Master of Science

thesisComputing and data acquisition have become an integral part of everyday life. From reading emails on cell phones to kids playing with motion sensing game consoles, we are surrounded with sensors and mobile computing devices. As the availability of powerful computing devices increases, applications in previously limited environments become possible. Training devices in rehabilitation are becoming increasingly common and more mobile. Community based rehabilitative devices are emerging that embrace these mobile advances. To further the flexibility of devices used in rehabilitation, research has explored the use of smartphones as a means to process data and provide feedback to the user. In combination with sensor embedded insoles, smartphones provide a powerful tool for the clinician in gathering data and as a standalone training tool in rehabilitation. This thesis presents the continuing research of sensor based insoles, feedback systems and increasing the capabilities of the Adaptive Real-Time Instrumentation System for Tread Imbalance Correction, or ARTISTIC, with the introduction of ARTISTIC 2.0. To increase the capabilities of the ARTISTIC an Inertial Measurement Unit (IMU) was added, which gave the system the ability to quantify the motion of the gait cycle and, more specifically, determine stride length. The number of sensors in the insole was increased from two to ten, as well as placing the microprocessor and a vibratory motor in the insole. The transmission box weight was reduced by over 50 percent and the volume by over 60 percent. Stride length was validated against a motion capture system and found the average stride length to be within 2.7 ± 6.9 percent. To continue the improvement of the ARTISTIC 2.0, future work will include implementing real-time stride length feedback

Instrumented shoes for daily activity monitoring in healthy and at risk populations

Daily activity reflects the health status of an individual. Ageing and disease drastically affect all dimensions of mobility, from the number of active bouts to their duration and intensity. Performing less activity leads to muscle deterioration and further weakness that could lead to increased fall risk. Gait performance is also affected by ageing and could be detrimental for daily mobility. Therefore, activity monitoring in older adults and at risk persons is crucial to obtain relevant quantitative information about daily life performance. Activity evaluation has mainly been established through questionnaires or daily logs. These methods are simple but not sufficiently accurate and are prone to errors. With the advent of microelectromechanical systems (MEMS), the availability of wearable sensors has shifted activity analysis towards ambulatory monitoring. In particular, inertial measurement units consisting of accelerometers and gyroscopes have shown to be extremely relevant for characterizing human movement. However, monitoring daily activity requires comfortable and easy to use systems that are strategically placed on the body or integrated in clothing to avoid movement hindrance. Several research based systems have employed multiple sensors placed at different locations, capable of recognizing activity types with high accuracy, but not comfortable for daily use. Single sensor systems have also been used but revealed inaccuracies in activity recognition. To this end, we propose an instrumented shoe system consisting of an inertial measurement unit and a pressure sensing insole with all the sensors placed at the shoe/foot level. By measuring the foot movement and loading, the recognition of locomotion and load bearing activities would be appropriate for activity classification. Furthermore, inertial measurement units placed on the foot can perform detailed gait analysis, providing the possibility of characterizing locomotion. The system and dedicated activity classification algorithms were first designed, tested and validated during the first part of the thesis. Their application to clinical rehabilitation of at risk persons was demonstrated over the second part. In the first part of the thesis, the designed instrumented shoes system was tested in standardized conditions with healthy elderly subjects performing a sequence of structured activities. An algorithm based on movement biomechanics was built to identify each activity, namely sitting, standing, level walking, stairs, ramps, and elevators. The rich array of sensors present in the system included a 3D accelerometer, 3D gyroscope, 8 force sensors, and a barometer allowing the algorithm to reach a high accuracy in classifying different activity types. The tuning parameters of the algorithm were shown to be robust to small changes, demonstrating the suitability of the algorithm to activity classification in older adults. Next, the system was tested in daily life conditions on the same elderly participants. Using a wearable reference system, the concurrent validity of the instrumented shoes in classifying daily activity was shown. Additionally, daily gait metrics were obtained and compared to the literature. Further insight into the relationship between some gait parameters as well as a global activity metric, the activity âcomplexityâ, was discussed. Participants positively rated their comfort while using the system... (Please refer to thesis for full abstract

Assessment of Foot Signature Using Wearable Sensors for Clinical Gait Analysis and Real-Time Activity Recognition

Locomotion is one of the most important abilities of humans. Actually, gait locomotion provides mobility, and symbolizes freedom and independence. However, gait can be affected by several pathologies, due to aging, neurodegenerative disease, or trauma. The evaluation and treatment of mobility diseases thus requires clinical gait assessment, which is commonly done by using either qualitative analysis based on subjective observations and questionnaires, or expensive analysis established in complex motion laboratories settings. This thesis presents a new wearable system and algorithmic methods for gait assessment in natural conditions, addressing the limitations of existing methods. The proposed system provides quantitative assessment of gait performance through simple and precise outcome measures. The system includes wireless inertial sensors worn on the foot, that record data unobtrusively over long periods of time without interfering with subject's walking. Signal processing algorithms are presented for the automatic calibration and online virtual alignment of sensor signals, the detection of temporal parameters and gait phases, and the estimation of 3D foot kinematics during gait based on fusion methods and biomechanical assumptions. The resulting 3D foot trajectory during one gait cycle is defined as Foot Signature, by analogy with hand-written signature. Spatio-temporal parameters of interest in clinical assessment are derived from foot signature, including commonly parameters, such as stride velocity and gait cycle time, as well as original parameters describing inner-stance phases of gait, foot clearance, and turning. Algorithms based on expert and machine learning methods have been also adapted and implemented in real-time to provide input features to recognize locomotion activities including level walking, stairs, and ramp locomotion. Technical validation of the presented methods against gold standard systems was carried out using experimental protocols on subjects with normal and abnormal gait. Temporal aspects and quantitative estimation of foot-flat were evaluated against pressure insoles in subjects with ankle treatments during long-term gait. Furthermore, spatial parameters and foot clearance were compared in young and elderly persons to data obtained from an optical motion capture system during forward gait trials at various speeds. Finally, turning was evaluated in children with cerebral palsy and people with Parkinson's disease against optical motion capture data captured during timed up and go and figure-of-8 tests. Overall, the results demonstrated that the presently proposed system and methods were precise and accurate, and showed agreement with reference systems as well as with clinical evaluations of subjects' mobility disease using classical scores. Currently, no other methods based on wearable sensors have been validated with such precision to measure foot signature and subsequent parameters during unconstrained walking. Finally, we have used the proposed system in a large-scale clinical application involving more than 1800 subjects from age 7 to 77. This analysis provides reference data of common and original gait parameters, as well as their relationship with walking speed, and allows comparisons between different groups of subjects with normal and abnormal gait. Since the presented methods can be used with any foot-worn inertial sensors, or even combined with other systems, we believe our work to open the door to objective and quantitative routine gait evaluations in clinical settings for supporting diagnosis. Furthermore, the present studies have high potential for further research related to rehabilitation based on real-time devices, the investigation of new parameters' significance and their association with various mobility diseases, as well as for the evaluation of clinical interventions

Design of a Knee Exoskeleton for Gait Assistance

abstract: The world population is aging. Age-related disorders such as stroke and spinal cord injury are increasing rapidly, and such patients often suffer from mobility impairment. Wearable robotic exoskeletons are developed that serve as rehabilitation devices for these patients. In this thesis, a knee exoskeleton design with higher torque output compared to the first version, is designed and fabricated. A series elastic actuator is one of the many actuation mechanisms employed in exoskeletons. In this mechanism a torsion spring is used between the actuator and human joint. It serves as torque sensor and energy buffer, making it compact and safe. A version of knee exoskeleton was developed using the SEA mechanism. It uses worm gear and spur gear combination to amplify the assistive torque generated from the DC motor. It weighs 1.57 kg and provides a maximum assistive torque of 11.26 N·m. It can be used as a rehabilitation device for patients affected with knee joint impairment. A new version of exoskeleton design is proposed as an improvement over the first version. It consists of components such as brushless DC motor and planetary gear that are selected to meet the design requirements and biomechanical considerations. All the other components such as bevel gear and torsion spring are selected to be compatible with the exoskeleton. The frame of the exoskeleton is modeled in SolidWorks to be modular and easy to assemble. It is fabricated using sheet metal aluminum. It is designed to provide a maximum assistive torque of 23 N·m, two times over the present exoskeleton. A simple brace is 3D printed, making it easy to wear and use. It weighs 2.4 kg. The exoskeleton is equipped with encoders that are used to measure spring deflection and motor angle. They act as sensors for precise control of the exoskeleton. An impedance-based control is implemented using NI MyRIO, a FPGA based controller. The motor is controlled using a motor driver and powered using an external battery source. The bench tests and walking tests are presented. The new version of exoskeleton is compared with first version and state of the art devices.Dissertation/ThesisMasters Thesis Mechanical Engineering 201

Design and and validation of an improved wearable foot-ankle motion capture device using soft robotic sensors

Soft robotic sensors (SRSs) are a class of pliable, passive sensors which vary by some electrical characteristic in response to changes in geometry. The properties of SRSs make them excellent candidates for use in wearable motion analysis technology. Wearable technology is a fast-growing industry, and the improvement of existing human motion analysis tools is needed. Prior research has proven the viability of SRSs as a tool for capturing motion of the foot-ankle complex; this work covers extensive effort to improve and ruggedize a lab tool utilizing this technology. The improved lab tool is validated against a camera-based motion capture system to show either improvement or equivalence to the previous prototype while introducing enhanced data throughput, reliability, battery life, and durability

A Review on Accelerometry-Based Gait Analysis and Emerging Clinical Applications

Gait analysis continues to be an important technique for many clinical applications to diagnose and monitor certain diseases. Many mental and physical abnormalities cause measurable differences in a person's gait. Gait analysis has applications in sport, computer games, physical rehabilitation, clinical assessment, surveillance, human recognition, modelling, and many other fields. There are established methods using various sensors for gait analysis, of which, accelerometers are one of the most often employed. Accelerometer sensors are generally more user friendly and less invasive. In this paper, we review research regarding accelerometer sensors used for gait analysis with particular focus on clinical applications. We provide a brief introduction to accelerometer theory followed by other popular sensing technologies. The commonly used gait phases and parameters are enumerated. The details of extracting the papers for review are provided. We also review several gait analysis software. Then, we provide an extensive report of accelerometry based gait analysis systems and applications with additional emphasis on trunk accelerometry. We conclude this review with future research directions

Wearable Movement Sensors for Rehabilitation: From Technology to Clinical Practice

This Special Issue shows a range of potential opportunities for the application of wearable movement sensors in motor rehabilitation. However, the papers surely do not cover the whole field of physical behavior monitoring in motor rehabilitation. Most studies in this Special Issue focused on the technical validation of wearable sensors and the development of algorithms. Clinical validation studies, studies applying wearable sensors for the monitoring of physical behavior in daily life conditions, and papers about the implementation of wearable sensors in motor rehabilitation are under-represented in this Special Issue. Studies investigating the usability and feasibility of wearable movement sensors in clinical populations were lacking. We encourage researchers to investigate the usability, acceptance, feasibility, reliability, and clinical validity of wearable sensors in clinical populations to facilitate the application of wearable movement sensors in motor rehabilitation

User-centered design and development of TWIN-Acta: A novel control suite of the TWIN lower limb exoskeleton for the rehabilitation of persons post-stroke

Introduction: Difficulties faced while walking are common symptoms after stroke, significantly reducing the quality of life. Walking recovery is therefore one of the main priorities of rehabilitation. Wearable powered exoskeletons have been developed to provide lower limb assistance and enable training for persons with gait impairments by using typical physiological movement patterns. Exoskeletons were originally designed for individuals without any walking capacities, such as subjects with complete spinal cord injuries. Recent systematic reviews suggested that lower limb exoskeletons could be valid tools to restore independent walking in subjects with residual motor function, such as persons post-stroke. To ensure that devices meet end-user needs, it is important to understand and incorporate their perspectives. However, only a limited number of studies have followed such an approach in the post-stroke population. Methods: The aim of the study was to identify the end-users needs and to develop a user-centered-based control system for the TWIN lower limb exoskeleton to provide post-stroke rehabilitation. We thus describe the development and validation, by clinical experts, of TWIN-Acta: a novel control suite for TWIN, specifically designed for persons post-stroke. We detailed the conceived control strategy and developmental phases, and reported evaluation sessions performed on healthy clinical experts and people post-stroke to evaluate TWIN-Acta usability, acceptability, and barriers to usage. At each developmental stage, the clinical experts received a one-day training on the TWIN exoskeleton equipped with the TWIN-Acta control suite. Data on usability, acceptability, and limitations to system usage were collected through questionnaires and semi-structured interviews. Results: The system received overall good usability and acceptability ratings and resulted in a well-conceived and safe approach. All experts gave excellent ratings regarding the possibility of modulating the assistance provided by the exoskeleton during the movement execution and concluded that the TWIN-Acta would be useful in gait rehabilitation for persons post-stroke. The main limit was the low level of system learnability, attributable to the short-time of usage. This issue can be minimized with prolonged training and must be taken into consideration when planning rehabilitation. Discussion: This study showed the potential of the novel control suite TWIN-Acta for gait rehabilitation and efficacy studies are the next step in its evaluation process