Design and control of a bio-inspired soft wearable robotic device for ankle-foot rehabilitation

Abstract We describe the design and control of a wearable robotic device powered by pneumatic artificial muscle actuators for use in ankle-foot rehabilitation. The design is inspired by the biological musculoskeletal system of the human foot and lower leg, mimicking the morphology and the functionality of the biological muscle-tendon-ligament structure. A key feature of the device is its soft structure that provides active assistance without restricting natural degrees of freedom at the ankle joint. Four pneumatic artificial muscles assist dorsiflexion and plantarflexion as well as inversion and eversion. The prototype is also equipped with various embedded sensors for gait pattern analysis. For the subject tested, the prototype is capable of generating an ankle range of motion of 27 • (14 • dorsiflexion and 13 • plantarflexion). The controllability of the system is experimentally demonstrated using a linear time-invariant (LTI) controller. The controller is found using an identified LTI model of the system, resulting from the interaction of the soft orthotic device with a human leg, and model-based classical control design techniques. The suitability of the proposed control strategy is demonstrated with several angle-reference following experiments

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

Knee Exoskeletons Design Approaches to Boost Strength Capability: A Review

Exoesqueleto para incrementar la fuerza en las rodillasThere are different devices to increase the strength capacity of people with walking problems. These devices can be classified into exoskeletons, orthotics, and braces. This review aims to identify the state of the art in the design of these medical devices, based on an analysis of patents and literature. However, there are some difficulties in processing the records due to the lack of filters and standardization in the names, generating discrepancies between the search engines, among others. Concerning the patents, 74 patents were analyzed using search engines such as Google Patents, Derwent, The Lens, Patentscope, and Espacenet over the past ten years. A bibliometric analysis was performed using 63 scientific reports from Web of Science and The Lens in the same period for scientific communications. The results show a trend to use the mechanical design of exoskeletons based on articulated rigid structures and elements that provide force to move the structure. These are generally two types: (a) elastic elements and (b) electromechanical elements. The United States accounts for 32% of the technological patents reviewed. The results suggest that the use of exoskeletons or orthoses customized to the users’ needs will continue to increase over the years due to the worldwide growth in disability, particularly related to mobility difficulties and technologies related to the combined use of springs and actuators

Towards a human-in-the-loop control for a smart orthotic system

Dissertação de mestrado integrado em Engenharia Biomédica (área de especialização em Eletrónica Médica)Stroke is the main cause of paralysis. This pathology has provoked a considerable increase of persons with motor impairments. With a therapy focused on each clinical case, the total or partial recovery can be achieved. Powered orthoses have been developed to promote an effective recover, based on repetitive gait training and user’s active participation. Many control approaches have been developed to control these devices, but none of them promotes an user-oriented strategy focused to the user’s needs. In an attempt of solving this issue, a new approach named Human-in-the-loop is emerging. This strategy allows the adaptation of some assistive parameters based on the user’s energetic cost, promoting a therapy tailored to each end-user needs. However, to estimate the energy expenditure, the use of non-ergonomic sensors, not suitable for clinical context, is required. Thus, it is necessary to find new ways of estimating energy expenditure using wearable and comfortable sensors. In this dissertation, the first steps to introduce the Human-in-the-loop strategy into a powered orthosis are presented. For this purpose, two strategies were developed: a strategy that allows the angular trajectory adaptation in real-time and other that promotes a stiffness adaptation all over the gait cycle. Both strategies were validated with healthy subjects. In the first strategy, the orthosis was able to modify its assistance in a fraction of microseconds, and the end-users were able to follow her with a median error below 10%. Regarding the second strategy, the results show that the orthosis allowed an effective change in the systems’ interaction stiffness, promoting an active participation of each user during its assistance. The energetic impact of using the robotic assistive device is also presented. As it promotes an energy expenditure augmentation in more than 30% in comparison to walk without the device, the necessity of implementing the Human-in-the-loop strategy was highlighted. In an attempt of finding an ergonomic technique to estimate the energetic cost, the use of machine learning algorithms was tested. The results, obtained with a MLP and a LSTM, prove that it is possible to estimate the energy expenditure with a mean error close to 11%. Future work consists in the implementation of the model in real-time and the collection of more data with the aforementioned control approaches, in a way of constructing a more robust model.O AVC é uma das maiores causas de paralisia. Esta patologia, cada vez mais com maior incidência nos jovens, tem provocado um aumento considerável de pessoas com problemas de mobilidade. Com uma terapia focada a cada caso clínico, a recuperação total ou parcial pode ser conseguida. As ortóteses ativas têm vindo a ser desenvolvidas com o propósito de promover uma recuperação eficaz, baseada em treinos repetitivos e numa participação ativa dos utilizadores. Várias abordagens de controlo têm vindo a ser desenvolvidas para controlar estes dispositivos, mas nenhuma delas promove uma estratégia orientada às necessidades do utilizador. Na tentativa de solucionar este problema, uma nova abordagem, designada por Human-in-the-loop está a emergir. Baseada no custo energético, esta estratégia permite adaptar parâmetros da assistência, promovendo uma terapia focada e direcionada a cada utilizador. No entanto, para estimar o custo energético, recorre-se ao uso de sensores que não são adequados para contexto clínico. Assim, torna-se necessário estudar novas formas de estimar o custo energético. Nesta dissertação são apresentados os primeiros passos para introduzir o controlo Human-in-the-loop numa ortótese ativa. Para isso, duas estratégias foram apresentadas: uma estratégia que permite adaptar a trajetória angular da ortótese, em tempo real, e outra que promove a adaptação da complacência do sistema ao longo do ciclo da marcha. Ambas foram validadas com sujeitos saudáveis. Relativamente à primeira abordagem, a ortótese foi capaz de modificar a sua assistência em microssegundos, e os utilizadores foram capazes de a seguir com um erro mediano inferior a 10%. No que diz respeito à segunda abordagem, os resultados mostram que a ortótese promoveu uma alteração eficaz da complacência de interação, promovendo uma participação ativa do utilizador durante a sua assistência. O impacto energético do uso do sistema robótico é, também, apresentado. Promovendo um aumento do custo energético em mais de 30%, a necessidade da estratégia Human-in-the-loop foi realçada. Na tentativa de encontrar uma técnica para estimar o custo energético, recorreu-se ao uso de machine learning. Os resultados, obtidos com uma MLP e uma LSTM, provam que é possível estimar o custo energético com um erro médio próximo dos 11%. Trabalho futuro passa pela implementação do modelo em tempo real e a recolha de mais dados com as abordagens de controlo apresentadas, de forma a construir um modelo mais robusto

Feasibility Analysis of a Powered Lower-Limb Orthotic for the Mobility Impaired User

Powered orthotic devices can be used to restore mobility to the impaired user, and may thereby assist them in daily living tasks. An investigation is performed herein to examine the feasibility of a powered lower-limb orthotic in assisting the sit-to-stand task by 50% of the required torque. Feasibility is considered via simulation. A three-link sit-to-stand model, which is driven by kinematic data, is developed. Models of a Pneumatic Muscle Actuator and a DC motor are used to determine which of the two technologies can make a more appropriate contribution to the sit-to-stand task. Simulation revealed that both the Pneumatic Muscle Actuator and the DC motor are reasonable actuator choices, and neither limited the ability to achieve 50% torque assistance. The ability to assist the task was, however, limited by the ability to derive a control signal for the actuator from the user-orthotic interface. It was concluded that the user-orthotic interface requires further investigation. It was also found that while both actuator technologies are suitable for contributing 50% of the required torque, the Pneumatic Muscle Actuator is preferable due to its ability to scale to greater torques

Design and control of soft rehabilitation robots actuated by pneumatic muscles: State of the art

Robot-assisted rehabilitation has become a new mainstream trend for the treatment of stroke patients with movement disability. Pneumatic muscle (PM) is one of the most promising actuators for rehabilitation robots, due to its inherent compliance and safety features. In this paper, we conduct a systematic review on the soft rehabilitation robots driven by pneumatic muscles. This review discusses up to date mechanical structures and control strategies for PMs-actuated rehabilitation robots. A variety of state-of-the-art soft rehabilitation robots are classified and reviewed according to the actuation configurations. Special attentions are paid to control strategies under different mechanical designs, with advanced control approaches to overcome PM’s highly nonlinear and time-varying behaviors and to enhance the adaptability to different patients. Finally, we analyze and highlight the current research gaps and the future directions in this field, which is potential for providing a reliable guidance on the development of advanced soft rehabilitation robots