Individuals with hemiparesis following a stroke are left with various degrees of impairment in function, especially affecting their walking ability. This BRP renewal application focuses on developing and testing novel rehabilitation solutions for gait retraining of stroke and other motor-impaired patients. Our rehab solutions consist of un-motorized and motorized exoskeletons, integrated with functional electric stimulation (FES), supplemented by biomechanical models. In the first five years of this project, we showed the feasibility of this approach through development of robotic exoskeletons with limited subject testing. The next five-year goal of this project is to integrate and expand on our current understanding of component science and technologies, i.e., un-motorized and motorized exoskeletons, FES, and biomechanics to fabricate and test novel rehabilitation solutions for gait training of patients with stroke.

Public Health Relevance

The goal of this renewal application is to integrate and expand on our current understanding of component science and technologies, i.e., un-motorized and motorized exoskeletons, FES, and biomechanics. We plan to test novel rehabilitation solutions for gait training of patients with stroke and compare these with currently accepted training methods, such as the body-weight supported treadmill training. The project aims are:
Aim 1 : Develop bilateral gait rehabilitation systems for treadmill training of hemiparetic stroke patients using un-motorized and motorized exoskeletons and FES. We will fabricate and test the following two rehabilitation systems: (i) Bilateral Gravity Balancing Orthosis (GBO) with FES/Motorized control of the ankle, (ii) Bilateral Active Limb Exoskeleton (ALEX) with FES/Motorized control of the ankle. Novel symbiotic control of the ankle will be implemented where the ankle motor will be used as a safety net for delivery of the FES training.
Aim 2 : Test the effectiveness of these two rehabilitation solutions in patients with stroke and compare their performances with body weight supported treadmill training (BWSTT), a paradigm used currently in the literature for gait training.
Aim 3 : Prediction of muscle coordination deficits off-line in individuals with hemiparesis using gait analysis, biomechanics, FES models, and sensors on the exoskeleton. The musculoskeletal models will be used before training, as a screening mechanism, and post-training to understand why a particular gait training strategy with the exoskeleton worked.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Research Project (R01)
Project #
5R01HD038582-10
Application #
8305550
Study Section
Musculoskeletal Tissue Engineering Study Section (MTE)
Program Officer
Quatrano, Louis A
Project Start
1999-09-01
Project End
2014-07-31
Budget Start
2012-08-01
Budget End
2014-07-31
Support Year
10
Fiscal Year
2012
Total Cost
$551,950
Indirect Cost
$191,198
Name
University of Delaware
Department
Biomedical Engineering
Type
Schools of Engineering
DUNS #
059007500
City
Newark
State
DE
Country
United States
Zip Code
19716
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Zanotto, Damiano; Rosati, Giulio; Spagnol, Simone et al. (2013) Effects of complementary auditory feedback in robot-assisted lower extremity motor adaptation. IEEE Trans Neural Syst Rehabil Eng 21:775-86
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Kesar, Trisha M; Binder-Macleod, Stuart A; Hicks, Gregory E et al. (2011) Minimal detectable change for gait variables collected during treadmill walking in individuals post-stroke. Gait Posture 33:314-7
Kesar, Trisha M; Reisman, Darcy S; Perumal, Ramu et al. (2011) Combined effects of fast treadmill walking and functional electrical stimulation on post-stroke gait. Gait Posture 33:309-13
Perumal, Ramu; Wexler, Anthony S; Kesar, Trisha M et al. (2010) A phenomenological model that predicts forces generated when electrical stimulation is superimposed on submaximal volitional contractions. J Appl Physiol 108:1595-604

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