Design and investigation of the effectiveness of a metatarsophalangeal assistive device on the muscle activities of the lower extremity

The metatarsophalangeal (MTP) joint is not considered in most current walking assistive devices even though it plays an important role during walking. The purpose of this study was to develop a new MTP assistive device and investigate its effectiveness on the muscle activities of the lower extremities during walking while wearing the device. The MTP assistive device is designed to support MTP flexion by transmitting force through a cable that runs parallel with the plantar fascia. Eight participants were instructed to walk at a constant speed on a treadmill while wearing the device. The muscle activities of their lower extremities and MTP joint kinematics were obtained during walking under both actuated and non-actuated conditions. Paired t-tests were performed to compare the differences in each dependent variable between the two conditions. The muscle activity of the MTP flexor was significantly reduced during walking under actuated conditions (p = 0.013), whereas no differences were found in the muscle activities of other muscles or in the MTP joint angle between actuated and non-actuated conditions (p > 0.05 for all comparisons). In conclusion, the cable-driven MTP assistive device is able to properly assist the MTP flexor without interfering with the action of other muscles in the lower extremities; as such, this MTP assistive device, when integrated into existing exoskeleton designs, has the potential to offer improved walking assistance by reducing the amount of muscle activity needed from the MTP flexor.