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

Advances on mechanical designs for assistive ankle-foot orthoses

Assistive ankle-foot orthoses (AFOs) are powerful solutions to assist or rehabilitate gait on humans. Existing assistive AFO technologies include passive, quasi-passive, and active principles to provide assistance to the users, and their mechanical configuration and control depend on the eventual support they aim for within the gait pattern. In this research we analyze the state-of-the-art of assistive AFOs and classify the different approaches into clusters, describing their basis and working principles. Additionally, we reviewed the purpose and experimental validation of the devices, providing the reader with a better view of the technology readiness level. Finally, the reviewed designs, limitations, and future steps in the field are summarized and discussed.Comment: Figures appear at the end. Article submitted to Frontiers in Bioengineering and Biotechnology (currently under review

A Review of Lower Limb Exoskeletons

In general, exoskeletons are defined as wearable robotic mechanisms for providing mobility. In the last six decades, many research work have been achieved to enhance the performance of exoskeletons thus developing them to nearly commercialized products. In this paper, a review is made for the lower limb exoskeleton concerning history, classification, selection and development, also a discussion for the most important aspects of comparison between different designs is presented. Further, some concluding remarks are withdrawn which could be useful for future work. Keywords: Exoskeletons, Lower extremity exoskeleton, Wearable robot

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 of an Elastic Actuation System for a Gait-Assistive Active Orthosis for Incomplete Spinal Cord Injured Subjects

A spinal cord injury severely reduces the quality of life of affected people. Following the injury, limitations of the ability to move may occur due to the disruption of the motor and sensory functions of the nervous system depending on the severity of the lesion. An active stance-control knee-ankle-foot orthosis was developed and tested in earlier works to aid incomplete SCI subjects by increasing their mobility and independence. This thesis aims at the incorporation of elastic actuation into the active orthosis to utilise advantages of the compliant system regarding efficiency and human-robot interaction as well as the reproduction of the phyisological compliance of the human joints. Therefore, a model-based procedure is adapted to the design of an elastic actuation system for a gait-assisitve active orthosis. A determination of the optimal structure and parameters is undertaken via optimisation of models representing compliant actuators with increasing level of detail. The minimisation of the energy calculated from the positive amount of power or from the absolute power of the actuator generating one human-like gait cycle yields an optimal series stiffness, which is similar to the physiological stiffness of the human knee during the stance phase. Including efficiency factors for components, especially the consideration of the electric model of an electric motor yields additional information. A human-like gait cycle contains high torque and low velocities in the stance phase and lower torque combined with high velocities during the swing. Hence, the efficiency of an electric motor with a gear unit is only high in one of the phases. This yields a conceptual design of a series elastic actuator with locking of the actuator position during the stance phase. The locked position combined with the series compliance allows a reproduction of the characteristics of the human gait cycle during the stance phase. Unlocking the actuator position for the swing phase enables the selection of an optimal gear ratio to maximise the recuperable energy. To evaluate the developed concept, a laboratory specimen based on an electric motor, a harmonic drive gearbox, a torsional series spring and an electromagnetic brake is designed and appropriate components are selected. A control strategy, based on impedance control, is investigated and extended with a finite state machine to activate the locking mechanism. The control scheme and the laboratory specimen are implemented at a test bench, modelling the foot and shank as a pendulum articulated at the knee. An identification of parameters yields high and nonlinear friction as a problem of the system, which reduces the energy efficiency of the system and requires appropriate compensation. A comparison between direct and elastic actuation shows similar results for both systems at the test bench, showing that the increased complexity due to the second degree of freedom and the elastic behaviour of the actuator is treated properly. The final proof of concept requires the implementation at the active orthosis to emulate uncertainties and variations occurring during the human gait

Application of wearable sensors in actuation and control of powered ankle exoskeletons: a Comprehensive Review

Powered ankle exoskeletons (PAEs) are robotic devices developed for gait assistance, rehabilitation, and augmentation. To fulfil their purposes, PAEs vastly rely heavily on their sensor systems. Human–machine interface sensors collect the biomechanical signals from the human user to inform the higher level of the control hierarchy about the user’s locomotion intention and requirement, whereas machine–machine interface sensors monitor the output of the actuation unit to ensure precise tracking of the high-level control commands via the low-level control scheme. The current article aims to provide a comprehensive review of how wearable sensor technology has contributed to the actuation and control of the PAEs developed over the past two decades. The control schemes and actuation principles employed in the reviewed PAEs, as well as their interaction with the integrated sensor systems, are investigated in this review. Further, the role of wearable sensors in overcoming the main challenges in developing fully autonomous portable PAEs is discussed. Finally, a brief discussion on how the recent technology advancements in wearable sensors, including environment—machine interface sensors, could promote the future generation of fully autonomous portable PAEs is provided