Brain functional connectivity in unconstrained walking with and without an exoskeleton

An exoskeleton is utilized to effectively restore the motor function of amputees’ limbs and is frequently employed in motor rehabilitation training during convalescence. Understanding of exoskeleton impact on the brain is required in order to better and more efficiently use the exoskeleton. Almost all previous studies investigated the exoskeleton effect on the brain in a situation with constraints such as predefined walking speed, which could lead to findings differed from that obtained in an unconstrained situation. We, therefore, performed an experiment of unconstrained walking with and without an exoskeleton. Both individual connections and graph metrics were explored and compared among walking conditions. We found that low-order functional connections and associated high-order functional connections mainly between the left centroparietal region and right frontal region were significantly different among walking conditions. Generally speaking, connective strength was enhanced in LOFC and was decreased in aHOFC when assistant force was provided by the exoskeleton. Further, we proposed connection length investigation and revealed the large majority of these connections were long-distance connectivity. Graph metric investigation discovered higher connectivity clustering in the walking with low exoskeleton-aided force compared to the walking without the exoskeleton. This study expanded the existing knowledge of the effect of exoskeleton on the brain and is of implications on new exoskeleton development and exoskeleton-aided rehabilitation training.