Influence of Varied Load Assistance with Exoskeleton-Type Robotic Device on Gait Rehabilitation in Healthy Adult Men

This study aimed to clarify how the power-assist function of the hybrid assistive limb (HAL(®)), an exoskeleton-type gait-assist device, affected the gait characteristics of patients who wear it, specifically focusing on the “misalignment” of the robot joints and landmarks with the corresponding body parts. Five healthy adult men were video-recorded wearing the HAL(®) as they walked normally on a treadmill under seven conditions corresponding to the strengths and sites of robotic power assistance. For kinematic analysis, reflective markers were attached to the HAL(®) and the wearer at key locations, and participants were recorded walking past a set of four video cameras for each condition. A motion analysis system was used for analysis. The walking motion was segmented into eight-phase gait cycles. Knee misalignment, or the relative offset in position of the HAL(®)/wearer knee joints, was calculated from kinematic data and joint angles. These values were compared with respect to two factors: assist level and gait phase. Statistical analysis consisted of parametric and nonparametric tests for comparing the values of misalignment of each gait phase, followed by multiple comparisons to confirm significant differences. The results showed that the knee misalignment was greatest in the pre-swing phase and was significantly lower overall in conditions with high levels of power assistance. The result of greater knee misalignment in the pre-swing phase may be attributed to the structural properties of the HAL(®) lower-limb exoskeleton. This provides valuable insight regarding the walking stages that should be given special attention during the evaluation of synchrony between exoskeleton-type gait-assist robots and their wearers.