Comfort-Centered Design of a Lightweight and Backdrivable Knee Exoskeleton

This paper presents design principles for comfort-centered wearable robots and their application in a lightweight and backdrivable knee exoskeleton. The mitigation of discomfort is treated as mechanical design and control issues and three solutions are proposed in this paper: 1) a new wearable structure optimizes the strap attachment configuration and suit layout to ameliorate excessive shear forces of conventional wearable structure design; 2) rolling knee joint and double-hinge mechanisms reduce the misalignment in the sagittal and frontal plane, without increasing the mechanical complexity and inertia, respectively; 3) a low impedance mechanical transmission reduces the reflected inertia and damping of the actuator to human, thus the exoskeleton is highly-backdrivable. Kinematic simulations demonstrate that misalignment between the robot joint and knee joint can be reduced by 74% at maximum knee flexion. In experiments, the exoskeleton in the unpowered mode exhibits 1.03 Nm root mean square (RMS) low resistive torque. The torque control experiments demonstrate 0.31 Nm RMS torque tracking error in three human subjects.Comment: 8 pages, 16figures, Journa

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

Design and Control of a Knee Exoskeleton for Assistance and Power Augmentation

Thanks to the technological advancements, assistive lower limb exoskeletons are moving from laboratory settings to daily life scenarios. This dissertation makes a contribution toward the development of assistive/power augmentation knee exoskeletons with an improved wearability, ergonomics and intuitive use. In particular, the design and the control of a novel knee exoskeleton system, the iT-Knee Bipedal System, is presented. It is composed by: a novel mechanism to transmit the assistance generated by the exoskeleton to the knee joint in a more ergonomic manner; a novel method that requires limited information to estimate online the torques experienced by the ankles, knees and hips of a person wearing the exoskeleton; a novel sensor system for shoes able to track the feet orientation and monitor their full contact wrench with the ground. In particular, the iT-Knee exoskeleton, the main component of the aforementioned system, is introduced. It is a novel six degree of freedom knee exoskeleton module with under-actuated kinematics, able to assist the flexion/extension motion of the knee while all the other joint\u2019s movements are accommodated. Thanks to its mechanism, the system: solves the problem of the alignment between the joint of the user and the exoskeleton; it automatically adjusts to different users\u2019 size; reduces the undesired forces and torques exchanged between the attachment points of its structure and the user\u2019s skin. From a control point of view, a novel approach to address difficulties arising in real life scenarios (i.e. noncyclic locomotion activity, unexpected terrain or unpredicted interactions with the surroundings) is presented. It is based on a method that estimates online the torques experienced by a person at his ankles, knees and hips with the major advantage that does not rely on any information of the user\u2019s upper body (i.e. pose, weight and center of mass location) or on any interaction of the user\u2019s upper body with the environment (i.e. payload handling or pushing and pulling task). This is achieved v by monitoring the full contact wrench of the subject with the ground and applying an inverse dynamic approach to the lower body segments. To track the full contact wrench between the subject\u2019s feet and the ground, a novel add on system for shoes has been developed. The iT-Shoe is adjustable to different user\u2019s size and accommodates the plantar flexion of the foot. It tracks the interactions and the orientation of the foot thanks to two 6axis Force/Torque sensors, developed in-house, with dedicated embedded MEMS IMUs placed at the toe and heel area. Different tasks and ground conditions were tested to validate and highlight the potentiality of the proposed knee exoskeleton system. The experimental results obtained and the feedback collected confirm the validity of the research conducted toward the design of more ergonomic and intuitive to use exoskeletons

Best practice statement : use of ankle-foot orthoses following stroke

NHS Quality Improvement Scotland (NHSQIS) leads the use of knowledge to promote improvement in the quality of health care for the people of Scotland and performs three key functions. It provides advice and guidance on effective clinical practice, including setting standards; drives and supports implementation of improvements in quality, and assessing the performance of the NHS, reporting and publishing findings

Design, implementation and control of self-aligning, bowden cable-driven, series elastic exoskeletons for lower extremity rehabilitation

We present AssistOn-Leg, a modular, self-aligning exoskeleton for robotassisted rehabilitation of lower extremities. AssistOn-Leg consists of three selfaligning, powered exoskeletons targeting ankle, knee and hip joints, respectively. Each module can be used in a stand-alone manner to provide therapy to its corresponding joint or the modules can be connected together to deliver natural gait training to patients. In particular, AssistOn-Ankle targets dorsiflexion/ plantarflexion and supination/pronation of human ankle and can be configured to deliver balance/proprioception or range of motion/strengthening exercises; AssistOn-Knee targets flexion/extension movements of the knee joint, while also accommodating its translational movements in the sagittal plane; and AssistOn- Hip targets flexion/extension movements hip joint, while allowing for translations of hip-pelvis complex in the sagittal plane. Automatically aligning their joint axes, modules of AssistOn-Leg ensure an ideal match between human joint axes and the exoskeleton axes. Self-alignment of the modules not only guarantees ergonomy and comfort throughout the therapy, but also significantly shortens the setup time required to attach a patient to the exoskeleton. Bowden cable-driven series elastic actuation is utilized in the modules located at the distal (knee and ankle) joints of AssistOn-Leg to keep the apparent inertia of the system low, while simultaneously providing large actuation torques required to support human gait. Series elasticity also provides good force tracking characteristics, active back-driveability within the control bandwidth and passive compliance as well as impact resistance for excitations above this bandwidth. AssistOn-Hip is designed to be passively back-driveable with a capstan-based multi-level transmission. Thanks to passive compliance of the distal modules and passive backdriveability of the hip module, the overall design ensures safety even under power losses and robustness throughout the whole frequency spectrum

Self-adjusting, Isostatic Exoskeleton for The Human Knee Joint

International audienceA knee-joint exoskeleton design that can apply programmable torques to the articulation and that self-adjusts to its physiological movements is described. Self-adjustment means that the articular torque is automatically produced around the rotational axis of the joint. The requirements are first discussed and the conditions under which the system tracks the spatial relative movements of the limbs are given. If these conditions are met, the torque applied to the joint takes into account the possible relative movements of the limbs without introducing constraints. A prototype was built to demonstrate the applicability of these principles and preliminary tests were carried out to validate the design

The use of body weight support on ground level: an alternative strategy for gait training of individuals with stroke

<p>Abstract</p> <p>Background</p> <p>Body weight support (BWS) systems on treadmill have been proposed as a strategy for gait training of subjects with stroke. Considering that ground level is the most common locomotion surface and that there is little information about individuals with stroke walking with BWS on ground level, it is important to investigate the use of BWS on ground level in these individuals as a possible alternative strategy for gait training.</p> <p>Methods</p> <p>Thirteen individuals with chronic stroke (four women and nine men; mean age 54.46 years) were videotaped walking on ground level in three experimental conditions: with no harness, with harness bearing full body weight, and with harness bearing 30% of full body weight. Measurements were recorded for mean walking speed, cadence, stride length, stride speed, durations of initial and terminal double stance, single limb support, swing period, and range of motion of ankle, knee, and hip joints; and foot, shank, thigh, and trunk segments.</p> <p>Results</p> <p>The use of BWS system leads to changes in stride length and speed, but not in stance and swing period duration. Only the hip joint was influenced by the BWS system in the 30% BWS condition. Shank and thigh segments presented less range of motion in the 30% BWS condition than in the other conditions, and the trunk was held straighter in the 30% BWS condition than in the other conditions.</p> <p>Conclusion</p> <p>Individuals with stroke using BWS system on ground level walked slower and with shorter stride length than with no harness. BWS also led to reduction of hip, shank, and thigh range of motion. However, this system did not change walking temporal organization and body side asymmetry of individuals with stroke. On the other hand, the BWS system enabled individuals with chronic stroke to walk safely and without physical assistance. In interventions, the physical therapist can watch and correct gait pattern in patients' performance without the need to provide physical assistance.</p

Self-adjusting, Isostatic Exoskeleton for The Human Knee Joint

Abstract — A knee-joint exoskeleton design that can apply programmable torques to the articulation and that self-adjusts to its physiological movements is described. Self-adjustment means that the articular torque is automatically produced around the rotational axis of the joint. The requirements are first discussed and the conditions under which the system tracks the spatial relative movements of the limbs are given. If these conditions are met, the torque applied to the joint takes into account the possible relative movements of the limbs without introducing constraints. A prototype was built to demonstrate the applicability of these principles and preliminary tests were carried out to validate the design. I