Robotic Exoskeletons, FES, and Biomechanics: Treating Movement Disorders

描述(申请人提供)：中风后偏瘫患者会留下不同程度的功能障碍，特别是影响他们的行走能力。这一BRP更新应用专注于为中风和其他运动障碍患者的步态再训练开发和测试新的康复解决方案。我们的康复解决方案包括非电动和电动外骨骼，集成了功能电刺激(FES)，并辅之以生物力学模型。在这个项目的前五年，我们通过开发有限的受试者测试的机器人外骨骼来展示这种方法的可行性。该项目下一个五年的目标是整合和扩展我们目前对组件科学和技术的理解，即非机动和机动外骨骼、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：这项续订申请的目标是整合和扩展我们目前对零部件科学和技术的理解，即非机动和机动外骨骼、FES和生物力学。我们计划测试用于中风患者步态训练的新型康复解决方案，并将这些方案与目前公认的训练方法进行比较，例如体重支持的跑步机训练。本项目的目标是：目标1：开发用于偏瘫中风患者跑步机训练的双侧步态康复系统，使用非机动和机动的外骨骼和FES。我们将制作和测试以下两种康复系统：(I)双侧重力平衡矫形器(GBO)，采用FES/踝关节机动控制；(Ii)双侧主动肢体外骨骼(Alex)，采用FES/机动控制踝关节。新的脚踝共生控制将被实施，其中脚踝马达将被用作提供FES训练的安全网。目的2：测试这两种康复方案在中风患者中的有效性，并与目前文献中用于步态训练的体重支持跑步机训练(BWSTT)进行比较。目的3：使用步态分析、生物力学、FES模型和外骨骼传感器离线预测偏瘫患者的肌肉协调缺陷。肌肉骨骼模型将用于训练前，作为筛选机制，以及训练后，以了解为什么特定的步态训练策略与外骨骼一起工作。

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.