CAREER: Hybrid Ankle Exoskeleton Therapy to Optimize Long-Term Gait Rehabilitation

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This NSF Faculty Early Career Development (CAREER) project seeks to advance the scientific study of walking rehabilitation and pioneer a novel wearable rehabilitation strategy. There is a critical need for treatments that address the root causes of walking disability, including impaired strength, muscle control, and coordination. While wearable robotic exoskeletons hold potential for individuals with walking disabilities, prior research has focused on immediate improvements in walking performance from powered assistance. This project seeks to understand if alternating assistance and resistance with a wearable ankle exoskeleton will elicit greater improvements in walking than either approach alone. The outcomes of this project have the potential to transform the treatment of walking disabilities across a wide range of conditions. Through a new curriculum in assistive robotics and engineering, this project aims to motivate engineering students to address the challenges experienced by individuals with disabilities and improve engineering education on human-centered design.The purpose of this CAREER project is to develop a holistic treatment framework for gait rehabilitation based on the hybrid application of adaptive assistance and resistance and apply it to the treatment of ankle plantar-flexor dysfunction. The first objective is to establish foundational knowledge on the hybrid delivery of adaptive plantar-flexor assistance and resistance across different severities of walking impairment. The second objective is to develop a framework to optimize the long-term delivery of the hybrid exoskeleton therapy through the use of a holistic performance metric, accounting for both spatiotemporal and neuromuscular outcomes, and an artificial neural network to learn from participant responses over time. The third objective is to validate the hybrid optimization framework against training with assistance and resistance alone and compare hybrid exoskeleton training to standard gait training. This CAREER project is expected to pioneer the development of long-term human-in-the-loop optimization techniques to deliver lasting improvements in neuromuscular function and walking ability. This project will establish fundamental knowledge on the interplay between disease severity and wearable assistance and resistance. The strategies developed will be generalizable, enabling other investigators to apply this framework to different types of control algorithms, devices, joints, and patient populations. New Curriculum in Assistive Robotics and Engineering (CARE) will be developed as part of this project, incorporating advanced robotics course modules, design-for-disability capstone projects, and K-12 experiences. It is anticipated that the students involved in CARE will gain an improved understanding of the needs of people with physical disabilities, which will translate into effective engineering solutions, and result in more motivated, insightful, and impactful engineering students and professionals.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.