CAREER: Interlimb Neural Coupling to Enhance Gait Rehabilitation

University Of Maine, Orono ME

Investigators

Abstract

Mobility issues affect many people across the lifespan. People with walking problems due to aging or neurological disorders such as stroke and Parkinson's disease often participate in gait training therapy to improve their walking ability. Current gait training methods primarily focus on improving leg movements and overlook the role of arm movement, even though many people do not demonstrate appropriate arm swing. Walking is a complex skill requiring highly coordinated leg and arm movements. Arm swing then is an essential component of walking that impacts stability, balance, and energy efficiency. To improve walking, a whole-body approach should be adopted, one that takes advantage of how all four limbs work together in gait production. This Early Career Development Program (CAREER) project will establish a novel framework for employing appropriate arm swing in gait training to create more effective methods with enduring improvements for people with walking difficulties. The objective of this project will be accomplished by quantifying normal arm swing while considering factors such as age and walking speed, and then creating novel approaches using wearable robotic devices to induce normal arm swing during walking. The use of these robotic devices will enhance gait rehabilitation providing a significant impact on society given that the ability to walk is crucial for daily living activities, and many individuals, for a variety of reasons, have difficulty in walking efficiently. The education plan will engage students with disabilities, who are underrepresented in science and engineering. Their involvement in research using assistive robotic devices will encourage them to pursue further education and careers in this field and help with student retention. The research goal of this proposal is to establish an effective gait training approach by inducing whole-body responses during walking. This project seeks to fundamentally understand how to exploit interlimb neural coupling and utilize arm swing to enhance gait rehabilitation. Two major approaches for incorporating appropriate arm swing into gait training will be investigated to determine how interlimb coupling can be used to improve key parameters such as coordination, symmetry, variability, and walking speed. In one approach, arm-swing patterns generated in real-time by a novel model using thigh and shank kinematic data will be utilized in wearable robotic devices. These devices will attempt to induce correct arm movement in coordination with leg movements at various walking speeds while gait parameters are recorded. In the second approach, arm swing will be altered by robotic devices to modulate the amplitude and frequency of leg movements to improve gait parameters. Two novel wearable robotic devices will be created as research tools to examine how tactile and kinesthetic force feedback methods can instigate and alter arm swing in users during walking at self-selected speeds. The interlimb coupling in each approach will be quantified by analyzing muscle activity using techniques such as intermuscular coherence analysis. Participants in these studies will include healthy young and older adults, older adults with slow gait speed, and individuals who have suffered a stroke and walk with difficulty but are able to walk without an assistive device. This research project will employ the intrinsic tendency to couple upper and lower extremities in creating a highly effective gait rehabilitation approach that will be significantly beneficial for a wide variety of individuals with gait deficits. The project’s education plan will promote teaching and training assistive robotics among students with disabilities, K-12 students in rural areas, and groups underrepresented in mechanical engineering including female students. This project is jointly funded by the Disability and Rehabilitation Engineering Program and the Established Program to Stimulate Competitive Research (EPSCoR). This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.