Review Reports

Round 1

Reviewer 1 Report

A lightweight passive exoskeleton was designed to reduce the hip and knee flexion for most patients with CP. Rigorous experiments conducted to veryfy the effectiveness. It could be improved by addressing following issues.

1. The first paragraph on the background of CP is too long.

2. The  author gives many disadvantages of active exoskeleton, what is the disadvantage of passive exoskeleton? 

3. How does the pushrod work ? Does it need a large force applied on it ? Does it need a flat ground ? If  the patient is standing , could he /she squat down ? This action is also ordinary in dally life .

4. The designed exoskeleton's relationship with gait cycle is not significant. It is controlled by the push rod  when corresponding shoe touches ground. It seems that only this one relationship. 

5. The academic  innovation needs to be strengthened.

Author Response

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Author Response File: Author Response.pdf

Reviewer 2 Report

1. Thanks for your excellent work and future contribution for the CP patient. 

2. I would like to know that, is there any signal latency effect of the activation of knee extensor muscles, i.e., the delay of knee extension, that the experimental CP patient felt about ?

Author Response

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Author Response File: Author Response.pdf

Reviewer 3 Report

This study aimed to propose a passive exoskeleton with gait-based knee joint support for individuals with cerebral palsy.  I have to fix the following major drawbacks.

1.    What is the novelty of this study although several Passive Exoskeleton with Gait-Based Knee Joint Support have been studied earlier?

2.    The abstract should be rewritten and improved by combining the objectives, short methodology, main findings, and prospective application.

3.    Please write down the contribution of the study at the end part of the Introduction section in bulleted form.

4.    Authors should include conceptual figures of their proposed model with more details and design parametrization.

5.    Patient demographics should contain spatio-temporal information on gait.

6.    Authors should add a figure of the experimental protocol and image of real experiment scenario in this study.

7.    Authors should write down the methodology of motion camera and EMG data processing in details.

8.    Authors should report the averaged gait cycle waveforms of studied subjects with stance/swing phase markers.

9.    Authors should review gait changes due to diseases and improve references for broader perspctives by mentioning studies of various neuromuscular changes, such as in article; prediction of myoelectric biomarkers in post-stroke gait. and in the article, real-time gait monitoring system for consumer stroke prediction service.

10.  Authors should report more performance measures of gait, such as muscle co-contraction etc.

 

11.  The results and discussion section need to be extended and improved. Authors should discuss the strength and weaknesses of reported findings with other previous exoskeleton findings in the discussion section.

Author Response

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Author Response File: Author Response.pdf

Round 2

Reviewer 3 Report

Thank you for addressing comments. 

Authors claim that the device was able to reduce the hip and knee flexion of most participants. Without a statistics significance test of relevant features, their claim is not valid. 

Author Response

Please see the attachment.

Author Response File: Author Response.pdf