Advances on mechanical designs for assistive ankle-foot orthoses

Assistive ankle-foot orthoses (AFOs) are powerful solutions to assist or rehabilitate gait on humans. Existing assistive AFO technologies include passive, quasi-passive, and active principles to provide assistance to the users, and their mechanical configuration and control depend on the eventual support they aim for within the gait pattern. In this research we analyze the state-of-the-art of assistive AFOs and classify the different approaches into clusters, describing their basis and working principles. Additionally, we reviewed the purpose and experimental validation of the devices, providing the reader with a better view of the technology readiness level. Finally, the reviewed designs, limitations, and future steps in the field are summarized and discussed.Comment: Figures appear at the end. Article submitted to Frontiers in Bioengineering and Biotechnology (currently under review

Motor Electrical Damping for Back-Drivable Prosthetic Knee

The paper presents a model and analysis of a backdrivable knee prosthesis. In this context, the investigation into the design, modelling and analysis of a back-drivable semiactive prosthetic knee is presented. A mathematical model has been developed for evaluating the electrical damping characteristics of the DC motor in passive mode. The analysis shows that a single actuator could be suitable to work in active mode to provide mechanical power and in passive mode as a damper dissipating energy

A reconfigurable wheelchair for mobility and rehabilitation:Design and development

This paper presents the design and development of a prototype of a reconfigurable wheelchair for rehabilitation and self-assistance to fit the size of a seven years old child (average 35 kg weight). Though the developed prototype is developed at this stage to fit a child, it can be resized, after considering variations in weight and size, to fit an older adult. The developed prototype has a mechanism that enables the user to transform from sit-to-stand (STS) posture and vice versa. With the help of the developed wheelchair, the user will also be able to adjust the posture of his upper body using an adjustable back support using two linear actuators. This configuration will allow the user to use the wheelchair as a mobility device as well as for rehabilitation purposes without the need of external support. The availability of STS and back adjustment mechanisms will allow the user to do regular exercising which will enhance blood circulation as sitting for long periods inflates lower limbs disability. The proposed configuration will help in enhancing the functional capabilities of end-users allowing for increased independence and ultimately quality of life

Design of a wearable active ankle-foot orthosis for both sides

Dissertação de mestrado integrado em Engenharia Biomédica (área de especialização em Biomateriais, Reabilitação e Biomecânica)Portugal is the west European country with the highest rate of stroke-related mortality, being that, of those who suffer cerebrovascular accidents, 40% feature an impairment which can manifest itself through motor sequelae, namely drop foot. An ankle-foot orthosis is often recommended to passively accommodate these motor problems; however, active/powered exoskeletons are also a suitable solution for post-stroke patients. Due to the high complexity of the human ankle joint, one of the problems regarding these active devices is the misalignment occurring between the rehabilitation device and the human joint, which is a cause of parasitic forces, discomfort, and pain. The present master dissertation proposes the development of an adjustable wearable active ankle-foot orthosis that is able to tackle this misalignment issue concerning commercially available lower limb orthotic devices. This work is integrated on the SmartOs – Smart, Stand-alone Active Orthotic System – project that proposes an innovative robotic technology (a wearable mobile lab) oriented to gait rehabilitation. The conceptual design of a standard version of the SmartOs wearable active orthosis was initiated with the analysis of another ankle-foot orthosis – Exo-H2 (Technaid) – from which the necessary design changes were implemented, aiming at the improvement of the established device. In order to achieve a conceptual solution, both the practical knowledge of the Orthos XXI design team and several design methods were used to ensure the accomplishment of the defined requirements. The detailed design process of the standard SmartOs wearable active orthosis prototype is disclosed. With the purpose of validating the design, the critical components were simulated with the resources available in SolidWorks®, and the necessary CAD model’s adaptations were implemented to guarantee a reliable and safe design. The presented design is currently set for further production in Orthos XXI, followed by the mandatory mechanical tests.Portugal é o país da Europa ocidental com maior taxa de mortalidade por acidente vascular cerebral (AVC), sendo que, dos que sofrem acidentes vasculares cerebrais, 40% apresentam uma deficiência que pode manifestar-se por sequelas motoras, nomeadamente o pé pendente. Uma ortótese do tornozelo é recomendada frequentemente para acomodar passivamente esses problemas motores; no entanto, exoesqueletos ativos são também uma solução adequada para pacientes pós-AVC. Devido à alta complexidade da articulação do tornozelo humano, um dos problemas associados a esses dispositivos ativos é o desalinhamento que ocorre entre o dispositivo de reabilitação e a articulação humana, que é uma causa de forças parasitas, desconforto e dor. A presente dissertação de mestrado propõe o desenvolvimento de uma ortótese ativa do tornozelo ajustável e vestível, que seja capaz de resolver esse problema de desalinhamento relativo aos dispositivos ortóticos de membros inferiores disponíveis comercialmente. Este trabalho está integrado no projeto SmartOs - Smart, Stand-alone Active Orthotic System - projeto que propõe uma tecnologia robótica inovadora (wearable mobile lab) direcionada para a reabilitação da marcha. O projeto conceptual de uma versão padrão da ortótese ativa vestível do projeto SmartOs foi iniciado com a análise de outra ortótese do tornozelo – Exo-H2 (Technaid) - a partir da qual foram implementadas as alterações de projeto necessárias, visando o aprimoramento do dispositivo estabelecido. Para se chegar a uma solução conceptual, tanto o conhecimento prático da equipa de projeto da Orthos XXI como os diversos métodos de projeto foram utilizados para garantir o cumprimento dos requisitos definidos. O processo do desenho detalhado da versão padrão da ortótese ativa SmartOs será também divulgado. Com o objetivo de validar o projeto, os componentes críticos foram simulados com os recursos disponíveis no SolidWorks® e as adaptações necessárias do modelo CAD foram implementadas para garantir um projeto fidedigno e seguro. O projeto apresentado está atualmente em preparação para produção na empresa Orthos XXI, depois do qual se seguem os ensaios mecânicos obrigatórios

A low-power ankle-foot prosthesis for push-off enhancement

Passive ankle-foot prostheses are light-weighted and reliable, but they cannot generate net positive power, which is essential in restoring the natural gait pattern of amputees. Recent robotic prostheses addressed the problem by actively controlling the storage and release of energy generated during the stance phase through the mechanical deformation of elastic elements housed in the device. This study proposes an innovative low-power active prosthetic module that fits on off-the-shelf passive ankle-foot energy-storage-and-release (ESAR) prostheses. The module is placed parallel to the ESAR foot, actively augmenting the energy stored in the foot and controlling the energy return for an enhanced push-off. The parallel elastic actuation takes advantage of the amputee’s natural loading action on the foot’s elastic structure, retaining its deformation. The actuation unit is designed to additionally deform the foot and command the return of the total stored energy. The control strategy of the prosthesis adapts to changes in the user’s cadence and loading conditions to return the energy at a desired stride phase. An early verification on two transtibial amputees during treadmill walking showed that the proposed mechanism could increase the subjects’ dorsiflexion peak of 15.2% and 41.6% for subjects 1 and 2, respectively, and the cadence of about 2%. Moreover, an increase of 26% and 45% was observed in the energy return for subjects 1 and 2, respectively

Design, Fabrication, and Control of an Upper Arm Exoskeleton Assistive Robot

Stroke is the primary cause of permanent impairment and neurological damage in the United States and Europe. Annually, about fifteen million individuals worldwide suffer from stroke, which kills about one third of them. For many years, it was believed that major recovery can be achieved only in the first six months after a stroke. More recent research has demonstrated that even many years after a stroke, significant improvement is not out of reach. However, economic pressures, the aging population, and lack of specialists and available human resources can interrupt therapy, which impedes full recovery of patients after being discharged from hospital following initial rehabilitation. Robotic devices, and in particular portable robots that provide rehabilitation therapy at home and in clinics, are a novel way not only to optimize the cost of therapy but also to let more patients benefit from rehabilitation for a longer time. Robots used for such purposes should be smaller, lighter and more affordable than the robots currently used in clinics and hospitals. The common human-machine interaction design criteria such as work envelopes, safety, comfort, adaptability, space limitations, and weight-to-force ratio must still be taken into consideration.;In this work a light, wearable, affordable assistive robot was designed and a controller to assist with an activity of daily life (ADL) was developed. The mechanical design targeted the most vulnerable group of the society to stroke, based on the average size and age of the patients, with adjustability to accommodate a variety of individuals. The novel mechanical design avoids motion singularities and provides a large workspace for various ADLs. Unlike similar exoskeleton robots, the actuators are placed on the patient\u27s torso and the force is transmitted through a Bowden cable mechanism. Since the actuators\u27 mass does not affect the motion of the upper extremities, the robot can be more agile and more powerful. A compact novel actuation method with high power-to-weight ratio called the twisted string actuation method was used. Part of the research involved selection and testing of several string compositions and configurations to compare their suitability and to characterize their performance. Feedback sensor count and type have been carefully considered to keep the cost of the system as low as possible. A master-slave controller was designed and its performance in tracking the targeted ADL trajectory was evaluated for one degree of freedom (DOF). An outline for proposed future research will be presented

Elbow exoskeleton mechanism for multistage poststroke rehabilitation.

More than three million people are suffering from stroke in England. The process of post-stroke rehabilitation consists of a series of biomechanical exercises- controlled joint movement in acute phase; external assistance in the mid phase; and variable levels of resistance in the last phase. Post-stroke rehabilitation performed by physiotherapist has many limitations including cost, time, repeatability and intensity of exercises. Although a large variety of arm exoskeletons have been developed in the last two decades to substitute the conventional exercises provided by physiotherapist, most of these systems have limitations with structural configuration, sensory data acquisition and control architecture. It is still difficult to facilitate multistage post-stroke rehabilitation to patients sited around hospital bed without expert intervention. To support this, a framework for elbow exoskeleton has been developed that is portable and has the potential to offer all three types of exercises (external force, assistive and resistive) in a single structure. The design enhances torque to weight ratio compared to joint based actuation systems. The structural lengths of the exoskeleton are determined based on the mean anthropometric parameters of healthy users and the lengths of upperarm and forearm are determined to fit a wide range of users. The operation of the exoskeleton is divided into three regions where each type of exercise can be served in a specific way depending on the requirements of users. Electric motor provides power in the first region of operation whereas spring based assistive force is used in the second region and spring based resistive force is applied in the third region. This design concept provides an engineering solution of integrating three phases of post-stroke exercises in a single device. With this strategy, the energy source is only used in the first region to power the motor whereas the other two modes of exercise can work on the stored energy of springs. All these operations are controlled by a single motor and the maximum torque of the motor required is only 5 Nm. However, due to mechanical advantage, the exoskeleton can provide the joint torque up to 10 Nm. To remove the dependency on biosensor, the exoskeleton has been designed with a hardware-based mechanism that can provide assistive and resistive force. All exoskeleton components are integrated into a microcontroller-based circuit for measuring three joint parameters (angle, velocity and torque) and for controlling exercises. A user-friendly, multi-purpose graphical interface has been developed for participants to control the mode of exercise and it can be managed manually or in automatic mode. To validate the conceptual design, a prototype of the exoskeleton has been developed and it has been tested with healthy subjects. The generated assistive torque can be varied up to 0.037 Nm whereas resistive torque can be varied up to 0.057 Nm. The mass of the exoskeleton is approximately 1.8 kg. Two comparative studies have been performed to assess the measurement accuracy of the exoskeleton. In the first study, data collected from two healthy participants after using the exoskeleton and Kinect sensor by keeping Kinect sensor as reference. The mean measurement errors in joint angle are within 5.18 % for participant 1 and 1.66% for participant 2; the errors in torque measurement are within 8.48% and 7.93% respectively. In the next study, the repeatability of joint measurement by exoskeleton is analysed. The exoskeleton has been used by three healthy users in two rotation cycles. It shows a strong correction (correlation coefficient: 0.99) between two consecutive joint angle measurements and standard deviation is calculated to determine the error margin which comes under acceptable range (maximum: 8.897). The research embodied in this thesis presents a design framework of a portable exoskeleton model for providing three modes of exercises, which could provide a potential solution for all stages of post- stroke rehabilitation