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

Feedback Control of an Exoskeleton for Paraplegics: Toward Robustly Stable Hands-free Dynamic Walking

This manuscript presents control of a high-DOF fully actuated lower-limb exoskeleton for paraplegic individuals. The key novelty is the ability for the user to walk without the use of crutches or other external means of stabilization. We harness the power of modern optimization techniques and supervised machine learning to develop a smooth feedback control policy that provides robust velocity regulation and perturbation rejection. Preliminary evaluation of the stability and robustness of the proposed approach is demonstrated through the Gazebo simulation environment. In addition, preliminary experimental results with (complete) paraplegic individuals are included for the previous version of the controller.Comment: Submitted to IEEE Control System Magazine. This version addresses reviewers' concerns about the robustness of the algorithm and the motivation for using such exoskeleton

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

Controller design of a robotic orthosis using sinusoidal-input describing function model

Stroke is one of top leading causes of death in the world and it happens to more than 15 million people yearly. According to the National Stroke Association of Malaysia (NASAM), stroke is the third leading cause of death in Malaysia with around 40,000 cases reported annually. Forty percent of stroke survivors suffer from movement impairments after stroke. My grandfather was one of the victims and he was unable to attend any rehabilitation sessions due to several reasons. Hence, he lost the golden time to regain his movement and freedom. There are a lot of similar cases that happen daily in Malaysia. Besides, as the number of stroke patients increases yearly, the need for physiotherapists or rehabilitation machines equally increases. Hence, a low-cost clinical rehabilitation device is essential to provide assistance for an effective rehabilitation program and substitute the conventional method, as well as to reduce the burden of physiotherapists. In future, the proposed rehabilitation device would benefit not only stroke patients, but any patients who lost their normal walking ability including post-accident patients or those who suffer from spinal cord injury. The rehabilitation device aims to provide training assistance to patients not only in rehabilitation centres but also at home for daily training. The robotic orthosis is planned to be configured based on moving joint angles of human lower extremities. In the first stage of this research, angle-time characteristics for knee and hip swinging motion are utilised as a sagittal motion reference for the rehabilitation devices. The aim of following a proper gait cycle during rehabilitation training is to train patients to perform standing and swinging phases at proper timing and simultaneously provide the correct position reference to the patient during rehabilitation training. This can prevent patients from walking abnormally with an asymmetric gait cycle along or after the rehabilitation program. Besides, various limitations and the bulky structure of other rehabilitation devices lead to the design of the two-link lower limb rehabilitation device. This project aims to develop an assistive robotic rehabilitation device that generates a human gait trajectory for hemiplegic stroke patient gait rehabilitation in future. The shortcomings of other control applications due to environmental conditions and disturbances lead to the implementation of the describing function approach in the development of the devices. A sinusoidal-input describing function (SIDF) approach was implemented to linearize the nonlinear robotic orthosis with linear transfer function. The reason for utilising the SIDF approach is due to the nonlinear actual plant model with the present of load torque disturbances, discontinuous nonlinearities such as saturation and backlash, and also multivariable in the system. The nonlinear properties of the plant were proven in the preliminary stage of the research. A conventional controller, PID control combined with position and trajectory inputs were also applied to the system in the early stage of research. However, the experimental results were not satisfying. Finally, the SIDF approach was chosen to linearize the nonlinear system. Hence, generating a controller is much easier with a linear model of the nonlinear system. A SIDF approach was implemented to generate a controller for the multivariable, nonlinear closed loop system. Firstly, the SIDF approach enables the determination of the linear function of the nonlinear model known as the SIDF model. By utilising the linear model to mimic the behaviour of the nonlinear rehabilitation system, the controller for the nonlinear plant was able to be generated. In this research a controller based on linear control theory technique was used. The MATLAB library was used to design the lead-lag controller for the rehabilitation device. Various simulations such as step responses, tracking and decoupling of both links were performed on the generated controller with the nonlinear model to study the capability of the controller. Besides that, real life experiment testing was carried out to validate the feasibility of the controller designed via the SIDF approach. Simulation and experimental results were obtained, compared, and discussed. The highly accurate responses gained from experimental setup showed the robustness of the controller generated via SIDF approach. The implementation of the SIDF approach in a rehabilitation device (vertical two-link manipulator) is a first and hence, fulfils a novelty requirement for this research

Review of control strategies for robotic movement training after neurologic injury

There is increasing interest in using robotic devices to assist in movement training following neurologic injuries such as stroke and spinal cord injury. This paper reviews control strategies for robotic therapy devices. Several categories of strategies have been proposed, including, assistive, challenge-based, haptic simulation, and coaching. The greatest amount of work has been done on developing assistive strategies, and thus the majority of this review summarizes techniques for implementing assistive strategies, including impedance-, counterbalance-, and EMG- based controllers, as well as adaptive controllers that modify control parameters based on ongoing participant performance. Clinical evidence regarding the relative effectiveness of different types of robotic therapy controllers is limited, but there is initial evidence that some control strategies are more effective than others. It is also now apparent there may be mechanisms by which some robotic control approaches might actually decrease the recovery possible with comparable, non-robotic forms of training. In future research, there is a need for head-to-head comparison of control algorithms in randomized, controlled clinical trials, and for improved models of human motor recovery to provide a more rational framework for designing robotic therapy control strategies

Prediction of three-dimensional crutch walking patterns using a torque-driven model

Computational prediction of 3D crutch-assisted walking patterns is a challenging problem that could be applied to study different biomechanical aspects of crutch walking in virtual subjects, to assist physiotherapists to choose the optimal crutch walking pattern for a specific subject, and to help in the design and control of exoskeletons, when crutches are needed for balance. The aim of this work is to generate a method to predict three-dimensional crutch-assisted walking motions following different patterns without tracking any experimental data. To reach this goal, we collected gait data from a healthy subject performing a four-point non-alternating crutch walking pattern, and developed a 3D torque-driven full-body model of the subject including the crutches and foot- and crutch-ground contact models. First, we developed a predictive (i.e., no tracking of experimental data) optimal control problem formulation to predict crutch walking cycles following the same pattern as the experimental data collected, using different cost functions. To reduce errors with respect to reference data, a cost function combining minimization terms of angular momentum, mechanical power, joint jerk and torque change was chosen. Then, the problem formulation was adapted to handle different foot- and crutch-ground conditions to make it capable of predicting three new crutch walking patterns, one of them at different speeds. A key aspect of our algorithm is that having ground reactions as additional controls allows one to define phases inside the cycle without the need of formulating a multiple-phase problem, thus facilitating the definition of different crutch walking patterns.Postprint (author's final draft

Controller design of a robotic orthosis using sinusoidal-input describing function model

Stroke is one of top leading causes of death in the world and it happens to more than 15 million people yearly. According to the National Stroke Association of Malaysia (NASAM), stroke is the third leading cause of death in Malaysia with around 40,000 cases reported annually. Forty percent of stroke survivors suffer from movement impairments after stroke. My grandfather was one of the victims and he was unable to attend any rehabilitation sessions due to several reasons. Hence, he lost the golden time to regain his movement and freedom. There are a lot of similar cases that happen daily in Malaysia. Besides, as the number of stroke patients increases yearly, the need for physiotherapists or rehabilitation machines equally increases. Hence, a low-cost clinical rehabilitation device is essential to provide assistance for an effective rehabilitation program and substitute the conventional method, as well as to reduce the burden of physiotherapists. In future, the proposed rehabilitation device would benefit not only stroke patients, but any patients who lost their normal walking ability including post-accident patients or those who suffer from spinal cord injury. The rehabilitation device aims to provide training assistance to patients not only in rehabilitation centres but also at home for daily training. The robotic orthosis is planned to be configured based on moving joint angles of human lower extremities. In the first stage of this research, angle-time characteristics for knee and hip swinging motion are utilised as a sagittal motion reference for the rehabilitation devices. The aim of following a proper gait cycle during rehabilitation training is to train patients to perform standing and swinging phases at proper timing and simultaneously provide the correct position reference to the patient during rehabilitation training. This can prevent patients from walking abnormally with an asymmetric gait cycle along or after the rehabilitation program. Besides, various limitations and the bulky structure of other rehabilitation devices lead to the design of the two-link lower limb rehabilitation device. This project aims to develop an assistive robotic rehabilitation device that generates a human gait trajectory for hemiplegic stroke patient gait rehabilitation in future. The shortcomings of other control applications due to environmental conditions and disturbances lead to the implementation of the describing function approach in the development of the devices. A sinusoidal-input describing function (SIDF) approach was implemented to linearize the nonlinear robotic orthosis with linear transfer function. The reason for utilising the SIDF approach is due to the nonlinear actual plant model with the present of load torque disturbances, discontinuous nonlinearities such as saturation and backlash, and also multivariable in the system. The nonlinear properties of the plant were proven in the preliminary stage of the research. A conventional controller, PID control combined with position and trajectory inputs were also applied to the system in the early stage of research. However, the experimental results were not satisfying. Finally, the SIDF approach was chosen to linearize the nonlinear system. Hence, generating a controller is much easier with a linear model of the nonlinear system. A SIDF approach was implemented to generate a controller for the multivariable, nonlinear closed loop system. Firstly, the SIDF approach enables the determination of the linear function of the nonlinear model known as the SIDF model. By utilising the linear model to mimic the behaviour of the nonlinear rehabilitation system, the controller for the nonlinear plant was able to be generated. In this research a controller based on linear control theory technique was used. The MATLAB library was used to design the lead-lag controller for the rehabilitation device. Various simulations such as step responses, tracking and decoupling of both links were performed on the generated controller with the nonlinear model to study the capability of the controller. Besides that, real life experiment testing was carried out to validate the feasibility of the controller designed via the SIDF approach. Simulation and experimental results were obtained, compared, and discussed. The highly accurate responses gained from experimental setup showed the robustness of the controller generated via SIDF approach. The implementation of the SIDF approach in a rehabilitation device (vertical two-link manipulator) is a first and hence, fulfils a novelty requirement for this research

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