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Mohammadzadeh Gonabadi A, Antonellis P, Dzewaltowski AC, Myers SA, Pipinos II, Malcolm P. Design and Evaluation of a Bilateral Semi-Rigid Exoskeleton to Assist Hip Motion. Biomimetics (Basel) 2024; 9:211. [PMID: 38667222 PMCID: PMC11048386 DOI: 10.3390/biomimetics9040211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 03/18/2024] [Accepted: 03/25/2024] [Indexed: 04/28/2024] Open
Abstract
This study focused on designing and evaluating a bilateral semi-rigid hip exoskeleton. The exoskeleton assisted the hip joint, capitalizing on its proximity to the body's center of mass. Unlike its rigid counterparts, the semi-rigid design permitted greater freedom of movement. A temporal force-tracking controller allowed us to prescribe torque profiles during walking. We ensured high accuracy by tuning control parameters and series elasticity. The evaluation involved experiments with ten participants across ten force profile conditions with different end-timings and peak magnitudes. Our findings revealed a trend of greater reductions in metabolic cost with assistance provided at later timings in stride and at greater magnitudes. Compared to walking with the exoskeleton powered off, the largest reduction in metabolic cost was 9.1%. This was achieved when providing assistance using an end-timing at 44.6% of the stride cycle and a peak magnitude of 0.11 Nm kg-1. None of the tested conditions reduced the metabolic cost compared to walking without the exoskeleton, highlighting the necessity for further enhancements, such as a lighter and more form-fitting design. The optimal end-timing aligns with findings from other soft hip exosuit devices, indicating a comparable interaction with this prototype to that observed in entirely soft exosuit prototypes.
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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, NE 68182, USA; (P.A.); (A.C.D.); (S.A.M.); (P.M.)
- Institute for Rehabilitation Science and Engineering, Madonna Rehabilitation Hospitals, Lincoln, NE 68506, USA
| | - Prokopios Antonellis
- Department of Biomechanics, and Center for Research in Human Movement Variability, University of Nebraska at Omaha, Omaha, NE 68182, USA; (P.A.); (A.C.D.); (S.A.M.); (P.M.)
- Department of Neurology, Oregon Health & Science University, Portland, OR 97239, USA
| | - Alex C. Dzewaltowski
- Department of Biomechanics, and Center for Research in Human Movement Variability, University of Nebraska at Omaha, Omaha, NE 68182, USA; (P.A.); (A.C.D.); (S.A.M.); (P.M.)
- Scholl College of Podiatric Medicine, Rosalind Franklin University of Medicine & Science, North Chicago, IL 60064, USA
| | - Sara A. Myers
- Department of Biomechanics, and Center for Research in Human Movement Variability, University of Nebraska at Omaha, Omaha, NE 68182, USA; (P.A.); (A.C.D.); (S.A.M.); (P.M.)
- Department of Surgery and Research Service, Nebraska-Western Iowa Veterans Affairs Medical Center, Omaha, NE 68105, USA;
| | - Iraklis I. Pipinos
- Department of Surgery and Research Service, Nebraska-Western Iowa Veterans Affairs Medical Center, Omaha, NE 68105, USA;
- Department of Surgery, University of Nebraska Medical Center, Omaha, NE 68105, USA
| | - Philippe Malcolm
- Department of Biomechanics, and Center for Research in Human Movement Variability, University of Nebraska at Omaha, Omaha, NE 68182, USA; (P.A.); (A.C.D.); (S.A.M.); (P.M.)
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Herrin KR, Kwak ST, Rock CG, Chang YH. Gait quality in prosthesis users is reflected by force-based metrics when learning to walk on a new research-grade powered prosthesis. FRONTIERS IN REHABILITATION SCIENCES 2024; 5:1339856. [PMID: 38370855 PMCID: PMC10869520 DOI: 10.3389/fresc.2024.1339856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 01/12/2024] [Indexed: 02/20/2024]
Abstract
Introduction Powered prosthetic feet require customized tuning to ensure comfort and long-term success for the user, but tuning in both clinical and research settings is subjective, time intensive, and the standard for tuning can vary depending on the patient's and the prosthetist's experience levels. Methods Therefore, we studied eight different metrics of gait quality associated with use of a research-grade powered prosthetic foot in seven individuals with transtibial amputation during treadmill walking. We compared clinically tuned and untuned conditions with the goal of identifying performance-based metrics capable of distinguishing between good (as determined by a clinician) from poor gait quality. Results Differences between the tuned and untuned conditions were reflected in ankle power, both the vertical and anterior-posterior impulse symmetry indices, limb-force alignment, and positive ankle work, with improvements seen in all metrics during use of the tuned prosthesis. Discussion Notably, all of these metrics relate to the timing of force generation during walking which is information not directly accessible to a prosthetist during a typical tuning process. This work indicates that relevant, real-time biomechanical data provided to the prosthetist through the future provision of wearable sensors may enhance and improve future clinical tuning procedures associated with powered prostheses as well as their long-term outcomes.
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Affiliation(s)
- Kinsey R. Herrin
- Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA, United States
- Institute for Robotics and Intelligent Machines, Georgia Institute of Technology, Atlanta, GA, United States
| | - Samuel T. Kwak
- School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, United States
| | - Chase G. Rock
- School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, United States
| | - Young-Hui Chang
- Institute for Robotics and Intelligent Machines, Georgia Institute of Technology, Atlanta, GA, United States
- School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, United States
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3
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Lakmazaheri A, Song S, Vuong BB, Biskner B, Kado DM, Collins SH. Optimizing exoskeleton assistance to improve walking speed and energy economy for older adults. J Neuroeng Rehabil 2024; 21:1. [PMID: 38167151 PMCID: PMC10763092 DOI: 10.1186/s12984-023-01287-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 11/29/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Walking speed and energy economy tend to decline with age. Lower-limb exoskeletons have demonstrated potential to improve either measure, but primarily in studies conducted on healthy younger adults. Promising techniques like optimization of exoskeleton assistance have yet to be tested with older populations, while speed and energy consumption have yet to be simultaneously optimized for any population. METHODS We investigated the effectiveness of human-in-the-loop optimization of ankle exoskeletons with older adults. Ten healthy adults > 65 years of age (5 females; mean age: 72 ± 3 yrs) participated in approximately 240 min of training and optimization with tethered ankle exoskeletons on a self-paced treadmill. Multi-objective human-in-the-loop optimization was used to identify assistive ankle plantarflexion torque patterns that simultaneously improved self-selected walking speed and metabolic rate. The effects of optimized exoskeleton assistance were evaluated in separate trials. RESULTS Optimized exoskeleton assistance improved walking performance for older adults. Both objectives were simultaneously improved; self-selected walking speed increased by 8% (0.10 m/s; p = 0.001) and metabolic rate decreased by 19% (p = 0.007), resulting in a 25% decrease in energetic cost of transport (p = 8e-4) compared to walking with exoskeletons applying zero torque. Compared to younger participants in studies optimizing a single objective, our participants required lower exoskeleton torques, experienced smaller improvements in energy use, and required more time for motor adaptation. CONCLUSIONS Our results confirm that exoskeleton assistance can improve walking performance for older adults and show that multiple objectives can be simultaneously addressed through human-in-the-loop optimization.
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Affiliation(s)
- Ava Lakmazaheri
- Department of Mechanical Engineering, Stanford University, Stanford, CA, USA
| | - Seungmoon Song
- Department of Mechanical Engineering, Stanford University, Stanford, CA, USA
- Department of Mechanical and Industrial Engineering, Northeastern University, Boston, MA, USA
| | - Brian B Vuong
- Department of Mechanical Engineering, Stanford University, Stanford, CA, USA
| | - Blake Biskner
- Department of Mechanical Engineering, Stanford University, Stanford, CA, USA
| | - Deborah M Kado
- Geriatrics Research Education and Clinical Center, Veterans Affairs, Palo Alto, CA, USA
- Department of Medicine, Stanford University, Stanford, CA, USA
| | - Steven H Collins
- Department of Mechanical Engineering, Stanford University, Stanford, CA, USA.
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Gehlhar R, Tucker M, Young AJ, Ames AD. A Review of Current State-of-the-Art Control Methods for Lower-Limb Powered Prostheses. ANNUAL REVIEWS IN CONTROL 2023; 55:142-164. [PMID: 37635763 PMCID: PMC10449377 DOI: 10.1016/j.arcontrol.2023.03.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Abstract
Lower-limb prostheses aim to restore ambulatory function for individuals with lower-limb amputations. While the design of lower-limb prostheses is important, this paper focuses on the complementary challenge - the control of lower-limb prostheses. Specifically, we focus on powered prostheses, a subset of lower-limb prostheses, which utilize actuators to inject mechanical power into the walking gait of a human user. In this paper, we present a review of existing control strategies for lower-limb powered prostheses, including the control objectives, sensing capabilities, and control methodologies. We separate the various control methods into three main tiers of prosthesis control: high-level control for task and gait phase estimation, mid-level control for desired torque computation (both with and without the use of reference trajectories), and low-level control for enforcing the computed torque commands on the prosthesis. In particular, we focus on the high- and mid-level control approaches in this review. Additionally, we outline existing methods for customizing the prosthetic behavior for individual human users. Finally, we conclude with a discussion on future research directions for powered lower-limb prostheses based on the potential of current control methods and open problems in the field.
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Affiliation(s)
- Rachel Gehlhar
- Department of Mechanical and Civil Engineering, California Institute of Technology, 1200 E. California Blvd., Pasadena, 91125, CA, USA
| | - Maegan Tucker
- Department of Mechanical and Civil Engineering, California Institute of Technology, 1200 E. California Blvd., Pasadena, 91125, CA, USA
| | - Aaron J Young
- Woodruff School of Mechanical Engineering, Georgia Institute of Technology, North Avenue, Atlanta, 30332, GA, USA
- Institute for Robotics and Intelligent Machines, Georgia Institute of Technology, North Avenue, Atlanta, 30332, GA, USA
| | - Aaron D Ames
- Department of Mechanical and Civil Engineering, California Institute of Technology, 1200 E. California Blvd., Pasadena, 91125, CA, USA
- Department of Computing and Mathematical Sciences, California Institute of Technology, 1200 E. California Blvd., Pasadena, 91125, CA, USA
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Siviy C, Baker LM, Quinlivan BT, Porciuncula F, Swaminathan K, Awad LN, Walsh CJ. Opportunities and challenges in the development of exoskeletons for locomotor assistance. Nat Biomed Eng 2022; 7:456-472. [PMID: 36550303 DOI: 10.1038/s41551-022-00984-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 11/08/2022] [Indexed: 12/24/2022]
Abstract
Exoskeletons can augment the performance of unimpaired users and restore movement in individuals with gait impairments. Knowledge of how users interact with wearable devices and of the physiology of locomotion have informed the design of rigid and soft exoskeletons that can specifically target a single joint or a single activity. In this Review, we highlight the main advances of the past two decades in exoskeleton technology and in the development of lower-extremity exoskeletons for locomotor assistance, discuss research needs for such wearable robots and the clinical requirements for exoskeleton-assisted gait rehabilitation, and outline the main clinical challenges and opportunities for exoskeleton technology.
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Affiliation(s)
- Christopher Siviy
- John A Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, USA
| | - Lauren M Baker
- John A Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, USA
| | - Brendan T Quinlivan
- John A Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, USA
| | - Franchino Porciuncula
- John A Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, USA.,Department of Physical Therapy, College of Health and Rehabilitation Sciences: Sargent, Boston University, Boston, MA, USA
| | - Krithika Swaminathan
- John A Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, USA
| | - Louis N Awad
- Department of Physical Therapy, College of Health and Rehabilitation Sciences: Sargent, Boston University, Boston, MA, USA
| | - Conor J Walsh
- John A Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, USA.
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6
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Mahon CE, Hendershot BD. Biomechanical accommodation to walking with an ankle-foot prosthesis: An exploratory analysis of novice users with transtibial limb loss within the first year of ambulation. Prosthet Orthot Int 2022; 46:452-458. [PMID: 35333820 DOI: 10.1097/pxr.0000000000000124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 02/15/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND The way in which a person with limb loss interacts with a prosthesis changes over time; however, there remains a lack of guidance for defining accommodation to walking with a prosthesis, limiting consistency and generalizability of research. OBJECTIVE To evaluate accommodations to walking with dynamic elastic response prosthetic ankle-foot devices among novice users with unilateral transtibial limb loss during the first year of ambulation. STUDY DESIGN This is a retrospective cohort study. METHODS Prosthetic and intact ankle-foot mechanical power profiles and mechanical work during step-to-step transitions were calculated using the Unified Deformable model for 22 male individuals with limb loss at five time points within the first year of independent ambulation (0, 2, 4, 6, and 12 months). Subjects walked at a self-selected walking velocity and controlled walking velocity (CWV). Subjective measures included the Prosthetic Evaluation Questionnaire and the 36-Item Short-Form Health Survey. RESULTS Self-selected walking velocity ranged from 1.24 ± 0.06 m/s at 0 month to 1.38 ± 0.04 m/s at 12 months, whereas CWV was 1.20 ± 0.02 m/s. At both velocities, positive work/peak power during prosthetic push-off trended upward until the 4-month time point. In addition, negative peak power during intact foot-strike seemed to qualitatively become less negative until 4 months. Positive work during intact push-off trended downward until 4 months at CWV, whereas positive peak power during intact push-off qualitatively became more positive at self-selected walking velocity. CONCLUSIONS These trends may partially indicate (biomechanical) accommodation to walking by appearance of a "plateau" at 4 months after initial ambulation with a prosthesis.
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Affiliation(s)
- Caitlin E Mahon
- Research & Surveillance Division, DoD-VA Extremity Trauma and Amputation Center of Excellence, Bethesda, MD, USA
- Research and Development Section, Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Brad D Hendershot
- Research & Surveillance Division, DoD-VA Extremity Trauma and Amputation Center of Excellence, Bethesda, MD, USA
- Research and Development Section, Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, USA
- Department of Rehabilitation Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
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7
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Slade P, Kochenderfer MJ, Delp SL, Collins SH. Personalizing exoskeleton assistance while walking in the real world. Nature 2022; 610:277-282. [PMID: 36224415 PMCID: PMC9556303 DOI: 10.1038/s41586-022-05191-1] [Citation(s) in RCA: 42] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 08/04/2022] [Indexed: 11/12/2022]
Abstract
Personalized exoskeleton assistance provides users with the largest improvements in walking speed1 and energy economy2-4 but requires lengthy tests under unnatural laboratory conditions. Here we show that exoskeleton optimization can be performed rapidly and under real-world conditions. We designed a portable ankle exoskeleton based on insights from tests with a versatile laboratory testbed. We developed a data-driven method for optimizing exoskeleton assistance outdoors using wearable sensors and found that it was equally effective as laboratory methods, but identified optimal parameters four times faster. We performed real-world optimization using data collected during many short bouts of walking at varying speeds. Assistance optimized during one hour of naturalistic walking in a public setting increased self-selected speed by 9 ± 4% and reduced the energy used to travel a given distance by 17 ± 5% compared with normal shoes. This assistance reduced metabolic energy consumption by 23 ± 8% when participants walked on a treadmill at a standard speed of 1.5 m s-1. Human movements encode information that can be used to personalize assistive devices and enhance performance.
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Affiliation(s)
- Patrick Slade
- Department of Mechanical Engineering, Stanford University, Stanford, CA, USA
- Department of Bioengineering, Stanford University, Stanford, CA, USA
| | - Mykel J Kochenderfer
- Department of Aeronautics and Astronautics, Stanford University, Stanford, CA, USA
| | - Scott L Delp
- Department of Mechanical Engineering, Stanford University, Stanford, CA, USA
- Department of Bioengineering, Stanford University, Stanford, CA, USA
| | - Steven H Collins
- Department of Mechanical Engineering, Stanford University, Stanford, CA, USA.
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Wu M, Qiu Y, Ueda J, Ting LH. A Versatile Emulator for Haptic Communication to Alter Human Gait Parameters. IEEE Robot Autom Lett 2022. [DOI: 10.1109/lra.2022.3182109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Mengnan Wu
- W. H. Coulter Department of Biomedical Engineering, Emory University and Georgia Institute of Technology, Atlanta, GA, USA
| | - Yingxin Qiu
- George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - Jun Ueda
- George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - Lena H. Ting
- W. H. Coulter Department of Biomedical Engineering, Emory University and Georgia Institute of Technology, Atlanta, GA, USA
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Khamar M, Edrisi M, Forghany S. Designing a robust controller for a lower limb exoskeleton to treat an individual with crouch gait pattern in the presence of actuator saturation. ISA TRANSACTIONS 2022; 126:513-532. [PMID: 34479722 DOI: 10.1016/j.isatra.2021.08.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 08/02/2021] [Accepted: 08/18/2021] [Indexed: 06/13/2023]
Abstract
Crouch gait is a gait anomaly observed in youngsters with cerebral palsy (CP). Rehabilitation robots are useful for treating individuals with crouch gait. Multiple factors have impact on crouch, including contracture, spasticity, weak motor control, and muscle feebleness, which make the designing and controlling of these exoskeletons for this population a challenging job. A harsh kinematic trajectory enforced by an exoskeleton control strategy may place individuals with spasticity at a high risk of muscle tissue injury. Therefore, in this article, a multi-input multi-output (MIMO) control method is proposed to reduce this risk and improve crouch gait pattern. A constrained control law is used in the model since high power demands may threaten the wearer. In addition, the controller needs to be robust enough against external disturbances and uncertainties. Thus, a nonlinear disturbance observer (NDO) is presented to compute the wearer-generated muscular torque and the uncertainties in the modeling. In addition, a robust constrained MIMO backstepping sliding controller (CMBSC) based on NDO is used to deal with the effect of actuator saturation and uncertainties. A simulation test was used to validate the proposed model and controller. The results of Simulation confirmed the efficiency of the proposed control method when applied to crouch gait with subject specific gait reference. Then, some experimental tests were undertaken to validate the efficiency of the proposed controller.
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Affiliation(s)
- Maryam Khamar
- Electrical Department, Faculty of Engineering, University of Isfahan, Iran.
| | - Mehdi Edrisi
- Electrical Department, Faculty of Engineering, University of Isfahan, Iran.
| | - Saeed Forghany
- School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran.
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10
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Halsne EG, Curran C, Caputo JM, Hansen A, Hafner BJ, Morgenroth D. Emulating the Effective Ankle Stiffness of Commercial Prosthetic Feet Using a Robotic Prosthetic Foot Emulator. J Biomech Eng 2022; 144:1141731. [PMID: 35722979 DOI: 10.1115/1.4054834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Indexed: 11/08/2022]
Abstract
Prosthetic foot selection for individuals with lower limb amputation relies primarily on clinician judgment. The prosthesis user rarely has an opportunity to provide experiential input into the decision by trying different feet. A prosthetic foot emulator (PFE) is a robotic prosthetic foot that could facilitate prosthesis users' ability to trial feet with different mechanical characteristics. Here, we introduce a procedure by which a robotic PFE is configured to emulate the sagittal plane effective ankle stiffness of a range of commercial prosthetic forefeet. Mechanical testing was used to collect data on five types of commercial prosthetic feet across a range of foot sizes and intended user body weights. Emulated forefoot profiles were parameterized using Bezier curve fitting on ankle torque-angle data. Mechanical testing was repeated with the PFE, across a subset of emulated foot conditions, to assess the accuracy of the emulation. Linear mixed-effects regression and Bland-Altman Limits of Agreement analyses were used to compare emulated and commercial ankle torque-angle data. Effective ankle stiffness of the emulated feet was significantly associated with the corresponding commercial prosthetic feet (p<.001). On average, the emulated forefeet reproduced the effective ankle stiffness of corresponding commercial feet within 1%. Furthermore, differences were independent of prosthetic foot type, foot size, or user body weight. These findings suggest a PFE could be an effective tool for emulating commercial prosthetic feet, enabling prosthesis users to quickly trial different feet and provide experiential input as part of a prosthetic foot prescription.
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Affiliation(s)
- Elizabeth G Halsne
- Center for Limb Loss and Mobility, VA Puget Sound Health Care System, 1660 S Columbian Way (MS 151), Seattle, WA 98108; Department of Rehabilitation Medicine, University of Washington, 1959 NE Pacific Street, Box 356490, Seattle, WA 98195
| | - Carl Curran
- Human Motion Technologies LLC d/b/a Humotech, 630 William Pitt Way, U-PARC, Building A2, Pittsburgh, PA 15238
| | - Joshua M Caputo
- Human Motion Technologies LLC d/b/a Humotech, 630 William Pitt Way, U-PARC, Building A2, Pittsburgh, PA 15238
| | - Andrew Hansen
- Minneapolis Adaptive Design & Engineering (MADE) Program, Minneapolis VA Health Care System, 1 Veterans Dr (MS 151), Minneapolis, MN 55417; Departments of Rehabilitation Medicine & Biomedical Engineering, University of Minnesota, Rehabilitation Science Program, MMC 388, 420 Delaware St. SE, Minneapolis, MN 55455
| | - Brian J Hafner
- Department of Rehabilitation Medicine, University of Washington, 1959 NE Pacific Street, Box 356490, Seattle, WA 98195
| | - David Morgenroth
- Center for Limb Loss and Mobility, VA Puget Sound Health Care System, 1660 S Columbian Way (MS 151), Seattle, WA 98108; Department of Rehabilitation Medicine, University of Washington, 1959 NE Pacific Street, Box 356490, Seattle, WA 98195
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11
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Durandau G, Rampeltshammer WF, Kooij HVD, Sartori M. Neuromechanical Model-Based Adaptive Control of Bilateral Ankle Exoskeletons: Biological Joint Torque and Electromyogram Reduction Across Walking Conditions. IEEE T ROBOT 2022. [DOI: 10.1109/tro.2022.3170239] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Guillaume Durandau
- Department of Biomechanical Engineering, Technical Medical Centre, University of Twente, Enschede, NB, The Netherlands
| | - Wolfgang F. Rampeltshammer
- Department of Biomechanical Engineering, Technical Medical Centre, University of Twente, Enschede, NB, The Netherlands
| | - Herman van der Kooij
- Department of Biomechanical Engineering, Technical Medical Centre, University of Twente, Enschede, NB, The Netherlands
| | - Massimo Sartori
- Department of Biomechanical Engineering, Technical Medical Centre, University of Twente, Enschede, NB, The Netherlands
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12
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13
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Azocar AF, Rouse EJ. Characterization of Open-loop Impedance Control and Efficiency in Wearable Robots. IEEE Robot Autom Lett 2022. [DOI: 10.1109/lra.2022.3150523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Visual guidance can help with the use of a robotic exoskeleton during human walking. Sci Rep 2022; 12:3881. [PMID: 35273244 PMCID: PMC8913727 DOI: 10.1038/s41598-022-07736-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 02/15/2022] [Indexed: 11/29/2022] Open
Abstract
Walking is an important activity that supports the health-related quality of life, and for those who need assistance, robotic devices are available to help. Recent progress in wearable robots has identified the importance of customizing the assistance provided by the robot to the individual, resulting in robot adaptation to the human. However, current implementations minimize the role of human adaptation to the robot, for example, by the users modifying their movements based on the provided robot assistance. This study investigated the effect of visual feedback to guide the users in adapting their movements in response to wearable robot assistance. The visual feedback helped the users reduce their metabolic cost of walking without any changes in robot assistance in a given time. In a case with the initially metabolic expensive (IMExp) exoskeleton condition, both training methods helped reduce the metabolic cost of walking. The results suggest that visual feedback training is helpful to use the exoskeleton for various conditions. Without feedback, the training is helpful only for the IMExp exoskeleton condition. This result suggests visual feedback training can be useful to facilitate the use of non-personalized, generic assistance, where the assistance is not tuned for each user, in a relatively short time.
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15
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Huang TH, Zhang S, Yu S, MacLean MK, Zhu J, Di Lallo A, Jiao C, Bulea TC, Zheng M, Su H. Modeling and Stiffness-Based Continuous Torque Control of Lightweight Quasi-Direct-Drive Knee Exoskeletons for Versatile Walking Assistance. IEEE T ROBOT 2022; 38:1442-1459. [DOI: 10.1109/tro.2022.3170287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Tzu-Hao Huang
- Laboratory of Biomechatronics and Intelligent Robotics, Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC 27695 USA
| | - Sainan Zhang
- Laboratory of Biomechatronics and Intelligent Robotics, Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC 27695 USA
| | - Shuangyue Yu
- Laboratory of Biomechatronics and Intelligent Robotics, Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC 27695 USA
| | - Mhairi K. MacLean
- Laboratory of Biomechatronics and Intelligent Robotics 57522, Enschede The Netherlands, and also with the Department of Mechanical Engineering, University of Twente 57522, Enschede The Netherlands
| | - Junxi Zhu
- Laboratory of Biomechatronics and Intelligent Robotics, Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC 27695 USA
| | - Antonio Di Lallo
- Laboratory of Biomechatronics and Intelligent Robotics, Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC 27695 USA
| | - Chunhai Jiao
- Laboratory of Biomechatronics and Intelligent Robotics, Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC 27695 USA
| | - Thomas C. Bulea
- Functional and Applied Biomechanics Section, Rehabilitation Medicine Department, Clinical Center, National Institutes of Health, Bethesda, MD 20892 USA
| | - Minghui Zheng
- Department of Mechanical and Aerospace Engineering, University at Buffalo, Buffalo, NY 14260 USA
| | - Hao Su
- Laboratory of Biomechatronics and Intelligent Robotics, Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC 27695 USA
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16
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Huang H(H, Si J, Brandt A, Li M. Taking Both Sides: Seeking Symbiosis Between Intelligent Prostheses and Human Motor Control during Locomotion. CURRENT OPINION IN BIOMEDICAL ENGINEERING 2021; 20:100314. [PMID: 34458654 PMCID: PMC8388605 DOI: 10.1016/j.cobme.2021.100314] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Robotic lower-limb prostheses aim to replicate the power-generating capability of biological joints during locomotion to empower individuals with lower-limb loss. However, recent clinical trials have not demonstrated clear advantages of these devices over traditional passive devices. We believe this is partly because the current designs of robotic prothesis controllers and clinical methods for fitting and training individuals to use them do not ensure good coordination between the prosthesis and user. Accordingly, we advocate for new holistic approaches in which human motor control and intelligent prosthesis control function as one system (defined as human-prosthesis symbiosis). We hope engineers and clinicians will work closely to achieve this symbiosis, thereby improving the functionality and acceptance of robotic prostheses and users' quality of life.
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Affiliation(s)
- He (Helen) Huang
- NC State/UNC Joint Department of Biomedical Engineering, North Carolina State University, Raleigh, North Carolina, USA, 27695
- NC State/UNC Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA, 27514
| | - Jennie Si
- Department of Electrical, Computer, and Energy Engineering, Arizona State University, Tempe, Arizona, USA, 85281
| | - Andrea Brandt
- NC State/UNC Joint Department of Biomedical Engineering, North Carolina State University, Raleigh, North Carolina, USA, 27695
- NC State/UNC Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA, 27514
| | - Minhan Li
- NC State/UNC Joint Department of Biomedical Engineering, North Carolina State University, Raleigh, North Carolina, USA, 27695
- NC State/UNC Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA, 27514
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17
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Franks PW, Bryan GM, Martin RM, Reyes R, Lakmazaheri AC, Collins SH. Comparing optimized exoskeleton assistance of the hip, knee, and ankle in single and multi-joint configurations. WEARABLE TECHNOLOGIES 2021; 2:e16. [PMID: 38486633 PMCID: PMC10936256 DOI: 10.1017/wtc.2021.14] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 09/13/2021] [Accepted: 10/20/2021] [Indexed: 03/17/2024]
Abstract
Exoskeletons that assist the hip, knee, and ankle joints have begun to improve human mobility, particularly by reducing the metabolic cost of walking. However, direct comparisons of optimal assistance of these joints, or their combinations, have not yet been possible. Assisting multiple joints may be more beneficial than the sum of individual effects, because muscles often span multiple joints, or less effective, because single-joint assistance can indirectly aid other joints. In this study, we used a hip-knee-ankle exoskeleton emulator paired with human-in-the-loop optimization to find single-joint, two-joint, and whole-leg assistance that maximally reduced the metabolic cost of walking. Hip-only and ankle-only assistance reduced the metabolic cost of walking by 26 and 30% relative to walking in the device unassisted, confirming that both joints are good targets for assistance (N = 3). Knee-only assistance reduced the metabolic cost of walking by 13%, demonstrating that effective knee assistance is possible (N = 3). Two-joint assistance reduced the metabolic cost of walking by between 33 and 42%, with the largest improvements coming from hip-ankle assistance (N = 3). Assisting all three joints reduced the metabolic cost of walking by 50%, showing that at least half of the metabolic energy expended during walking can be saved through exoskeleton assistance (N = 4). Changes in kinematics and muscle activity indicate that single-joint assistance indirectly assisted muscles at other joints, such that the improvement from whole-leg assistance was smaller than the sum of its single-joint parts. Exoskeletons can assist the entire limb for maximum effect, but a single well-chosen joint can be more efficient when considering additional factors such as weight and cost.
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Affiliation(s)
- Patrick W. Franks
- Department of Mechanical Engineering, Stanford University, Stanford, California, USA
| | - Gwendolyn M. Bryan
- Department of Mechanical Engineering, Stanford University, Stanford, California, USA
| | - Russell M. Martin
- Department of Mechanical Engineering, Stanford University, Stanford, California, USA
| | - Ricardo Reyes
- Department of Mechanical Engineering, Stanford University, Stanford, California, USA
| | - Ava C. Lakmazaheri
- Department of Mechanical Engineering, Stanford University, Stanford, California, USA
| | - Steven H. Collins
- Department of Mechanical Engineering, Stanford University, Stanford, California, USA
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18
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Ghillebert J, Geeroms J, Flynn L, De Bock S, Govaerts R, Lathouwers E, Crea S, Vitiello N, Lefeber D, Meeusen R, De Pauw K. Performance of the CYBERLEGs motorized lower limb prosthetic device during simulated daily activities. WEARABLE TECHNOLOGIES 2021; 2:e15. [PMID: 38486632 PMCID: PMC10936386 DOI: 10.1017/wtc.2021.15] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 10/17/2021] [Accepted: 10/29/2021] [Indexed: 03/17/2024]
Abstract
Background The CYBERLEGs-gamma (CLs-ɣ) prosthesis has been developed to investigate the possibilities of powerful active prosthetics in restoring human gait capabilities after lower limb amputation. Objective The objective of this study was to determine the performance of the CLs-ɣ prosthesis during simulated daily activities. Methods Eight participants with a transfemoral amputation (age: 55 ± 15 years, K-level 3, registered under: NCT03376919) performed a familiarization session, an experimental session with their current prosthesis, three training sessions with the CLs-ɣ prosthesis and another experimental session with the CLs-ɣ prosthesis. Participants completed a stair-climbing-test, a timed-up-and-go-test, a sit-to stand-test, a 2-min dual-task and a 6-min treadmill walk test. Results Comparisons between the two experimental sessions showed that stride length significantly increased during walking with the CLs-ɣ prosthesis (p = .012) due to a greater step length of the amputated leg (p = .035). Although a training period with the prototype was included, preferred walking speed was significantly slower (p = .018), the metabolic cost of transport was significantly higher (p = .028) and reaction times significantly worsened (p = .012) when walking with the CLs-ɣ compared to the current prosthesis. Conclusions It can be stated that a higher physical and cognitive effort were required when wearing the CLs-ɣ prosthesis. Positive outcomes were observed regarding stride length and stair ambulation. Future prosthetics development should minimize the weight of the device and integrate customized control systems. A recommendation for future research is to include several shorter training periods or a prolonged adaptation period.
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Affiliation(s)
- Jo Ghillebert
- Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, Brussels, Belgium
- Brussels Human Robotic Research Center (BruBotics), Vrije Universiteit Brussel, Brussels, Belgium
| | - Joost Geeroms
- Brussels Human Robotic Research Center (BruBotics), Vrije Universiteit Brussel, Brussels, Belgium
- Department of Mechanical Engineering, Faculty of Applied Sciences, Vrije Universiteit Brussel and Flanders Make, Brussels, Belgium
| | - Louis Flynn
- Brussels Human Robotic Research Center (BruBotics), Vrije Universiteit Brussel, Brussels, Belgium
- Department of Mechanical Engineering, Faculty of Applied Sciences, Vrije Universiteit Brussel and Flanders Make, Brussels, Belgium
| | - Sander De Bock
- Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, Brussels, Belgium
- Brussels Human Robotic Research Center (BruBotics), Vrije Universiteit Brussel, Brussels, Belgium
| | - Renée Govaerts
- Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, Brussels, Belgium
- Brussels Human Robotic Research Center (BruBotics), Vrije Universiteit Brussel, Brussels, Belgium
| | - Elke Lathouwers
- Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, Brussels, Belgium
- Brussels Human Robotic Research Center (BruBotics), Vrije Universiteit Brussel, Brussels, Belgium
| | - Simona Crea
- The BioRobotics Institute, Scuola Superiore Sant’Anna, Pisa, Italy
- Department of Excellence in Robotics & AI, Piazza Martiri della Libertà, Pisa, Italy
| | - Nicola Vitiello
- The BioRobotics Institute, Scuola Superiore Sant’Anna, Pisa, Italy
- Department of Excellence in Robotics & AI, Piazza Martiri della Libertà, Pisa, Italy
| | - Dirk Lefeber
- Brussels Human Robotic Research Center (BruBotics), Vrije Universiteit Brussel, Brussels, Belgium
- Department of Mechanical Engineering, Faculty of Applied Sciences, Vrije Universiteit Brussel and Flanders Make, Brussels, Belgium
| | - Romain Meeusen
- Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, Brussels, Belgium
- Brussels Human Robotic Research Center (BruBotics), Vrije Universiteit Brussel, Brussels, Belgium
- Strategic Research Program ‘Exercise and the Brain in Health and Disease: The Added Value of Human-Centered Robotics’, Vrije Universiteit Brussel, Brussels, Belgium
| | - Kevin De Pauw
- Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, Brussels, Belgium
- Brussels Human Robotic Research Center (BruBotics), Vrije Universiteit Brussel, Brussels, Belgium
- Strategic Research Program ‘Exercise and the Brain in Health and Disease: The Added Value of Human-Centered Robotics’, Vrije Universiteit Brussel, Brussels, Belgium
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19
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Ziemnicki DM, Caputo JM, McDonald KA, Zelik KE. Development and Evaluation of a Prosthetic Ankle Emulator With an Artificial Soleus and Gastrocnemius. J Med Device 2021. [DOI: 10.1115/1.4052518] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Abstract
In individuals with transtibial limb loss, a contributing factor to mobility-related challenges is the disruption of biological calf muscle function due to transection of the soleus and gastrocnemius. Powered prosthetic ankles can restore primary function of the mono-articular soleus muscle, which contributes to ankle plantarflexion. In effect, a powered ankle acts like an artificial soleus (AS). However, the biarticular gastrocnemius connection that simultaneously contributes to ankle plantarflexion and knee flexion torques remains missing, and there are currently no commercially available prosthetic ankles that incorporate an artificial gastrocnemius (AG). The goal of this work is to describe the design of a novel emulator capable of independently controlling artificial soleus and gastrocnemius behaviors for transtibial prosthesis users during walking. To evaluate the emulator's efficacy in controlling the artificial gastrocnemius behaviors, a case series walking study was conducted with four transtibial prosthesis users. Data from this case series showed that the emulator exhibits low resistance to the user's leg swing, low hysteresis during passive spring emulation, and accurate force tracking for a range of artificial soleus and gastrocnemius behaviors. The emulator presented in this paper is versatile and can facilitate experiments studying the effects of various artificial soleus and gastrocnemius dynamics on gait or other movement tasks. Using this system, it is possible to address existing knowledge gaps and explore a wide range of artificial soleus and gastrocnemius behaviors during gait and potentially other activities of daily living.
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Affiliation(s)
- David M. Ziemnicki
- Department of Mechanical Engineering, Vanderbilt University, 2201 West End Avenue, Nashville, TN 37235
| | - Joshua M. Caputo
- Human Motion Technologies LLC, 630 William Pitt Way U-PARC Building A2, Pittsburgh, PA 15238
| | - Kirsty A. McDonald
- Department of Exercise Physiology, School of Health Sciences, University of New South Wales, Level 2, Wallace Wurth Building, UNSW, Sydney, NSW 2052, Australia
| | - Karl E. Zelik
- Department of Mechanical Engineering, Vanderbilt University, 2201 West End Avenue, Nashville, TN 37235; Department of Biomedical Engineering, Vanderbilt University, 2201 West End Avenue, Nashville, TN 37235; Department of Physical Medicine and Rehabilitation, Vanderbilt University, 2201 West End Avenue, Nashville, TN 37235
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20
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Clites TR, Shepherd MK, Ingraham KA, Wontorcik L, Rouse EJ. Understanding patient preference in prosthetic ankle stiffness. J Neuroeng Rehabil 2021; 18:128. [PMID: 34433472 PMCID: PMC8390224 DOI: 10.1186/s12984-021-00916-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 07/21/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND User preference has the potential to facilitate the design, control, and prescription of prostheses, but we do not yet understand which physiological factors drive preference, or if preference is associated with clinical benefits. METHODS Subjects with unilateral below-knee amputation walked on a custom variable-stiffness prosthetic ankle and manipulated a dial to determine their preferred prosthetic ankle stiffness at three walking speeds. We evaluated anthropomorphic, metabolic, biomechanical, and performance-based descriptors at stiffness levels surrounding each subject's preferred stiffness. RESULTS Subjects preferred lower stiffness values at their self-selected treadmill walking speed, and elected to walk faster overground with ankle stiffness at or above their preferred stiffness. Preferred stiffness maximized the kinematic symmetry between prosthetic and unaffected joints, but was not significantly correlated with body mass or metabolic rate. CONCLUSION These results imply that some physiological factors are weighted more heavily when determining preferred stiffness, and that preference may be associated with clinically relevant improvements in gait.
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Affiliation(s)
- Tyler R Clites
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI, 48109, USA
- Robotics Institute, University of Michigan, Ann Arbor, MI, 48109, USA
- Neurobionics Lab, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Max K Shepherd
- Department of Biomedical Engineering, Northwestern University, Evanston, IL, 60208, USA
- Shirley Ryan Ability Lab, Chicago, IL, 60611, USA
- Neurobionics Lab, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Kimberly A Ingraham
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI, 48109, USA
- Robotics Institute, University of Michigan, Ann Arbor, MI, 48109, USA
- Neurobionics Lab, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Leslie Wontorcik
- Department of Physical Medicine and Rehabilitation, Michigan Medicine, University of Michigan Orthotics and Prosthetics Center, Ann Arbor, MI, 48104, USA
| | - Elliott J Rouse
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI, 48109, USA.
- Robotics Institute, University of Michigan, Ann Arbor, MI, 48109, USA.
- Neurobionics Lab, University of Michigan, Ann Arbor, MI, 48109, USA.
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21
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Welker CG, Voloshina AS, Chiu VL, Collins SH. Shortcomings of human-in-the-loop optimization of an ankle-foot prosthesis emulator: a case series. ROYAL SOCIETY OPEN SCIENCE 2021; 8:202020. [PMID: 34035945 PMCID: PMC8097204 DOI: 10.1098/rsos.202020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 04/12/2021] [Indexed: 06/12/2023]
Abstract
Human-in-the-loop optimization allows for individualized device control based on measured human performance. This technique has been used to produce large reductions in energy expenditure during walking with exoskeletons but has not yet been applied to prosthetic devices. In this series of case studies, we applied human-in-the-loop optimization to the control of an active ankle-foot prosthesis used by participants with unilateral transtibial amputation. We optimized the parameters of five control architectures that captured aspects of successful exoskeletons and commercial prostheses, but none resulted in significantly lower metabolic rate than generic control. In one control architecture, we increased the exposure time per condition by a factor of five, but the optimized controller still resulted in higher metabolic rate. Finally, we optimized for self-reported comfort instead of metabolic rate, but the resulting controller was not preferred. There are several reasons why human-in-the-loop optimization may have failed for people with amputation. Control architecture is an unlikely cause given the variety of controllers tested. The lack of effect likely relates to changes in motor adaptation, learning, or objectives in people with amputation. Future work should investigate these potential causes to determine whether human-in-the-loop optimization for prostheses could be successful.
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Affiliation(s)
- Cara Gonzalez Welker
- Department of Bioengineering, Stanford University, Stanford, CA 94305, USA
- Department of Mechanical Engineering, Stanford University, Stanford, CA 94305, USA
| | - Alexandra S. Voloshina
- Department of Mechanical and Aerospace Engineering, University of California Irvine, Irvine, CA 92697, USA
| | - Vincent L. Chiu
- Department of Mechanical Engineering, Stanford University, Stanford, CA 94305, USA
| | - Steven H. Collins
- Department of Mechanical Engineering, Stanford University, Stanford, CA 94305, USA
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22
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Liu J, Abu Osman NA, Al Kouzbary M, Al Kouzbary H, Abd Razak NA, Shasmin HN, Arifin N. Classification and Comparison of Mechanical Design of Powered Ankle–Foot Prostheses for Transtibial Amputees Developed in the 21st Century: A Systematic Review. J Med Device 2021. [DOI: 10.1115/1.4049437] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Abstract
A systematic review of the mechanical design of powered ankle–foot prostheses developed from 2000 to 2019 was conducted through database and manual searches. A total of ten English and two Chinese databases were searched using the same keywords. Moreover, information on commercialized prostheses was collected through a manual search. A total of 8729 publications were obtained from the database search, and 83 supplementary publications and 49 online product introductions were accumulated through the manual search. A total of 91 powered ankle–foot prostheses were extracted from 159 publications and online information after exclusion. The mechanical design characteristics of the prostheses were described briefly and compared after they were categorized into 11 subclassifications. This review revealed that a considerable number of powered ankle–foot prostheses were developed in the last 20 years. The development of such prostheses was characterized by alternative modes, that is, from pneumatic or hydraulic drivers to motorized drivers and from rigid transmissions to elastic actuators. This review contributes to the comprehensive understanding of current designs, which can benefit the combination of the advantages of and redundancy avoidance in future powered ankle–foot prostheses.
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Affiliation(s)
- Jingjing Liu
- Centre for Applied Biomechanics, Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur 50603, Malaysia
| | - Noor Azuan Abu Osman
- Centre for Applied Biomechanics, Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur 50603, Malaysia
| | - Mouaz Al Kouzbary
- Centre for Applied Biomechanics, Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur 50603, Malaysia
| | - Hamza Al Kouzbary
- Centre for Applied Biomechanics, Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur 50603, Malaysia
| | - Nasrul Anuar Abd Razak
- Centre for Applied Biomechanics, Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur 50603, Malaysia
| | - Hanie Nadia Shasmin
- Centre for Applied Biomechanics, Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur 50603, Malaysia
| | - Nooranida Arifin
- Centre for Applied Biomechanics, Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur 50603, Malaysia
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23
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Bryan GM, Franks PW, Klein SC, Peuchen RJ, Collins SH. A hip–knee–ankle exoskeleton emulator for studying gait assistance. Int J Rob Res 2020. [DOI: 10.1177/0278364920961452] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Lower-limb exoskeletons could improve the mobility of people with disabilities, older adults, workers, first responders, and military personnel. Despite recent advances, few products are commercially available and exoskeleton research is still often limited by hardware constraints. Many promising multi-joint assistance strategies, especially those with high-torque and high-power components, have yet to be tested because they are beyond the capabilities of current devices. To study these untested assistance strategies, we present a hip–knee–ankle exoskeleton emulator that can apply high torques and powers that match or exceed those observed in uphill running. The system has powerful off-board motors that actuate a 13.5 kg exoskeleton end effector worn by the user. It can apply up to 200 Nm of torque in hip flexion, hip extension, and ankle plantarflexion, 250 Nm of torque in knee extension, and 140 Nm of torque in knee flexion, with over 4.5 kW of power at each joint and a closed-loop torque bandwidth of at least 18 Hz in each direction of actuation. The exoskeleton is compliant in unactuated directions, adjustable for a wide range of users and comfortable during walking and running. When paired with human-in-the-loop optimization, we expect that this system will identify new assistance strategies to improve human mobility. A complete computer-aided design (CAD) model of the exoskeleton and a bill of materials are included and available for download.
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Affiliation(s)
- Gwendolyn M Bryan
- Mechanical Engineering, Stanford University, USA
- Mechanical Engineering, Carnegie Mellon University, USA
| | - Patrick W Franks
- Mechanical Engineering, Stanford University, USA
- Mechanical Engineering, Carnegie Mellon University, USA
| | - Stefan C Klein
- Mechanical Engineering, Stanford University, USA
- Mechanical Engineering, Carnegie Mellon University, USA
| | - Robert J Peuchen
- BioMechanical Engineering, Delft University of Technology, Netherlands
| | - Steven H Collins
- Mechanical Engineering, Stanford University, USA
- Mechanical Engineering, Carnegie Mellon University, USA
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24
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Azocar AF, Mooney LM, Duval JF, Simon AM, Hargrove LJ, Rouse EJ. Design and clinical implementation of an open-source bionic leg. Nat Biomed Eng 2020; 4:941-953. [PMID: 33020601 PMCID: PMC7581510 DOI: 10.1038/s41551-020-00619-3] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 08/27/2020] [Indexed: 11/09/2022]
Abstract
In individuals with lower-limb amputations, robotic prostheses can increase walking speed, and reduce energy use, the incidence of falls and the development of secondary complications. However, safe and reliable prosthetic-limb control strategies for robust ambulation in real-world settings remain out of reach, partly because control strategies have been tested with different robotic hardware in constrained laboratory settings. Here, we report the design and clinical implementation of an integrated robotic knee-ankle prosthesis that facilitates the real-world testing of its biomechanics and control strategies. The bionic leg is open source, it includes software for low-level control and for communication with control systems, and its hardware design is customizable, enabling reduction in its mass and cost, improvement in its ease of use and independent operation of the knee and ankle joints. We characterized the electromechanical and thermal performance of the bionic leg in benchtop testing, as well as its kinematics and kinetics in three individuals during walking on level ground, ramps and stairs. The open-source integrated-hardware solution and benchmark data that we provide should help with research and clinical testing of knee-ankle prostheses in real-world environments.
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Affiliation(s)
- Alejandro F Azocar
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI, USA.,Robotics Institute, University of Michigan, Ann Arbor, MI, USA
| | | | | | - Ann M Simon
- Center for Bionic Medicine, Shirley Ryan AbilityLab, Chicago, IL, USA.,Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, IL, USA
| | - Levi J Hargrove
- Center for Bionic Medicine, Shirley Ryan AbilityLab, Chicago, IL, USA.,Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, IL, USA.,Department of Biomedical Engineering, Northwestern University, Evanston, IL, USA
| | - Elliott J Rouse
- Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI, USA. .,Robotics Institute, University of Michigan, Ann Arbor, MI, USA.
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25
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Kim M, Lyness H, Chen T, Collins SH. The Effects of Prosthesis Inversion/Eversion Stiffness on Balance-Related Variability During Level Walking: A Pilot Study. J Biomech Eng 2020; 142:1082575. [PMID: 32280955 DOI: 10.1115/1.4046881] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Indexed: 11/08/2022]
Abstract
Prosthesis features that enhance balance are desirable to people with transtibial amputation. Ankle inversion/eversion compliance is intended to improve balance on uneven ground, but its effects remain unclear on level ground. We posited that increasing ankle inversion/eversion stiffness during level-ground walking would reduce balance-related effort by assisting in recovery from small disturbances in frontal-plane motions. We performed a pilot test with an ankle-foot prosthesis emulator programmed to apply inversion/eversion torques in proportion to the deviation from a nominal inversion/eversion position trajectory. We applied a range of stiffnesses to clearly understand the effect of the stiffness on balance-related effort, hypothesizing that positive stiffness would reduce effort while negative stiffness would increase effort. Nominal joint angle trajectories were calculated online as a moving average over several steps. In experiments with K3 ambulators with unilateral transtibial amputation (N = 5), stiffness affected step-width variability, average step width, margin of stability, intact-foot center of pressure variability, and user satisfaction (p ≤ 0.05, Friedman's test), but not intact-limb evertor average, intact-limb evertor variability, and metabolic rate (p ≥ 0.38, Friedman's test). Compared to zero stiffness, high positive stiffness reduced step-width variability by 13%, step width by 3%, margin of stability by 3%, and intact-foot center of pressure variability by 14%, whereas high negative stiffness had opposite effects and decreased satisfaction by 63%. The results of this pilot study suggest that positive ankle inversion stiffness can reduce active control requirements during level walking.
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Affiliation(s)
- Myunghee Kim
- Department of Mechanical and Industrial Engineering, University of Illinois at Chicago, Chicago, IL 60607
| | - Hannah Lyness
- Robotics Institute, Carnegie Mellon University, Pittsburgh, PA 15213
| | - Tianjian Chen
- Department of Mechanical Engineering, Columbia University, New York, NY 10027
| | - Steven H Collins
- Department of Mechanical Engineering, Stanford University, Stanford, CA 94305
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26
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Nuckols RW, Sawicki GS. Impact of elastic ankle exoskeleton stiffness on neuromechanics and energetics of human walking across multiple speeds. J Neuroeng Rehabil 2020; 17:75. [PMID: 32539840 PMCID: PMC7294672 DOI: 10.1186/s12984-020-00703-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Accepted: 05/21/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Elastic ankle exoskeletons with intermediate stiffness springs in parallel with the human plantarflexors can reduce the metabolic cost of walking by ~ 7% at 1.25 m s- 1. In a move toward 'real-world' application, we examined whether the unpowered approach has metabolic benefit across a range of walking speeds, and if so, whether the optimal exoskeleton stiffness was speed dependent. We hypothesized that, for any walking speed, there would be an optimal ankle exoskeleton stiffness - not too compliant and not too stiff - that minimizes the user's metabolic cost. In addition, we expected the optimal stiffness to increase with walking speed. METHODS Eleven participants walked on a level treadmill at 1.25, 1.50, and 1.75 m s- 1 while we used a state-of-the-art exoskeleton emulator to apply bilateral ankle exoskeleton assistance at five controlled rotational stiffnesses (kexo = 0, 50, 100, 150, 250 Nm rad- 1). We measured metabolic cost, lower-limb joint mechanics, and EMG of muscles crossing the ankle, knee, and hip. RESULTS Metabolic cost was significantly reduced at the lowest exoskeleton stiffness (50 Nm rad- 1) for assisted walking at both 1.25 (4.2%; p = 0.0162) and 1.75 m s- 1 (4.7%; p = 0.0045). At these speeds, the metabolically optimal exoskeleton stiffness provided peak assistive torques of ~ 0.20 Nm kg- 1 that resulted in reduced biological ankle moment of ~ 12% and reduced soleus muscle activity of ~ 10%. We found no stiffness that could reduce the metabolic cost of walking at 1.5 m s- 1. Across all speeds, the non-weighted sum of soleus and tibialis anterior activation rate explained the change in metabolic rate due to exoskeleton assistance (p < 0.05; R2 > 0.56). CONCLUSIONS Elastic ankle exoskeletons with low rotational stiffness reduce users' metabolic cost of walking at slow and fast but not intermediate walking speed. The relationship between the non-weighted sum of soleus and tibialis activation rate and metabolic cost (R2 > 0.56) indicates that muscle activation may drive metabolic demand. Future work using simulations and ultrasound imaging will get 'under the skin' and examine the interaction between exoskeleton stiffness and plantarflexor muscle dynamics to better inform stiffness selection in human-machine systems.
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Affiliation(s)
- Richard W Nuckols
- Joint Department of Biomedical Engineering, UNC Chapel Hill and NC State University, Raleigh, NC, USA.
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, 02138, USA.
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Cambridge, MA, 02138, USA.
| | - Gregory S Sawicki
- Joint Department of Biomedical Engineering, UNC Chapel Hill and NC State University, Raleigh, NC, USA.
- George W. Woodruff School of Mechanical Engineering and School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, 30332, USA.
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27
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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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Schnall BL, Dearth CL, Elrod JM, Golyski PR, Koehler-McNicholas SR, Ray SF, Hansen AH, Hendershot BD. A more compliant prosthetic foot better accommodates added load while walking among Servicemembers with transtibial limb loss. J Biomech 2020; 98:109395. [PMID: 31668413 DOI: 10.1016/j.jbiomech.2019.109395] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 10/03/2019] [Accepted: 10/06/2019] [Indexed: 11/16/2022]
Abstract
Selecting an optimal prosthetic foot is particularly challenging for highly active individuals with limb loss, such as military personnel, who need to seamlessly perform a variety of demanding activities/tasks (often with and without external loads) while minimizing risk of musculoskeletal injuries over the longer term. Here, we expand on prior work by comparing biomechanical and functional outcomes in two prosthetic feet with the largest differences in mechanical response to added load (i.e., consistently "Compliant" and "Stiff" forefoot properties). In each foot, fourteen male Servicemembers with unilateral transtibial limb loss (from trauma) completed instrumented gait analyses in all combinations of two loading conditions (with and without 22 kg weighted vest) and two walking speeds (1.34 and 1.52 m/s), as well as the Prosthesis Evaluation Questionnaire. With the Stiff foot, sound limb peak loading was 2% smaller (p = 0.043) in the loaded versus unloaded condition, but similar between loading conditions in the Compliant foot (note, the Stiff foot was associated with larger loads, overall). Independent of load or walking speed, the Compliant (versus Stiff) foot provided 67.9% larger (p < 0.001) prosthetic push-off, 17.7% larger (p = 0.01) roll-over shape radii, and was subjectively favored by 10 participants. A more Compliant versus Stiff prosthetic foot therefore appears to better accommodate walking with and without added load, and reinforce the notion that mechanical properties of prosthetic feet should be considered for near-term performance and longer-term (joint) health.
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Affiliation(s)
- Barri L Schnall
- Research & Development Section, Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Christopher L Dearth
- Research & Development Section, Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, USA; DoD-VA Extremity Trauma and Amputation Center of Excellence, Bethesda, MD, USA; Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Jonathan M Elrod
- Research & Development Section, Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Pawel R Golyski
- Research & Development Section, Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Sara R Koehler-McNicholas
- Minneapolis Department of Veterans Affairs Health Care System, Minneapolis, MN, USA; Division of Rehabilitation Science, Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Samuel F Ray
- Research & Development Section, Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Andrew H Hansen
- Minneapolis Department of Veterans Affairs Health Care System, Minneapolis, MN, USA; Division of Rehabilitation Science, Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Brad D Hendershot
- Research & Development Section, Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, USA; DoD-VA Extremity Trauma and Amputation Center of Excellence, Bethesda, MD, USA; Department of Rehabilitation Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
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29
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Jackson RW, Collins SH. Heuristic-Based Ankle Exoskeleton Control for Co-Adaptive Assistance of Human Locomotion. IEEE Trans Neural Syst Rehabil Eng 2019; 27:2059-2069. [DOI: 10.1109/tnsre.2019.2936383] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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30
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Heitkamp LN, Stimpson KH, Dean JC. Application of a Novel Force-Field to Manipulate the Relationship Between Pelvis Motion and Step Width in Human Walking. IEEE Trans Neural Syst Rehabil Eng 2019; 27:2051-2058. [PMID: 31545734 DOI: 10.1109/tnsre.2019.2941372] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Motion of the pelvis throughout a step predicts step width during human walking. This behavior is often considered an important component of ensuring bipedal stability, but can be disrupted in populations with neurological injuries. The purpose of this study was to determine whether a novel force-field that exerts mediolateral forces on the legs can manipulate the relationship between pelvis motion and step width, providing proof-of-concept for a future clinical intervention. We designed a force-field able to: 1) minimize the delivered mediolateral forces (Transparent mode); 2) apply mediolateral forces to assist the leg toward mechanically-appropriate step widths (Assistive mode); and 3) apply mediolateral forces to perturb the leg away from mechanically-appropriate step widths (Perturbing mode). Neurologically-intact participants were randomly assigned to either the Assistive group (n = 12) or Perturbing group (n = 12), and performed a series of walking trials in which they interfaced with the force-field. We quantified the step-by-step relationship between mediolateral pelvis displacement and step width using partial correlations. Walking in the Transparent force-field had a minimal effect on this relationship. However, force-field assistance directly strengthened the relationship between pelvis displacement and step width, whereas force-field perturbations weakened this relationship. Both assistance and perturbations were followed by short-lived effects during a wash-out period, in which the relationship between pelvis displacement and step width differed from the baseline value. The present results demonstrate that the link between pelvis motion and step width can be manipulated through mechanical means, which may be useful for retraining gait balance in clinical populations.
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31
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A Novel Robust Model Reference Adaptive Impedance Control Scheme for an Active Transtibial Prosthesis. ROBOTICA 2019. [DOI: 10.1017/s0263574719000146] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
SummaryIn this paper, a novel robust model reference adaptive impedance control (RMRAIC) scheme is presented for an active transtibial ankle prosthesis. The controller makes the closed loop dynamics of the prosthesis similar to a reference impedance model and provides asymptotic tracking of the response trajectory of this impedance model. The interactions between human and prosthesis are taken into account by designing a second-order reference impedance model. The proposed controller is robust against parametric uncertainties in the nonlinear dynamic model of the prosthesis. Also, the controller has robustness against bounded uncertainties due to unavailable ground reaction forces and unmeasurable feedbacks of accelerations at the socket place. Moreover, an appropriate Series Elastic Actuator (SEA) mechanism for the prosthetic ankle is included in this work and its effects are discussed. Tracking performance and stability of the closed-loop system are proven via the Lyapunov stability analysis. Using simulations on an overall amputee prosthetic foot system, the effectiveness of the proposed RMRAIC controller is investigated for the task of level ground walking.
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Anderson A, Richburg C, Czerniecki J, Aubin P. A Model-Based Method for Minimizing Reflected Motor Inertia in Off-board Actuation Systems: Applications in Exoskeleton Design. IEEE Int Conf Rehabil Robot 2019; 2019:360-367. [PMID: 31374656 DOI: 10.1109/icorr.2019.8779452] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The research and development of wearable robotic devices has been accelerated by off-board control and actuation systems. While off-board robotic actuation systems provide many benefits, the impedance at the robotic joint is often high. High joint impedance is undesirable for wearable devices like exoskeletons, as the user is unable to move their joint without actively controlled motion from the motors. We propose that the impedance can be reduced substantially in off-board robotic actuation systems by minimizing the reflected inertia from the motor. We have developed a model and optimization-based methodology for selecting a motor and set of mechanical design parameters that minimize reflected inertia. This methodology was implemented in the design of an off-board knee exoskeleton as a case study. A grey-box model was developed that incorporates biomechanical knee trajectories, an experimentally determined human-device interface stiffness model, Bowden cable stiffness and friction, and a motor model. A constrained optimization routine was developed that uses the model and a library of157 candidate servo motors to select the actuator and mechanical design parameters that minimize reflected inertia at the exoskeleton joint. We found that S6 of the motors were able to carry out the necessary torque-velocity trajectories to achieve the prescribed exoskeleton joint torques and limb motions. The optimal motor was the Kollmorgen C133A-one of the largest in the library of candidate servo motors and required a 2.25 cm actuator pulley at the knee joint and a 17.5 cm cable sheave at the motor output. This methodology can be adapted by exoskeleton designers to develop more backdriveable exoskeletons and improve experimental capabilities. All code developed for the case study is open-source and freely available online.
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33
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Wang X, Guo S, Qu H, Song M. Design of a Purely Mechanical Sensor-Controller Integrated System for Walking Assistance on an Ankle-Foot Exoskeleton. SENSORS 2019; 19:s19143196. [PMID: 31331126 PMCID: PMC6679259 DOI: 10.3390/s19143196] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 07/14/2019] [Accepted: 07/16/2019] [Indexed: 11/19/2022]
Abstract
Propulsion during push-off (PO) is a key factor to realize human locomotion. Through the detection of real-time gait stage, assistance could be provided to the human body at the proper time. In most cases, ankle-foot exoskeletons consist of electronic sensors, microprocessors, and actuators. Although these three essential elements contribute to fulfilling the function of the detection, control, and energy injection, they result in a huge system that reduces the wearing comfort. To simplify the sensor-controller system and reduce the mass of the exoskeleton, we designed a smart clutch in this paper, which is a sensor-controller integrated system that comprises a sensing part and an executing part. With a spring functioning as an actuator, the whole exoskeleton system is completely made up of mechanical parts and has no external power source. By controlling the engagement of the actuator based on the signal acquired from the sensing part, the proposed clutch enables the ankle-foot exoskeleton (AFE) to provide additional ankle torque during PO, and allows free rotation of the ankle joint during swing phase, thus reducing the metabolic cost of the human body. There are two striking advantages of the designed clutch. On the one hand, the clutch is lightweight and reliable—it resists the possible shock during walking since there is no circuit connection or power in the system. On the other hand, the detection of gait relies on the contact states between human feet and the ground, so the clutch is universal and does not need to be customized for individuals.
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Affiliation(s)
- Xiangyang Wang
- Robotics Research Center, School of Mechanical, Electronic and Control Engineering, Beijing Jiaotong University, Beijing 100044, China
| | - Sheng Guo
- Robotics Research Center, School of Mechanical, Electronic and Control Engineering, Beijing Jiaotong University, Beijing 100044, China.
- Key Laboratory of Vehicle Advanced Manufacturing, Measuring and Control Technology, Ministry of Education, Beijing Jiaotong University, Beijing 100044, China.
| | - Haibo Qu
- Robotics Research Center, School of Mechanical, Electronic and Control Engineering, Beijing Jiaotong University, Beijing 100044, China
- Key Laboratory of Vehicle Advanced Manufacturing, Measuring and Control Technology, Ministry of Education, Beijing Jiaotong University, Beijing 100044, China
| | - Majun Song
- Robotics Research Center, School of Mechanical, Electronic and Control Engineering, Beijing Jiaotong University, Beijing 100044, China
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34
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Price MA, Beckerle P, Sup FC. Design Optimization in Lower Limb Prostheses: A Review. IEEE Trans Neural Syst Rehabil Eng 2019; 27:1574-1588. [PMID: 31283485 DOI: 10.1109/tnsre.2019.2927094] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
This paper aims to develop a knowledge base and identify the promising research pathways toward designing lower limb prostheses for optimal biomechanical and clinical outcomes. It is based on the literature search representing the state of the art in the lower limb prosthesis joint design and biomechanical analysis. Current design solutions are organized in terms of fulfilling four key functional roles: body support, propulsion, task flexibility, and loading relief. Biomechanical analyses of these designs reveal that the hypothesized outcomes are not consistently observed. We suggest that these outcomes may be improved by incorporating tools that can predict user performance metrics to optimize the device during the initial design process. We also note that the scope of the solution space of most current designs is limited by focusing on the anthropomorphic design approaches that do not account for the person's altered anatomy post-amputation. The effects of the prosthetic joint behavior on whole-body gait biomechanics and user experience are likewise under-explored. Two research paths to support the goal of better predicting the user outcomes are proposed: experimental parameterization of designs and model-based simulations. However, while work in these areas has introduced promising new possibilities, connecting both to improve real-world performance remains a challenge.
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35
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Khazoom C, Veronneau C, Bigue JPL, Grenier J, Girard A, Plante JS. Design and Control of a Multifunctional Ankle Exoskeleton Powered by Magnetorheological Actuators to Assist Walking, Jumping, and Landing. IEEE Robot Autom Lett 2019. [DOI: 10.1109/lra.2019.2924852] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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36
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Comparison of Human-Robot Interaction Torque Estimation Methods in a Wrist Rehabilitation Exoskeleton. J INTELL ROBOT SYST 2019. [DOI: 10.1007/s10846-018-0786-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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37
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McCain EM, Dick TJM, Giest TN, Nuckols RW, Lewek MD, Saul KR, Sawicki GS. Mechanics and energetics of post-stroke walking aided by a powered ankle exoskeleton with speed-adaptive myoelectric control. J Neuroeng Rehabil 2019; 16:57. [PMID: 31092269 PMCID: PMC6521500 DOI: 10.1186/s12984-019-0523-y] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 04/16/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Ankle exoskeletons offer a promising opportunity to offset mechanical deficits after stroke by applying the needed torque at the paretic ankle. Because joint torque is related to gait speed, it is important to consider the user's gait speed when determining the magnitude of assistive joint torque. We developed and tested a novel exoskeleton controller for delivering propulsive assistance which modulates exoskeleton torque magnitude based on both soleus muscle activity and walking speed. The purpose of this research is to assess the impact of the resulting exoskeleton assistance on post-stroke walking performance across a range of walking speeds. METHODS Six participants with stroke walked with and without assistance applied to a powered ankle exoskeleton on the paretic limb. Walking speed started at 60% of their comfortable overground speed and was increased each minute (n00, n01, n02, etc.). We measured lower limb joint and limb powers, metabolic cost of transport, paretic and non-paretic limb propulsion, and trailing limb angle. RESULTS Exoskeleton assistance increased with walking speed, verifying the speed-adaptive nature of the controller. Both paretic ankle joint power and total limb power increased significantly with exoskeleton assistance at six walking speeds (n00, n01, n02, n03, n04, n05). Despite these joint- and limb-level benefits associated with exoskeleton assistance, no subject averaged metabolic benefits were evident when compared to the unassisted condition. Both paretic trailing limb angle and integrated anterior paretic ground reaction forces were reduced with assistance applied as compared to no assistance at four speeds (n00, n01, n02, n03). CONCLUSIONS Our results suggest that despite appropriate scaling of ankle assistance by the exoskeleton controller, suboptimal limb posture limited the conversion of exoskeleton assistance into forward propulsion. Future studies could include biofeedback or verbal cues to guide users into limb configurations that encourage the conversion of mechanical power at the ankle to forward propulsion. TRIAL REGISTRATION N/A.
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Affiliation(s)
- Emily M McCain
- North Carolina State University, 911 Oval Drive, Raleigh, NC, 27606, USA.
| | - Taylor J M Dick
- School of Biomedical Sciences, University of Queensland, St. Lucia, QLD, Australia
| | - Tracy N Giest
- North Carolina State University, 911 Oval Drive, Raleigh, NC, 27606, USA
| | | | - Michael D Lewek
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Katherine R Saul
- North Carolina State University, 911 Oval Drive, Raleigh, NC, 27606, USA
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38
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Chiu VL, Voloshina AS, Collins SH. An Ankle-Foot Prosthesis Emulator Capable of Modulating Center of Pressure. IEEE Trans Biomed Eng 2019; 67:166-176. [PMID: 30969914 DOI: 10.1109/tbme.2019.2910071] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Several powered ankle-foot prostheses have demonstrated moderate reductions in energy expenditure by restoring pushoff work in late stance or by assisting with balance. However, it is possible that center of pressure trajectory modulation could provide even further improvements in user performance. Here, we describe the design of a prosthesis emulator with two torque-controlled forefoot digits and a torque-controlled heel digit. Independent actuation of these three digits can modulate the origin and magnitude of the total ground reaction force vector. METHODS The emulator was designed to be compact and lightweight while exceeding the range of motion and torque requirements of the biological ankle during walking. We ran a series of tests to determine torque-measurement accuracy, closed-loop torque control bandwidth, torque-tracking error, and center of pressure control accuracy. RESULTS Each of the three digits demonstrated less than 2 Nm of RMS torque measurement error, a 90% rise time of 19 ms, and a bandwidth of 33 Hz. The untethered end-effector has a mass of 1.2 kg. During walking trials, the emulator demonstrated less than 2 Nm of RMS torque-tracking error and was able to maintain full digit ground contact for 56% of stance. In fixed, standing, and walking conditions, the emulator was able to control center of pressure along a prescribed pattern with RMS errors of about 10% the length of the pattern. CONCLUSION The proposed emulator system meets all design criteria and can effectively modulate center of pressure and ground reaction force magnitude. SIGNIFICANCE This emulator system will enable rapid development of controllers designed to enhance user balance and reduce user energy expenditure. Experiments conducted using this emulator could identify beneficial control behaviors that can be implemented on autonomous devices, thus improving mobility and quality of life of individuals with amputation.
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39
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Pickle NT, Silverman AK, Wilken JM, Fey NP. Statistical analysis of timeseries data reveals changes in 3D segmental coordination of balance in response to prosthetic ankle power on ramps. Sci Rep 2019; 9:1272. [PMID: 30718756 PMCID: PMC6362138 DOI: 10.1038/s41598-018-37581-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 12/03/2018] [Indexed: 11/09/2022] Open
Abstract
Active ankle-foot prostheses generate mechanical power during the push-off phase of gait, which can offer advantages over passive prostheses. However, these benefits manifest primarily in joint kinetics (e.g., joint work) and energetics (e.g., metabolic cost) rather than balance (whole-body angular momentum, H), and are typically constrained to push-off. The purpose of this study was to analyze differences between active and passive prostheses and non-amputees in coordination of balance throughout gait on ramps. We used Statistical Parametric Mapping (SPM) to analyze time-series contributions of body segments (arms, legs, trunk) to three-dimensional H on uphill, downhill, and level grades. The trunk and prosthetic-side leg contributions to H at toe-off when using the active prosthesis were more similar to non-amputees compared to using a passive prosthesis. However, using either a passive or active prosthesis was different compared to non-amputees in trunk contributions to sagittal-plane H during mid-stance and transverse-plane H at toe-off. The intact side of the body was unaffected by prosthesis type. In contrast to clinical balance assessments (e.g., single-leg standing, functional reach), our analysis identifies significant changes in the mechanics of segmental coordination of balance during specific portions of the gait cycle, providing valuable biofeedback for targeted gait retraining.
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Affiliation(s)
- Nathaniel T Pickle
- Department of Bioengineering, The University of Texas at Dallas, Richardson, TX, 75080, USA.
| | - Anne K Silverman
- Department of Mechanical Engineering, Colorado School of Mines, Golden, CO, 80401, USA
| | - Jason M Wilken
- Center for the Intrepid, Brooke Army Medical Center, JBSA Ft Sam Houston, TX, 78234, USA.,Extremity Trauma and Amputation Center of Excellence, JBSA Ft Sam Houston, TX, 78234, USA
| | - Nicholas P Fey
- Department of Bioengineering, The University of Texas at Dallas, Richardson, TX, 75080, USA.,Department of Physical Medicine and Rehabilitation, The University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA
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40
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Shepherd MK, Azocar AF, Major MJ, Rouse EJ. Amputee perception of prosthetic ankle stiffness during locomotion. J Neuroeng Rehabil 2018; 15:99. [PMID: 30409168 PMCID: PMC6225626 DOI: 10.1186/s12984-018-0432-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 09/25/2018] [Indexed: 12/02/2022] Open
Abstract
Background Prosthetic feet are spring-like, and their stiffness critically affects the wearer’s stability, comfort, and energetic cost of walking. Despite the importance of stiffness in ambulation, the prescription process often entails testing a limited number of prostheses, which may result in patients receiving a foot with suboptimal mechanics. To understand the resolution with which prostheses should be individually optimized, we sought to characterize below-knee prosthesis users’ psychophysical sensitivity to prosthesis stiffness. Methods We used a novel variable-stiffness ankle prosthesis to measure the repeatability of user-selected preferred stiffness, and implemented a psychophysical experiment to characterize the just noticeable difference of stiffness during locomotion. Results All eight subjects with below-knee amputation exhibited high repeatability in selecting their Preferred Stiffness (mean coefficient of variation: 14.2 ± 1.7%) and were able to correctly identify a 7.7 ± 1.3% change in ankle stiffness (with 75% accuracy). Conclusions This high sensitivity suggests prosthetic foot stiffness should be tuned with a high degree of precision on an individual basis. These results also highlight the need for a pairing of new robotic prescription tools and mechanical characterizations of prosthetic feet.
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Affiliation(s)
- Max K Shepherd
- Shirley Ryan AbilityLab, Room 11-1414, 355 E Erie St, Chicago, IL, 60611, USA. .,Department of Biomedical Engineering, Northwestern University, 663 Clark St, Evanston, IL, 60208, USA. .,Neurobionics Lab, University of Michigan, Ann Arbor, MI, 48109, USA.
| | - Alejandro F Azocar
- Neurobionics Lab, University of Michigan, Ann Arbor, MI, 48109, USA.,Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI, 48109, USA.,Robotics Institute, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Matthew J Major
- Northwestern University Feinberg School of Medicine, Department of Physical Medicine and Rehabilitation, 710 North Lake Shore Drive, #1022, Chicago, IL, 60611, USA
| | - Elliott J Rouse
- Neurobionics Lab, University of Michigan, Ann Arbor, MI, 48109, USA.,Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI, 48109, USA.,Robotics Institute, University of Michigan, Ann Arbor, MI, 48109, USA
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Glanzer EM, Adamczyk PG. Design and Validation of a Semi-Active Variable Stiffness Foot Prosthesis. IEEE Trans Neural Syst Rehabil Eng 2018; 26:2351-2359. [PMID: 30371376 DOI: 10.1109/tnsre.2018.2877962] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
This paper presents the design and validation of a novel lower limb prosthesis called the variable stiffness foot (VSF), designed to vary its forefoot stiffness in response to user activity. The VSF is designed as a semi-active device that adjusts its stiffness once per stride during swing phases, in order to minimize size, mass, and power consumption. The forefoot keel is designed as an overhung composite beam, whose stiffness is varied by moving a support fulcrum to change the length of the overhang. Stiffness modulation is programmed in response to the gait characteristics detected through foot trajectory reconstruction based on an embedded inertial sensor. The prototype VSF has a mass of only 649 g including the battery, and a build height of 87 mm. Mechanical testing demonstrated a forefoot stiffness range of 10-32 N/mm for the prototype, a threefold range of stiffness variation. The stiffness range can be altered by changing the keel material or geometry. Actuation testing showed that the VSF can make a full-scale stiffness adjustment within three strides, and tracks moderate speed-driven variations within one swing phase. Human subjects testing demonstrated greater energy storage and return with lower stiffness settings. This capability may be useful for the modulating prosthesis energy return to better mimic human ankle function. Subjective feedback indicated clear perception by the subjects of contrasts among the stiffness settings, including interpretation of scenarios for which different settings may be beneficial. Future applications of the VSF include adapting stiffness to optimize stairs, ramps, turns, and standing.
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Alamdari A, Haghighi R, Krovi V. Stiffness Modulation in an Elastic Articulated-Cable Leg-Orthosis Emulator: Theory and Experiment. IEEE T ROBOT 2018. [DOI: 10.1109/tro.2018.2830356] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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43
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An Ankle–Foot Prosthesis Emulator With Control of Plantarflexion and Inversion–Eversion Torque. IEEE T ROBOT 2018. [DOI: 10.1109/tro.2018.2830372] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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44
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Liu Y, Zang X, Zhang N, Wu M. Design and Evaluation of a Wearable Powered Foot Orthosis with Metatarsophalangeal Joint. Appl Bionics Biomech 2018; 2018:9289505. [PMID: 30327683 PMCID: PMC6169210 DOI: 10.1155/2018/9289505] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2018] [Accepted: 08/16/2018] [Indexed: 11/18/2022] Open
Abstract
The metatarsophalangeal (MTP) joints play critical roles in human locomotion. Functional restriction or loss of MTP joints will lead to lower walking speed, poorer walking balance, and more consumed metabolic energy cost compared with normal walking. However, existing foot orthoses are focused on maintaining the movement of the ankle joint, without assisting the MTP joints. In this paper, in order to improve the walking performance of people with lower limb impairments, a wearable powered foot orthosis (WPFO) which has actuated MTP joint is designed and constructed. Preliminary experiments on three nondisabled subjects demonstrated functionality and capabilities of the WPFO to provide correctly timed dorsiflexion and plantar flexion assistance at the MTP joint during walking. These results also suggest that the WPFO could offer promise in certain rehabilitation applications and clinical treatment.
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Affiliation(s)
- Yixiang Liu
- State Key Laboratory of Robotics and System, Harbin Institute of Technology, Harbin 150080, China
- Legs and Walking Lab, Shirley Ryan AbilityLab Formerly the Rehabilitation Institute of Chicago, Chicago, IL 60611, USA
- Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, IL 60611, USA
| | - Xizhe Zang
- State Key Laboratory of Robotics and System, Harbin Institute of Technology, Harbin 150080, China
| | - Niansong Zhang
- Legs and Walking Lab, Shirley Ryan AbilityLab Formerly the Rehabilitation Institute of Chicago, Chicago, IL 60611, USA
- Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, IL 60611, USA
- School of Mechanical Engineering, Nanjing University of Science and Technology, Nanjing 210016, China
| | - Ming Wu
- Legs and Walking Lab, Shirley Ryan AbilityLab Formerly the Rehabilitation Institute of Chicago, Chicago, IL 60611, USA
- Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, IL 60611, USA
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45
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Handford ML, Srinivasan M. Energy-Optimal Human Walking With Feedback-Controlled Robotic Prostheses: A Computational Study. IEEE Trans Neural Syst Rehabil Eng 2018; 26:1773-1782. [DOI: 10.1109/tnsre.2018.2858204] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Park H, Islam MS, Grover MA, Klishko AN, Prilutsky BI, DeWeerth SP. A Prototype of a Neural, Powered, Transtibial Prosthesis for the Cat: Benchtop Characterization. Front Neurosci 2018; 12:471. [PMID: 30057524 PMCID: PMC6053514 DOI: 10.3389/fnins.2018.00471] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2017] [Accepted: 06/21/2018] [Indexed: 01/11/2023] Open
Abstract
We developed a prototype of a neural, powered, transtibial prosthesis for the use in a feline model of prosthetic gait. The prosthesis was designed for attachment to a percutaneous porous titanium implant integrated with bone, skin, and residual nerves and muscles. In the benchtop testing, the prosthesis was fixed in a testing rig and subjected to rhythmic vertical displacements and interactions with the ground at a cadence corresponding to cat walking. Several prosthesis functions were evaluated. They included sensing ground contact, control of transitions between the finite states of prosthesis loading, and a closed-loop modulation of the linear actuator gain in each loading cycle. The prosthetic design parameters (prosthesis length = 55 mm, mass = 63 g, peak extension moment = 1 Nm) corresponded closely to those of the cat foot-ankle with distal shank and the peak ankle extension moment during level walking. The linear actuator operated the prosthetic ankle joint using inputs emulating myoelectric activity of residual muscles. The linear actuator gain was modulated in each cycle to minimize the difference between the peak of ground reaction forces (GRF) recorded by a ground force sensor and a target force value. The benchtop test results demonstrated a close agreement between the GRF peaks and patterns produced by the prosthesis and by cats during level walking.
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Affiliation(s)
- Hangue Park
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, United States.,Biomechanics and Motor Control Laboratory, School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, United States
| | - Muhammad S Islam
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, United States
| | - Martha A Grover
- School of Chemical & Biomolecular Engineering, Georgia Institute of Technology, Atlanta, GA, United States
| | - Alexander N Klishko
- Biomechanics and Motor Control Laboratory, School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, United States
| | - Boris I Prilutsky
- Biomechanics and Motor Control Laboratory, School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, United States
| | - Stephen P DeWeerth
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, United States.,P.C. Rossin College of Engineering and Applied Science, Lehigh University, Bethlehem, PA, United States
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Jayaraman C, Hoppe-Ludwig S, Deems-Dluhy S, McGuire M, Mummidisetty C, Siegal R, Naef A, Lawson BE, Goldfarb M, Gordon KE, Jayaraman A. Impact of Powered Knee-Ankle Prosthesis on Low Back Muscle Mechanics in Transfemoral Amputees: A Case Series. Front Neurosci 2018; 12:134. [PMID: 29623025 PMCID: PMC5874899 DOI: 10.3389/fnins.2018.00134] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 02/20/2018] [Indexed: 12/04/2022] Open
Abstract
Regular use of prostheses is critical for individuals with lower limb amputations to achieve everyday mobility, maintain physical and physiological health, and achieve a better quality of life. Use of prostheses is influenced by numerous factors, with prosthetic design playing a critical role in facilitating mobility for an amputee. Thus, prostheses design can either promote biomechanically efficient or inefficient gait behavior. In addition to increased energy expenditure, inefficient gait behavior can expose prosthetic user to an increased risk of secondary musculoskeletal injuries and may eventually lead to rejection of the prosthesis. Consequently, researchers have utilized the technological advancements in various fields to improve prosthetic devices and customize them for user specific needs. One evolving technology is powered prosthetic components. Presently, an active area in lower limb prosthetic research is the design of novel controllers and components in order to enable the users of such powered devices to be able to reproduce gait biomechanics that are similar in behavior to a healthy limb. In this case series, we studied the impact of using a powered knee-ankle prostheses (PKA) on two transfemoral amputees who currently use advanced microprocessor controlled knee prostheses (MPK). We utilized outcomes pertaining to kinematics, kinetics, metabolics, and functional activities of daily living to compare the efficacy between the MPK and PKA devices. Our results suggests that the PKA allows the participants to walk with gait kinematics similar to normal gait patterns observed in a healthy limb. Additionally, it was observed that use of the PKA reduced the level of asymmetry in terms of mechanical loading and muscle activation, specifically in the low back spinae regions and lower extremity muscles. Further, the PKA allowed the participants to achieve a greater range of cadence than their predicate MPK, thus allowing them to safely ambulate in variable environments and dynamically control speed changes. Based on the results of this case series, it appears that there is considerable potential for powered prosthetic components to provide safe and efficient gait for individuals with above the knee amputation.
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Affiliation(s)
- Chandrasekaran Jayaraman
- Max Nader Lab for Rehabilitation Technologies & Outcomes Research, Center for Bionic Medicine, Shirley Ryan Ability Lab, Chicago, IL, United States.,Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, United States
| | - Shenan Hoppe-Ludwig
- Max Nader Lab for Rehabilitation Technologies & Outcomes Research, Center for Bionic Medicine, Shirley Ryan Ability Lab, Chicago, IL, United States
| | - Susan Deems-Dluhy
- Max Nader Lab for Rehabilitation Technologies & Outcomes Research, Center for Bionic Medicine, Shirley Ryan Ability Lab, Chicago, IL, United States
| | - Matt McGuire
- Max Nader Lab for Rehabilitation Technologies & Outcomes Research, Center for Bionic Medicine, Shirley Ryan Ability Lab, Chicago, IL, United States
| | - Chaithanya Mummidisetty
- Max Nader Lab for Rehabilitation Technologies & Outcomes Research, Center for Bionic Medicine, Shirley Ryan Ability Lab, Chicago, IL, United States
| | - Rachel Siegal
- Max Nader Lab for Rehabilitation Technologies & Outcomes Research, Center for Bionic Medicine, Shirley Ryan Ability Lab, Chicago, IL, United States
| | - Aileen Naef
- Max Nader Lab for Rehabilitation Technologies & Outcomes Research, Center for Bionic Medicine, Shirley Ryan Ability Lab, Chicago, IL, United States.,School of Life Sciences, Swiss Federal Institute of Technology in Lausanne, Lausanne, Switzerland
| | - Brian E Lawson
- Department of Mechanical Engineering, Vanderbilt University, Nashville, TN, United States
| | - Michael Goldfarb
- Department of Mechanical Engineering, Vanderbilt University, Nashville, TN, United States
| | - Keith E Gordon
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, United States
| | - Arun Jayaraman
- Max Nader Lab for Rehabilitation Technologies & Outcomes Research, Center for Bionic Medicine, Shirley Ryan Ability Lab, Chicago, IL, United States.,Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, United States
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Reviewing Clinical Effectiveness of Active Training Strategies of Platform-Based Ankle Rehabilitation Robots. JOURNAL OF HEALTHCARE ENGINEERING 2018; 2018:2858294. [PMID: 29675142 PMCID: PMC5838480 DOI: 10.1155/2018/2858294] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Accepted: 01/09/2018] [Indexed: 11/17/2022]
Abstract
Objective This review aims to provide a systematical investigation of clinical effectiveness of active training strategies applied in platform-based ankle robots. Method English-language studies published from Jan 1980 to Aug 2017 were searched from four databases using key words of "Ankle∗" AND "Robot∗" AND "Effect∗ OR Improv∗ OR Increas∗." Following an initial screening, three rounds of discrimination were successively conducted based on the title, the abstract, and the full paper. Result A total of 21 studies were selected with 311 patients involved; of them, 13 studies applied a single group while another eight studies used different groups for comparison to verify the therapeutic effect. Virtual-reality (VR) game training was applied in 19 studies, while two studies used proprioceptive neuromuscular facilitation (PNF) training. Conclusion Active training techniques delivered by platform ankle rehabilitation robots have been demonstrated with great potential for clinical applications. Training strategies are mostly combined with one another by considering rehabilitation schemes and motion ability of ankle joints. VR game environment has been commonly used with active ankle training. Bioelectrical signals integrated with VR game training can implement intelligent identification of movement intention and assessment. These further provide the foundation for advanced interactive training strategies that can lead to enhanced training safety and confidence for patients and better treatment efficacy.
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Zhang J, Fiers P, Witte KA, Jackson RW, Poggensee KL, Atkeson CG, Collins SH. Human-in-the-loop optimization of exoskeleton assistance during walking. Science 2018. [PMID: 28642437 DOI: 10.1126/science.aal5054] [Citation(s) in RCA: 319] [Impact Index Per Article: 53.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Exoskeletons and active prostheses promise to enhance human mobility, but few have succeeded. Optimizing device characteristics on the basis of measured human performance could lead to improved designs. We have developed a method for identifying the exoskeleton assistance that minimizes human energy cost during walking. Optimized torque patterns from an exoskeleton worn on one ankle reduced metabolic energy consumption by 24.2 ± 7.4% compared to no torque. The approach was effective with exoskeletons worn on one or both ankles, during a variety of walking conditions, during running, and when optimizing muscle activity. Finding a good generic assistance pattern, customizing it to individual needs, and helping users learn to take advantage of the device all contributed to improved economy. Optimization methods with these features can substantially improve performance.
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Affiliation(s)
- Juanjuan Zhang
- Department of Mechanical Engineering, Carnegie Mellon University, Pittsburgh, PA, USA.,School of Electrical and Electronic Engineering, Nanyang Technological University, Singapore
| | - Pieter Fiers
- Department of Mechanical Engineering, Carnegie Mellon University, Pittsburgh, PA, USA
| | - Kirby A Witte
- Department of Mechanical Engineering, Carnegie Mellon University, Pittsburgh, PA, USA
| | - Rachel W Jackson
- Department of Mechanical Engineering, Carnegie Mellon University, Pittsburgh, PA, USA
| | - Katherine L Poggensee
- Department of Mechanical Engineering, Carnegie Mellon University, Pittsburgh, PA, USA
| | | | - Steven H Collins
- Department of Mechanical Engineering, Carnegie Mellon University, Pittsburgh, PA, USA. .,Robotics Institute, Carnegie Mellon University, Pittsburgh, PA, USA
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Shepherd MK, Rouse EJ. The VSPA Foot: A Quasi-Passive Ankle-Foot Prosthesis With Continuously Variable Stiffness. IEEE Trans Neural Syst Rehabil Eng 2017; 25:2375-2386. [DOI: 10.1109/tnsre.2017.2750113] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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