Design Advancements Toward a Wearable Pediatric Robotic Knee Exoskeleton for Overground Gait Rehabilitation

Ji, Chen; Hochstein, Jon; Kim, Christina; Damiano, Diane L.; Bulea, Thomas C.

doi:10.1109/biorob.2018.8487195

Cited by 13 publications

(23 citation statements)

References 12 publications

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“…Limitations in this proposed design and study include the simplicity of the FSM used for this experiment (two state FSM). It would be beneficial to test the robustness of NMES and exoskeleton assistance synchronization in more complex cases, such as a five-state FSM and adaptive controllers which we have recently developed for use with motorized assistance [42]. Testing the NMESexoskeleton system on only one participant presents another limitation in making conclusions about its potential clinical effectiveness in other patients.…”

Section: Discussionmentioning

confidence: 99%

“…The NMES was triggered by the exoskeleton controller to deliver stimulation to the quadriceps muscles throughout stance phase, i.e., when the FSR value was above the tuned threshold indicating foot contact with the ground. The NIH pediatric exoskeleton is a lightweight (3.2 kg), modular device based on the architecture of a knee-ankle-foot orthosis [14,15,20] designed to provide motorized assistance at the knee joint to augment knee extension during walking, and thus is specifically designed for rehabilitation of crouch gait in children with CP [14,42]. In this study, however, the motors provided only enough torque to compensate for the friction and inertia of the exoskeleton and thus were not actively assisting knee extension.…”

Section: Pediatric Robotic Exoskeletonmentioning

confidence: 99%

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Toward a hybrid exoskeleton for crouch gait in children with cerebral palsy: neuromuscular electrical stimulation for improved knee extension

Shideler

Bulea

et al. 2020

J NeuroEngineering Rehabil

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Background: Neuromuscular Electrical Stimulation (NMES) has been utilized for many years in cerebral palsy (CP) with limited success despite its inherent potential for improving muscle size and/or strength, inhibiting or reducing spasticity, and enhancing motor performance during functional activities such as gait. While surface NMES has been shown to successfully improve foot drop in CP and stroke, correction of more complex gait abnormalities in CP such as flexed knee (crouch) gait remains challenging due to the level of stimulation needed for the quadriceps muscles that must be balanced with patient tolerability and the ability to deliver NMES assistance at precise times within a gait cycle. Methods: This paper outlines the design and evaluation of a custom, noninvasive NMES system that can trigger and adjust electrical stimulation in real-time. Further, this study demonstrates feasibility of one possible application for this digitally-controlled NMES system as a component of a pediatric robotic exoskeleton to provide on-demand stimulation to leg muscles within specific phases of the gait cycle for those with CP and other neurological disorders who still have lower limb sensation and volitional control. A graphical user interface was developed to digitally set stimulation parameters (amplitude, pulse width, and frequency), timing, and intensity during walking. Benchtop testing characterized system delay and power output. System performance was investigated during a single session that consisted of four overground walking conditions in a 15-year-old male with bilateral spastic CP, GMFCS Level III: (1) his current Ankle-Foot Orthosis (AFO); (2) unassisted Exoskeleton; (3) NMES of the vastus lateralis; and (4) NMES of the vastus lateralis and rectus femoris. We hypothesized in this participant with crouch gait that NMES triggered with low latency to knee extensor muscles during stance would have a modest but positive effect on knee extension during stance.

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Section: Discussionmentioning

confidence: 99%

Section: Pediatric Robotic Exoskeletonmentioning

confidence: 99%

Toward a hybrid exoskeleton for crouch gait in children with cerebral palsy: neuromuscular electrical stimulation for improved knee extension

Shideler

Bulea

et al. 2020

J NeuroEngineering Rehabil

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“…The exoskeleton controller (Figure 1(b)) has been previously designed. [5][6][7] The exoskeleton has two In Standby Mode, the goal is to be transparent to the wearer and therefore only minimal assistive torque is provided to compensate for device friction and inertia but no walking assistance is provided. In Walking Mode, the user can select from three different torquebased assistance strategies: 1) constant torque; 2) impedance-based control that tracks a target knee trajectory; or 3) real-time adaptive control.…”

Section: Design Environmentmentioning

confidence: 99%

“… 5 Our recent efforts have expanded the assistive capabilities of the exoskeleton to include three different options; constant torque assistance, 5 target trajectory tracking with impedance-based control, or real-time adaptive control. 6 , 7 The overall goal of our research is to develop a wearable exoskeleton to provide gait training optimized for each individual that can be performed outside of the laboratory or clinical setting. In general, wearable pediatric exoskeletons are an active area of research with several recent studies in addition to our own demonstrating new systems designed to improve pediatric gait and facilitate gait training in a wide variety of movement disorders.…”

Section: Introductionmentioning

confidence: 99%

An open source graphical user interface for wireless communication and operation of wearable robotic technology

Tucker

Hammel

et al. 2020

Journal of Rehabilitation and Assistive Technologies Engineerin

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Introduction Wearable robotic exoskeletons offer the potential to move gait training from the clinic to the community thereby providing greater therapy dosage in more naturalistic settings. To capitalize on this potential, intuitive and robust interfaces are necessary between robotic devices and end users. Such interfaces hold great promise for research if they are also designed to record data from the robot during its use. Methods We present the design and validation of an open source graphical user interface (GUI) for wireless operation of and real-time data logging from a pediatric robotic exoskeleton. The GUI was designed for trained users such as an engineer or clinician. A simplified mobile application is also provided to enable exoskeleton operation by an end-user or their caretaker. GUI function was validated during simulated walking with the exoskeleton using a motion capture system. Results Our results demonstrate the ability of the GUI to wirelessly operate and save data from exoskeleton sensors with high fidelity comparable to motion capture. Conclusion The GUI code, available in a public repository with a detailed description and step-by-step tutorial, is configurable to interact with any robotic device operated by a microcontroller and therefore represents a potentially powerful tool for deployment and evaluation of community based robotics.

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“…It is also recommended that the developed controllers should do the same as a therapist exercises of gait scheme [24]. In this context, two controllers are proposed, a classical PD controller [25] and a robust sliding mode controller [26], in order to evaluate and compare their robustness towards parameter variations.…”

Section: Control Related Issuesmentioning

confidence: 99%

Towards an Effective Robotic Device for Gait Rehabilitation of Children With Cerebral Palsy

Maalej

Chemori

Derbel

2019

2019 International Conference on Signal, Control and Communication (SCC)

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The objective of this study is to focus on the feasibility of a robotic solution for rehabilitation of children with Cerebral Palsy (CP). For this purpose, to restore the walking abilities and in order to stimulate the brain functionality, two rehabilitation techniques have been compared (a conventional rehabilitation and a robotized one). Results indicate that the key of a performant exoskeleton with a good tracking of the gait cycle is to use robust controllers to guarantee the tracking even with kids' parameter variations. A PD controller and a sliding mode controller are implemented and compared in order to prove the difference of their robustness. Through the proposed solution, it has been shown that sliding mode control is more robust than PD controller.

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Design Advancements Toward a Wearable Pediatric Robotic Knee Exoskeleton for Overground Gait Rehabilitation

Cited by 13 publications

References 12 publications

Toward a hybrid exoskeleton for crouch gait in children with cerebral palsy: neuromuscular electrical stimulation for improved knee extension

Toward a hybrid exoskeleton for crouch gait in children with cerebral palsy: neuromuscular electrical stimulation for improved knee extension

An open source graphical user interface for wireless communication and operation of wearable robotic technology

Towards an Effective Robotic Device for Gait Rehabilitation of Children With Cerebral Palsy

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