Ageing population is now a global challenge, where physical deterioration is the common feature in elderly people. In addition, the diseases, such as spinal cord injury, stroke, and injury, could cause a partial or total loss of the ability of human locomotion. Thus, assistance is necessary for them to perform safe activities of daily living. Robotic hip exoskeletons are able to support ambulatory functions in elderly people and provide rehabilitation for the patients with gait impairments. They can also augment human performance during normal walking, loaded walking, and manual handling of heavy-duty tasks by providing assistive force/torque. In this article, a systematic review of robotic hip exoskeletons is presented, where biomechanics of the human hip joint, pathological gait pattern, and common approaches to the design of robotic hip exoskeletons are described. Finally, limitations of the available robotic hip exoskeletons and their possible future directions are discussed, which could serve a useful reference for the engineers and researchers to develop robotic hip exoskeletons with practical and plausible applications in geriatric orthopaedics.The translational potential of this articleThe past decade has witnessed a remarkable progress in research and development of robotic hip exoskeletons. Our aim is to summarize recent developments of robotic hip exoskeletons for the engineers, clinician scientists and rehabilitation personnel to develop efficient robotic hip exoskeletons for practical and plausible applications.
This paper introduces a wearable exoskeleton suit CUHK-EXO that can help paraplegic patients regain their mobility to stand up, sit down, and walk. An offline design and online modification (ODOM) algorithm is proposed for the exoskeleton to generate reference joint trajectories during walking assistance. First, reference trajectories of CUHK-EXO are designed offline based on motion capture data considering leg geometry constraints. Then the human-exoskeleton system (HES) including a pair of crutches is modeled as an eight-link system for analysis. Since the relative position of system center of pressure (COP) is an important factor to indicate system balance during walking, it is estimated in real-time and monitored for exoskeleton control. Based on the system COP position, this paper further proposes the reference trajectories online modification method for CUHK-EXO to counteract disturbances applied to the HES, and hence stabilize system balance in the walking assistance. Finally, walking tests are performed in both healthy subjects and a paraplegic patient to validate the effectiveness of the proposed ODOM algorithm. Testing results demonstrate that knowing the COP desired areas of the wearer, the exoskeleton CUHK-EXO can counteract perturbations and decrease the wearer's efforts, so as to maintain system balance with the ODOM algorithm.
Patients suffering from neurological and orthopedic diseases or injuries usually have mobility impairment problems, and they require customized rehabilitation training to recover. In recent years, robotic assistive devices have been widely studied for gait rehabilitation. In this paper, methods to determine user-adaptive assistance of assistive knee braces (AKBs) in gait rehabilitation are investigated. A fuzzy expert system, which takes a patient's physical condition and gait analysis results as inputs, is proposed to configure suitable levels of different assistive functions of the AKB. During gait rehabilitation, the AKB generates a reference knee trajectory according to the patient's individual gait pattern, and the interaction force is controlled through a hybrid impedance controller considering the individual assistive function configuration. The proposed methods are verified through clinical pilot studies of a patient with lower limb weakness. Experimental results show that AKB with the proposed control strategies can provide effective assistance to improve the patient's gait performance during gait rehabilitation.
The increasing requirement of powering portable electronic devices can be potentially met by recycling the biomechanical energy generated during the human joint motion through a knee-ankle exoskeleton. In this paper, a knee-ankle exoskeleton is designed to recycle the negative work from the wearer’s knee extension and ankle dorsiflexion. The exoskeleton can convert the mechanical energy into electrical energy for energy harvesting and assist the knee flexion and ankle plantarflexion to reduce the wearer’s metabolic cost during walking. It is mainly composed of two torsion springs, two one-way transmission mechanisms, a gear train, and a generator. The torsion springs can store the elastic energy when the wearer’s ankle and knee joints do negative work and release it to assist walking when positive work is required. The one-way transmission mechanisms are employed to filter the knee flexion and ankle plantarflexion and to convert the knee extension and ankle dorsiflexion into the one-way rotation of the generator by symmetrically arranging the gear train. Finally, experiments are conducted to evaluate the performance of the developed knee-ankle exoskeleton. The experimental results indicate that the exoskeleton can generate an average electrical power of 0.49 W and a maximum instantaneous electrical power of 1.8 W at a walking speed of 5.5 km/h during a gait cycle, and reductions of 3.48% ± 0.33%, 9.50% ± 0.29%, and 4.54% ± 0.47% of the average muscle activities of the semitendinosus, soleus, and gastrocnemius during a gait cycle are observed, respectively.
In this paper, the design and experimental validation of a knee exoskeleton are presented. The exoskeleton can capture the negative work from the wearer’s knee motion while decreasing the muscle activities of the wearer. First, the human knee biomechanics during the normal walking is described. Then, the design of the exoskeleton is presented. The exoskeleton mainly includes a left one-way transmission mechanism, a right one-way transmission mechanism, and a front transmission mechanism. The left and right one-way transmission mechanisms are designed to capture the negative work from the wearer’s knee motion in the stance and swing phases, respectively. The front transmission mechanism is designed to transform the bidirectional rotation of the wearer’s knee joint into the generator unidirectional rotation. Additionally, the modeling and analysis of the energy harvesting of the exoskeleton is described. Finally, walking experiments are performed to validate the effectiveness of the proposed knee exoskeleton. The testing results verify that the developed knee exoskeleton can output a maximum power of 5.68 ± 0.23 W and an average power of 1.45 ± 0.13 W at a speed of 4.5 km/h in a gait cycle. The average rectus femoris and semitendinosus activities of the wearers in a gait cycle are decreased by 3.68% and 3.40%, respectively.
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