A Passive Pediatric Exoskeleton to Improve the Walking Ability of Children with Neuromuscular Disorders

Abstract

Children with neuromuscular disorders, such as cerebral palsy (CP) often have walking limitations. Assistive devices for home use, such as walkers and crutches, may not provide optimal participation opportunities or lead to effective walking dosage. Even with therapy and assistive devices, children with CP get significantly less walking practice than typically developing peers. Recent research has shown that passive exotendon driven exoskeletons are effective for improving walking outcomes for adults with neurologic injury. A passive pediatric exoskeleton using exotendons was developed and evaluated for improving gait of children with CP and other forms of hemiparesis. Three typically developing (TD) children and two children with hemiparesis walked on level ground with the exoskeleton at three stiffness settings. Motion capture and electromyography data were collected to evaluate changes in joint kinematic symmetry, walking speed, and step width. The exoskeleton had no significant impact on gait outcome measures for TD participants, but for participants with hemiparesis the exoskeleton significantly improved kinematic joint symmetry at the hip or the ankle depending on the participant’s natural gait pattern. These results suggest that exotendon-based designs for passive exoskeletons may provide a novel platform to improve walking for children with neurologic injuries and support community-based gait training.