkers (4WW) while walking on level and sloping surfaces. To eliminate the effects of variation in neurological conditions, 12 healthy subjects participated. All participants ambulated using the WRE and the 4WW on level and sloping surfaces. The outcomes were the mean distances between the WRE users and the 4WWs in the level and slope conditions. To examine the influence of uphill and downhill slopes on distance, comparisons were conducted between the uphill or downhill conditions and the respective transitional periods. In the uphill condition, the mean distances were significantly greater than that in the level condition. Conversely, the mean distance moving downhill was significantly shorter than that in the level condition. Changes in the distance between the WRE user and the 4WW might increase the risk of falling forward on an uphill slope and backward on a downhill slope. This study's results will assist in developing a new feedback system to prevent falls.

Keywords: assistive device; fall prevention; gait training; powered exoskeleton; rehabilitation robotics; slope.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The setup for measuring distance between the four-wheeled walker (4WW) and the wearable robotic exoskeleton (WRE) user. SP2-50 TE Connectivity (Schaffhausen, Switzerland) was used as the string potentiometer. The string potentiometer was mounted on the front of the 4WW at the same height as that of the WPAL hip joint.
Figure 2
Figure 2
Definitions for classifying the slope walking path into six sections. The uphill and downhill conditions were defined as the periods from the time when the second step crossed the boundary line to the time when the front wheel of the four-wheeled walker crossed the boundary line. The transition between level and slope (L-Up, Up-L, L-Dn, and Dn-L) was defined as the period from the time when the front wheel of the four-wheeled walker crossed the boundary line to the time when the first step crossed the boundary line. The slope was inclined at 10%.
Figure 3
Figure 3
Raw data of distance from one participant walking in uphill condition. This data shows temporal changes in the distance between the WRE user and the 4WW. The dotted line shows the transition between level and slope conditions (L-Up and Up-L). L-Up, level to uphill; Up-L, uphill to level. Gray shading indicates excluded data (i.e., data during the first three steps of level surface and the first step of the slope).
Figure 4
Figure 4
Mean distance for each condition (cond.). An asterisk indicates p < 0.005, and a double asterisk indicates p < 0.001. L-Up, level to uphill; Up-L, uphill to level; L-Dn, level to downhill; Dn-L, downhill to level; cond., condition.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. James S.L., Theadom A., Ellenbogen R.G., Bannick M.S., Montjoy-Venning W., Lucchesi L.R., Abbasi N., Abdulkader R., Abraha H.N., Adsuar J.C., et al. Global, regional, and national burden of traumatic brain injury and spinal cord injury, 1990–2016: A systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2019;18:56–87. doi: 10.1016/S1474-4422(18)30415-0. - DOI - PMC - PubMed
    1. Harvey L.A., Adams R., Chu J., Batty J., Barratt D. A comparison of patients’ and physiotherapists’ expectations about walking post spinal cord injury: A longitudinal cohort study. Spinal Cord. 2012;50:548–552. doi: 10.1038/sc.2012.1. - DOI - PubMed
    1. Simpson K., Jiang P., Shewokis P., Odum S., Reeves K. Kinematic and plantar pressure adjustments to downhill gradients during gait. Gait Posture. 1993;1:172–179. doi: 10.1016/0966-6362(93)90060-E. - DOI
    1. Battaglino R.A., Lazzari A.A., Garshick E., Morse L.R. Spinal cord injury-induced osteoporosis: Pathogenesis and emerging therapies. Curr. Osteoporos. Rep. 2012;10:278–285. doi: 10.1007/s11914-012-0117-0. - DOI - PMC - PubMed
    1. Stampacchia G., Rustici A., Bigazzi S., Gerini A., Tombini T., Mazzoleni S. Walking with a powered robotic exoskeleton: Subjective experience, spasticity and pain in spinal cord injured persons. NeuroRehabilitation. 2016;39:277–283. doi: 10.3233/NRE-161358. - DOI - PubMed

LinkOut - more resources