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Freezing is likely one of the commonest and debilitating signs of Parkinson’s illness, a neurodegenerative dysfunction that impacts greater than 9 million individuals worldwide. When people with Parkinson’s illness freeze, they all of a sudden lose the flexibility to maneuver their ft, usually mid-stride, leading to a collection of staccato stutter steps that get shorter till the individual stops altogether. These episodes are one of many greatest contributors to falls amongst individuals dwelling with Parkinson’s illness.

Right this moment, freezing is handled with a variety of pharmacological, surgical or behavioral therapies, none of that are notably efficient.

What if there was a strategy to cease freezing altogether?

Researchers from the Harvard John A. Paulson Faculty of Engineering and Utilized Sciences (SEAS) and the Boston College Sargent School of Well being & Rehabilitation Sciences have used a gentle, wearable robotic to assist an individual dwelling with Parkinson’s stroll with out freezing. The robotic garment, worn across the hips and thighs, provides a mild push to the hips because the leg swings, serving to the affected person obtain an extended stride.

The system utterly eradicated the participant’s freezing whereas strolling indoors, permitting them to stroll sooner and additional than they may with out the garment’s assist.

We discovered that only a small quantity of mechanical help from our gentle robotic attire delivered instantaneous results and persistently improved strolling throughout a variety of situations for the person in our examine.”


Conor Walsh, the Paul A. Maeder Professor of Engineering and Utilized Sciences at SEAS and co-corresponding writer of the examine

The analysis demonstrates the potential of sentimental robotics to deal with this irritating and doubtlessly harmful symptom of Parkinson’s illness and will permit individuals dwelling with the illness to regain not solely their mobility however their independence.

The analysis is printed in Nature Medication.

For over a decade, Walsh’s Biodesign Lab at SEAS has been creating assistive and rehabilitative robotic applied sciences to enhance mobility for people’ post-stroke and people dwelling with ALS or different illnesses that affect mobility. A few of that know-how, particularly an exosuit for post-stroke gait retraining, obtained help from the Wyss Institute for Biologically Impressed Engineering, and was licensed and commercialized by ReWalk Robotics.

In 2022, SEAS and Sargent School obtained a grant from the Massachusetts Expertise Collaborative to help the event and translation of next-generation robotics and wearable applied sciences. The analysis is centered on the Transfer Lab, whose mission is to help advances in human efficiency enhancement with the collaborative house, funding, R&D infrastructure, and expertise needed to show promising analysis into mature applied sciences that may be translated by means of collaboration with business companions.

This analysis emerged from that partnership.

“Leveraging gentle wearable robots to forestall freezing of gait in sufferers with Parkinson’s required a collaboration between engineers, rehabilitation scientists, bodily therapists, biomechanists and attire designers,” stated Walsh, whose group collaborated intently with that of Terry Ellis, Professor and Bodily Remedy Division Chair and Director of the Middle for Neurorehabilitation at Boston College.

The group spent six months working with a 73-year-old man with Parkinson’s illness, who — regardless of utilizing each surgical and pharmacologic remedies — endured substantial and incapacitating freezing episodes greater than 10 instances a day, inflicting him to fall steadily. These episodes prevented him from strolling round his neighborhood and compelled him to depend on a scooter to get round outdoors.

In earlier analysis, Walsh and his group leveraged human-in-the-loop optimization to reveal {that a} gentle, wearable system could possibly be used to reinforce hip flexion and help in swinging the leg ahead to offer an environment friendly method to cut back power expenditure throughout strolling in wholesome people.

Right here, the researchers used the identical method however to handle freezing. The wearable system makes use of cable-driven actuators and sensors worn across the waist and thighs. Utilizing movement knowledge collected by the sensors, algorithms estimate the part of the gait and generate assistive forces in tandem with muscle motion.

The impact was instantaneous. With none particular coaching, the affected person was capable of stroll with none freezing indoors and with solely occasional episodes outdoor. He was additionally capable of stroll and discuss with out freezing, a rarity with out the system.

“Our group was actually excited to see the affect of the know-how on the participant’s strolling,” stated Jinsoo Kim, former PhD pupil at SEAS and co-lead writer on the examine.

Through the examine visits, the participant advised researchers: “The go well with helps me take longer steps and when it isn’t lively, I discover I drag my ft far more. It has actually helped me, and I really feel it’s a constructive step ahead. It may assist me to stroll longer and keep the standard of my life.”

“Our examine members who volunteer their time are actual companions,” stated Walsh. “As a result of mobility is tough, it was an actual problem for this particular person to even come into the lab, however we benefited a lot from his perspective and suggestions.”

The system may be used to raised perceive the mechanisms of gait freezing, which is poorly understood.

“As a result of we do not actually perceive freezing, we do not actually know why this method works so nicely,” stated Ellis. “However this work suggests the potential advantages of a ‘bottom-up’ quite than ‘top-down’ answer to treating gait freezing. We see that restoring almost-normal biomechanics alters the peripheral dynamics of gait and will affect the central processing of gait management.”

The analysis was co-authored by Jinsoo Kim, Franchino Porciuncula, Hee Doo Yang, Nicholas Wendel, Teresa Baker and Andrew Chin. Asa Eckert-Erdheim and Dorothy Orzel additionally contributed to the design of the know-how, in addition to Ada Huang, and Sarah Sullivan managed the medical analysis. It was supported by the Nationwide Science Basis below grant CMMI-1925085; the Nationwide Institutes of Well being below grant NIH U01 TR002775; and the Massachusetts Expertise Collaborative, Collaborative Analysis and Growth Matching Grant.

Supply:

Journal reference:

Kim, J., et al. (2024). Delicate robotic attire to avert freezing of gait in Parkinson’s illness. Nature Medication. doi.org/10.1038/s41591-023-02731-8.

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