Design and Control of a Knee Exoskeleton for Assistance and Power Augmentation

Thanks to the technological advancements, assistive lower limb exoskeletons are moving from laboratory settings to daily life scenarios. This dissertation makes a contribution toward the development of assistive/power augmentation knee exoskeletons with an improved wearability, ergonomics and intuitive use. In particular, the design and the control of a novel knee exoskeleton system, the iT-Knee Bipedal System, is presented. It is composed by: a novel mechanism to transmit the assistance generated by the exoskeleton to the knee joint in a more ergonomic manner; a novel method that requires limited information to estimate online the torques experienced by the ankles, knees and hips of a person wearing the exoskeleton; a novel sensor system for shoes able to track the feet orientation and monitor their full contact wrench with the ground. In particular, the iT-Knee exoskeleton, the main component of the aforementioned system, is introduced. It is a novel six degree of freedom knee exoskeleton module with under-actuated kinematics, able to assist the flexion/extension motion of the knee while all the other joint\u2019s movements are accommodated. Thanks to its mechanism, the system: solves the problem of the alignment between the joint of the user and the exoskeleton; it automatically adjusts to different users\u2019 size; reduces the undesired forces and torques exchanged between the attachment points of its structure and the user\u2019s skin. From a control point of view, a novel approach to address difficulties arising in real life scenarios (i.e. noncyclic locomotion activity, unexpected terrain or unpredicted interactions with the surroundings) is presented. It is based on a method that estimates online the torques experienced by a person at his ankles, knees and hips with the major advantage that does not rely on any information of the user\u2019s upper body (i.e. pose, weight and center of mass location) or on any interaction of the user\u2019s upper body with the environment (i.e. payload handling or pushing and pulling task). This is achieved v by monitoring the full contact wrench of the subject with the ground and applying an inverse dynamic approach to the lower body segments. To track the full contact wrench between the subject\u2019s feet and the ground, a novel add on system for shoes has been developed. The iT-Shoe is adjustable to different user\u2019s size and accommodates the plantar flexion of the foot. It tracks the interactions and the orientation of the foot thanks to two 6axis Force/Torque sensors, developed in-house, with dedicated embedded MEMS IMUs placed at the toe and heel area. Different tasks and ground conditions were tested to validate and highlight the potentiality of the proposed knee exoskeleton system. The experimental results obtained and the feedback collected confirm the validity of the research conducted toward the design of more ergonomic and intuitive to use exoskeletons

Making Bipedal Robot Experiments Reproducible and Comparable: The Eurobench Software Approach

This study describes the software methodology designed for systematic benchmarking of bipedal systems through the computation of performance indicators from data collected during an experimentation stage. Under the umbrella of the European project Eurobench, we collected approximately 30 protocols with related testbeds and scoring algorithms, aiming at characterizing the performances of humanoids, exoskeletons, and/or prosthesis under different conditions. The main challenge addressed in this study concerns the standardization of the scoring process to permit a systematic benchmark of the experiments. The complexity of this process is mainly due to the lack of consistency in how to store and organize experimental data, how to define the input and output of benchmarking algorithms, and how to implement these algorithms. We propose a simple but efficient methodology for preparing scoring algorithms, to ensure reproducibility and replicability of results. This methodology mainly constrains the interface of the software and enables the engineer to develop his/her metric in his/her favorite language. Continuous integration and deployment tools are then used to verify the replicability of the software and to generate an executable instance independent of the language through dockerization. This article presents this methodology and points at all the metrics and documentation repositories designed with this policy in Eurobench. Applying this approach to other protocols and metrics would ease the reproduction, replication, and comparison of experiments.This study is supported by the European Union’s Horizon 2020 research and innovation program under Grant Agreement no 779963, project Eurobench

Making Bipedal Robot Experiments Reproducible and Comparable: The Eurobench Software Approach

This study describes the software methodology designed for systematic benchmarking of bipedal systems through the computation of performance indicators from data collected during an experimentation stage. Under the umbrella of the European project Eurobench, we collected approximately 30 protocols with related testbeds and scoring algorithms, aiming at characterizing the performances of humanoids, exoskeletons, and/or prosthesis under different conditions. The main challenge addressed in this study concerns the standardization of the scoring process to permit a systematic benchmark of the experiments. The complexity of this process is mainly due to the lack of consistency in how to store and organize experimental data, how to define the input and output of benchmarking algorithms, and how to implement these algorithms. We propose a simple but efficient methodology for preparing scoring algorithms, to ensure reproducibility and replicability of results. This methodology mainly constrains the interface of the software and enables the engineer to develop his/her metric in his/her favorite language. Continuous integration and deployment tools are then used to verify the replicability of the software and to generate an executable instance independent of the language through dockerization. This article presents this methodology and points at all the metrics and documentation repositories designed with this policy in Eurobench. Applying this approach to other protocols and metrics would ease the reproduction, replication, and comparison of experiments.This study is supported by the European Union’s Horizon 2020 research and innovation program under Grant Agreement no 779963, project Eurobench

Sensory Augmentation for Balance Rehabilitation Using Skin Stretch Feedback

This dissertation focuses on the development and evaluation of portable sensory augmentation systems that render skin-stretch feedback of posture for standing balance training and for postural control improvement. Falling is one of the main causes of fatal injuries among all members of the population. The high incidence of fall-related injuries also leads to high medical expenses, which cost approximately $34 billion annually in the United States. People with neurological diseases, e.g., stroke, multiple sclerosis, spinal cord injuries, and the elderly are more prone to falling when compared to healthy individuals. Falls among these populations can also lead to hip fracture, or even death. Thus, several balance and gait rehabilitation approaches have been developed to reduce the risk of falling. Traditionally, a balance-retraining program includes a series of exercises for trainees to strengthen their sensorimotor and musculoskeletal systems. Recent advances in technology have incorporated biofeedback such as visual, auditory, or haptic feedback to provide the users with extra cues about their postural sway. Studies have also demonstrated the positive effects of biofeedback on balance control. However, current applications of biofeedback for interventions in people with impaired balance are still lacking some important characteristics such as portability (in-home care), small-size, and long-term viability. Inspired by the concept of light touch, a light, small, and wearable sensory augmentation system that detects body sway and supplements skin stretch on one’s fingertip pad was first developed. The addition of a shear tactile display could significantly enhance the sensation to body movement. Preliminary results have shown that the application of passive skin stretch feedback at the fingertip enhanced standing balance of healthy young adults. Based on these findings, two research directions were initiated to investigate i) which dynamical information of postural sway could be more effectively conveyed by skin stretch feedback, and ii) how can such feedback device be easily used in the clinical setting or on a daily basis. The major sections of this research are focused on understanding how the skin stretch feedback affects the standing balance and on quantifying the ability of humans to interpret the cutaneous feedback as the cues of their physiological states. Experimental results from both static and dynamic balancing tasks revealed that healthy subjects were able to respond to the cues and subsequently correct their posture. However, it was observed that the postural sway did not generally improve in healthy subjects due to skin stretch feedback. A possible reason was that healthy subjects already had good enough quality sensory information such that the additional artificial biofeedback may have interfered with other sensory cues. Experiments incorporating simulated sensory deficits were further conducted and it was found that subjects with perturbed sensory systems (e.g., unstable surface) showed improved balance due to skin stretch feedback when compared to the neutral standing conditions. Positive impacts on balance performance have also been demonstrated among multiple sclerosis patients when they receive skin stretch feedback from a sensory augmentation walker. The findings in this research indicated that the skin stretch feedback rendered by the developed devices affected the human balance and can potentially compensate underlying neurological or musculoskeletal disorders, therefore enhancing quiet standing postural control

Rehabilitation Engineering

Population ageing has major consequences and implications in all areas of our daily life as well as other important aspects, such as economic growth, savings, investment and consumption, labour markets, pensions, property and care from one generation to another. Additionally, health and related care, family composition and life-style, housing and migration are also affected. Given the rapid increase in the aging of the population and the further increase that is expected in the coming years, an important problem that has to be faced is the corresponding increase in chronic illness, disabilities, and loss of functional independence endemic to the elderly (WHO 2008). For this reason, novel methods of rehabilitation and care management are urgently needed. This book covers many rehabilitation support systems and robots developed for upper limbs, lower limbs as well as visually impaired condition. Other than upper limbs, the lower limb research works are also discussed like motorized foot rest for electric powered wheelchair and standing assistance device

Sensory Augmentation for Balance Rehabilitation Using Skin Stretch Feedback

This dissertation focuses on the development and evaluation of portable sensory augmentation systems that render skin-stretch feedback of posture for standing balance training and for postural control improvement. Falling is one of the main causes of fatal injuries among all members of the population. The high incidence of fall-related injuries also leads to high medical expenses, which cost approximately $34 billion annually in the United States. People with neurological diseases, e.g., stroke, multiple sclerosis, spinal cord injuries, and the elderly are more prone to falling when compared to healthy individuals. Falls among these populations can also lead to hip fracture, or even death. Thus, several balance and gait rehabilitation approaches have been developed to reduce the risk of falling. Traditionally, a balance-retraining program includes a series of exercises for trainees to strengthen their sensorimotor and musculoskeletal systems. Recent advances in technology have incorporated biofeedback such as visual, auditory, or haptic feedback to provide the users with extra cues about their postural sway. Studies have also demonstrated the positive effects of biofeedback on balance control. However, current applications of biofeedback for interventions in people with impaired balance are still lacking some important characteristics such as portability (in-home care), small-size, and long-term viability. Inspired by the concept of light touch, a light, small, and wearable sensory augmentation system that detects body sway and supplements skin stretch on one’s fingertip pad was first developed. The addition of a shear tactile display could significantly enhance the sensation to body movement. Preliminary results have shown that the application of passive skin stretch feedback at the fingertip enhanced standing balance of healthy young adults. Based on these findings, two research directions were initiated to investigate i) which dynamical information of postural sway could be more effectively conveyed by skin stretch feedback, and ii) how can such feedback device be easily used in the clinical setting or on a daily basis. The major sections of this research are focused on understanding how the skin stretch feedback affects the standing balance and on quantifying the ability of humans to interpret the cutaneous feedback as the cues of their physiological states. Experimental results from both static and dynamic balancing tasks revealed that healthy subjects were able to respond to the cues and subsequently correct their posture. However, it was observed that the postural sway did not generally improve in healthy subjects due to skin stretch feedback. A possible reason was that healthy subjects already had good enough quality sensory information such that the additional artificial biofeedback may have interfered with other sensory cues. Experiments incorporating simulated sensory deficits were further conducted and it was found that subjects with perturbed sensory systems (e.g., unstable surface) showed improved balance due to skin stretch feedback when compared to the neutral standing conditions. Positive impacts on balance performance have also been demonstrated among multiple sclerosis patients when they receive skin stretch feedback from a sensory augmentation walker. The findings in this research indicated that the skin stretch feedback rendered by the developed devices affected the human balance and can potentially compensate underlying neurological or musculoskeletal disorders, therefore enhancing quiet standing postural control