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Antonellis P, Mohammadzadeh Gonabadi A, Myers SA, Pipinos II, Malcolm P. Metabolically efficient walking assistance using optimized timed forces at the waist. Sci Robot 2022; 7:eabh1925. [PMID: 35294219 DOI: 10.1126/scirobotics.abh1925] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The metabolic rate of walking can be reduced by applying a constant forward force at the center of mass. It has been shown that the metabolically optimal constant force magnitude minimizes propulsion ground reaction force at the expense of increased braking. This led to the hypothesis that selectively assisting propulsion could lead to greater benefits. We used a robotic waist tether to evaluate the effects of forward forces with different timings and magnitudes. Here, we show that it is possible to reduce the metabolic rate of healthy participants by 48% with a greater efficiency ratio of metabolic cost reduction per unit of net aiding work compared with other assistive robots. This result was obtained using a sinusoidal force profile with peak timing during the middle of the double support. The same timing could also reduce the metabolic rate in patients with peripheral artery disease. A model explains that the optimal force profile accelerates the center of mass into the inverted pendulum movement during single support. Contrary to the hypothesis, the optimal force timing did not entirely coincide with propulsion. Within the field of wearable robotics, there is a trend to use devices to mimic biological torque or force profiles. Such bioinspired actuation can have relevant benefits; however, our results demonstrate that this is not necessarily optimal for reducing metabolic rate.
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Affiliation(s)
- Prokopios Antonellis
- Department of Biomechanics and Center for Research in Human Movement Variability, University of Nebraska at Omaha, 6160 University Drive South, Omaha, NE 68182, USA.,Department of Neurology, School of Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, OP-32, Portland, OR 97239, USA
| | - Arash Mohammadzadeh Gonabadi
- Department of Biomechanics and Center for Research in Human Movement Variability, University of Nebraska at Omaha, 6160 University Drive South, Omaha, NE 68182, USA.,Rehabilitation Engineering Center, Institute for Rehabilitation Science and Engineering, Madonna Rehabilitation Hospital, 5401 South Street, Lincoln, NE 68506, USA
| | - Sara A Myers
- Department of Biomechanics and Center for Research in Human Movement Variability, University of Nebraska at Omaha, 6160 University Drive South, Omaha, NE 68182, USA.,Department of Surgery and Research Service, Veterans Affairs Nebraska-Western Iowa Medical Center, Omaha, NE 68105, USA
| | - Iraklis I Pipinos
- Department of Surgery and Research Service, Veterans Affairs Nebraska-Western Iowa Medical Center, Omaha, NE 68105, USA.,Department of Surgery, University of Nebraska Medical Center, 982500 Nebraska Medical Center, Omaha, NE 68198, USA
| | - Philippe Malcolm
- Department of Biomechanics and Center for Research in Human Movement Variability, University of Nebraska at Omaha, 6160 University Drive South, Omaha, NE 68182, USA
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Shepherd MK, Simon AM, Zisk J, Hargrove LJ. Patient-Preferred Prosthetic Ankle-Foot Alignment for Ramps and Level-Ground Walking. IEEE Trans Neural Syst Rehabil Eng 2021; 29:52-59. [PMID: 33104504 PMCID: PMC8060022 DOI: 10.1109/tnsre.2020.3033711] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Patient preference of lower limb prosthesis behavior informally guides clinical decision making, and may become increasingly important for tuning new robotic prostheses. However, the processes for quantifying preference are still being developed, and the strengths and weaknesses of preference are not adequately understood. The present study sought to characterize the reliability (consistency) of patient preference of alignment during level-ground walking, and determine the patient-preferred ankle angle for ascent and descent of a 10° ramp, with implications for the design and control of robotic prostheses. Seven subjects with transtibial amputation walked over level ground, and ascended and descended a 10° ramp on a semi-active prosthetic ankle capable of unweighted repositioning in dorsiflexion and plantarflexion. Preferred ankle angle was measured with an adaptive forced-choice psychophysics paradigm, in which subjects walked on a randomized static ankle angle and reported whether they would prefer the ankle to be dorsiflexed or plantarflexed. Subjects had reliable preferences for alignment during level-ground walking, with deviations of 1.5° from preference resulting in an 84% response rate preferring changes toward the preference. Relative to level walking, subjects preferred 7.8° (SD: 4.8°) of dorsiflexion during ramp ascent, and 5.3° (SD: 3.8°) plantarflexion during ramp descent. As the ankle angle better matched the ramp angle, socket pressures and tibial progression (shank pitch) both more closely mirrored those during level walking. These findings provide baseline behaviors for prosthetic ankles capable of adapting to slopes based on patient preference, and provide strong evidence that people with transtibial amputation can finely perceive ankle alignment.
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Mohammadzadeh Gonabadi A, Antonellis P, Malcolm P. Differences between joint-space and musculoskeletal estimations of metabolic rate time profiles. PLoS Comput Biol 2020; 16:e1008280. [PMID: 33112850 PMCID: PMC7592801 DOI: 10.1371/journal.pcbi.1008280] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 08/21/2020] [Indexed: 11/18/2022] Open
Abstract
Motion capture laboratories can measure multiple variables at high frame rates, but we can only measure the average metabolic rate of a stride using respiratory measurements. Biomechanical simulations with equations for calculating metabolic rate can estimate the time profile of metabolic rate within the stride cycle. A variety of methods and metabolic equations have been proposed, including metabolic time profile estimations based on joint parameters. It is unclear whether differences in estimations are due to differences in experimental data or due to methodological differences. This study aimed to compare two methods for estimating the time profile of metabolic rate, within a single dataset. Knowledge about the consistency of different methods could be useful for applications such as detecting which part of the gait cycle causes increased metabolic cost in patients. Here we compare estimations of metabolic rate time profiles using a musculoskeletal and a joint-space method. The musculoskeletal method was driven by kinematics and electromyography data and used muscle metabolic rate equations, whereas the joint-space method used metabolic rate equations based on joint parameters. Both estimations of changes in stride average metabolic rate correlated significantly with large changes in indirect calorimetry from walking on different grades showing that both methods accurately track changes. However, estimations of changes in stride average metabolic rate did not correlate significantly with more subtle changes in indirect calorimetry due to walking with different shoe inclinations, and both the musculoskeletal and joint-space time profile estimations did not correlate significantly with each other except in the most downward shoe inclination. Estimations of the relative cost of stance and swing matched well with previous simulations with similar methods and estimations from experimental perturbations. Rich experimental datasets could further advance time profile estimations. This knowledge could be useful to develop therapies and assistive devices that target the least metabolically economic part of the gait cycle.
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Affiliation(s)
- Arash Mohammadzadeh Gonabadi
- Department of Biomechanics and Center for Research in Human Movement Variability, University of Nebraska at Omaha, Omaha, Nebraska, United States of America
- Rehabilitation Engineering Center, Institute for Rehabilitation Science and Engineering, Madonna Rehabilitation Hospitals, Lincoln, Nebraska, United States of America
- * E-mail: (AMG); (PM)
| | - Prokopios Antonellis
- Department of Biomechanics and Center for Research in Human Movement Variability, University of Nebraska at Omaha, Omaha, Nebraska, United States of America
| | - Philippe Malcolm
- Department of Biomechanics and Center for Research in Human Movement Variability, University of Nebraska at Omaha, Omaha, Nebraska, United States of America
- * E-mail: (AMG); (PM)
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Gonabadi AM, Antonellis P, Malcolm P. A System for Simple Robotic Walking Assistance With Linear Impulses at the Center of Mass. IEEE Trans Neural Syst Rehabil Eng 2020; 28:1353-1362. [PMID: 32340953 PMCID: PMC7404782 DOI: 10.1109/tnsre.2020.2988619] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Walking can be simplified as an inverted pendulum motion where both legs generate linear impulses to redirect the center of mass (COM) into every step. In this work, we describe a system to assist walking in a simpler way than exoskeletons by providing linear impulses directly at the COM instead of providing torques at the joints. We developed a novel waist end-effector and high-level controller for an existing cable-robot. The controller allows for the application of cyclic horizontal force profiles with desired magnitudes, timings, and durations based on detection of the step timing. By selecting a lightweight rubber series elastic element with optimal stiffness and carefully tuning the gains of the closed-loop proportional-integral-derivative (PID) controller in a number of single-subject experiments, we were able to reduce the within-step root mean square error between desired and actual forces up to 1.21% of body weight. This level of error is similar or lower compared to the performance of other robotic tethers designed to provide variable or constant forces at the COM. The system can produce force profiles with peaks of up to 15 ± 2% of body weight within a root mean square error (RMSE) of 2.5% body weight. This system could be used to assist patient populations that require levels of assistance that are greater than current exoskeletons and in a way that does not make the user rely on vertical support.
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