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

Anaya, Francisco; Thangavel, Pavithra; Huang, Yu

doi:10.1007/s41315-017-0042-6

Cited by 42 publications

(28 citation statements)

References 82 publications

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“…Wearable robots like exoskeletons are coupled to the user, and the robot moves with the wearer cooperatively (Awad et al, 2017 ; Anaya et al, 2018 ; Bai et al, 2018 ; Fani et al, 2018 ). In this case, the design should be able to follow the human movements minimizing resistive forces felt by the human, i.e., the design should be mechanically transparent.…”

Section: Mechanical Transparencymentioning

confidence: 99%

System Transparency in Shared Autonomy: A Mini Review

Alonso

Puente

2018

Front. Neurorobot.

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What does transparency mean in a shared autonomy framework? Different ways of understanding system transparency in human-robot interaction can be found in the state of the art. In one of the most common interpretations of the term, transparency is the observability and predictability of the system behavior, the understanding of what the system is doing, why, and what it will do next. Since the main methods to improve this kind of transparency are based on interface design and training, transparency is usually considered a property of such interfaces, while natural language explanations are a popular way to achieve transparent interfaces. Mechanical transparency is the robot capacity to follow human movements without human-perceptible resistive forces. Transparency improves system performance, helping reduce human errors, and builds trust in the system. One of the principles of user-centered design is to keep the user aware of the state of the system: a transparent design is a user-centered design. This article presents a review of the definitions and methods to improve transparency for applications with different interaction requirements and autonomy degrees, in order to clarify the role of transparency in shared autonomy, as well as to identify research gaps and potential future developments.

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Section: Mechanical Transparencymentioning

confidence: 99%

System Transparency in Shared Autonomy: A Mini Review

Alonso

Puente

2018

Front. Neurorobot.

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“…Depending primarily on FES alone for gait can be metabolically taxing, is prone to rapid fatigue, and may lack limb control and stability. For these reasons effort has gone into combining FES with orthotic devices, generally called hybrid FES systems, which can provide several advantages relative to using FES alone (Andrews et al, 1988 ; Isakov et al, 1992 ; Goldfarb et al, 2003 ; Bulea et al, 2013 ; del-Ama et al, 2014 ; Chang et al, 2017 ; Anaya et al, 2018 ), and one prior study investigated a hybrid FES system that couples FES with a robotic exoskeleton (Ha et al, 2016 ). That study specifically coupled a lower limb exoskeleton with FES of the quadriceps and hamstrings muscle groups of each leg, and demonstrated reduced exoskeleton motor torque and power when used in a hybrid FES manner.…”

Section: Introductionmentioning

confidence: 99%

Supplemental Stimulation Improves Swing Phase Kinematics During Exoskeleton Assisted Gait of SCI Subjects With Severe Muscle Spasticity

Ekelem

Goldfarb

2018

Front. Neurosci.

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Spasticity is a common comorbidity associated with spinal cord injury (SCI). Robotic exoskeletons have recently emerged to facilitate legged mobility in people with motor complete SCI. Involuntary muscle activity attributed to spasticity, however, can prevent such individuals from using an exoskeleton. Specifically, although most exoskeleton technologies can accommodate low to moderate spasticity, the presence of moderate to severe spasticity can significantly impair gait kinematics when using an exoskeleton. In an effort to potentially enable individuals with moderate to severe spasticity to use exoskeletons more effectively, this study investigates the use of common peroneal stimulation in conjunction with exoskeleton gait assistance. The electrical stimulation is timed with the exoskeleton swing phase, and is intended to acutely suppress extensor spasticity through recruitment of the flexion withdrawal reflex (i.e., while the stimulation is activated) to enable improved exoskeletal walking. In order to examine the potential efficacy of this approach, two SCI subjects with severe extensor spasticity (i.e., modified Ashworth ratings of three to four) walked in an exoskeleton with and without supplemental stimulation while knee and hip motion was measured during swing phase. Stimulation was alternated on and off every ten steps to eliminate transient therapeutic effects, enabling the acute effects of stimulation to be isolated. These experiments indicated that common peroneal stimulation on average increased peak hip flexion during the swing phase of walking by 21.1° (236%) and peak knee flexion by 14.4° (56%). Additionally, use of the stimulation decreased the swing phase RMS motor current by 228 mA (15%) at the hip motors and 734 mA (38%) at the knee motors, indicating improved kinematics were achieved with reduced effort from the exoskeleton. Walking with the exoskeleton did not have a significant effect on modified Ashworth scores, indicating the common peroneal stimulation has only acute effects on suppressing extensor tone and aiding flexion. This preliminary data indicates that such supplemental stimulation may be used to improve the quality of movement provided by exoskeletons for persons with severe extensor spasticity in the lower limb.

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“…In this first approach, we take the weighting factors to be the same for both actuators (δ = 0.5). The weighting factors can be associated with the level of assistance in a hybrid orthosis (Anaya et al, 2018). The parameter δ basically represents some priority given to the use of either the FES actuation or the motor actuators.…”

Section: Methodsmentioning

confidence: 99%

“…Using hybrid orthosis to stimulate the lower extremity muscles has proven to evoke muscle hypertrophy, increase strength, improve cardiopulmonary fitness, and reduce fatigue during gait, even in subjects with severe spasticity (Nightingale et al, 2007; Qiu and Taylor, 2016; Deley et al, 2017; Ekelem and Goldfarb, 2018; Lambach et al, 2018). Complete recent reviews of hybrid exoskeletons can be found in Stewart et al (2017) for the upper limbs, and Anaya et al (2018) for the lower limbs.…”

Section: Introductionmentioning

confidence: 99%

Design of the Cooperative Actuation in Hybrid Orthoses: A Theoretical Approach Based on Muscle Models

et al. 2019

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Hybrid orthoses or rehabilitation exoskeletons have proven to be a powerful tool for subjects with gait disabilities due to their combined use of electromechanical actuation to provide motion and support, and functional electrical stimulation (FES) to contract muscle tissue so as to improve the rehabilitation process. In these devices, each degree of freedom is governed by two actuators. The main issue arises in the design of the two actuation profiles for there to be natural or normative gait motion in which the two actuators are transparent to each other. Hybrid exoskeleton control solutions proposed in the literature have been based on tracking the desired kinematics and applying FES to maintain the desired motion rather than to attain the values expected for physiological movement. This work proposes a muscle-model approach involving inverse dynamics optimization for the design of combined actuation in hybrid orthoses. The FES profile calculated in this way has the neurophysiological meaningfulness for the device to be able to fulfill its rehabilitative purpose. A general scheme is proposed for a hybrid hip-knee-ankle-foot orthosis. The actuation profiles, when muscle tissue is fatigued due to FES actuation are analyzed, and an integrated approach is presented for estimating the actuation profiles so as to overcome muscle peak force reduction during stimulation. The objective is to provide a stimulation profile for each muscle individually that is compatible with the desired kinematics and actuation of the orthosis. The hope is that the results may contribute to the design of subject-specific rehabilitation routines with hybrid exoskeletons, improving the exoskeleton's actuation while maintaining its rehabilitative function.

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

Cited by 42 publications

References 82 publications

System Transparency in Shared Autonomy: A Mini Review

System Transparency in Shared Autonomy: A Mini Review

Supplemental Stimulation Improves Swing Phase Kinematics During Exoskeleton Assisted Gait of SCI Subjects With Severe Muscle Spasticity

Design of the Cooperative Actuation in Hybrid Orthoses: A Theoretical Approach Based on Muscle Models

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