Clinical and biomechanical foundation of application of the exoskeleton Exoatlet at walking of patients with poststroke disturbances

Influence of training in the exoskeleton on the biomechanical and innervative structure of walking of patients with the ischemic stroke has been revealed for the first time in Russia. It has been established that the most expressed locomotor disturbances in patients with the ischemic stroke are seen in combination of recurvation (hyperextension) at a knee joint with equinus deformation of the foot, which is characterized by its stable plantar flexion or equinovarus deformation of the foot and ankle joint (invertion inside and plantar flexion of the foot). Biomechanical and innervative structure of walking in 5 patients with consequences of the ischemic stroke in 3-4 months after the beginning of the disease has been considered. The main disorders of the biomechanical structure of walking in these patients have been determined, namely, decrease of walking velocity, cadence and double step length, expressed asymmetry of the temporal, kinematic and dynamic parameters, disappearance of the separate phases of the locomotor cycle, change of the pattern of movements, reduction of the support and push functions of the lower extremities, remarkable transformation of electromyography pattern of muscles. Method of application of the exoskeleton in this contingent of patients has been demonstrated in this article, which includes determination of duration of the session of training, duration of the course, distance, which patient could walk for the session. It has been revealed, that the following changes take place after 10-days course of training in the exoskeleton: increase of walking velocity, cadence and step length, complete elimination of the temporal asymmetry, growth of the support and push functions of the lower extremities, enhancement of amplitude of angular displacements at the joints of the lower extremities, inconsiderable improvements of electromyography pattern of muscles.