A Poincare map based analysis of stroke patients' walking after a rehabilitation by a robot

Math Biosci. 2018 May:299:73-84. doi: 10.1016/j.mbs.2018.03.001. Epub 2018 Mar 5.

Abstract

Since the past decade, rehabilitation robots have become common technologies for recovering gait ability after a stroke. Nevertheless, it is believed that these robots can be further enhanced. Hence, several researches are making progress in optimizing gait rehabilitation robots. However, most of these researches have only assessed the robots and their controllers in improving spatiotemporal and kinetic features of walking. There are not many researchers have focused on the robots' controllers' effects on the central nervous or neuromuscular systems. On the other hand, recently computational methods have been utilized to investigate the rehabilitations of neural disorders, through developing neuromechanical models. However, these methods have neither studied the robot-assisted gait rehabilitation, nor have they theoretically proved why rehabilitation exercises enhance patients' walking ability. Therefore, this paper merged a theoretical approach into a computational method to investigate the effects of gait rehabilitation robots on post-stroke neuromuscular system. To this end, a neuromechanical model of gait has been developed and thereby, the Poincare maps of intact and stroke people have been obtained. Comparison of these maps revealed why a stroke reduces the stability of walking. Then, the effect of an impedance controller, which is used in a rehabilitative robot, is scrutinized in stabilizing a walking motion. Obtaining the Poincare map of this close-loop system, proved that this controller improves motion stability. Finally, the effect of this controller is investigated by simulations and experiments. The experimental tests are performed by Arman rehabilitative robot. Clinical Reference Number: IR.TMU.REC.1394.254.

Keywords: Neuromuscular system; Poincare map; Rehabilitation robot; Stroke.

MeSH terms

  • Gait Disorders, Neurologic / etiology
  • Gait Disorders, Neurologic / rehabilitation*
  • Hemiplegia / etiology
  • Hemiplegia / rehabilitation*
  • Humans
  • Models, Theoretical*
  • Robotics / instrumentation*
  • Robotics / methods
  • Stroke / complications
  • Stroke / therapy*
  • Stroke Rehabilitation / instrumentation*
  • Stroke Rehabilitation / methods
  • Walking / physiology*