Assist-as-needed training paradigms for robotic rehabilitation of spinal cord injuries

Cai, L.L.; Fong, Andy J.; Liang, Yongqiang; Burdick, Joel W.; Edgerton, V. Reggie

doi:10.1109/robot.2006.1642237

Cited by 42 publications

(37 citation statements)

References 22 publications

(20 reference statements)

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“…voluntary muscle contraction, range of joint motion, bioelectrical residual activity) and adaptation, urge us to vouch for long-term rehabilitation in place of, or at least in conjunction with, motor substitution. This suggests the inclusion of principles in motor rehabilitation, including "assist-as-needed" (Cai et al 2006) and "challenged-based" in the development of hybrid robotic systems.…”

Section: Improving Functional Outcomes In Physical Rehabilitationmentioning

confidence: 99%

Hybrid FES–robotic gait rehabilitation technologies: a review on mechanical design, actuation, and control strategies

Anaya

Thangavel

Huang

2018

Int J Intell Robot Appl

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Gait disorders in neurologically disabled people can be treated by various techniques available today which include passive orthoses, functional electrical stimulation (FES) and robot assisted gait training devices (RAGT). However, each system has its own drawback. For example, gait rehabilitation with orthosis is physically taxing for the patient with no significant functional improvement. FES uses muscle powers as physiological actuators to promote balance and improve gait but leads to fatigue, along with poor control of joint trajectories. RAGT devices including powered exoskeletons, gait rehabilitation systems employing programmable footplates and mobile training platforms, have shown significant advantages but the devices are not yet mature due to numerous drawbacks associated with physical and cognitive interaction, energy-management and portability issues. The combination of FES technology and RAGT devices, often named hybrid FES-robot technologies, has arisen as a promising approach to aid in gait restoration. This work reports a comprehensive review on the hybrid FES-robot technologies over the last decades, focusing on different mechanical structures, actuator designs, sensing technologies, and control approaches. The hybrid robotic structures are classified into two categories: (i) orthotic-based hybrid systems, where (a) FES is used to stimulate the muscles and produce joint torque while the robotic system acts as energy dissipating device, and (b) FES and robotic systems are both torque-generating devices; and (ii) non-orthotic based hybrid systems. The review compiles a variety of sources and illustrates the technology's most important challenges in the fields of hybrid rehabilitation robotics which may contribute towards further development of hybrid robot systems.

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Section: Improving Functional Outcomes In Physical Rehabilitationmentioning

confidence: 99%

Hybrid FES–robotic gait rehabilitation technologies: a review on mechanical design, actuation, and control strategies

Anaya

Thangavel

Huang

2018

Int J Intell Robot Appl

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“…The amplitude of mechanical perturbation as well as its frequency can be adjusted based on a patient's performance, providing assistance only as needed to promote the patient's participation, which is an essential element of neurorestoration [11], [12]. An important limitation of the current preliminary version of the training protocol is that the subjects were asked to walk on a treadmill at a constant speed; it is not obvious whether the subject can actually improve their walking speed in overground walking.…”

Section: B a Potential Strategy For Locomotion Therapymentioning

confidence: 99%

Feasibility of entrainment with ankle mechanical perturbation to treat locomotor deficit of neurologically impaired patients

Ahn

Patterson

Lee

et al. 2011

2011 Annual International Conference of the IEEE Engineering in Medicine and Biology Society

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Entraining human gait with periodic torque from a robot may provide a novel approach to robot-aided walking therapy that is competent to exploit the natural oscillating dynamics of human walking. To test the feasibility of this strategy we applied a periodic ankle torque to neurologically impaired patients (one with stroke and one with multiple sclerosis). As observed in normal human walking, both patients adapted their gait periods to synchronize with the perturbation by phase-locking the robotic torque at terminal stance phase. In addition, their gait cadence became significantly faster due to the training with clear after effects when the perturbation ceased. These results support a new strategy for walking therapy that exploits an embedded neural oscillator interacting with peripheral mechanics and the resulting natural dynamics of walking, which are essential but hitherto neglected elements of walking therapy.

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“…By controlling not only the frequency but also the amplitude of the supplementary torque, we may also continuously adjust the robotic assistance to promote patient participation, assisting only as needed. This has proven to be an essential component of neuro-restoration [14], [15].…”

Section: B a Potential Strategy Of Locomotion Therapymentioning

confidence: 99%

Feasibility of dynamic entrainment with ankle mechanical perturbation to treat locomotor deficit

Ahn

Hogan

2010

2010 Annual International Conference of the IEEE Engineering in Medicine and Biology

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Dynamically entraining human gait with periodic torque from a robot may provide an approach to walking therapy that is uniquely supportive of normal biological function. To test the feasibility of this approach we perturbed the gait of unimpaired human subjects by applying a periodic impulsive ankle torque at various frequencies. Eighteen subjects out of 19 exhibited entrained gaits: for a small range of frequencies their gait periods adapted to synchronize with the mechanical perturbation. In addition, the phase when synchronized was such that the robot perturbation assisted propulsion. These results support a new strategy for walking therapy that exploits an embedded neural oscillator interacting with peripheral mechanics and the resulting natural dynamics of walking, which are essential but hitherto neglected elements of walking therapy.

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Assist-as-needed training paradigms for robotic rehabilitation of spinal cord injuries

Cited by 42 publications

References 22 publications

Hybrid FES–robotic gait rehabilitation technologies: a review on mechanical design, actuation, and control strategies

Hybrid FES–robotic gait rehabilitation technologies: a review on mechanical design, actuation, and control strategies

Feasibility of entrainment with ankle mechanical perturbation to treat locomotor deficit of neurologically impaired patients

Feasibility of dynamic entrainment with ankle mechanical perturbation to treat locomotor deficit

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