Hydraulic Ankle Foot Orthosis for Prescription of Orthoses for Children with CP

 描述（由申请人提供）：虽然约50%的脑瘫（CP）儿童使用踝足矫形器（AFO）来改善步态障碍，但没有系统或过程使临床医生能够快速评估AFO的有效性和局限性，或在AFO的选择中进行筛选以确定哪种最适合患者。动力AFO技术的最新进展为满足这一需求提供了机会。这项研究的长期目标是开发和部署一种基于技术的解决方案，以处方被动AFO。重量轻，可穿戴，动力机器人提供了一条通往处方系统的道路，该系统可以模拟任何被动AFO的铰链特性。本申请的目的是利用小型动力液压系统的最新进展来开发第一代AFO仿真器。推动这项研究的中心假设是，微型液压是AFO模拟器的最佳技术，液压AFO（HAFO）模拟器可以由计算机控制，因此在临床实验室环境中，使用HAFO行走和使用传统AFO行走没有区别。我们进行这项研究的原因是，通过拟议的技术进步，我们将迈出第一步，将AFO处方过程从基于直觉的过程转变为基于理性过程的过程。本研究的目的一是设计、制作一种具有计算机控制踝关节刚度的小儿大小的HAFO并进行台架测试。这一目标的目的是生产确定该方法的技术可行性所需的设备。沿着HAFO的实现，该目标将提供一种控制器，该控制器使HAFO表现得像具有可调节弹簧刚度的旋转刚度。本研究的目的2是使用五名CP儿童进行试点研究，以证明HAFO在实验室环境中的能力。与该目标相关的假设是，与HAFO正在模拟的具有不同刚度的三种传统被动AFO相比，使用调谐的HAFO模拟器行走时，四个关键步态指标没有显著差异。本申请中描述的研究是创新的，因为它提出了一种全新的AFO处方方法，到目前为止，这一直是一个特设的过程。该方法是探索性的，但有可能将AFO的处方方式推向一个新的方向。

 DESCRIPTION (provided by applicant): While ankle foot orthoses (AFOs) are used by about 50% of children with cerebral palsy (CP) to ameliorate gait impairments, there are no systems or processes that enable a clinician to rapidly evaluate the effectiveness and limitations of an AFO, or to iterate among a selection of AFOs to determine which is most appropriate for the patient. Recent advances in powered AFO technology provide an opportunity to address this need. The long-term goal of this research is to develop and deploy a technology-based solution to prescribing passive AFOs. Light-weight, wearable, powered robotics present a path to a prescription system that can emulate the hinge characteristics of any passive AFO. The objective of the present application is to capitalize on recent advances in small, powered hydraulic systems to develop a first-generation AFO emulator. The central hypothesis driving the research is that tiny hydraulics is the best technology for an AFO emulator and that a hydraulic AFO (HAFO) emulator can be computer controlled so that in the clinical lab setting there is no difference between walking with the HAFO and walking with the traditional AFO being emulated. The reason we are undertaking this research is that through the proposed technology advances we will be taking the first steps towards moving the AFO prescription process from one based on intuition to one based on a rational process. Aim 1 of the research is to design, fabricate and bench test a pediatric-sized HAFO with computer- controlled ankle stiffness. The purpose of this aim is to produce the apparatus that is needed to determine technical feasibility of the approach. Along with realizing the HAFO, this aim will deliver a controller that causes the HAFO to behave like a rotary stiffness with adjustable spring rate. Aim 2 of the research is to perform a pilot study using five children with CP to demonstrate the capabilities of the HAFO in a laboratory environment. The hypothesis associated with this aim is that there is no significant difference in four key gait metrics when walking with the tuned HAFO emulator compared to walking with three traditional, passive AFOs of varying stiffness that the HAFO is emulating. The research described in this application is innovative because it proposes an entirely new approach to AFO prescription, which up until now has been an ad hoc process. The approach is exploratory, but has potential for moving how AFOs are prescribed in a new direction.