196 research outputs found
Design, control and evaluation of a low-cost active orthosis for the gait of spinal cord injured subjects
Robotic gait training after spinal cord injury is of high priority to maximize independence and improve the living conditions of the patients. Current rehabilitation robots are expensive and heavy, and are generally found only in the clinical environment. To overcome these issues, we present the design of a low-cost, low-weight and personalized robotic orthosis for incomplete spinal cord injured subjects. The paper also presents a preliminary experimental evaluation of the assistive device on one subject with spinal cord injury that can control hip flexion to a certain extent, but lacks control of knee and ankle muscles. Results show that gait velocity, stride length and cadence
of walking increased (24,11%, 7,41% and 15,56%, respectively) when wearing active orthoses compared to the case when the subject used the usual passive orthoses.Postprint (published version
Orthoses for Spinal Cord Injury Patients
There are some limitations for patients with spinal cord injury (SCI) when walking with assistive devices. Heavy energy expenditure and walking high loads on the upper limb joints are two main reasons of high rejection rate of orthosis by these patients . Many devices have been designed to enable people with paraplegia to ambulate in an upright position as a solution of these limitations such as mechanical orthoses, hybrid orthoses and powered orthoses. All these devices are designed to solve the problem of standing and walking, but there are some other important notes, which should be considered. For example, the size and weight of external orthoses, donning and doffing, cumbersomeness and independency for using are very important
Cycle-to-cycle control of swing phase of paraplegic gait induced by surface electrical stimulation
Parameterised swing phase of gait in paraplegics was obtained using surface electrical stimulation of the hip flexors, hamstrings and quadriceps; the hip flexors were stimulated to obtain a desired hip angle range, the hamstrings to provide foot clearance in the forward swing, and the quadriceps to acquire knee extension at the end of the swing phase. We report on two main aspects; optimisation of the initial stimulation parameters, and parameter adaption (control). The initial stimulation patterns were experimentally optimised in two paraplegic subjects using a controlled stand device, resulting in an initial satisfactory swinging motion in both subjects. Intersubject differences appeared in the mechanical output (torque joint) per muscle group. During a prolonged open-loop controlled trial with the optimised but unregulated stimulation onsets and burst duration for the three muscle groups, the hip angle range per cycle initially increased above the desired value and subsequently decreased below it. The mechanical performance of the hamstrings and quadriceps remained relatively unaffected. A cycle-to-cycle controller was then designed, operating on the basis of the hip angle ranges obtained in previous swings. This controller successfully adapted the burst duration of the hip flexors to maintain the desired hip angle range
Low-cost active orthosis for gait assistance of subjects with spinal cord injury
Postprint (published version
Quantification of gait kinematics and walking ability of people with multiple sclerosis who are new users of functional electrical stimulation
Objective: To assess whether the application of Functional Electrical Stimulation improves gait kinematics and walking ability in people with multiple sclerosis who experience foot drop. Design: Acute open labelled comparative observation trial. Participants: Twelve people (3 females, 9 males, EDSS 2-4) with relapsing remitting multiple sclerosis (47.8 years (standard deviation 6.6)) who were new users of functional electrical stimulation. Methods: Gait kinematics were recorded using 3D gait analysis. Walking ability was assessed through the 10-m walk test and the 6-min walk test. All assessments were performed with and without the assistance of functional electrical stimulation. The effect of functional electrical stimulation was analysed using paired t-tests. Results: Ankle dorsiflexion at initial contact (p-=-0.026), knee flexion at initial contact (p-=-0.044) and peak knee flexion during swing (p-=-0.011) were significantly greater whilst walking with Functional Electrical Stimulation. The increased peak dorsiflexion in swing of nearly 4 degrees during functional electrical stimulation assisted walking approached significance (p-=-0.069). The 10-m walk time was significantly improved by functional electrical stimulation (p-=-0.004) but the 6 min walk test was not. Conclusion: The acute application of functional electrical stimulation resulted in an orthotic effect through a change in ankle and knee kinematics and increased walking speed over a short distance in people with multiple sclerosis who experience foot dropsch_phy45pub3130pub
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, control, and pilot study of a lightweight and modular robotic exoskeleton for walking assistance after spinal cord injury
Walking rehabilitation using exoskeletons is of high importance to maximize independence and improve the general well-being of spinal cord injured subjects. We present the design and control of a lightweight and modular robotic exoskeleton to assist walking in spinal cord injured subjects who can control hip flexion, but lack control of knee and ankle muscles. The developed prototype consists of two robotic orthoses, which are powered by a motor-harmonic drive actuation system that controls knee flexion–extension. This actuation module is assembled on standard passive orthoses. Regarding the control, the stance-to-swing transition is detected using two inertial measurement units mounted on the tibial supports, and then the corresponding motor performs a predefined flexion–extension cycle that is personalized to the specific patient’s motor function. The system is portable by means of a backpack that contains an embedded computer board, the motor drivers, and the battery. A preliminary biomechanical evaluation of the gait-assistive device used by a female patient with incomplete spinal cord injury at T11 is presented. Results show an increase of gait speed (+24.11%), stride length (+7.41%), and cadence (+15.56%) when wearing the robotic orthoses compared with the case with passive orthoses. Conversely, a decrease of lateral displacement of the center of mass (-19.31%) and step width (-13.37% right step, -8.81% left step) are also observed, indicating gain of balance. The biomechanical assessment also reports an overall increase of gait symmetry when wearing the developed assistive device.Peer ReviewedPostprint (published version
Analysis and control of FES-assisted paraplegic walking with wheel walker.
The number of people with spinal cord injury (SCI) is increasing every year and
walking has been found to be the most exciting and important prospect to these
patients to improve their quality of life. Many individuals with incomplete SCI
have the potential to walk and everyone of them wants to try. Unfortunately up to
now, there is less than one third of patients could walk again after SCI. Residual
function, the orthotic support, energy expenditure, patient motivation and control
technique are some of the factors that influence the walking outcome of spinal cord
injured people. In this thesis, a series of studies are carried out to investigate the
possibility of enhancing the performance of the functional electrical stimulation
(PES) assisted paraplegic walking with wheel walker through the development and
implementation of intelligent control technique and spring brake orthosis (SBO)
with full utilization of the voluntary upper body effort. The main aim of this thesis
is to enable individuals with complete paraplegia to walk again with maximum
performance and the simplest approach as possible.
Firstly, before simulation of the system can be made, it is important to select the
right model to represent the actual plant. In this thesis, the development of a
humanoid and wheel walker models are carried out using MSC.visualNastran4D
(vN4D) software and this is integrated with Matlab Simulink® for simulation. The
newly developed quadriceps and hamstrings muscle models from the series of
experiments are used to represent subject muscles after comparison and validation
with other two well-known muscle models are performed.
Several experiments are conducted to investigate the effect of stimulation frequency
and pulse-width in intermittent stimulation with isometric measurement from
paraplegic subjects. The results from this work can serve as a guidance to determine
the optimum stimulation parameters such as frequency and pulse-width to reduce
muscle fatigue during PES application. The ability test is introduced to determine
the maximum leg force that can be applied to the specific paraplegic subject during
FES functional task with minimum chance of spasm and leg injury.
Investigations are carried out on the control techniques implemented for FES
walking with wheel walker. PID control and fuzzy logic control (FLC) are used to
regulate the electrical stimulation required by the quadriceps and hamstrings
muscles in order to perform the FES walking manoeuvre according to predefined
walking trajectory. The body weight transfer is introduced to increase the efficiency
of FES walking performance. The effectiveness of body weight transfer and control
strategy to enhance the performance of FES walking and reduce stimulation pulses
required is examined.
Investigations are carried out on the effectiveness of spring brake orthosis (SBO)
for FES assisted paraplegic walking with wheel walker. A new concept in hybrid
orthotics provides solutions to the problems that affect current 'hybrid orthosis,
including knee and hip flexion without relying on the withdrawal reflex or a
powered actuator and foot-ground clearance without extra upper body effort. The
use of SBO can also eliminate electrical stimulation pulses required by the
hamstrings muscle for the same FES walking system.
Further improvement of the FES walking system is achieved by introducing finite
state control (FSC) to control the switching time between springs, brakes and
electrical stimulation during FES assisted walking with wheel walker with the
combInation of FLC to regulate the electrical stimulation required for the knee
extension. The results show that FSC can be used to accurately control the
switching time and improve the system robustness and stability
Biped locomotion control through a biologically-inspired closed-loop controller
Dissertação de mestrado integrado em Engenharia BiomédicaCurrently motor disability in industrialized countries due to neural and physical impairments
is an increasingly worrying phenomenon and the percentage of patients is expected
to be increasing continuously over the coming decades due to a process of ageing the world
is undergoing. Additionally, rising retirement ages, higher demand of elderly people for an
independent, dignified life and mobility, huge cost in the provision of health care are some
other determinants that motivate the restoration of motor function as one of the main goals of
rehabilitation. Modern concepts of motor learning favor a task-specific training in which all
movements in daily life should be trained/assisted repetitively in a physically correct fashion.
Considering the functional activity of the neuronal circuits within the spinal cord, namely
the central pattern generator (CPG), as the foundation to human locomotion, motor relearning
should be based on intensive training strategies directed to the stimulation and reorganization
of such neural pathways through mechanisms addressed by neural plasticity. To this
end, neuromodelings are required to simulate the human locomotion control to overcome the
current technological challenges such as developing smaller, intelligent and cost-effective
devices for home and work rehabilitation scenarios which can enable a continuous therapy/
assistance to guide the impaired limbs in a gentle manner, avoiding abrupt perturbations
and providing as little assistance as necessary. Biomimetic models, taking neurological and
biomechanical inspiration from biological animals, have been embracing these challenges
and developing effective solutions on refining the locomotion models in terms of energy
efficiency, simplicity in the structure and robust adaptability to environment changes and
unexpected perturbations.
Thus, the aim target of this work is to study the applicability of the CPG model for
gait rehabilitation, either for assistance and/or therapy purposes. Focus is developed on the
locomotion control to increase the knowledge of the underlying principles useful for gait
restoration, exploring the brainstem-spinal-biomechanics interaction more fully. This study
has great application in the project of autonomous robots and in the rehabilitation technology,
not only in the project of prostheses and orthoses, but also in the searching of procedures that
help to recuperate motor functions of human beings.
Encouraging results were obtained which pave the way towards the simulation of more
complex behaviors and principles of human locomotion, consequently contributing for improved
automated motor rehabilitation adapted to the rehabilitation emerging needs.Actualmente a debilidade motora em países industrializados devido a deficiências neurais
e físicas é um fenómeno crescente de apreensão sendo expectável um contínuo aumento do
rácio de pacientes nas próximas décadas devido ao processo de envelhecimento. Inclusivé,
o aumento da idade de reforma, a maior procura por parte dos idosos para uma mobilidade
e vida autónoma e condigna, o elevado custo nos cuidados de saúde são incentivos para a
restauração da função motora como um dos objectivos principais da reabilitação. Conceitos
recentes de aprendizagem motora apoiam um treino de tarefas específicas no qual movimentos
no quotidiano devem ser treinados/assistidos de forma repetitiva e fisicamente correcta.
Considerando a actividade funcional dos circuitos neurais na medula, nomeadamente
o gerador de padrão central (CPG), como a base da locomoção, a reaprendizagem motora
deve-se basear em estratégias intensivas de treino visando a estimulação e reorganização
desses vias neurais através de mecanismos abordados pela plasticidade neural. Assim,
são necessários modelos neurais para simular o controlo da locomoção humana de modo
a superar desafios tecnológicos actuais tais como o desenvolvimento de dispositivos mais
compactos, inteligentes e económicos para os cenários de reabilitação domiciliar e laboral
que podem permitir uma terapia/assistência contínua na guia dos membros debilitados de
uma forma suave, evitando perturbações abruptas e fornecendo assistência na medida do
necessário. Modelos biomiméticos, inspirando-se nos princípios neurológicos e biomecânicos
dos animais, têm vindo a abraçar esses desafios e a desenvolver soluções eficazes na
refinação de modelos de locomoção em termos da eficiência de energia, da simplicidade na
estrutura e da adaptibilidade robusta face a alterações ambientais e perturbações inesperadas.
Então, o objectivo principal do trabalho é estudar a aplicabilidade do modelo de CPG para
a reabilitação da marcha, para efeitos de assistência e/ou terapia. É desenvolvido um foco no
controlo da locomoção para maior entendimento dos princípios subjacentes úteis para a recuperação
da marcha, explorando a interacção tronco cerebral-espinal medula-biomecânica de
forma mais detalhada. Este estudo tem potencial aplicação no projecto de robôs autónomos
e na tecnologia de reabilitação, não só no desenvolvimento de ortóteses e próteses, mas também
na procura de procedimentos úteis para a recuperação da função motora.
Foram obtidos resultados promissores susceptíveis de abrir caminho à simulação de comportamentos
e princípios mais complexos da marcha, contribuindo consequentemente para
uma aprimorada reabilitação motora automatizada adaptada às necessidades emergentes
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