Design Principles for FES Concept Development

© Cranfield University 2013. All rights reserved. No part of this publication may be reproduced without the written permission of the copyright owner.A variety of pathologies can cause injury to the spinal cord and hinder movement. A range of equipment is available to help spinal injury sufferers move their affected limbs. One method of rehabilitation is functional electrical stimulation (FES). FES is a technique where small electrical currents are applied to the surface of the user’s legs to stimulate the muscles. Studies have demonstrated the benefits of using this method and it has also been incorporated into a number of devices. The aim of the project was to produce a number of designs for a new device that uses FES technology. The project was completed in conjunction with an industrial partner. A review of the literature and consultation with industrial experts suggested a number of ways current devices could be improved. These included encouraging the user to lean forwards while walking and powering the device using a more ergonomic method. A group of designers were used to produce designs that allowed the user to walk with a more natural gait and avoided cumbersome power packs. The most effective of these designs were combined to form one design that solved both problems. A 3-dimensional model of this design was simulated using computer-aided design software. Groups of engineers, scientists and consumers were also invited to provide input on how a new device should function. Each of these groups provided a design that reflected their specific needs, depending on their experience with similar technology. Low level prototypes were produced of these designs. A group of designers were also used to design concepts for a functional electrical stimulation device based on an introduction given by industry experts. Each of the designs was presented to experienced professionals to obtain feedback. A set of guidelines were also produced during the project that instructed how to create the designs

Towards better assessment and training of kinematics in post-stroke gait therapy

Gait impairment is common following neurological injury such as stroke. Therapists train patients based on restoring healthy motions, or kinematics, but evidence for training proper kinematics is not well-established. Because the dosage of therapy has not been well quantified, it is unclear what aspects of gait therapy are important, but simply that more therapy is likely better. However, cost restrictions prevent such intensive therapy, incentivizing value-based care. Robotic gait trainers that repetitively train a specific kinematic walking motions can potentially ease the burden on therapists and allow greater patient throughput, improving the value of therapy. Still, the cost of these trainers is only affordable to the wealthiest clinics, leaving them unavailable to the vast majority of stroke survivors. The overall goal of my research is twofold: to show the role of kinematics in gait recovery following stroke, and how these kinematics can be trained in an economical manner. My first aim focuses on design of an affordable robotic gait trainer that can adapt to an individual’s healthy gait pattern. Such a device could make robotic gait training more accessible to new markets including resource-limited hospitals and even patients’ homes. My second aim presents development of an online algorithm for producing speed-dependent reference joint trajectories that can be used for general robotic gait training applications. The goals of my third and fourth aims investigate the importance of gait kinematics using a novel longitudinal cohort approach in subacute stroke patients. I quantified the dosage of therapy using a wearable motion capture to find correlates of functional recovery, defined as gait speed. I then questioned whether gait speed was sufficient to define gait recovery, taking an innovative look at how gait quality during this subacute period changes as gait function improves. I expect these aims will justify the importance of kinematics and suggest that wearable sensors can become a valuable tool for monitoring detailed kinematic motion, providing insight for more effective therapy regimens.Mechanical Engineerin

Computing with Simulated and Cultured Neuronal Networks

Ph.DDOCTOR OF PHILOSOPH

Synthèse sur la conception, commande et planification de trajectoire d'une interface de locomotion pour la réadaptation de la marche

Tableau d'honneur de la Faculté des études supérieures et postdorales, 2016-2017Cette thèse synthétise la conception d'une plateforme de marche destinée à la réadaptation des membres inférieurs pour le mouvement de la marche. L'automatisation du travail des thérapeutes, la réduction de leur charge de travail et la diversification des exercices pour les patients est un atout par rapport aux outils existants sur le marché tels que les tapis roulants ou les allées instrumentées pour la réadaptation. La conception d'une interface de locomotion pour la simulation de la marche présente des défis en terme de performance et de stabilité du mécanisme, de même que pour assurer la sécurité de l'utilisateur. L'équilibre de l'utilisateur doit être préservé grâce à une interaction humain-robot souple durant la phase d'élancement du pied et une sensation de rigidité lors de la phase d'appui. Dans un premier temps, la thèse présente le mouvement de la marche humaine pour trois types de milieux, c'est-à-dire la marche au sol, la marche d'escalier ascendante et la marche d'escalier descendante. Entre autres, le chapitre 1 cible les points essentiels de la cinématique et de la dynamique des membres inférieurs afin d'établir les exigences physiques pour la conception de la plateforme de marche. Le chapitre 2 introduit l'architecture mécanique de l'interface de locomotion basé sur deux systèmes indépendants de courroies déplaçant les deux effecteurs dans les translations horizontale et verticale, correspondant au plan sagittal dans lequel la majeure partie du mouvement de marche s'effectue. L'architecture du routage de courroies découple les degrés de liberté et simplifie ainsi la commande de la plateforme en séparant chaque degré de liberté en système indépendant. Cette architecture augmente également le rendement des efforts articulaires transmis aux effecteurs comparativement à un système dont les degrés de liberté sont co-dépendants. La thèse introduit ensuite la commande mise en place pour l'interaction entre le mécanisme et l'opérateur. Les exigences cinématiques et dynamiques diffèrent selon la phase d'élancement et la phase d'appui de la marche. Ainsi, le chapitre 3 présente la stratégie mise en place dans la direction horizontale pour minimiser les forces d'interaction entre l'utilisateur et l'effecteur. La commande en force permet, dans un premier temps, de diminuer l'inertie apparente de l'effecteur ressentie par l'utilisateur. Par la suite, un mécanisme passif à câbles est utilisé en tant qu'interface pour réduire davantage l'impédance ressentie du système. Le chapitre 4, quant à lui, décrit la stratégie mise en place pour gérer la phase d'appui de la marche afin de générer la contrainte rigide nécessaire à la simulation du sol virtuel. Le chapitre introduit la commande pour générer la limite virtuelle ainsi que la mise en place du système d'équilibrage statique à ressort à gaz pour diminuer le travail des moteurs et supporter le poids de la personne. Finalement, le chapitre 5 introduit la commande haut niveau pour générer le mouvement infini sur l'interface de locomotion avec un algorithme de recul, ramenant l'utilisateur dans la direction opposée à son mouvement pour générer l'espace nécessaire aux prochaines phases de marche, dans la direction horizontale comme pour le fonctionnement d'un tapis de course et dans la direction verticale, comme pour le fonctionnement d'un escalier mécanique inversé.This thesis summarizes the design of a locomotion interface for gait rehabilitation. The aim of the mechanism is to alleviate the workload of therapists by automating the repetitive movements involved in the rehabilitation exercises. Moreover, by offering a larger panel of exercises, the locomotion interface should be an asset compared to standard treadmills or rehabilitation walkways. Walking simulation is a challenge in terms of performance, power and safety since the mechanism includes the user in the workspace of the effectors. The balance of the user should be ensured during the swing phase with a reduced human-robot interaction and reliable during the stance phase. First, Chapter 1 describes the walking motion, the stair climbing up and down movement and highlights their main kinematic and dynamic features. Chapter 2 then introduces the architecture of the locomotion interface based on independent belt routings which transmit the movement to two end-effectors that carry the user. Each foot platform has two degrees of freedom (dofs) corresponding to the horizontal and vertical translations in the sagittal plane. Decoupling the dofs simplifies the control of the locomotion interface and increases the efficiency of the torque of the motor sent to the end-effectors compared to systems with co-dependent degrees-of-freedom. Then, the thesis presents the strategies used to supervise the human-robot interaction. The kinematic and dynamic requirements are different during the swing phase and the stance phase of the human gait. Therefore, Chapter 3 introduces the force controllers that lighten the apparent inertia of the mechanism as well as the additional mechanism based on passive cables in order to further alleviate the impedance of the effector. Chapter 4 presents the controller that generates the vertical virtual constraint in order to produce the required reliable floor during the stance phase. The rendering of the virtual environment is improved with the implementation of a static balancing system based on gas springs that alleviates the workload of the motors that handle the weight of the user. Finally, Chapter 5 introduces the cancellation algorithm that generates the infinite environment. Horizontally, the user is brought backward such as on a treadmill. Vertically, the user is moved in the opposite direction of his/her movement such as in a reversed escalator

The adoption of virtual reality for medical training in the context of South African higher education.

Masters Degree. University of KwaZulu-Natal, Pietermaritzburg.Virtual reality (VR) is progressively being acknowledged as a useful tool for medical training. The adoption of VR for medical training in developing countries is at a slow pace compared to developed countries. The paucity of innovative systems such as VR training systems and the lack of exposure to these systems in developing countries tend to widen the gap in competency between medical professionals from developed and developing countries. VR in South Africa is a new concept and, therefore, limited literature exists from a South African educational perspective. This study aimed to fill the gap in literature from a South African perspective by investigating the determinants of the adoption of VR for medical training at the University of KwaZulu-Natal. The Unified Theory of Acceptance and Use of Technology (UTAUT) was used as the guiding framework to investigate the perceived usefulness of using VR, the perceived effort required to use it, and the social factors and facilitating conditions that can influence its adoption for medical training. The study further aimed to determine the challenges associated with the adoption of VR for medical training within the South African higher education context. Findings from interviews with 12 purposively sampled lecturers revealed that most respondents perceived that VR would be easy to use for medical training should the necessary training and support be provided. Some respondents had not previously experienced VR immersive environments and hence felt that using VR for medical training would be difficult. The researcher deduced from the responses that the respondents would be influenced to adopt VR for medical training by other medical professionals who were currently using VR and that the degree of influence would be an important factor in adoption. Although the respondents perceived VR to be useful, they voiced that the adoption of VR for medical training at South African educational institutions could be hampered by challenges associated with the lack of infrastructure, knowledge of VR, finance, resistance to change, user’s inability to differentiate simulated environments from the real-world and poor design of the VR system (interface). The respondents suggested a gradual approach to VR adoption, forming partnerships with VR companies and seeking sponsorships or donations from alumni to address the finance-related impediments. Furthermore, to ensure the successful adoption of VR for medical training by South African educational institutions, they mentioned the need for: government to address financial constraints by increasing the budget allocated to South African healthcare; an effective change management process to address resistance to change; a cost-benefit analysis; and, finally, training to surmount the challenges.List of Tables on page ix

Proceedings of the 5th international conference on disability, virtual reality and associated technologies (ICDVRAT 2004)

The proceedings of the conferenc