Improving Ankle Muscle Recruitment via Plantar Pressure Biofeedback during Robot Resisted Gait Training in Cerebral Palsy

Benjamin C. Conner, Zachary F. Lerner

Research output: Chapter in Book/Report/Conference proceedingConference contribution

7 Scopus citations


Neurological impairment from stroke or cerebral palsy often presents with diminished ankle plantar flexor function during the propulsive phase of gait. This deficit often results in slow, energy-expensive walking patterns that limit community mobility. Robotic gait training interventions may prove effective in improving functional outcomes, including exoskeleton resistance used to provide targeted neuromuscular recruitment. However, these interventions to date have required regular verbal cues and coaching for proper plantar flexor engagement with resistance, particularly for pediatric applications. In this validation study, we sought to address the need for automating and improving the effectiveness of facilitating user engagement with robotic resistance. Specifically, our main goal was to compare changes in plantar flexor activity between walking with plantar flexor resistance alone vs plantar flexor resistance combined with plantar pressure biofeedback in individuals with cerebral palsy. We recruited 8 ambulatory adolescents with cerebral palsy between the ages of 11-18 years old to participate in this cross-sectional feasibility study. Supporting our hypothesis, we observed a 36 ± 36% and 46 ± 39% increase in mean and peak soleus activity, respectively, between resistance plus biofeedback vs resistance alone (both p < 0.05). Compared to other biofeedback sensing modalities like assessment of muscle activity via surface electrodes, integrating the plantar pressure-based system within the wearable robotic devices minimizes barriers to clinical implementation by reducing cost, complexity, and setup time. With these positive feasibility results, our future work will explore longer-term training effects of ankle resistance combined with plantar pressure biofeedback.

Original languageEnglish (US)
Title of host publication2022 International Conference on Rehabilitation Robotics, ICORR 2022
PublisherIEEE Computer Society
ISBN (Electronic)9781665488297
StatePublished - 2022
Externally publishedYes
Event2022 International Conference on Rehabilitation Robotics, ICORR 2022 -
Duration: Jan 1 2022 → …

Publication series

NameIEEE International Conference on Rehabilitation Robotics


Conference2022 International Conference on Rehabilitation Robotics, ICORR 2022
Period1/1/22 → …

ASJC Scopus subject areas

  • Control and Systems Engineering
  • Rehabilitation
  • Electrical and Electronic Engineering

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