Could an Exoskeleton-Driven Rehabilitation Treatment Improve Muscle Forces Generation in PD? - a Pilot Study

Research focusing on optimal rehabilitation methods has been directed towards powered lower-limb exoskeletons which combines the advantages delivered from the grounded robotic devices with the ability to train the patient in a real-world environment. In this context literature has highlighted the benefit of coupling gait analysis and musculoskeletal modeling for treatment planning. Recently, this combined approach has been successfully applied to detect the alterations in motor control related to Parkinson’s Disease (PD). However, no study has reported about the effects of an overground wearable exoskeleton in terms of both gait analysis and musculoskeletal modeling-derived parameters in people with PD. The aim of this study was to quantitatively assess the effect of an overground rehabilitation treatment on a PD participant both in terms of gait parameters and muscle forces. One people with PD has been enrolled and gait analysis was performed before and after a 4-weeks gait training intervention with an overground exoskeleton. Inverse kinematics, inverse dynamics, and static optimization were performed in OpenSim. Results from joint moments and muscle forces were compared with a group of healthy controls. Preliminary results showed that after the therapy joint loads in both ankle and knee joints were reduced during the stance phase and muscle forces displayed an increased magnitude in their peak after the treatment. For the best of our knowledge, the presented case study is the first attempt to track rehabilitation improvement via muscle forces assessment. Further studies should focus on increasing the sample size to generalize the outcomes.