Joint Trajectory Generation and High-level Control for Patient-tailored Robotic Gait Rehabilitation

This dissertation presents a group of novel methods for robot-based gait rehabilitation which were developed aiming to offer more individualized therapies based on the specific condition of each patient, as well as to improve the overall rehabilitation experience for both patient and therapist. A novel methodology for gait pattern generation is proposed, which offers estimated hip and knee joint trajectories corresponding to healthy walking, and allows the therapist to graphically adapt the reference trajectories in order to fit better the patient's needs and disabilities. Additionally, the motion controllers for the hip and knee joints, mobile platform, and pelvic mechanism of an over-ground gait rehabilitation robotic system are also presented, as well as some proposed methods for assist as needed therapy. Two robot-patient synchronization approaches are also included in this work, together with a novel algorithm for online hip trajectory adaptation developed to reduce obstructive forces applied to the patient during therapy with compliant robotic systems. Finally, a prototype graphical user interface for the therapist is also presented

Patient Movement Monitoring Based on IMU and Deep Learning

Osteoarthritis (OA) is the leading cause of disability among the aging population in the United States and is frequently treated by replacing deteriorated joints with metal and plastic components. Developing better quantitative measures of movement quality to track patients longitudinally in their own homes would enable personalized treatment plans and hasten the advancement of promising new interventions. Wearable sensors and machine learning used to quantify patient movement could revolutionize the diagnosis and treatment of movement disorders. The purpose of this dissertation was to overcome technical challenges associated with the use of wearable sensors, specifically Inertial Measurement Units (IMUs), as a diagnostic tool for osteoarthritic (OA) and total knee replacement patients (TKR) through a detailed biomechanical assessment and development of machine learning algorithms. Specifically, the first study developed a relevant dataset consisting of IMU and associated biomechanical parameters of OA and TKR patients performing various activities, created a machine learning-based framework to accurately estimate spatiotemporal movement characteristics from IMU during level ground walking, and defined optimum sensor configuration associated with the patient population and activity. The second study designed a framework to generate synthetic kinematic and associated IMU data as well as investigated the influence of adding synthetic data into training-measured data on deep learning model performance. The third study investigated the kinematic variation between two patient’s population across various activities: stair ascent, stair descent, and gait using principle component analysis PCA. Additionally, PCA-based autoencoders were developed to generate synthetic kinematics data for each patient population and activity. The fourth study investigated the potential use of a universal deep learning model for the estimation of lower extremities’ kinematics across various activities. Therefore, this model can be used as a global model for transfer learning methods in future research. This line of study resulted in a machine-learning framework that can be used to estimate biomechanical movements based on a stream of signals emitted from low-cost and portable IMUs. Eventually, this could lead to a simple clinical tool for tracking patients\u27 movements in their own homes and translating those movements into diagnostic metrics that clinicians will be able to use to tailor treatment to each patient\u27s needs in the future

Human Activity Recognition and Control of Wearable Robots

abstract: Wearable robotics has gained huge popularity in recent years due to its wide applications in rehabilitation, military, and industrial fields. The weakness of the skeletal muscles in the aging population and neurological injuries such as stroke and spinal cord injuries seriously limit the abilities of these individuals to perform daily activities. Therefore, there is an increasing attention in the development of wearable robots to assist the elderly and patients with disabilities for motion assistance and rehabilitation. In military and industrial sectors, wearable robots can increase the productivity of workers and soldiers. It is important for the wearable robots to maintain smooth interaction with the user while evolving in complex environments with minimum effort from the user. Therefore, the recognition of the user's activities such as walking or jogging in real time becomes essential to provide appropriate assistance based on the activity. This dissertation proposes two real-time human activity recognition algorithms intelligent fuzzy inference (IFI) algorithm and Amplitude omega ($A \omega$) algorithm to identify the human activities, i.e., stationary and locomotion activities. The IFI algorithm uses knee angle and ground contact forces (GCFs) measurements from four inertial measurement units (IMUs) and a pair of smart shoes. Whereas, the $A \omega$ algorithm is based on thigh angle measurements from a single IMU. This dissertation also attempts to address the problem of online tuning of virtual impedance for an assistive robot based on real-time gait and activity measurement data to personalize the assistance for different users. An automatic impedance tuning (AIT) approach is presented for a knee assistive device (KAD) in which the IFI algorithm is used for real-time activity measurements. This dissertation also proposes an adaptive oscillator method known as amplitude omega adaptive oscillator ($A\omega AO$) method for HeSA (hip exoskeleton for superior augmentation) to provide bilateral hip assistance during human locomotion activities. The $A \omega$ algorithm is integrated into the adaptive oscillator method to make the approach robust for different locomotion activities. Experiments are performed on healthy subjects to validate the efficacy of the human activities recognition algorithms and control strategies proposed in this dissertation. Both the activity recognition algorithms exhibited higher classification accuracy with less update time. The results of AIT demonstrated that the KAD assistive torque was smoother and EMG signal of Vastus Medialis is reduced, compared to constant impedance and finite state machine approaches. The $A\omega AO$ method showed real-time learning of the locomotion activities signals for three healthy subjects while wearing HeSA. To understand the influence of the assistive devices on the inherent dynamic gait stability of the human, stability analysis is performed. For this, the stability metrics derived from dynamical systems theory are used to evaluate unilateral knee assistance applied to the healthy participants.Dissertation/ThesisDoctoral Dissertation Aerospace Engineering 201

Fall prevention strategy for an active orthotic system

Dissertação de mestrado integrado em Engenharia Biomédica (especialização em Eletrónica Médica)Todos os anos, são reportadas cerca de 684,000 quedas fatais e 37.3 milhões de quedas não fatais que requerem atenção médica, afetando principalmente a população idosa. Assim, é necessário identificar eficientemente indivíduos com alto risco de queda, a partir da população alvo idosa, e prepará los para superar perturbações da marcha inesperadas. Uma estratégia de prevenção de queda capaz de eficientemente e atempadamente detetar e contrariar os eventos de perdas de equilíbrio (PDE) mais frequentes pode reduzir o risco de queda. Como slips foram identificados como a causa mais prevalente de quedas, estes eventos devem ser abordados como foco principal da estratégia. No entanto, há falta de estratégias de prevenção de quedas por slip. Esta dissertação tem como objetivo o design de uma estratégia de prevenção de quedas de slips baseada na conceção das etapas de atuação e deteção. A estratégia de atuação foi delineada com base na resposta biomecânica humana a slips, onde o joelho da perna perturbada (leading) apresenta um papel proeminente para contrariar LOBs induzidas por slips. Quando uma slip é detetada, a estratégia destaca uma ortótese de joelho que providencia um torque assisstivo para prevenir a queda. A estratégia de deteção considerou as propriedades atrativas dos controladores Central Pattern Generator (CPG) para prever parâmetros da marcha. Algoritmos baseados em threshold monitorizam o erro de previsão do CPG, que aumenta após uma perturbação inesperada na marcha, para a deteção de slips. O ângulo do joelho e a velocidade angular da canela foram selecionados como os parâmetros de monitorização da marcha. Um protocolo experimental concebido para provocar perturbações de slip a sujeitos humanos permitiu a recolha de dados destas variáveis para posteriormente validar o algoritmo de deteção de perturbações. Algoritmos CPG foram capazes de produzir aproximações aceitáveis dos sinais de marcha em estado estacionário do ângulo do joelho e da velocidade angular da canela com sucesso. Além disso, o algoritmo de threshold adaptativo detetou LOBs induzidas por slips eficientemente. A melhor performance global foi obtida usando este algoritmo para monitorizar o ângulo do joelho, que detetou quase 80% (78.261%) do total de perturbações com um tempo médio de deteção (TMD) de 250 ms. Além disso, uma média de 0.652 falsas perturbações foram detetadas por cada perturbação corretamente identificada. Estes resultados sugerem uma performance aceitável de deteção de perturbações do algoritmo, de acordo com os requisitos especificados para a deteção.Every year, an estimated 684,000 fatal falls and 37.3 million non-fatal falls requiring medical attention are reported, mostly affecting the older population. Thus, it is necessary to effectively screen high fall risk individuals from targeted elderly populations and prepare them to successfully overcome unexpected gait perturbations. A fall prevention strategy capable of effectively and timely detect and counteract the most frequent loss of balance (LOB) events may reduce the fall risk. Since slips were identified as the main contributors to falls, these events should be addressed as a main focus of the strategy. Nonetheless, there is a lack of slip-induced fall prevention strategies. This dissertation aims the design of a slip-related fall prevention strategy based on the conception of an actuation and a detection stage. The actuation strategy was delineated based on the human biomechanical reactions to slips, where the perturbed (leading) leg’s knee joint presents a prominent role to counteract slip-induced LOBs. Thereby, upon the detection of a slip, this strategy highlighted a knee orthotic device that provides an assistive torque to prevent the falls. The detection strategy considered the attractive properties of biological-inspired Central Pattern Generator (CPG) controllers to predict gait parameters. Threshold-based algorithms monitored the CPG’s prediction error produced, which increases upon an unexpected gait perturbation, to perform slip detection. The knee angle and shank angular velocity were selected as the monitoring gait parameters. An experimental protocol designed to provoke slip perturbations to human subjects allowed to collect data from these variables to further validate the perturbation detection algorithm. CPG algorithms were able to successfully produce acceptable estimations of the knee angle and shank angular velocity signals during steady-state walking. Furthermore, an adaptive threshold algorithm effectively detected slip-induced LOBs. The best overall performance was obtained using this algorithm to monitor the knee angle from the perturbed leg, which detected almost 80% (78.261%) of the total perturbations with a mean detection time (MDT) of 250 ms. In addition, a mean of 0.652 false perturbations were detected for each correct perturbation identified. These results suggest an acceptable perturbation detection performance of the algorithm implemented in light of the detection requirements specified

Comparison of knee loading during walking via musculoskeletal modelling using marker-based and IMU-based approaches

openThe current thesis is the result of the candidate's work over a six-month period with the assistance of the supervisor and co-supervisors, thanks to the collaboration between the Human Movement Bioengineering Laboratory Research group at the University of Padova (Italy) and the Human Movement Biomechanics Research group at KU Leuven (Belgium). Gait analysis, at a clinical level, is a diagnostic test with multiple potentials, in particular in identifying functional limitations related to a pathological path. Three-dimensional motion capture is now consolidated as an approach for human movement research studies and consists of a set of very precise measurements, the latter are processed by biomechanical models, and curves relating to the kinematics and indirect dynamics, i.e., the joint angles and the relative forces and moments, can be obtained. These results are considered fully reliable and based on these curves it is decided how to intervene on the specific subject to make the path as less pathological as possible. However, the use of wearable sensors (IMUs) consisting of accelerometers, gyroscopes, and magnetic sensors for gait analysis, has increased in the last decade due to the low production costs, portability, and small size that have allowed for studies in everyday life conditions. Inertial capture (InCap) systems have become an appealing alternative to 3D Motion Capture (MoCap) systems due to the ability of inertial measurement units (IMUs) to estimate the orientation of 3D sensors and segments. Musculoskeletal modelling and simulation provide the ideal framework to examine quantities in silico that cannot be measured in vivo, such as musculoskeletal loading, muscle forces and joint contact forces. The specific software used in this study is Opensim: an open-source software that allows modelling, analysis, and simulation of the musculoskeletal system. The aim of this thesis is to compare a marker-based musculoskeletal modelling approach with an IMUs-based one, in terms of kinematics, dynamics, and muscle activations. In particular, the project will focus on knee loading, using an existing musculoskeletal model of the lower limb. The current project was organized as follows: first, the results for the MoCap approach were obtained, following a specific workflow that used the COMAK IK tool and the COMAK algorithm to get the secondary knee kinematics, muscle activations, and knee contact forces. Where COMAK is a modified static optimization algorithm that solves for muscle activations and secondary kinematics to obtain measured primary DOF accelerations while minimizing muscle activation. Then these results were used to make a comparison with those obtained by the inertial-based approach, with the attempt to use as little information as possible from markers while estimating kinematics from IMU data using an OpenSim toolbox called OpenSense. Afterward, in order to promote an approach more independent from the constraints of a laboratory, the Zero Moment Point (ZMP) method was used to estimate the center of pressure position of the measured ground reaction forces (GRFs), and a specific Matlab code was implemented to improve this estimation. Using the measured GRFs with the new CoPs, the results of Inverse Dynamics, muscle activations, and finally knee loading were calculated and compared to the MoCap results. The final step was to conduct a statistical analysis to compare the two approaches and emphasize the importance of using IMUs for gait analysis, particularly to study knee mechanics

Proceedings XXIII Congresso SIAMOC 2023

Il congresso annuale della Società Italiana di Analisi del Movimento in Clinica (SIAMOC), giunto quest’anno alla sua ventitreesima edizione, approda nuovamente a Roma. Il congresso SIAMOC, come ogni anno, è l’occasione per tutti i professionisti che operano nell’ambito dell’analisi del movimento di incontrarsi, presentare i risultati delle proprie ricerche e rimanere aggiornati sulle più recenti innovazioni riguardanti le procedure e le tecnologie per l’analisi del movimento nella pratica clinica. Il congresso SIAMOC 2023 di Roma si propone l’obiettivo di fornire ulteriore impulso ad una già eccellente attività di ricerca italiana nel settore dell’analisi del movimento e di conferirle ulteriore respiro ed impatto internazionale. Oltre ai qualificanti temi tradizionali che riguardano la ricerca di base e applicata in ambito clinico e sportivo, il congresso SIAMOC 2023 intende approfondire ulteriori tematiche di particolare interesse scientifico e di impatto sulla società. Tra questi temi anche quello dell’inserimento lavorativo di persone affette da disabilità anche grazie alla diffusione esponenziale in ambito clinico-occupazionale delle tecnologie robotiche collaborative e quello della protesica innovativa a supporto delle persone con amputazione. Verrà infine affrontato il tema dei nuovi algoritmi di intelligenza artificiale per l’ottimizzazione della classificazione in tempo reale dei pattern motori nei vari campi di applicazione

Machine Learning for Gait Classification

Machine learning is a powerful tool for making predictions and has been widely used for solving various classification problems in last decades. As one of important applications of machine learning, gait classification focuses on distinguishing different gait patterns by investigating the quality of gait of individuals and categorizing them as belonging to particular classes. The most studied gait pattern classes are the normal gait patterns of healthy people, i.e., gait of people who do not have any gait disability caused by an illness or an injury, and the pathological gait of patients suffering from illnesses which cause gait disorders such as neurodegenerative diseases (NDDs). There has been significant research work trying to solve the gait classification problems using advanced machine learning techniques, as the results may be beneficial for the early detection of underlined NDDs and for the monitoring of the gait rehabilitation progress. Despite the huge development in the field of gait analysis and classification, there are still a number of challenges open to further research. One challenge is the optimization of applied machine learning strategies to achieve better classification results. Another challenge is to solve gait classification problems even in the case when only limited amount of data are available. Further, a challenge is the development of machine learning-based methods that could provide more precise results to evaluate the level of gait quality or gait disorder, in contrast of just classifying gait pattern as belonging to healthy or pathological gait. The focus of this thesis is on the development, implementation and evaluation of a novel and reliable solution for the complex gait classification problems by addressing the current challenges. This solution is presented as a classification framework that can be applied to different types of gait signals, such as lower-limbs joint angle signals, trunk acceleration signals, and stride interval signals. Developed framework incorporates a hybrid solution which combines two models to enhance the classification performance. In order to provide a large number of samples for training the models, a sample generation method is developed which could segments the gait signals into smaller fragments. Classification is firstly performed on the data sample level, and then the results are utilized to generate the subject-level results using a majority voting scheme. Besides the class labels, a confidence score is computed to interpret the level of gait quality. In order to significantly improve the gait classification performances, in this thesis a novel feature extraction methods are also proposed using statistical methods, as well as machine learning approaches. Gaussian mixture model (GMM), least square regression, and k-nearest neighbors (kNN) are employed to provide additional significant features. Promising classification results are achieved using the proposed framework and the extracted features. The framework is ultimately applied to the management of patients and their rehabilitation, and is proved to be feasible in many clinical scenarios, such as the evaluation of medication effect on Parkinsona s disease (PD) patientsa gait, the long-term gait monitoring of the hereditary spastic paraplegia (HSP) patient under physical therapy

Proceedings XXI Congresso SIAMOC 2021

XXI Congresso Annuale della SIAMOC, modalità telematica il 30 settembre e il 1° ottobre 2021. Come da tradizione, il congresso vuole essere un’occasione di arricchimento e mutuo scambio, dal punto di vista scientifico e umano. Verranno toccati i temi classici dell’analisi del movimento, come lo sviluppo e l’applicazione di metodi per lo studio del movimento nel contesto clinico, e temi invece estremamente attuali, come la teleriabilitazione e il telemonitoraggio

Exploring the Application of Wearable Movement Sensors in People with Knee Osteoarthritis

People with knee osteoarthritis have difficulty with functional activities, such as walking or get into/out of a chair. This thesis explored the clinical relevance of biomechanics and how wearable sensor technology may be used to assess how people move when their clinician is unable to directly observe them, such as at home or work. The findings of this thesis suggest that artificial intelligence can be used to process data from sensors to provide clinically important information about how people perform troublesome activities

Estimation of lower extremity joint moments in Clinical Gait Analysis by using Artificial Neural Networks

Gait analysis is typically conducted using an optoelectronic system which is known as the standard method for motion analysis. Despite advance development of instruments related to the optoelectronic approach, there are still a few limitations of the traditional gait analysis which limit the accessibility for individuals who would benefit from the investigation. A newly developed three-dimension motion capture system, known as Inertial Measurement Units (IMU) was introduced as an option for gait analysis. The IMU system is a transportable camera-free motion capture system. This also motivated the principle of out-of-the lab gait analysis. To broaden the use of the new system, this PhD project was conducted to examine whether the system should be used confidently for clinical gait analysis. The main purpose of this PhD project was to examine the feasibility of incorporating a machine learning method to estimate the kinetics of gait using the kinematics data obtained from an IMU system. Firstly, as pilot studies, an artificial neural network (ANN) was trained using gait data derived from the potential input signals which were signals of marker coordinates and joint angles obtained from an IMU system (Xsens) to predict joint moments of lower extremities. Promising findings were found as the ANN could reasonably predict the target joint moments. The results also showed the generalisation ability of the ANN to estimate the joint moment that it has not seen before, for instance, the ANN could fairly predict joint moments of the contralateral limb. The Xsens system was validated against the standard motion capture system before the main estimation study of the joint moment in gait began. The results revealed that joint angles obtained from the Xsens were comparable with the optoelectronic system in the sagittal plane and less comparable in the frontal plane according to the coefficient of multiple correlation and the linear fit methods. The results from the transverse plane were non-real numbers. The ANN was then trained using the joint angles derived from the Xsens system of three different walking speeds to predict the knee abduction moment (KAM). Gait data of 15 healthy volunteers were used to train the network. The ANN performed well, shown by small values of average normalised root mean square errors. Several methods were used to enhance the ANN performance. Due to the limited number of gait data used to train the network the randomisation of the input-target output data was performed. The results showed a remarkable improvement of the ANN performance. The best KAM estimation was found when the data of marker coordinates were used to train the ANN instead of joint angles. As few as three marker coordinates could provide sufficient information for the ANN to be trained and predict the KAM accurately. Principal component analysis was also used as input data manipulation and provided a reasonable KAM prediction. Overall, the kinematic gait data obtained from the Xsens could be used to train the ANN to predict the KAM in healthy gait. There is a possibility to combine machine learning methods with IMU data to produce a clinical gait analysis without the restriction of the traditional motion laboratory