Robotic Exoskeletons, FES, and Biomechanics: Treating Movement Disorders

描述（由申请人提供）：中风后轻偏瘫患者留下不同程度的功能障碍，特别是影响他们的行走能力。此BRP更新应用程序专注于开发和测试用于中风和其他运动障碍患者步态再训练的新型康复解决方案。我们的康复解决方案包括非电动和电动外骨骼，结合功能性电刺激（FES），辅以生物力学模型。在该项目的前五年，我们通过开发机器人外骨骼并进行有限的主题测试，展示了这种方法的可行性。该项目的下一个五年目标是整合和扩展我们目前对组件科学和技术的理解，即，非机动化和机动化外骨骼、FES和生物力学，以制造和测试用于中风患者步态训练的新型康复解决方案。 公共卫生相关性：这种更新应用的目标是整合和扩展我们目前对组件科学和技术的理解，即，非机动化和机动化外骨骼、FES和生物力学。我们计划测试中风患者步态训练的新型康复解决方案，并将其与目前接受的训练方法（如体重支持的跑步机训练）进行比较。该项目的目标是：目标1：利用非机动和机动外骨骼和FES开发用于偏瘫中风患者跑步机训练的双侧步态康复系统。我们将制造和测试以下两种康复系统：（i）双侧重力平衡矫形器（GBO），带FES/踝关节电动控制;（ii）双侧活动肢体外骨骼（ALEX），带FES/踝关节电动控制。新的踝关节共生控制将被实施，其中踝关节电机将被用作FES训练的安全网。目标二：测试这两种康复解决方案在中风患者中的有效性，并将其性能与体重支持跑步机训练（BWSTT）进行比较，BWSTT是目前文献中用于步态训练的范例。目标3：使用步态分析、生物力学、FES模型和外骨骼上的传感器离线预测轻偏瘫患者的肌肉协调缺陷。肌肉骨骼模型将在训练前用作筛选机制，并在训练后用于了解为什么外骨骼的特定步态训练策略有效。

DESCRIPTION (provided by applicant): Individuals with hemiparesis following a stroke are left with various degrees of impairment in function, especially affecting their walking ability. This BRP renewal application focuses on developing and testing novel rehabilitation solutions for gait retraining of stroke and other motor-impaired patients. Our rehab solutions consist of un-motorized and motorized exoskeletons, integrated with functional electric stimulation (FES), supplemented by biomechanical models. In the first five years of this project, we showed the feasibility of this approach through development of robotic exoskeletons with limited subject testing. The next five-year goal of this project is to integrate and expand on our current understanding of component science and technologies, i.e., un-motorized and motorized exoskeletons, FES, and biomechanics to fabricate and test novel rehabilitation solutions for gait training of patients with stroke. PUBLIC HEALTH RELEVANCE: The goal of this renewal application is to integrate and expand on our current understanding of component science and technologies, i.e., un-motorized and motorized exoskeletons, FES, and biomechanics. We plan to test novel rehabilitation solutions for gait training of patients with stroke and compare these with currently accepted training methods, such as the body-weight supported treadmill training. The project aims are: Aim 1: Develop bilateral gait rehabilitation systems for treadmill training of hemiparetic stroke patients using un-motorized and motorized exoskeletons and FES. We will fabricate and test the following two rehabilitation systems: (i) Bilateral Gravity Balancing Orthosis (GBO) with FES/Motorized control of the ankle, (ii) Bilateral Active Limb Exoskeleton (ALEX) with FES/Motorized control of the ankle. Novel symbiotic control of the ankle will be implemented where the ankle motor will be used as a safety net for delivery of the FES training. Aim 2: Test the effectiveness of these two rehabilitation solutions in patients with stroke and compare their performances with body weight supported treadmill training (BWSTT), a paradigm used currently in the literature for gait training. Aim 3: Prediction of muscle coordination deficits off-line in individuals with hemiparesis using gait analysis, biomechanics, FES models, and sensors on the exoskeleton. The musculoskeletal models will be used before training, as a screening mechanism, and post-training to understand why a particular gait training strategy with the exoskeleton worked.