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

项目摘要 外周动脉疾病(PAD)在美国影响着大约1000万患者，由 供应腿部的动脉中的动脉粥样硬化阻塞。传统的治疗方法，如血运重建 手术、药物和运动疗法不能充分恢复因跛行造成的行走障碍。 我们建议使用动力髋外骨骼来恢复活动能力。通过在臀部提供帮助，我们将风险降至最低 小腿上有皮肤刺激和溃疡。通过以下方式单独优化时刻模式是很重要的 外骨骼在步态周期中提供帮助。然而，所需的协议持续时间对于 PAD患者。目标1将使用我们在中提出的方法来确定最优辅助模式 最近发表在《科学》杂志上的一篇透视论文。我们建议使用步态可变性的实时测量作为一种 人在环优化的优化目标。我们将使用一种多功能的机外驱动系统， 将允许我们测试大范围的计时和大小。目标2将确定外骨骼是否 可以增加PAD患者的步行耐力。我们假设最初的6分钟步行时间 跛行距离和运输成本将有所改善。不同的外骨骼正在为移动性而出现 援助；然而，还没有在临床人群中进行广泛的人在环路研究。因此， 这种在PAD患者中的应用将是创新的。我们希望这种方法可以转移到 其他临床上行动不便的人群(例如，老年人和中风、帕金森氏症和脑瘫 用于优化其他设备，包括无源设备和移动外骨骼。

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.