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Open AccessArticle

Wearable Biofeedback Improves Human-Robot Compliance during Ankle-Foot Exoskeleton-Assisted Gait Training: A Pre-Post Controlled Study in Healthy Participants

Center for MicroElectroMechanical Systems (CMEMS), Department of Industrial Electronics, School of Engineering, University of Minho, 4800-058 Guimarães, Portugal
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This paper is an extended version of our paper published in Pinheiro, C.; Lopes, J.M.; Figueiredo, J.; Gonçalves, L.M.; Santos, C.P. Design and technical validation of a wearable biofeedback system for robotic-based gait rehabilitation. In Proceedings of the 20th IEEE International Conference on Autonomous Robot Systems and Competitions, Ponta Delgada, Portugal, 15–17 April 2020; pp. 16–21.
Sensors 2020, 20(20), 5876; https://doi.org/10.3390/s20205876
Received: 13 August 2020 / Revised: 27 September 2020 / Accepted: 14 October 2020 / Published: 17 October 2020
(This article belongs to the Special Issue Smart Sensors: Applications and Advances in Human Motion Analysis)
The adjunctive use of biofeedback systems with exoskeletons may accelerate post-stroke gait rehabilitation. Wearable patient-oriented human-robot interaction-based biofeedback is proposed to improve patient-exoskeleton compliance regarding the interaction torque’s direction (joint motion strategy) and magnitude (user participation strategy) through auditory and vibrotactile cues during assisted gait training, respectively. Parallel physiotherapist-oriented strategies are also proposed such that physiotherapists can follow in real-time a patient’s motor performance towards effective involvement during training. A preliminary pre-post controlled study was conducted with eight healthy participants to conclude about the biofeedback’s efficacy during gait training driven by an ankle-foot exoskeleton and guided by a technical person. For the study group, performance related to the interaction torque’s direction increased during (p-value = 0.07) and after (p-value = 0.07) joint motion training. Further, the performance regarding the interaction torque’s magnitude significantly increased during (p-value = 0.03) and after (p-value = 68.59 × 10−3) user participation training. The experimental group and a technical person reported promising usability of the biofeedback and highlighted the importance of the timely cues from physiotherapist-oriented strategies. Less significant improvements in patient–exoskeleton compliance were observed in the control group. The overall findings suggest that the proposed biofeedback was able to improve the participant-exoskeleton compliance by enhancing human-robot interaction; thus, it may be a powerful tool to accelerate post-stroke ankle-foot deformity recovery. View Full-Text
Keywords: ankle-foot exoskeleton; biofeedback control strategies; gait training; human-robot interaction; user-centered design; wearable biofeedback ankle-foot exoskeleton; biofeedback control strategies; gait training; human-robot interaction; user-centered design; wearable biofeedback
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Pinheiro, C.; Figueiredo, J.; Magalhães, N.; Santos, C.P. Wearable Biofeedback Improves Human-Robot Compliance during Ankle-Foot Exoskeleton-Assisted Gait Training: A Pre-Post Controlled Study in Healthy Participants. Sensors 2020, 20, 5876.

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