Immediate effects of the honda walking assist on spatiotemporal gait characteristics in individuals after stroke

The use of unconstrained lower limb exoskeletons has become a promising approach to assist individuals with gait impairments.The Honda Walking Assist(HWA)is a hip-assistive exoskeleton functioning as a gait trainer and has been shown to improve several gait related outcomes after training.Studies investigating its immediate effects on spatiotemporal gait parameters other than walking speed in stroke survivors are lacking.The aim of this study was to investigate immediate differences in spatiotemporal gait parameters of stroke survivors between normal overground walking,walking with an unpowered,non-assisting HWA and walking with an optimally assisting HWA.Five ischemic stroke survivors(mean time since stroke 115±213.6 days)walked 3 times 5 m in each condition.Differences in 14 spatiotemporal gait parameters between all 3 conditions were registered and reported in a descriptive manner.With optimal assistance,4 patients walked faster(0.057–0.095 m/s)with longer strides of the paretic(0.055–0.069 m)and non-paretic(0.053–0.077 m)leg compared to normal walking.Compared to unpowered walking,all patients walked faster(0.020–0.063 m/s)in the optimal assist condition,with longer strides of the paretic(0.036–0.072 m)and non-paretic leg(0.045–0.082 m).During unpowered walking,gait velocity remained unchanged in 2 patients,increased(0.012_0.051 m/s)in 2 patients and decreased(-0.022 m/s)in 1 patient compared to normal walking.Changes in paretic stride lengths ranged from-0.066 to 0.029 m.The optimal individualized motor assistance provided by the HWA induces small,positive changes in gait parameters.This indicates that this light-weight hip-assistive exoskeleton can be of value in rehabilitation setting,where multiple training sessions with the device are possible.

Assessment of muscle strength in para-athletes:A systematic review of observational studies

Accurate and reliable evaluation of muscle strength in para-athletes is essential for monitoring the effectiveness of strength training and/or rehabilitation programmes,and sport classification.Our aim is to synthesise evidence related to assessing muscle strength in para-athletes.Four databases were searched from January 1990 to July 2021 for observational studies focusing on strength assessment.Independent screening,data extraction,and quality assessment were performed in duplicate.A total of 1764 potential studies were identified.Thirty met the inclusion criteria and were included in the review.The mean age of participants was 30.7 years(standard deviation[SD]:2.4).The majority were men(88%)participating in wheelchair sports,including basketball,rugby,and tennis(23/30:76%).Overall quality varied,with more than half of the studies failing to identify strategies for dealing with confounding variables.Despite manual muscle testing being a standard component of para-sport classification systems,evidence examining strength characteristics in para-athletes is derived primarily from isometric and isokinetic testing.In studies that included comparative strength data,findings were mixed.Some studies found strength values were similar to or lower than able-bodied athletic controls.However,an important observation was that others reported higher shoulder strength in para-athletes taking part in wheelchair sports than both able-bodied and disabled non-athletes.Studies need to develop accessible,standardised strength testing methods that account for training influence and establish normative strength values in para-athletes.There is also a need for additional studies that include female para-athletes and para-athletes with greater functional impairments.