Development of a Passive Elastic Exoskeleton for Gait Rehabilitation

描述（由申请人提供）：患有脊髓损伤或中风的患者的功能移动性和生活质量通常可以通过称为跑步机训练的康复技术来改善，其中机械步态辅助由人类治疗师或动力外骨骼提供。不幸的是，治疗师辅助的跑步机训练是劳动密集型的，而动力外骨骼对于许多诊所来说可能过于昂贵，并且可能以不能最大化患者恢复的方式提供辅助。此外，这两种方法都限制患者在临床环境中在跑步机上行走，而不是在功能更相关的情况下在地面上行走。该拟议项目的长期目标是开发一种创新的步态康复设备，该设备成本低且比当前的康复技术更有效。如果成功，将为步态功能有限的人群提供更实惠的步态康复方法，使他们能够在更多的真实的世界，非临床情况下练习辅助行走。我们已经开发了一种新的被动弹性外骨骼的基础上模拟的动态步行模型，一个策略，已被证明是成功的步行机器人的设计，更便宜，更节能，比传统的工程双足机器人。我们假设我们的被动外骨骼将提供机械辅助，使行走更容易，从而减少步态过程中所需的肌肉活动和能量消耗。当前提案的具体目的是优化我们的被动弹性外骨骼的设计，并确定健康的人类受试者是否能够使他们的行走模式适应所产生的机械辅助，如肌肉活动和能量成本的显著降低所证明的。我们将进行一系列的四个实验，这些实验将研究改变我们的被动外骨骼设计的参数对健康受试者步态的影响，目标是优化有效的步态辅助。这些实验还将深入了解健康人在步态过程中适应新的机械环境的过程。我们预计，我们的优化设备将使行走变得更加容易，使能量消耗减少10%，使腿部摆动的肌肉活动减少30%。除了可能推动为中度运动限制的患者开发低成本步态辅助设备外，拟议项目的研究结果还可能提出更有效的步态控制方法，这可能有助于改善具有更严重限制的患者的动力外骨骼。 公共卫生相关性：步态康复通常可以改善中风或脊髓损伤患者的功能活动性，但现有的康复技术是劳动密集型或昂贵的。我们建议开发一种低成本的机械装置，使这些患者更容易行走，使他们能够在自然条件下练习行走的同时获得步态康复的好处。这个过程的第一步是测试我们的设备是否有助于健康受试者的行走，如能量需求和腿部肌肉活动的减少所示。

DESCRIPTION (provided by applicant): The functional mobility and quality of life of patients who have suffered a spinal cord injury or stroke can often be improved with a rehabilitation technique termed treadmill training, in which mechanical gait assistance is delivered either by human therapists or powered exoskeletons. Unfortunately, therapist-assisted treadmill training is labor intensive, while powered exoskeletons may be prohibitively expensive for many clinics and may deliver assistance in a way that does not maximize patient recovery. In addition, both of these methods restrict patients to walking on a treadmill in a clinical setting, rather than walking over ground in a more functionally relevant context. The long-term goal of the proposed project is to develop an innovative gait rehabilitation device that is low-cost and more effective than current rehabilitation techniques. If successful, populations with limited gait function would be provided a more affordable method of gait rehabilitation that could allow them to practice assisted walking in more real world, non-clinical situations. We have developed a novel passive elastic exoskeleton based on simulations of a dynamic walking model, a strategy which has proven successful in the design of walking robots that are much cheaper and more energetically efficient than traditionally engineered bipedal robots. We hypothesize that our passive exoskeleton will provide mechanical assistance that will make walking easier, thus reducing the muscle activity and energetic cost required during gait. The specific aim of the current proposal is to optimize the design of our passive elastic exoskeleton, and determine if healthy human subjects are able to adapt their walking patterns to the resultant mechanical assistance, as evidenced by significant decreases in muscle activity and energetic cost. We will perform a series of four experiments which will investigate the effects of varying the parameters of our passive exoskeleton design on the gait of healthy subjects, with the goal of optimizing effective gait assistance. These experiments will also provide insight into the process by which healthy humans adapt to a novel mechanical context during gait. We anticipate that our optimized device will make walking significantly easier, allowing a 10% decrease in energetic cost and a 30% decrease in the muscle activity powering leg swing. In addition to possibly motivating the development of a low-cost gait assistive device for patients with moderate locomotor limitations, the findings of the proposed project may also suggest more efficient methods for controlling gait which could be useful in the improvement of powered exoskeletons for patients with more severe limitations. PUBLIC HEALTH RELEVANCE: Gait rehabilitation can often improve the functional mobility of patients who have suffered a stroke or spinal cord injury, but existing rehabilitation techniques are labor intensive or expensive. We propose the development of a low-cost mechanical device that will make walking easier for these patients, allowing them to reap the benefits of gait rehabilitation while practicing walking under natural conditions. The first step in this process is testing whether our device assists walking in healthy subjects, as indicated by reductions in energetic demand and muscle activity of the legs.