Ekonomicky dostupný aktivní exoskeleton pro dolní končetiny pro paraplegiky

After a broad introduction to the medical and biomechanical background and detailed review of orthotic devices, two newly developed lower limbs exoskeletons for paraplegics are presented in this study. There was found out the main challenges of designing devices for paraplegic walking can be summarized into three groups, stability and comfort, high efficiency or low energy consumption, dimensions and weight. These all attributes have to be moreover considered and maintained during manufacturing of affordable device while setting a reasonable price of the final product. A new economical device for people with paraplegia which tackles all problems of the three groups is introduced in this work. The main idea of this device is based on HALO mechanism. HALO is a compact passive medial hip joint orthosis with contralateral hip and ankle linkage, which keeps the feet always parallel to the ground and assists swinging the leg. The medial hip joint is equipped with one actuator in the new design and the new active exoskeleton is called @halo. Due to this update, we can achieve more stable and smoother walking patterns with decreased energy consumption of the users, yet maintain its compact and lightweight features. It was proven by the results from preliminary experiments with able-bodied subjects during which the same device with and without actuator was evaluated. Waddling and excessive vertical elevation of the centre of gravity were decreased by 40% with significantly smaller standard deviations in case of the powered exoskeleton. There was 52% less energy spent by the user wearing @halo which was calculated from the vertical excursion difference. There was measured 38.5% bigger impulse in crutches while using passive orthosis, which produced bigger loads in upper extremities musculature. The inverse dynamics approach was chosen to calculate and investigate the loads applied to the upper extremities. The result of this calculation has proven that all main muscle groups are engaged more aggressively and indicate more energy consumption during passive walking. The new @halo device is the first powered exoskeleton for lower limbs with just one actuated degree of freedom for users with paraplegia.První část práce je věnována obsáhlému úvodu do zdravotnické a biomechanické terminologie a detailnímu souhrnnému představení ortopedických pomůcek. Následně jsou představeny dva nově vyvinuté exoskelety aplikovatelné na dolní končetiny paraplegiků. Bylo zjištěno, že hlavní úskalí konstrukčního návrhu asistenčních zařízení pro paraplegiky lze shrnout do tří hlavních skupin, jako první je stabilita a komfort, druhá je vysoká účinnost a nízká energetická náročnost uživatele a do třetí lze zahrnout rozměry a hmotnost zařízení. Toto všechno je navíc podmíněno přijatelnou výslednou cenou produktu. Nový ekonomicky dostupný exoskelet pro paraplegiky, který řeší problematiku všech tří zmíněných skupin je představen v této práci. Hlavní myšlenka tohoto zařízení je postavena na mechanismu HALO ortézy. HALO je kompaktní pasivní ortéza s mediálním kyčelním kloubem umístěným uprostřed mezi dolními končetinami. Speciální mediální kyčelní kloub je kontralaterálně propojen s kotníkem soustavou ocelových lanek což zajištuje paralelní polohu chodidla se zemí v každém okamžiku chůze a navíc asistuje zhoupnutí končetiny. Tento mediální kyčelní kloub je redesignován a v novém provedení je vybaven jedním aktuátorem, nové řešení aktivního exoskeletu dostalo název @halo. Díky tomuto vylepšení lze dosáhnout stabilnější a plynulejší chůze s výrazně redukovanou energetickou náročností uživatele přičemž dochází k zachování nízké hmotnosti a kompaktnosti zařízení. Toto bylo dokázáno během předběžných experimentů se zdravými subjekty, během kterých byla testována aktivní chůze se zařízením vybaveným odnímatelnou pohonnou jednotkou a pasivní chůze se stejným zařízením bez této aktivní jednotky. Nadměrné naklánění se během chůze ze strany na stranu a nadměrná výchylka pohybu těžiště těla ve vertikálním směru byly sníženy o necelých 40% s velmi významně menšími standardními odchylkami v případě chůze s pohonem. Z rozdílu výchylky pohybu těžiště těla ve vertikální poloze bylo vypočítáno snížení energetické náročnosti uživatele o 52% při chůzi s aktivní konfiguraci @halo. Při pohybu s pasivní ortézou byl naměřen o 38,5% větší reakční silový impuls v berlích, což znamená nárůst zátěže pro svalový aparát horních končetin. Pro podrobné vyšetření zátěže ramenních kloubů byl aplikován model inverzní dynamiky. Výsledek tohoto výpočtu jednoznačně indikuje agresivnější a hlubší zapojení všech svalových skupin ramenního kloubu a tím vyšší spotřebu energie uživatelem během pasivní chůze. Nové asistenční zařízení @halo je prvním exoskeletem svého druhu pro paraplegiky s jediným poháněným stupněm volnosti.354 - Katedra robotikyvyhově

Innovative gait robot for the repetitive practice of floor walking and stair climbing up and down in stroke patients

<p>Abstract</p> <p>Background</p> <p>Stair climbing up and down is an essential part of everyday's mobility. To enable wheelchair-dependent patients the repetitive practice of this task, a novel gait robot, G-EO-Systems (EO, Lat: I walk), based on the end-effector principle, has been designed. The trajectories of the foot plates are freely programmable enabling not only the practice of simulated floor walking but also stair climbing up and down. The article intended to compare lower limb muscle activation patterns of hemiparetic subjects during real floor walking and stairs climbing up, and during the corresponding simulated conditions on the machine, and secondly to demonstrate gait improvement on single case after training on the machine.</p> <p>Methods</p> <p>The muscle activation pattern of seven lower limb muscles of six hemiparetic patients during free and simulated walking on the floor and stair climbing was measured via dynamic electromyography. A non-ambulatory, sub-acute stroke patient additionally trained on the G-EO-Systems every workday for five weeks.</p> <p>Results</p> <p>The muscle activation patterns were comparable during the real and simulated conditions, both on the floor and during stair climbing up. Minor differences, concerning the real and simulated floor walking conditions, were a delayed (prolonged) onset (duration) of the thigh muscle activation on the machine across all subjects. Concerning stair climbing conditions, the shank muscle activation was more phasic and timely correct in selected patients on the device. The severely affected subject regained walking and stair climbing ability.</p> <p>Conclusions</p> <p>The G-EO-Systems is an interesting new option in gait rehabilitation after stroke. The lower limb muscle activation patterns were comparable, a training thus feasible, and the positive case report warrants further clinical studies.</p

On the non-disabled perceptions of four common mobility devices in Norway: A comparative study based on semantic differentials

acceptedVersio

Overcoming barriers and increasing independence: service robots for elderly and disabled people

This paper discusses the potential for service robots to overcome barriers and increase independence of elderly and disabled people. It includes a brief overview of the existing uses of service robots by disabled and elderly people and advances in technology which will make new uses possible and provides suggestions for some of these new applications. The paper also considers the design and other conditions to be met for user acceptance. It also discusses the complementarity of assistive service robots and personal assistance and considers the types of applications and users for which service robots are and are not suitable

介助者の自律駆動規範モデルを用いた介助用車いすの補助動力制御

関西大

Estratégias de controle de trajetórias para cadeira de rodas robotizadas

Orientador: Eleri CardozoDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Engenharia Elétrica e de ComputaçãoResumo: Desde os anos 80, diversos trabalhos foram publicados com o objetivo de propor soluções alternativas para usuários de cadeira de rodas motorizadas com severa deficiência motora e que não possuam capacidade de operar um joystick mecânico. Dentre essas soluções estão interfaces assistivas que auxiliam no comando da cadeira de rodas através de diversos mecanismos como expressões faciais, interfaces cérebro-computador, e rastreamento de olho. Além disso, as cadeiras de rodas ganharam certa autonomia para realizar determinadas tarefas que vão de desviar de obstáculos, abrir portas e até planejar e executar rotas. Para que estas tarefas possam ser executadas, é necessário que as cadeiras de rodas tenham estruturas não convencionais, habilidade de sensoriamento do ambiente e estratégias de controle de locomoção. O objetivo principal é disponibilizar uma cadeira de rodas que ofereça conforto ao usuário e que possua um condução segura não importando o tipo de deficiência do usuário. Entretanto, durante a condução da cadeira de rodas, o desalinhamento das rodas castores podem oferecer certo perigo ao usuário, uma vez que, dependendo da maneira em que elas estejam orientadas, instabilidades podem ocorrer, culminando em acidentes. Da mesma forma, o desalinhamento das rodas castores é considerado um dos principais causadores de desvios de trajetória que ocorrem durante a movimentação da cadeira de rodas, juntamente com diferentes distribuições de pesos ou diferentes atritos entre as rodas e o chão. Nesta dissertação, é considerado apenas o desalinhamento das rodas castores como único causador de desvio de trajetória da cadeira de rodas e, dessa forma, são propostas soluções que possam reduzir ou até mesmo eliminar o efeito deste desalinhamento. Com a implementação das melhores soluções desenvolvidas neste trabalho, é possível fazer com que diversas interfaces assistivas que têm baixa taxa de comandos possam ser utilizadas, uma vez que o usuário não precisa, constantemente, corrigir o desvio da trajetória desejada. Ademais, é elaborado um novo projeto de cadeira de rodas "inteligente" para a implementação das técnicas desenvolvidas neste trabalhoAbstract: Since the 1980s several works were published proposing alternative solutions for users of powered wheelchairs with severe mobility impairments and that are not able to operate a mechanical joystick. Such solutions commonly focus on assistive interfaces that help commanding the wheelchair through distinct mechanisms such as facial expressions, brain-computer interfaces, and eye tracking. Besides that, the wheelchairs have achieved a certain level of autonomy to accomplish determined tasks such as obstacle avoidance, doors opening and even path planning and execution. For these tasks to be performed, it is necessary the wheelchairs to have a non conventional designs, ability to sense the environment and locomotion control strategies. The ultimate objective is to offer a comfortable and safe conduction no matter the user's mobility impairments. However, while driving the wheelchair, the caster wheels' misalignment might offer risks to the user, because, depending on the way they are initially oriented, instabilities may occur causing accidents. Similarly, the caster wheels' misalignment can be considered, among others like different weight distribution or different friction between wheel and floor, one of the main causes of path deviation from the intended trajectory while the wheelchair is moving. In this dissertation, it is considered the caster wheels' misalignment as the unique generator of wheelchair path deviation and, therefore, it is proposed different solutions in order to reduce or even eliminate the effects of the misalignment. The implementation of the best solutions developed in this work allows assistive interfaces with low rate of commands to be widespread, once the user does not need to, constantly, correct path deviation. Additionally, a new smart wheelchair project is elaborated for the implementation of the techniques developed in this workMestradoEngenharia de ComputaçãoMestre em Engenharia Elétrica88882.329382/2019-01CAPE

Wheelchair Training Program for New Manual Wheelchair Users

Manual wheelchairs are commonly used for everyday mobility among people with lower limb impairments, including persons with spinal cord injury (SCI). Manual wheelchair users often experience pain and chronic overuse injuries in their upper extremities, limiting their mobility and their ability to complete daily activities. The repetitive trauma of propelling a wheelchair may be a contributing factor to upper extremity pain and injury. The anatomy of the upper extremities is not designed for the number of repetitions and the amount of force involved in everyday wheelchair propulsion. Research has been conducted to identify recommendations for decreasing the number of repetitions and the amount of force involved with manual wheelchair propulsion; however, training on how to use a wheelchair, specifically propulsion training, is often not implemented during rehabilitation. Important steps in identifying strategies for teaching wheelchair propulsion and skills include exploring devices for training, understanding health care professional and wheelchair user perspectives of wheelchair training, and training based on motor learning approaches. Therefore, the overall goal of this project was to further explore methodology for training of new manual wheelchair users. To this end, we conducted three studies (Chapters 2-4). In study 1 (Chapter 2), we tested a wheelchair dynamometer roller system, the WheelMill System (WMS), on its use in simulating different surfaces (i.e., overground and ramps) and assessing propulsion variables that can be used for training new wheelchair users. We identified that the WMS has the ability to accurately simulate flat overground movement; however, the accuracy of the WMS was poor in simulation of ramps. Modifications to the software model and the addition of visual feedback may improve the accuracy of the simulation of ramps. The WMS was accurate in the quantification of biomechanical propulsion variables. In study 2 (Chapter 3), we identified perspectives of health care professionals and manual wheelchair users to assist in prioritizing the focus of wheelchair skills training of new manual wheelchair users. During focus groups, health care professionals and manual wheelchair users discussed if and how wheelchair propulsion biomechanics were taught and important skills that should be included in training. Results indicate that propulsion biomechanics were introduced but not addressed in detail. Important training components discussed include propulsion techniques, transfers in an out of the wheelchair, providing maintenance to the wheelchair, and navigating barriers such as curbs, ramps, and rough terrain. Health care professionals and manual wheelchair users identified many of the same skills as important but ranked them in a different order. In study 3 (Chapter 4), we piloted a wheelchair training program implementing aspects of motor learning for new manual wheelchair users and measured the impact of this program on wheelchair propulsion biomechanics and overall wheelchair skills. Post-training wheelchair biomechanics changed, as well as propulsion performance overground. Wheelchair skills did not change significantly post-training. Wheelchair training has the potential for change; however, there are many challenges associated with implementing training programs for new manual wheelchair users. Together, these results contribute knowledge to evidence-based approaches to teaching new manual wheelchair users with SCI how to efficiently and effectively use their wheelchairs. Specifically, we obtained information about technology for simulating and assessing manual wheelchair propulsion, perspectives of stakeholders with regard to the manual wheelchair training process, and methodology for training new manual wheelchair users