Freezing is likely one of the most typical and debilitating signs of Parkinson’s illness, a neurodegenerative dysfunction that impacts greater than 9 million folks worldwide. When people with Parkinson’s illness freeze, they all of a sudden lose the flexibility to maneuver their ft, typically mid-stride, leading to a sequence of staccato stutter steps that get shorter till the individual stops altogether. These episodes are one of many greatest contributors to falls amongst folks dwelling with Parkinson’s illness.
As we speak, freezing is handled with a variety of pharmacological, surgical or behavioral therapies, none of that are significantly efficient.
What if there was a approach to cease freezing altogether?
Researchers from the Harvard John A. Paulson College of Engineering and Utilized Sciences (SEAS) and the Boston College Sargent Faculty of Well being & Rehabilitation Sciences have used a smooth, wearable robotic to assist an individual dwelling with Parkinson’s stroll with out freezing. The robotic garment, worn across the hips and thighs, offers a delicate push to the hips because the leg swings, serving to the affected person obtain an extended stride.
The machine utterly eradicated the participant’s freezing whereas strolling indoors, permitting them to stroll quicker and additional than they may with out the garment’s assist.
We discovered that only a small quantity of mechanical help from our smooth robotic attire delivered instantaneous results and constantly improved strolling throughout a variety of situations for the person in our research.”
Conor Walsh, the Paul A. Maeder Professor of Engineering and Utilized Sciences at SEAS and co-corresponding writer of the research
The analysis demonstrates the potential of soppy robotics to deal with this irritating and doubtlessly harmful symptom of Parkinson’s illness and will enable folks dwelling with the illness to regain not solely their mobility however their independence.
The analysis is printed in Nature Drugs.
For over a decade, Walsh’s Biodesign Lab at SEAS has been growing assistive and rehabilitative robotic applied sciences to enhance mobility for people’ post-stroke and people dwelling with ALS or different ailments that affect mobility. A few of that know-how, particularly an exosuit for post-stroke gait retraining, obtained assist from the Wyss Institute for Biologically Impressed Engineering, and was licensed and commercialized by ReWalk Robotics.
In 2022, SEAS and Sargent Faculty obtained a grant from the Massachusetts Know-how Collaborative to assist the event and translation of next-generation robotics and wearable applied sciences. The analysis is centered on the Transfer Lab, whose mission is to assist advances in human efficiency enhancement with the collaborative house, funding, R&D infrastructure, and expertise vital to show promising analysis into mature applied sciences that may be translated by way of collaboration with trade companions.
This analysis emerged from that partnership.
“Leveraging smooth 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,” mentioned Walsh, whose workforce collaborated intently with that of Terry Ellis, Professor and Bodily Remedy Division Chair and Director of the Middle for Neurorehabilitation at Boston College.
The workforce spent six months working with a 73-year-old man with Parkinson’s illness, who — regardless of utilizing each surgical and pharmacologic therapies — 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 group and compelled him to depend on a scooter to get round exterior.
In earlier analysis, Walsh and his workforce leveraged human-in-the-loop optimization to display {that a} smooth, wearable machine might be used to reinforce hip flexion and help in swinging the leg ahead to supply an environment friendly method to scale back vitality expenditure throughout strolling in wholesome people.
Right here, the researchers used the identical method however to handle freezing. The wearable machine makes use of cable-driven actuators and sensors worn across the waist and thighs. Utilizing movement knowledge collected by the sensors, algorithms estimate the section 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 open air. He was additionally capable of stroll and discuss with out freezing, a rarity with out the machine.
“Our workforce was actually excited to see the affect of the know-how on the participant’s strolling,” mentioned Jinsoo Kim, former PhD pupil at SEAS and co-lead writer on the research.
In the course of the research visits, the participant advised researchers: “The go well with helps me take longer steps and when it’s not lively, I discover I drag my ft way more. It has actually helped me, and I really feel it’s a optimistic step ahead. It may assist me to stroll longer and preserve the standard of my life.”
“Our research contributors who volunteer their time are actual companions,” mentioned Walsh. “As a result of mobility is troublesome, 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 machine is also 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,” mentioned Ellis. “However this work suggests the potential advantages of a ‘bottom-up’ reasonably 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 beneath grant CMMI-1925085; the Nationwide Institutes of Well being beneath grant NIH U01 TR002775; and the Massachusetts Know-how Collaborative, Collaborative Analysis and Growth Matching Grant.
Supply:
Journal reference:
Kim, J., et al. (2024). Mushy robotic attire to avert freezing of gait in Parkinson’s illness. Nature Drugs. doi.org/10.1038/s41591-023-02731-8.