脳卒中患者の歩行再学習を支援するロボット外骨格療法 (Robotic Exoskeleton Could Redefine How Stroke Survivors Relearn to Walk)

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2026-06-17 ノースウェスタン大学

ノースウェスタン大学の研究チームは、脳卒中後の歩行障害を改善する新しい外骨格(エクソスケルトン)療法を開発し、その有効性を実証した。脳卒中患者の多くは歩行能力の低下に悩まされるが、従来の外骨格装置は歩行動作を代行することが中心で、患者自身の運動学習を十分に促せないという課題があった。今回開発された装置は、利用者の動きを常時補助するのではなく、歩行中の脚の動きに応じて必要最小限の力だけを加えることで、自ら歩行を調整しながら学習できるよう設計されている。臨床試験では、脳卒中経験者がこの装置を用いて訓練した結果、歩行速度や歩行の左右対称性、下肢機能が改善し、装置を外した後も効果が維持されることが確認された。これは単なる補助機器ではなく、脳と神経系の再学習を促進する治療技術として機能する可能性を示している。研究チームは、歩行回復には誤差を感じながら身体を調整する学習過程が重要であると考えており、本技術は神経可塑性を活用した次世代リハビリテーション手法として期待される。今後は幅広い神経疾患患者への応用も検討されている。

脳卒中患者の歩行再学習を支援するロボット外骨格療法 (Robotic Exoskeleton Could Redefine How Stroke Survivors Relearn to Walk)
The Northwestern and Shirley Ryan AbilityLab team developed a novel intervention wherein a therapist and stroke survivor each wear a lower-limb exoskeleton virtually connected at the hips and knees. The connection behaves like a combination of springs and shock absorbers, allowing therapists and patients to influence each other’s movements in real time. Photo courtesy of the Shirley Ryan AbilityLab

<関連情報>

歩行療法におけるセラピスト・外骨格・患者の相互作用 Therapist-exoskeleton-patient interaction for gait therapy

Emek Barış Küçüktabak, Matthew R. Short, Lorenzo Vianello, Daniel Ludvig, […] , and Jose Pons
Science Robotics  Published:17 Jun 2026
DOI:https://doi.org/10.1126/scirobotics.adz9628

Abstract

After a stroke, individuals often experience mobility impairments because of weakness and loss of independent joint control in the lower limbs. As a result, gait recovery becomes a primary goal of physical rehabilitation, traditionally achieved through high-intensity therapist-led training. However, conventional therapist-led approaches involving manual assistance or resistance can be physically demanding and limit interaction at multiple joints simultaneously. Robotic exoskeletons have emerged as a promising solution, enabling multijoint support, reducing therapist strain, and offering objective performance feedback. However, typical exoskeleton control strategies limit the physical therapist’s involvement and adaptability to the patient’s needs, which may hinder clinical adoption and outcomes. In this study, we introduce a gait rehabilitation paradigm based on physical human-robot-human interaction that we call therapist-exoskeleton-patient interaction (TEPI), in which a therapist and a patient with stroke are each equipped with a lower-limb exoskeleton virtually connected at the hips and knees via spring-damper elements. This connection enables bidirectional physical interaction, allowing the therapist to guide the patient’s movement while receiving real-time haptic feedback. We evaluated this approach with eight patients with chronic stroke using a within-subject design, comparing TEPI training with conventional therapist-guided mobilization during treadmill walking. Results showed that, compared with conventional therapy, TEPI led to greater joint range of motion, increased step length and height, similar muscle activation, and high self-reported motivation and enjoyment. These findings suggest that TEPI can integrate robotic precision with therapist intuition, offering a framework for enhancing gait rehabilitation outcomes in populations recovering from stroke.

医療・健康
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