Joint Stiffness Compensation for Application in the EXTEND Hand Orthosis

This paper presents a passive hand orthosis, called EXTEND, that can be used during activities of daily living. In the design a negative stiffness spring mechanism is incorporated to overcome the high finger joint stiffness of stroke patients with hypertonia. The passive mechanism can be easily tuned by the user to compensate a linear joint stiffness of 0.15 to 0.33 Nm/rad for each finger independently. A prototype was tested with four patients showing an increased functional ability of the hand during several tasks. With the orthosis, patients were better able to pick up mid-sized objects (5-7.5cm diameter) of different shapes.</p

Analysis of the human interaction with a wearable lower-limb exoskeleton

The design of a wearable robotic exoskeleton needs to consider the interaction, either physical or cognitive, between the human user and the robotic device. This paper presents a method to analyse the interaction between the human user and a unilateral, wearable lower-limb exoskeleton. The lower-limb exoskeleton function was to compensate for muscle weakness around the knee joint. It is shown that the cognitive interaction is bidirectional; on the one hand, the robot gathered information from the sensors in order to detect human actions, such as the gait phases, but the subjects also modified their gait patterns to obtain the desired responses from the exoskeleton. The results of the two-phase evaluation of learning with healthy subjects and experiments with a patient case are presented, regarding the analysis of the interaction, assessed in terms of kinematics, kinetics and/or muscle recruitment. Human-driven response of the exoskeleton after training revealed the improvements in the use of the device, while particular modifications of motion patterns were observed in healthy subjects. Also, endurance (mechanical) tests provided criteria to perform experiments with one post-polio patient. The results with the post-polio patient demonstrate the feasibility of providing gait compensation by means of the presented wearable exoskeleton, designed with a testing procedure that involves the human users to assess the human-robot interaction

The influence of the reciprocal hip joint link in the advanced reciprocating gait orthosis on standing performance in paraplegia

The effect of reciprocally linking the hip hinges of a hip-knee-ankle-foot orthosis on standing performance was studied in a comparative trial of the Advanced Reciprocating Gait Orthosis (ARGO) and an ARGO in which the Bowden cable was removed (A_GO). Six male subjects with spinal cord injury (SCI) at T4 to T12 level participated in the study, which was conducted using a single case experimental design. Standing balance, the ability to handle balance disturbances (standing stability), and the performance of a functional hand task during standing were assessed in both orthosis configurations in the order A_GO-ARGO-A_GO-ARGO. No significant differences with respect to standing performance were found for the two orthosis configurations. However, the results indicate that the crutch force needed for maintaining balance during various tasks, especially for quiet standing with two crutches, may be much higher in the orthosis without Bowden cable. Therefore, it is very likely that the reciprocal hip joint link in the ARGO provides a substantial and clinically relevant reduction of upper body effort required for standing under functional conditions

Design And Development of A Powered Pediatric Lower-limb Orthosis

Gait impairments from disorders such as cerebral palsy are important to address early in life. A powered lower-limb orthosis can offer therapists a rehabilitation option using robot-assisted gait training. Although there are many devices already available for the adult population, there are few powered orthoses for the pediatric population. The aim of this dissertation is to embark on the first stages of development of a powered lower-limb orthosis for gait rehabilitation and assistance of children ages 6 to 11 years with walking impairments from cerebral palsy. This dissertation presents the design requirements of the orthosis, the design and fabrication of the joint actuators, and the design and manufacturing of a provisional version of the pediatric orthosis. Preliminary results demonstrate the capabilities of the joint actuators, confirm gait tracking capabilities of the actuators in the provisional orthosis, and evaluate a standing balance control strategy on the under-actuated provisional orthosis in simulation and experiment. In addition, this dissertation presents the design methodology for an anthropometrically parametrized orthosis, the fabrication of the prototype powered orthosis using this design methodology, and experimental application of orthosis hardware in providing walking assistance with a healthy adult. The presented results suggest the developed orthosis hardware is satisfactorily capable of operation and functional with a human subject. The first stages of development in this dissertation show encouraging results and will act as a foundation for further iv development of the device for rehabilitation and assistance of children with walking impairments

New control strategies for neuroprosthetic systems

The availability of techniques to artificially excite paralyzed muscles opens enormous potential for restoring both upper and lower extremity movements with\ud neuroprostheses. Neuroprostheses must stimulate muscle, and control and regulate the artificial movements produced. Control methods to accomplish these tasks include feedforward (open-loop), feedback, and adaptive control. Feedforward control requires a great deal of information about the biomechanical behavior of the limb. For the upper extremity, an artificial motor program was developed to provide such movement program input to a neuroprosthesis. In lower extremity control, one group achieved their best results by attempting to meet naturally perceived gait objectives rather than to follow an exact joint angle trajectory. Adaptive feedforward control, as implemented in the cycleto-cycle controller, gave good compensation for the gradual decrease in performance observed with open-loop control. A neural network controller was able to control its system to customize stimulation parameters in order to generate a desired output trajectory in a given individual and to maintain tracking performance in the presence of muscle fatigue. The authors believe that practical FNS control systems must\ud exhibit many of these features of neurophysiological systems

Best practice statement : use of ankle-foot orthoses following stroke

NHS Quality Improvement Scotland (NHSQIS) leads the use of knowledge to promote improvement in the quality of health care for the people of Scotland and performs three key functions. It provides advice and guidance on effective clinical practice, including setting standards; drives and supports implementation of improvements in quality, and assessing the performance of the NHS, reporting and publishing findings