Development of a Modular Soft Exosuit Platform Suitable for Community-Based Neurorehabilitation

项目摘要/摘要 中风是世界范围内导致长期残疾的主要原因。然而，尽管进行了广泛的恢复工作， 明显缺乏体力活动仍然是中风恢复期和慢性期患者的标志 会导致健康状况和生活质量下降。为了更好地定位中风后康复，使 较多的体力活动，训练剂量不足，生态有效性差等因素限制了 临床步态训练的有效性，必须加以克服。基于社区的康复方法可以 克服这些限制；然而，他们能够利用的步行练习的数量是天生的 由于中风后典型的步行能力下降而受到限制。事实上，最近的研究表明，尽管 中风后步行活动有所改善，个人在中风后仍基本上保持久坐不动 以社区为基础的步行计划。因此，迫切需要修复技术，以弥合 诊所和现实世界之间的差距，并促进在显著背景下的集体步行练习，即 是诱导经验依赖性神经可塑性所必需的。 为了满足这一需求，我们正在开发轻便、不显眼的软可穿戴机器人(Exosuits) 适合中风后的社区康复。外衣使用创新的力量传递， 固定在车身和近端安装的轻型缆索驱动系统的保形纺织品 以产生辅助合力。自适应控制算法，使用来自最小数目的信号 传感器控制着救援的时机。这些创新的可穿戴机器人有可能增加 个人在社区活动的能力。事实上，我们已经通过初步的 以跑步机为基础的研究表明，踝关节辅助外衣可促进偏瘫肢体功能恢复。 这种方式可以诱导步态对称，降低行走的能量成本，并增加行走的稳定性。 与主宰了过去半个世纪的刚性外骨骼相比，外骨骼提供了部分 通过需要低成本的轻便平台(总重3公斤，包括发动机和电池)提供帮助 功率(&lt；100W)，可以单方面使用，不会对佩戴者施加不自然的步态。外衣 这项技术非常适合于帮助中风后残留者的步态受损。 步行能力。这个以技术开发为重点的项目试图制造出能够恢复步态的外衣 可以轻松组装的模块化组件，以满足个人的不同需求 中风后。该项目将优化现有的脚踝、膝盖和髋关节模块，这些模块已经经历了&gt；1000小时 对130名健康和受损的受试者进行测试，供中风后患者在临床和社区使用- 设置。这项工作将由一个由工程师、临床医生和研究人员组成的多学科团队完成。 从患者和其他利益相关者那里收集的定性和定量数据将告知所有 发展。

Project Summary/Abstract Stroke is the leading cause of long-term disability worldwide. However, despite extensive rehabilitation efforts, marked physical inactivity remains emblematic of individuals in the chronic phase of stroke recovery and contributes to poor health and quality of life. For poststroke rehabilitation to be better positioned to enable more physical activity, factors such as insufficient training dosage and poor ecological validity, which limit the effectiveness of clinic-based gait training, must be overcome. Community-based rehabilitation approaches can overcome these limitations; however, the amount of walking practice that they are able to leverage is inherently limited by the reduced walking capacity typical after stroke. Indeed, recent work has shown that despite producing some improvement in poststroke walking activity, individuals still remain largely sedentary after community-based walking programs. A critical need thus exists for rehabilitation technologies that bridge the gap between the clinic and the real world and facilitate the massed walking practice in salient contexts that is necessary to induce experience-dependent neuroplasticity. In response to this need, we are developing lightweight and unobtrusive soft wearable robots (exosuits) suitable for community-based rehabilitation after stroke. Exosuits use innovative force-transmitting, conformal textiles that anchor to the body and proximally-mounted, lightweight, cable-based actuation systems to generate assistive joint forces. Adaptive control algorithms that use signals from the minimum number of sensors direct the timing of assistance. These innovative wearable robots have the potential to increase an individual's capacity for community ambulation. Indeed, we have demonstrated through preliminary treadmill-based studies that an ankle-assisting exosuit produces paretic limb functional restoration in a manner that induces gait symmetry, reduces the energy cost of walking, and increases walking stability. In contrast to the rigid exoskeletons that have dominated the last half century, exosuits provide partial assistance through a lightweight platform (<3kg overall, including motors and batteries) that requires low power (<100W), can be used unilaterally, and does not impose an unnatural gait on the wearer. The exosuit technology is ideally suited to assisting the impaired gait of individuals poststroke who have residual walking capacity. This technology development-focused project seeks to build gait-restorative exosuits made of modular components that can be easily assembled to serve the heterogeneous needs of individuals poststroke. This project will optimize existing ankle, knee, and hip modules that have undergone >1000 hours of testing on >130 healthy and impaired subjects for use by persons poststroke in clinical- and community- settings. This work will be completed by a multidisciplinary team of engineers, clinicians, and researchers. Qualitative and quantitative data gathered from patients and other stakeholders will inform all development.