Exoskeleton optimization for reducing gait variability in patients with Peripheral Artery Disease

项目摘要 外周动脉疾病（PAD）影响着美国约1000万患者， 动脉粥样硬化阻塞的动脉供应腿。传统治疗，如血管重建 手术、药物治疗和运动疗法不能充分恢复由于跛行引起的行走障碍。 我们建议使用动力髋关节外骨骼来恢复移动性。通过髋关节辅助，我们将风险降至最低 小腿皮肤发炎和溃疡重要的是要通过以下方式单独优化当前的模式： 外骨骼在步态周期期间辅助。然而，所需的协议持续时间对于以下情况是有问题的： PAD患者。目标1是通过使用我们在 最近发表在《科学》杂志上的一篇观点论文。我们建议使用步态变异性的实时测量作为 人在回路优化的优化目标。我们将使用一个多功能的非车载驱动系统， 能让我们测试各种时间和强度目标二是确定外骨骼 可以增加PAD患者的步行能力。我们假设6分钟的步行时间， 跛行距离和运输成本将得到改善。不同的外骨骼正在出现的流动性 然而，尚未在临床人群中进行广泛的人在回路研究。因此，在本发明中， 在PAD患者中的这种应用将是创新的。我们希望这种方法可以转移到 其他活动能力受损的临床人群（例如，老年人和中风，帕金森氏症，大脑性麻痹 患者）以及用于优化包括无源装置和移动的外骨骼的其它装置。

Project Summary Peripheral Artery Disease (PAD) affects approximately 10 million patients in the US and is produced by atherosclerotic blockages in the arteries that supply the legs. Traditional treatments, such as revascularization surgery, medication and exercise therapy, do not sufficiently restore walking impairments due to claudication. We propose to use a powered hip exoskeleton to restore mobility. By assisting at the hip, we minimize the risk of skin irritation and ulcers in the lower leg. It is important to individually optimize the pattern of the moment by which an exoskeleton assists during a gait cycle. However, the required protocol durations are problematic for PAD patients. Aim 1 will be to determine the optimal assistance pattern by using a method that we proposed in a recent perspective paper in Science. We propose using real-time measurements of gait variability as an optimization objective for human-in-the-loop optimization. We will use a versatile off-board actuation system that will allow us to test a wide range of timings and magnitudes. Aim 2 will be to determine whether an exoskeleton can increase walking endurances in patients with PAD. We hypothesize that the 6-minute walking time, initial claudication distance and cost of transport will improve. Different exoskeletons are emerging for mobility assistance; however, no extensive human-in-the-loop studies have been conducted in clinical populations. Thus, this application in PAD patients would be innovative. We expect that this methodology can be transferable to other clinical populations with impaired mobility (e.g., the elderly and stroke, Parkinson’s, and cerebral palsy patients) and for optimizing other devices including passive devices and mobile exoskeletons.