10 research outputs found

    Lower-Limb Exosuits for Rehabilitation or Assistance of Human Movement: A Systematic Review

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    Background: The aim of this review is to provide a comprehensive overview of the technological state-of-the-art of exosuits and the clinical results obtained when applied to users with mobility impairment. Methods: Searches are carried out in the COCHRANE, PubMed, IEEE Xplore and MEDLINE databases. Titles, abstracts and full texts are screened for inclusion criteria. Technological and clinical data are extracted. The quality of the studies is evaluated via a study quality assessment tool. Results: 19 studies are identified as relevant. Active (47%) and passive exosuits (53%) are used. Most are used untethered (84%), accommodating the demand of mobility. No study reports power consumption, which is important for dimensioning power systems. Fields of applications are post-stroke (79%), osteoarthritis (16%) and post-trauma (5%). Mostly the ankle joint is addressed (57%), while less studies address multiple joints (21%). The outcomes of clinical evaluations of lower-limb exosuits with patients suffering from mobility impairments are positive in the correction of gait pattern and reducing metabolic energy consumption during hemiparetic walking. Conclusions: Lower-limb exosuits for clinical applications are still facing technological challenges. Fields of application are limited to stroke, osteoarthritis and trauma. While clinical outcomes are overall positive, improvements in the study protocols are suggested.Peer ReviewedObjectius de Desenvolupament Sostenible::3 - Salut i BenestarPostprint (published version

    Advances on mechanical designs for assistive ankle-foot orthoses

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    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

    Towards a human-in-the-loop control for a smart orthotic system

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    Dissertação de mestrado integrado em Engenharia Biomédica (área de especialização em Eletrónica Médica)Stroke is the main cause of paralysis. This pathology has provoked a considerable increase of persons with motor impairments. With a therapy focused on each clinical case, the total or partial recovery can be achieved. Powered orthoses have been developed to promote an effective recover, based on repetitive gait training and user’s active participation. Many control approaches have been developed to control these devices, but none of them promotes an user-oriented strategy focused to the user’s needs. In an attempt of solving this issue, a new approach named Human-in-the-loop is emerging. This strategy allows the adaptation of some assistive parameters based on the user’s energetic cost, promoting a therapy tailored to each end-user needs. However, to estimate the energy expenditure, the use of non-ergonomic sensors, not suitable for clinical context, is required. Thus, it is necessary to find new ways of estimating energy expenditure using wearable and comfortable sensors. In this dissertation, the first steps to introduce the Human-in-the-loop strategy into a powered orthosis are presented. For this purpose, two strategies were developed: a strategy that allows the angular trajectory adaptation in real-time and other that promotes a stiffness adaptation all over the gait cycle. Both strategies were validated with healthy subjects. In the first strategy, the orthosis was able to modify its assistance in a fraction of microseconds, and the end-users were able to follow her with a median error below 10%. Regarding the second strategy, the results show that the orthosis allowed an effective change in the systems’ interaction stiffness, promoting an active participation of each user during its assistance. The energetic impact of using the robotic assistive device is also presented. As it promotes an energy expenditure augmentation in more than 30% in comparison to walk without the device, the necessity of implementing the Human-in-the-loop strategy was highlighted. In an attempt of finding an ergonomic technique to estimate the energetic cost, the use of machine learning algorithms was tested. The results, obtained with a MLP and a LSTM, prove that it is possible to estimate the energy expenditure with a mean error close to 11%. Future work consists in the implementation of the model in real-time and the collection of more data with the aforementioned control approaches, in a way of constructing a more robust model.O AVC é uma das maiores causas de paralisia. Esta patologia, cada vez mais com maior incidência nos jovens, tem provocado um aumento considerável de pessoas com problemas de mobilidade. Com uma terapia focada a cada caso clínico, a recuperação total ou parcial pode ser conseguida. As ortóteses ativas têm vindo a ser desenvolvidas com o propósito de promover uma recuperação eficaz, baseada em treinos repetitivos e numa participação ativa dos utilizadores. Várias abordagens de controlo têm vindo a ser desenvolvidas para controlar estes dispositivos, mas nenhuma delas promove uma estratégia orientada às necessidades do utilizador. Na tentativa de solucionar este problema, uma nova abordagem, designada por Human-in-the-loop está a emergir. Baseada no custo energético, esta estratégia permite adaptar parâmetros da assistência, promovendo uma terapia focada e direcionada a cada utilizador. No entanto, para estimar o custo energético, recorre-se ao uso de sensores que não são adequados para contexto clínico. Assim, torna-se necessário estudar novas formas de estimar o custo energético. Nesta dissertação são apresentados os primeiros passos para introduzir o controlo Human-in-the-loop numa ortótese ativa. Para isso, duas estratégias foram apresentadas: uma estratégia que permite adaptar a trajetória angular da ortótese, em tempo real, e outra que promove a adaptação da complacência do sistema ao longo do ciclo da marcha. Ambas foram validadas com sujeitos saudáveis. Relativamente à primeira abordagem, a ortótese foi capaz de modificar a sua assistência em microssegundos, e os utilizadores foram capazes de a seguir com um erro mediano inferior a 10%. No que diz respeito à segunda abordagem, os resultados mostram que a ortótese promoveu uma alteração eficaz da complacência de interação, promovendo uma participação ativa do utilizador durante a sua assistência. O impacto energético do uso do sistema robótico é, também, apresentado. Promovendo um aumento do custo energético em mais de 30%, a necessidade da estratégia Human-in-the-loop foi realçada. Na tentativa de encontrar uma técnica para estimar o custo energético, recorreu-se ao uso de machine learning. Os resultados, obtidos com uma MLP e uma LSTM, provam que é possível estimar o custo energético com um erro médio próximo dos 11%. Trabalho futuro passa pela implementação do modelo em tempo real e a recolha de mais dados com as abordagens de controlo apresentadas, de forma a construir um modelo mais robusto

    Inertial sensors for gait monitoring and design of adaptive controllers for exoskeletons after stroke: a feasibility study

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    Introduction: Tuning the control parameters is one of the main challenges in robotic gait therapy. Control strategies that vary the control parameters based on the user’s performance are still scarce and do not exploit the potential of using spatiotemporal metrics. The goal of this study was to validate the feasibility of using shank-worn Inertial Measurement Units (IMUs) for clinical gait analysis after stroke and evaluate their preliminary applicability in designing an automatic and adaptive controller for a knee exoskeleton (ABLE-KS). Methods: First, we estimated the temporal (i.e., stride time, stance, and swing duration) and spatial (i.e., stride length, maximum vertical displacement, foot clearance, and circumduction) metrics in six post-stroke participants while walking on a treadmill and overground and compared these estimates with data from an optical motion tracking system. Next, we analyzed the relationships between the IMU-estimated metrics and an exoskeleton control parameter related to the peak knee flexion torque. Finally, we trained two machine learning algorithms, i.e., linear regression and neural network, to model the relationship between the exoskeleton torque and maximum vertical displacement, which was the metric that showed the strongest correlations with the data from the optical system [r = 0.84; ICC(A,1) = 0.73; ICC(C,1) = 0.81] and peak knee flexion torque (r = 0.957). Results: Offline validation of both neural network and linear regression models showed good predictions (R2 = 0.70–0.80; MAE = 0.48–0.58 Nm) of the peak torque based on the maximum vertical displacement metric for the participants with better gait function, i.e., gait speed > 0.7 m/s. For the participants with worse gait function, both models failed to provide good predictions (R2 = 0.00–0.19; MAE = 1.15–1.29 Nm) of the peak torque despite having a moderate-to-strong correlation between the spatiotemporal metric and control parameter. Discussion: Our preliminary results indicate that the stride-by-stride estimations of shank-worn IMUs show potential to design automatic and adaptive exoskeleton control strategies for people with moderate impairments in gait function due to stroke.Peer ReviewedPostprint (published version

    Inertial sensors for gait monitoring and design of adaptive controllers for exoskeletons after stroke: a feasibility study

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    Introduction: Tuning the control parameters is one of the main challenges in robotic gait therapy. Control strategies that vary the control parameters based on the user’s performance are still scarce and do not exploit the potential of using spatiotemporal metrics. The goal of this study was to validate the feasibility of using shank-worn Inertial Measurement Units (IMUs) for clinical gait analysis after stroke and evaluate their preliminary applicability in designing an automatic and adaptive controller for a knee exoskeleton (ABLE-KS).Methods: First, we estimated the temporal (i.e., stride time, stance, and swing duration) and spatial (i.e., stride length, maximum vertical displacement, foot clearance, and circumduction) metrics in six post-stroke participants while walking on a treadmill and overground and compared these estimates with data from an optical motion tracking system. Next, we analyzed the relationships between the IMU-estimated metrics and an exoskeleton control parameter related to the peak knee flexion torque. Finally, we trained two machine learning algorithms, i.e., linear regression and neural network, to model the relationship between the exoskeleton torque and maximum vertical displacement, which was the metric that showed the strongest correlations with the data from the optical system [r = 0.84; ICC(A,1) = 0.73; ICC(C,1) = 0.81] and peak knee flexion torque (r = 0.957).Results: Offline validation of both neural network and linear regression models showed good predictions (R2 = 0.70–0.80; MAE = 0.48–0.58 Nm) of the peak torque based on the maximum vertical displacement metric for the participants with better gait function, i.e., gait speed > 0.7 m/s. For the participants with worse gait function, both models failed to provide good predictions (R2 = 0.00–0.19; MAE = 1.15–1.29 Nm) of the peak torque despite having a moderate-to-strong correlation between the spatiotemporal metric and control parameter.Discussion: Our preliminary results indicate that the stride-by-stride estimations of shank-worn IMUs show potential to design automatic and adaptive exoskeleton control strategies for people with moderate impairments in gait function due to stroke

    Robotic Home-Based Rehabilitation Systems Design: From a Literature Review to a Conceptual Framework for Community-Based Remote Therapy During COVID-19 Pandemic

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    During the COVID-19 pandemic, the higher susceptibility of post-stroke patients to infection calls for extra safety precautions. Despite the imposed restrictions, early neurorehabilitation cannot be postponed due to its paramount importance for improving motor and functional recovery chances. Utilizing accessible state-of-the-art technologies, home-based rehabilitation devices are proposed as a sustainable solution in the current crisis. In this paper, a comprehensive review on developed home-based rehabilitation technologies of the last 10 years (2011–2020), categorizing them into upper and lower limb devices and considering both commercialized and state-of-the-art realms. Mechatronic, control, and software aspects of the system are discussed to provide a classified roadmap for home-based systems development. Subsequently, a conceptual framework on the development of smart and intelligent community-based home rehabilitation systems based on novel mechatronic technologies is proposed. In this framework, each rehabilitation device acts as an agent in the network, using the internet of things (IoT) technologies, which facilitates learning from the recorded data of the other agents, as well as the tele-supervision of the treatment by an expert. The presented design paradigm based on the above-mentioned leading technologies could lead to the development of promising home rehabilitation systems, which encourage stroke survivors to engage in under-supervised or unsupervised therapeutic activities

    Physical Diagnosis and Rehabilitation Technologies

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    The book focuses on the diagnosis, evaluation, and assistance of gait disorders; all the papers have been contributed by research groups related to assistive robotics, instrumentations, and augmentative devices

    Model-based myoelectric control of robots for assistance and rehabilitation

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    The first anthropomorphic robots and exoskeletons were developed with the idea of combining man and machine into an intimate symbiotic unit that can perform as one joint system. A human-robot interface consists of processes of two different nature: (1) the physical interaction (pHRI) between the device and its user and (2) the exchange of cognitive information (cHRI) between the human and the robot. To achieve the symbiosis between the two actors, both need to be optimized. The evolution of mechanical design and the introduction of new materials pushed pHRI to new frontiers on ergonomics and assistance performance. However, cHRI still lacks on this direction because is more complicated: it requires communication from the cognitive processes occuring in the human agent to the robot, e.g. intention detection; but also from the robot to the human agent, e.g. feedback modalities such as haptic cues. A possible innovation is the inclusion of the electromyographic signal, the command signal from our brain to the musculoskeletal system for the movement, in the robot control loop. The aim of this thesis was to develop a real-time control framework for an assistive device that can generate the same force produced by the muscles. To do this, I incorporated in the robot control loop a detailed musculoskeletal model that estimates the net torque at the joint level by taking as inputs the electromyography signals and kinematic data. This module is called myoprocessor. Here I present two applications of this control approach: the first was implemented on a soft wearable arm exosuit in order to evaluate the adaptation of the controller on different motion and loads. The second one, was a generation of myoprocessor-driven force field on a planar robot manipulandum in order to study the modularity changes of the musculoskeletal system. Both applications showed that the device controlled by myoprocessor works symbiotically with the user, by reducing the muscular activity and preserving the motor performance. The ability of seamlessly combining musculoskeletal force estimators with assistive devices opens new avenues for assisting human movement both in healthy and impaired individuals

    Evaluating footwear “in the wild”: Examining wrap and lace trail shoe closures during trail running

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    Trail running participation has grown over the last two decades. As a result, there have been an increasing number of studies examining the sport. Despite these increases, there is a lack of understanding regarding the effects of footwear on trail running biomechanics in ecologically valid conditions. The purpose of our study was to evaluate how a Wrap vs. Lace closure (on the same shoe) impacts running biomechanics on a trail. Thirty subjects ran a trail loop in each shoe while wearing a global positioning system (GPS) watch, heart rate monitor, inertial measurement units (IMUs), and plantar pressure insoles. The Wrap closure reduced peak foot eversion velocity (measured via IMU), which has been associated with fit. The Wrap closure also increased heel contact area, which is also associated with fit. This increase may be associated with the subjective preference for the Wrap. Lastly, runners had a small but significant increase in running speed in the Wrap shoe with no differences in heart rate nor subjective exertion. In total, the Wrap closure fit better than the Lace closure on a variety of terrain. This study demonstrates the feasibility of detecting meaningful biomechanical differences between footwear features in the wild using statistical tools and study design. Evaluating footwear in ecologically valid environments often creates additional variance in the data. This variance should not be treated as noise; instead, it is critical to capture this additional variance and challenges of ecologically valid terrain if we hope to use biomechanics to impact the development of new products

    XLIII Jornadas de Automática: libro de actas: 7, 8 y 9 de septiembre de 2022, Logroño (La Rioja)

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    [Resumen] Las Jornadas de Automática (JA) son el evento más importante del Comité Español de Automática (CEA), entidad científico-técnica con más de cincuenta años de vida y destinada a la difusión e implantación de la Automática en la sociedad. Este año se celebra la cuadragésima tercera edición de las JA, que constituyen el punto de encuentro de la comunidad de Automática de nuestro país. La presente edición permitirá dar visibilidad a los nuevos retos y resultados del ámbito, y su uso en un gran número de aplicaciones, entre otras, las energías renovables, la bioingeniería o la robótica asistencial. Además de la componente científica, que se ve reflejada en este libro de actas, las JA son un punto de encuentro de las diferentes generaciones de profesores, investigadores y profesionales, incluyendo la componente social que es de vital importancia. Esta edición 2022 de las JA se celebra en Logroño, capital de La Rioja, región mundialmente conocida por la calidad de sus vinos de Denominación de Origen y que ha asumido el desafío de poder ganar competitividad a través de la transformación verde y digital. Pero también por ser la cuna del castellano e impulsar el Valle de la Lengua con la ayuda de las nuevas tecnologías, entre ellas la Automática Inteligente. Los organizadores de estas JA, pertenecientes al Área de Ingeniería de Sistemas y Automática del Departamento de Ingeniería Eléctrica de la Universidad de La Rioja (UR), constituyen un pilar fundamental en el apoyo a la región para el estudio, implementación y difusión de estos retos. Esta edición, la primera en formato íntegramente presencial después de la pandemia de la covid-19, cuenta con más de 200 asistentes y se celebra a caballo entre el Edificio Politécnico de la Escuela Técnica Superior de Ingeniería Industrial y el Monasterio de Yuso situado en San Millán de la Cogolla, dos marcos excepcionales para la realización de las JA. Como parte del programa científico, dos sesiones plenarias harán hincapié, respectivamente, sobre soluciones de control para afrontar los nuevos retos energéticos, y sobre la calidad de los datos para una inteligencia artificial (IA) imparcial y confiable. También, dos mesas redondas debatirán aplicaciones de la IA y la implantación de la tecnología digital en la actividad profesional. Adicionalmente, destacaremos dos clases magistrales alineadas con tecnología de última generación que serán impartidas por profesionales de la empresa. Las JA también van a albergar dos competiciones: CEABOT, con robots humanoides, y el Concurso de Ingeniería de Control, enfocado a UAVs. A todas estas actividades hay que añadir las reuniones de los grupos temáticos de CEA, las exhibiciones de pósteres con las comunicaciones presentadas a las JA y los expositores de las empresas. Por último, durante el evento se va a proceder a la entrega del “Premio Nacional de Automática” (edición 2022) y del “Premio CEA al Talento Femenino en Automática”, patrocinado por el Gobierno de La Rioja (en su primera edición), además de diversos galardones enmarcados dentro de las actividades de los grupos temáticos de CEA. Las actas de las XLIII Jornadas de Automática están formadas por un total de 143 comunicaciones, organizadas en torno a los nueve Grupos Temáticos y a las dos Líneas Estratégicas de CEA. Los trabajos seleccionados han sido sometidos a un proceso de revisión por pares
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