Wearable Biofeedback Improves Human-Robot Compliance during Ankle-Foot Exoskeleton-Assisted Gait Training: A Pre-Post Controlled Study in Healthy Participants

Pinheiro, Cristiana; Figueiredo, Joana; Magalhães, Nilvanda dos Santos; Santos, Cristina P.

doi:10.3390/s20205876

Cited by 13 publications

(15 citation statements)

References 17 publications

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“…We found that the instruction given to participants during exosuit-applied plantarflexion resistance training also played an important role in targeting the plantarflexors. Although providing no explicit instructions enabled us to capture the natural tradeoff between intralimb and interlimb changes in kinetics, the importance of task-specific instructions is well recognized both in the exoskeleton [ 65 ] and rehabilitation fields [ 66 , 67 ]. In the two-subject exploratory study, participants generated sufficient biological ankle torque to match or overcome the applied torque when instructed to pushoff against the exosuit-applied resistance, while only partially offsetting the applied torque when uninstructed.…”

Section: Discussionmentioning

confidence: 99%

Ankle resistance with a unilateral soft exosuit increases plantarflexor effort during pushoff in unimpaired individuals

Swaminathan

Park

Raza

et al. 2021

J NeuroEngineering Rehabil

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Background Ankle-targeting resistance training for improving plantarflexion function during walking increases rehabilitation intensity, an important factor for motor recovery after stroke. However, understanding of the effects of resisting plantarflexion during stance on joint kinetics and muscle activity—key outcomes in evaluating its potential value in rehabilitation—remains limited. This initial study uses a unilateral exosuit that resists plantarflexion during mid-late stance in unimpaired individuals to test the hypotheses that when plantarflexion is resisted, individuals would (1) increase plantarflexor ankle torque and muscle activity locally at the resisted ipsilateral ankle, but (2) at higher forces, exhibit a generalized response that also uses the unresisted joints and limb. Further, we expected (3) short-term retention into gait immediately after removal of resistance. Methods Ten healthy young adults walked at 1.25 m s−1 for four 10-min discrete bouts, each comprising baseline, exposure to active exosuit-applied resistance, and post-active sections. In each bout, a different force magnitude was applied based on individual baseline ankle torques. The peak resistance torque applied by the exosuit was 0.13 ± 0.01, 0.19 ± 0.01, 0.26 ± 0.02, and 0.32 ± 0.02 N m kg−1, in the LOW, MED, HIGH, and MAX bouts, respectively. Results (1) Across all bouts, participants increased peak ipsilateral biological ankle torque by 0.13–0.25 N m kg−1 (p < 0.001) during exosuit-applied resistance compared to corresponding baselines. Additionally, ipsilateral soleus activity during stance increased by 5.4–11.3% (p < 0.05) in all but the LOW bout. (2) In the HIGH and MAX bouts, vertical ground reaction force decreased on the ipsilateral limb while increasing on the contralateral limb (p < 0.01). Secondary analysis found that the force magnitude that maximized increases in biological ankle torque without significant changes in limb loading varied by subject. (3) Finally, peak ipsilateral plantarflexion angle increased significantly during post-exposure in the intermediate HIGH resistance bout (p < 0.05), which corresponded to the greatest average increase in soleus activity (p > 0.10). Conclusions Targeted resistance of ankle plantarflexion during stance by an exosuit consistently increased local ipsilateral plantarflexor effort during active resistance, but force magnitude will be an important parameter to tune for minimizing the involvement of the unresisted joints and limb during training.

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Section: Discussionmentioning

confidence: 99%

Ankle resistance with a unilateral soft exosuit increases plantarflexor effort during pushoff in unimpaired individuals

Swaminathan

Park

Raza

et al. 2021

J NeuroEngineering Rehabil

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“…Electric actuators were the most popular actuators deployed in the reviewed PAEs. They were powered by on-board battery packs [37,41,56,57,61,[65][66][67][76][77][78][79][80][81][82][83][84]86,87,94,[100][101][102]112,113,115,[118][119][120]126,127,130,144,145,[156][157][158][159][160][172][173][174][175]177,184,187,189,234,235], DC off-board power supply units [10,…”

Section: Low-level Control and Machine-machine Sensorsmentioning

confidence: 99%

“…Encoder[38,40,42,58,62-64,68,69,72,73,85,86,100,103,104,106,108- 110,117,118,138,139,142,149-151,159- 162,165,173,178,181,185-188,202,206,207,210],Potentiometer[10,43,59,101,102,114,143,147,148,154,155,166,167,170,171] …”

mentioning

confidence: 99%

Application of Wearable Sensors in Actuation and Control of Powered Ankle Exoskeletons: A Comprehensive Review

kian

Widanapathirana

Joseph

et al. 2022

Sensors

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Powered ankle exoskeletons (PAEs) are robotic devices developed for gait assistance, rehabilitation, and augmentation. To fulfil their purposes, PAEs vastly rely heavily on their sensor systems. Human–machine interface sensors collect the biomechanical signals from the human user to inform the higher level of the control hierarchy about the user’s locomotion intention and requirement, whereas machine–machine interface sensors monitor the output of the actuation unit to ensure precise tracking of the high-level control commands via the low-level control scheme. The current article aims to provide a comprehensive review of how wearable sensor technology has contributed to the actuation and control of the PAEs developed over the past two decades. The control schemes and actuation principles employed in the reviewed PAEs, as well as their interaction with the integrated sensor systems, are investigated in this review. Further, the role of wearable sensors in overcoming the main challenges in developing fully autonomous portable PAEs is discussed. Finally, a brief discussion on how the recent technology advancements in wearable sensors, including environment—machine interface sensors, could promote the future generation of fully autonomous portable PAEs is provided.

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“…The ankle joint is one of the important joints of the human body. The survey shows that ankle joint injuries account for 7% to 10% of the total number of patients admitted to the emergency department every day [1][2][3][4]. Ankle fracture patients are more common clinically, and the incidence accounts for 4% to 5% of systemic fracture injuries [5][6].For the elderly, as the age increases, the flexibility of the limbs gradually decreases, and severe patients may have foot circulation disorders [7][8][9].Ankle sprains are also a common sports injury.…”

Section: Related Workmentioning

confidence: 99%

Research on 4-UPUS Parallel Mechanism Ankle Joint Rehabilitation Training Robot

Hu¹,

Yin²,

He³

et al. 2022

Preprint

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In-depth research on the rehabilitation mechanism and motion characteristics of a rehabilitation training robot based on 4-UPUS parallel mechanism. The overall design and the working principle of each key component are explained, and the robot rehabilitation scheme is described. The static analysis and modal analysis of the robot bearing structure are carried out to verify whether the static mechanical characteristics of the mechanism meet the application requirements under working conditions.A simplified mathematical model of the six-bar linkage mechanism is established, and the kinematics of the mechanism is solved by the geometric analysis method. The motion characteristic diagram of each key point is obtained through simulation calculation. Establish the motion model of the parallel mechanism, and discuss the working space and motion performance analysis of the mechanism. The forward solution analysis of the mechanism position is carried out by using the numerical analysis method, and the three-dimensional graphics of the attitude angle and linear displacement of the reachable working space are obtained.Taking the UPUS single branch chain as the analysis object, the single open chain analysis method is used to solve the kinematics image of the corresponding surface in the working space of the mechanism, which verifies the correctness of the kinematics theoretical solution and the feasibility of simulation.The research results show that the 4-UPUS parallel mechanism rehabilitation training robot can cooperate with the ankle joint for rehabilitation training. It makes up for the single movement of the current lower limb rehabilitation robot and the unsatisfactory rehabilitation effect, and provides a reference for the practical application of the subsequent ankle joint rehabilitation robot system.

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Wearable Biofeedback Improves Human-Robot Compliance during Ankle-Foot Exoskeleton-Assisted Gait Training: A Pre-Post Controlled Study in Healthy Participants

Cited by 13 publications

References 17 publications

Ankle resistance with a unilateral soft exosuit increases plantarflexor effort during pushoff in unimpaired individuals

Ankle resistance with a unilateral soft exosuit increases plantarflexor effort during pushoff in unimpaired individuals

Application of Wearable Sensors in Actuation and Control of Powered Ankle Exoskeletons: A Comprehensive Review

Research on 4-UPUS Parallel Mechanism Ankle Joint Rehabilitation Training Robot

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