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

State of the Art Lower Limb Robotic Exoskeletons for Elderly Assistance

https://ieeexplore.ieee.org/document/8759880/keywords#keywordsThe number of elderly populations is rapidly increasing. Majority of elderly people face difficulties while walking because the muscular activity or other gait-related parameters start to deteriorate with aging. Therefore, the quality of life among them can be suffered. To make their life more comfortable, service providing robotic solutions in terms of wearable powered exoskeletons should be realized. Assistive powered exoskeletons are capable of providing additional torque to support various activities, such as walking, sit to stand, and stand to sit motions to subjects with mobility impairments. Specifically, the powered exoskeletons try to maintain and keep subjects' limbs on the specified motion trajectory. The state of the art of currently available lower limb assistive exoskeletons for weak and elderly people is presented in this paper. The technology employed in the assistive devices, such as actuation and power supply types, control strategies, their functional abilities, and the mechanism design, is thoroughly described. The outcome of studied literature reveals that there is still much work to be done in the improvement of assistive exoskeletons in terms of their technological aspects, such as choosing proper and effective control methods, developing user friendly interfaces, and decreasing the costs of device to make it more affordable, meanwhile ensuring safe interaction for the end-users

A Review of Lower Limb Exoskeletons

In general, exoskeletons are defined as wearable robotic mechanisms for providing mobility. In the last six decades, many research work have been achieved to enhance the performance of exoskeletons thus developing them to nearly commercialized products. In this paper, a review is made for the lower limb exoskeleton concerning history, classification, selection and development, also a discussion for the most important aspects of comparison between different designs is presented. Further, some concluding remarks are withdrawn which could be useful for future work. Keywords: Exoskeletons, Lower extremity exoskeleton, Wearable robot

Powered knee orthosis for human gait rehabilitation: first advances

This paper presents a new system for a powered knee orthosis, that was designed to assist and improve the gait function of patients with gait pathologies. The system contains the orthotic device (embedded with sensors for angle and user-orthosis interaction torque measurements, and an electric actuator) and wearable sensors (inertial measurement unit, force sensitive resistors, and electromyography sensors), which allows the generation of smart rehabilitation tools and several motion assistive techniques. The main goal is to present a conceptual overview and functional description of the system and use scenarios of each component. The attachment mechanism of the orthosis to the limb is also highlighted, being composed of a straps system fixed in the mechanical links of the joint. It was noticed that users with distinct lower-limb morphologies can presents difficulties wearing the orthosis, since the device needs constant adjust to align the mechanical and human joints. The system was validated in ground-level walking on healthy subjects, with emphasis on the impact of the device in the user. The subjects reported that the orthosis is comfortable to use, easy to wear, and no issues were raised regarding the aesthetics of the device. Only the weight was assimilated as a possible hindrance (compensated in the future). Future challenges involve the inclusion of an ankle joint in the system and the use of the proposed tool in rehabilitation.This work is supported by the FCT - Fundacao para a Ciencia e Tecnologia - with the reference scholarship SFRH/BD/108309/2015, with the reference project UID/EEA/04436/2013, and by FEDER funds through the COMPETE 2020 - Programa Operacional Competitividade e Internacionalizacao (POCI) - with the reference project POCI-01-0145-FEDER-006941, and partially supported with grant RYC-2014-16613 by Spanish Ministry of Economy and Competitiveness

Event-based control for sit-to-stand transition using a wearable exoskeleton

Sit-to-stand transition is an essential step in a lower limb rehabilitation therapy, mainly for assisting the patient to transit from wheel chair to the next level of therapy. A mixed stiffness-damping control adaptation is proposed for this task which will help in reaching the final position with a constant velocity. A combination of control model is proposed to ensure the initiation and the final stage of the transition, such as to ensure stability and to maintain the equilibrium. The combined control model helps in reaching the goal position with equal participation from the user. For patient studies, such as with paraplegic patients, a combinational control model with muscle stimulation can be included to provide a complete assistance. The role of muscle stimulation and joint movement assistance is also considered in this control model. Further, final stage of this transition must ensure keeping or helping the user to maintain the upright position.Peer ReviewedPostprint (author's final draft

Exoskeleton-Mediated Physical Human-Human Interaction for a Sit-to-Stand Rehabilitation Task

Sit-to-Stand (StS) is a fundamental daily activity that can be challenging for stroke survivors due to strength, motor control, and proprioception deficits in their lower limbs. Existing therapies involve repetitive StS exercises, but these can be physically demanding for therapists while assistive devices may limit patient participation and hinder motor learning. To address these challenges, this work proposes the use of two lower-limb exoskeletons to mediate physical interaction between therapists and patients during a StS rehabilitative task. This approach offers several advantages, including improved therapist-patient interaction, safety enforcement, and performance quantification. The whole body control of the two exoskeletons transmits online feedback between the two users, but at the same time assists in movement and ensures balance, and thus helping subjects with greater difficulty. In this study we present the architecture of the framework, presenting and discussing some technical choices made in the design.Comment: 7 pages, 6 figures, submitted to 2024 IEEE The International Conference on Robotics and Automation (ICRA

Human Activity Recognition and Control of Wearable Robots

abstract: Wearable robotics has gained huge popularity in recent years due to its wide applications in rehabilitation, military, and industrial fields. The weakness of the skeletal muscles in the aging population and neurological injuries such as stroke and spinal cord injuries seriously limit the abilities of these individuals to perform daily activities. Therefore, there is an increasing attention in the development of wearable robots to assist the elderly and patients with disabilities for motion assistance and rehabilitation. In military and industrial sectors, wearable robots can increase the productivity of workers and soldiers. It is important for the wearable robots to maintain smooth interaction with the user while evolving in complex environments with minimum effort from the user. Therefore, the recognition of the user's activities such as walking or jogging in real time becomes essential to provide appropriate assistance based on the activity. This dissertation proposes two real-time human activity recognition algorithms intelligent fuzzy inference (IFI) algorithm and Amplitude omega ($A \omega$) algorithm to identify the human activities, i.e., stationary and locomotion activities. The IFI algorithm uses knee angle and ground contact forces (GCFs) measurements from four inertial measurement units (IMUs) and a pair of smart shoes. Whereas, the $A \omega$ algorithm is based on thigh angle measurements from a single IMU. This dissertation also attempts to address the problem of online tuning of virtual impedance for an assistive robot based on real-time gait and activity measurement data to personalize the assistance for different users. An automatic impedance tuning (AIT) approach is presented for a knee assistive device (KAD) in which the IFI algorithm is used for real-time activity measurements. This dissertation also proposes an adaptive oscillator method known as amplitude omega adaptive oscillator ($A\omega AO$) method for HeSA (hip exoskeleton for superior augmentation) to provide bilateral hip assistance during human locomotion activities. The $A \omega$ algorithm is integrated into the adaptive oscillator method to make the approach robust for different locomotion activities. Experiments are performed on healthy subjects to validate the efficacy of the human activities recognition algorithms and control strategies proposed in this dissertation. Both the activity recognition algorithms exhibited higher classification accuracy with less update time. The results of AIT demonstrated that the KAD assistive torque was smoother and EMG signal of Vastus Medialis is reduced, compared to constant impedance and finite state machine approaches. The $A\omega AO$ method showed real-time learning of the locomotion activities signals for three healthy subjects while wearing HeSA. To understand the influence of the assistive devices on the inherent dynamic gait stability of the human, stability analysis is performed. For this, the stability metrics derived from dynamical systems theory are used to evaluate unilateral knee assistance applied to the healthy participants.Dissertation/ThesisDoctoral Dissertation Aerospace Engineering 201

Adaptive control for wearable robots in human-centered rehabilitation tasks

Robotic rehabilitation therapies have been improving by providing the needed assistance to the patient, in a human-centered environment, and also helping the therapist to choose the necessary procedure. This thesis presents an adaptive "Assistance-as-needed" strategy which adheres to the specific needs of the patient and with the inputs from the therapist, whenever needed. The exertion of assistive and responsive behavior of the lower limb wearable robot is dedicated for the rehabilitation of incomplete spinal cord injury (SCI) patients. The main objective is to propose and evaluate an adaptive control model on a wearable robot, assisting the user and adhering to their needs, with no or less combination of external devices. The adaptation must be more interactive to understand the user needs and their volitional orders. Similarly, by using the existing muscular strength, in incomplete SCI patients, as a motivation to pursue the movement and assist them, only when needed. The adaptive behavior of the wearable robot is proposed by monitoring the interaction and movement of the user. This adaptation is achieved by modulating the stiffness of the exoskeleton in function of joint parameters, such as positions and interaction torques. These joint parameters are measured from the user independently and then used to update the new stiffness value. The adaptive algorithm performs with no need of external sensors, making it simple in terms of usage. In terms of rehabilitation, it is also desirable to be compatible with combination of assistive devices such as muscle stimulation, neural activity (BMI) and body balance (Wii), to deliver a user friendly and effective therapy. Combination of two control approaches has been employed, to improve the efficiency of the adaptive control model and was evaluated using a wearable lower limb exoskeleton device, H1. The control approaches, Hierarchical and Task based approach have been used to assist the patient as needed and simultaneously motivate the patient to pursue the therapy. Hierarchical approach facilitates combination of multiple devices to deliver an effective therapy by categorizing the control architecture in two layers, Low level and High level control. Task-based approaches engage in each task individually and allow the possibility to combine them at any point of time. It is also necessary to provide an interaction based approach to ensure the complete involvement of the user and for an effective therapy. By means of this dissertation, a task based adaptive control is proposed, in function of human-orthosis interaction, which is applied on a hierarchical control scheme. This control scheme is employed in a wearable robot, with the intention to be applied or accommodated to different pathologies, with its adaptive capabilities. The adaptive control model for gait assistance provides a comprehensive solution through a single implementation: Adaptation inside a gait cycle, continuous support through gait training and in real time. The performance of this control model has been evaluated with healthy subjects, as a preliminary study, and with paraplegic patients. Results of the healthy subjects showed a significant change in the pattern of the interaction torques, elucidating a change in the effort and adaptation to the user movement. In case of patients, the adaptation showed a significant improvement in the joint performance (flexion/extension range) and change in interaction torques. The change in interaction torques (positive to negative) reflects the active participation of the patient, which also explained the adaptive performance. The patients also reported that the movement of the exoskeleton is flexible and the walking patterns were similar to their own distinct patterns. The presented work is performed as part of the project HYPER, funded by Ministerio de Ciencia y Innovación, Spain. (CSD2009 - 00067 CONSOLIDER INGENIOLas terapias de rehabilitación robóticas han sido mejoradas gracias a la inclusión de la asistencia bajo demanda, adaptada a las variaciones de las necesidades del paciente, así como a la inclusión de la ayuda al terapeuta en la elección del procedimiento necesario. Esta tesis presenta una estrategia adaptativa de asistencia bajo demanda, la cual se ajusta a las necesidades específicas del paciente junto a las aportaciones del terapeuta siempre que sea necesario. El esfuerzo del comportamiento asistencial y receptivo del robot personal portátil para extremidades inferiores está dedicado a la rehabilitación de pacientes con lesión de la médula espinal (LME) incompleta. El objetivo principal es proponer y evaluar un modelo de control adaptativo en un robot portátil, ayudando al usuario y cumpliendo con sus necesidades, en ausencia o con reducción de dispositivos externos. La adaptación debe ser más interactiva para entender las necesidades del usuario y sus intenciones u órdenes volitivas. De modo similar, usando la fuerza muscular existente (en pacientes con LME incompleta) como motivación para lograr el movimiento y asistirles solo cuando sea necesario. El comportamiento adaptativo del robot portátil se propone mediante la monitorización de la interacción y movimiento del usuario. Esta adaptación conjunta se consigue modulando la rigidez en función de los parámetros de la articulación, tales como posiciones y pares de torsión. Dichos parámetros se miden del usuario de forma independiente y posteriormente se usan para actualizar el nuevo valor de la rigidez. El desempeño del algoritmo adaptativo no requiere de sensores externos, lo que favorece la simplicidad de su uso. Para una adecuada rehabilitación, efectiva y accesible para el usuario, es necesaria la compatibilidad con diversos mecanismos de asistencia tales como estimulación muscular, actividad neuronal y equilibrio corporal. Para mejorar la eficiencia del modelo de control adaptativo se ha empleado una combinación de dos enfoques de control, y para su evaluación se ha utilizado un exoesqueleto robótico H1. Los enfoques de control Jerárquico y de Tarea se han utilizado para ayudar al usuario según sea necesario, y al mismo tiempo motivarle para continuar el tratamiento. Enfoque jerárquico facilita la combinación de múltiples dispositivos para ofrecer un tratamiento eficaz mediante la categorización de la arquitectura de control en dos niveles : el control de bajo nivel y de alto nivel. Los enfoques basados en tareas involucran a la persona en cada tarea individual, y ofrecen la posibilidad de combinarlas en cualquier momento. También es necesario proporcionar un enfoque basado en la interacción con el usuario, para asegurar su participación y lograr así una terapia eficaz. Mediante esta tesis, proponemos un control adaptativo basado en tareas y en función de la interacción persona-ortesis, que se aplica en un esquema de control jerárquico. Este esquema de control se emplea en un robot portátil, con la intención de ser aplicado o acomodado a diferentes patologías, con sus capacidades de adaptación. El modelo de control adaptativo propuesto proporciona una solución integral a través de una única aplicación: adaptación dentro de la marcha y apoyo continúo a través de ejercicios de movilidad en tiempo real. El rendimiento del modelo se ha evaluado en sujetos sanos según un estudio preliminar, y posteriormente también en pacientes parapléjicos. Los resultados en sujetos sanos mostraron un cambio significativo en el patrón de los pares de interacción, elucidando un cambio en la energía y la adaptación al movimiento del usuario. En el caso de los pacientes, la adaptación mostró una mejora significativa en la actuación conjunta (rango de flexión / extensión) y el cambio en pares de interacción. El cambio activo en pares de interacción (positivo a negativo) refleja la participación activa del paciente, lo que también explica el comportamiento adaptativo

Tele-impedance based assistive control for a compliant knee exoskeleton

This paper presents a tele-impedance based assistive control scheme for a knee exoskeleton device. The proposed controller captures the user’s intent to generate task-related assistive torques by means of the exoskeleton in different phases of the subject’s normal activity. To do so, a detailed musculoskeletal model of the human knee is developed and experimentally calibrated to best match the user’s kinematic and dynamic behavior. Three dominant antagonistic muscle pairs are used in our model, in which electromyography (EMG) signals are acquired, processed and used for the estimation of the knee joint torque, trajectory and the stiffness trend, in real time. The estimated stiffness trend is then scaled and mapped to a task-related stiffness interval to agree with the desired degree of assistance. The desired stiffness and equilibrium trajectories are then tracked by the exoskeleton’s impedance controller. As a consequence, while minimum muscular activity corresponds to low stiffness, i.e. highly transparent motion, higher co-contractions result in a stiffer joint and a greater level of assistance. To evaluate the robustness of the proposed technique, a study of the dynamics of the human–exoskeleton system is conducted, while the stability in the steady state and transient condition is investigated. In addition, experimental results of standing-up and sitting-down tasks are demonstrated to further investigate the capabilities of the controller. The results indicate that the compliant knee exoskeleton, incorporating the proposed tele-impedance controller, can effectively generate assistive actions that are volitionally and intuitively controlled by the user’s muscle activity