Reducing the physical effort of wearing a walking boot using a passive hip exosuit through enforced exploration training

초록

Background: Ankle injuries can be detrimental due to their long- recovery times. A walking boot (WB) is the most prescribed treatment. However, they disrupt gait biomechanics, increasing the metabolic cost of walking and the risk of further injuries. Research question: Does using a hip exosuit minimize the adverse effects of wearing a WB, improving gait spatio-temporal parameters, and reduce energy expenditure? Methods: We investigated the effects of a passive hip exosuit and enforced exploration training in users wearing a WB. Subjects wore a WB to simulate the effects of ankle injuries during recovery. Results: The results indicate the benefits of wearing the hip exosuit and training. Metabolic cost reductions of 6.2 ± 1.5% (p < 0.001) between the post training and pre-training and 3.5 ± 2.8% (p = 0.03) between the post training and no exosuit conditions were found. Training with the exosuit resulted in positive gait modifications in patients with ankle injuries associated with gait retraining. The effects of enforced exploration training in gait kinematics wearing the exosuit resulted in an increased maximum hip flexion of 6.04 ± 3.56° and 6.59 ± 5.16° for the boot and free leg, respectively, compared to not wearing the exosuit. Spatiotemporal parameter modifications were adopted after training, resulting in metabolic reductions. Some subjects varied their step frequency, while others varied their step length and width. Significance: The outcomes from this study show the potential benefits that hip exosuits could have in clinical sports rehabilitation of ankle injuries wearing a WB.

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