Pediatric Lower Limb Rehabilitation Training System with Soft Exosuit and Quantitative Partial Body Weight Support

The pediatric period is a crucial window for motor function learning and growth. Individuals with central nervous system injuries like cerebral palsy commonly display severe crouch gait in the lower limbs. Hyperflexion of the knee joints promotes the forward trunk and increases reliance on the handle frame of a walker for support. In this study, we developed a quantitative partial body weight training system integrated with a soft pneumatic exosuit to assist the knee extension during the stance phase of the gait cycle. In the preliminary results for five pediatric cerebral palsy subjects, compared to the baseline condition, excessive knee flexion ameliorated with the assistance of the soft pneumatic exosuit. The peak knee extension and range of motion increased by 19.72° (±3.47°) and 15.46° (±5.06°), respectively. With exosuit assistance, the subjects demonstrated improved gait retraining compared to baseline. They were able to bear significantly more body weight on their affected limb, as evidenced by a 33.3% increase in the fraction of body weight measured by the force plate. Additionally, they relied less on the handrail for support during walking. With more extended knee joints to bear the load over gravity, the pediatric subjects transferred the reliance from external support and upper limbs back to the lower limbs as a more independent status during the loading response to terminal stance.