Abstract
Many of those who survive a stroke develop a gait disability known as stiff-knee gait (SKG). Characterized by reduced knee flexion angle during swing, people with SKG walk with poor energy efficiency and asymmetry due to the compensatory mechanisms required to clear the foot. Previous modeling studies have shown that knee flexion activity directly before the foot leaves the ground, and this should result in improved knee flexion angle during swing. The goal of this research is to physically test this hypothesis using robotic intervention. We developed a device that is capable of assisting knee flexion torque before swing but feels imperceptible (transparent) for the rest of the gait cycle. This device uses sheathed Bowden cable to control the deflection of a compliant torsional spring in a configuration known as a Series Elastic Remote Knee Actuator (SERKA). In this investigation, we describe the design and evaluation of SERKA, which includes a pilot experiment on stroke subjects. SERKA could supply a substantial torque (12 N· m) in less than 20 ms, with a maximum torque of 41 N·m. The device resisted knee flexion imperceptibly when desired, at less than 1 N·m rms torque during normal gait. With the remote location of the actuator, the user experiences a mass of only 1.2 kg on the knee. We found that the device was capable of increasing both peak knee flexion angle and velocity during gait in stroke subjects. Thus, the SERKA is a valid experimental device that selectively alters knee kinetics and kinematics in gait after stroke.