GOALI: Active Knee Rehabilitation Orthotic Device with Variable-Damping Characteristics For Stroke Patient Rehabilitation

PI：Mavroidis，ConstantinosProposal编号：0828772中风是美国第三大死因；美国每年约有730,300例新病例和约160,000人死亡。大约80%的中风幸存者存在早期运动障碍，其中约50%患有慢性运动障碍。由于肌肉无力和痉挛导致的活动能力丧失，从而导致步态受损，是导致中风后残疾的主要原因。需要新的治疗方法来作为重建有效步态模式的训练辅助手段，以及作为解决残余运动障碍和功能限制的辅助装置。在过去的十年里，机器人学和机电一体化已经成为与康复密切相关的新的研究领域。机器人和机电一体化通过使用新型可穿戴和计算机控制的有源设备，提供了灵敏、客观的测量和移动性辅助。该项目汇集了机器人学、精密制造、生物力学和中风医学等领域的专家，旨在显著提高中风患者的生活质量。该项目的研究目标是开发和测试一种新型的、智能的、便携式的主动膝关节康复矫形器(AKROD)，旨在训练中风患者在站立和僵硬步态(定义为摆动时减少膝关节屈曲)时纠正膝关节过度伸展。膝关节支架将提供可变的阻尼和扭矩执行器能力，以我们假设的促进中风患者运动恢复的方式进行控制。该装置将开发两个不同的组件：阻性组件(可变阻尼器)和主动组件(扭矩执行器)。支撑的可变阻尼器组件将用于通过提供膝盖屈曲的阻力来促进站立时的膝盖屈曲。此外，膝关节支架将用于在摆动过程中帮助膝关节控制，即允许患者实现足够的膝盖屈曲，以清除脚趾和足够的膝盖伸展，为脚跟撞击做准备。扭矩执行器组件将用于鼓励患者在中端站立时主动伸展膝盖，促进初始摆动时的膝关节屈曲，并再次鼓励患者在中端摆动时伸展膝盖。将开发用于建立对膝关节支撑的适当控制的算法。利用来自正常志愿者和中风偏瘫幸存者的数据，我们将创建膝关节矫形器的训练计划，以帮助患者重建自然步态模式。拟议项目的智力优势是显著加强了中风患者的步态再训练，并显著改善了家庭和社区的矫形干预。一种可穿戴和便携式的智能训练矫形器，就像在这个项目中开发和测试的那样，可以被患者在日常活动中使用，并不断加强目标步态模式。这种在真实环境中不断加强步态再训练的做法有可能提供更有效和更快的步态再训练，提高一个人的行走能力。该项目的教育、更广泛的影响和推广活动包括：启动本科生的研究，与马萨诸塞州的科技高中建立生物医学工程和机器人方面的合作项目，组织关于便携式和可穿戴康复设备的会议特别会议、研讨会系列和网页，在工业中进行研究生和本科生实习，并与南加州大学技术创业学院(STE)合作，组织一个为期一学期的关于可穿戴式活动膝关节矫形器新技术的市场分析和商业规划的孵化器(学生)项目。这个为期3年的GALI项目将由马萨诸塞州波士顿的东北大学(NU)、马萨诸塞州波士顿的斯波尔丁康复医院(SRH)(哈佛医学院附属机构)和马萨诸塞州南威克的WGI Inc.联合实施。

PI: Mavroidis, ConstantinosProposal Number: 0828772Stroke is the third leading cause of death in the United States; with approximately 730,300 new cases and about 160,000 deaths in the United States annually. Approximately 80% of stroke survivors present an early motor deficit, with about 50% having chronic deficits. Loss of mobility due to muscle weakness and spasticity and thus impaired gait is a major contributor to post-stroke disability. Novel treatments are needed to serve as training aids for reestablishing efficient gait patterns, and as assistive devices to address residual motor impairments and functional limitations. During the last ten years, robotics and mechatronics have emerged as new research areas of great relevance to rehabilitation. Robotics and mechatronics offer the promise of sensitive, objective measurements and mobility assistance by using novel wearable and computer controlled active devices. The proposed project brings together experts in robotics, precision manufacturing, biomechanics, and stroke medicine with the goal of considerably improving the quality of life of stroke patients.The research goals of this project are to develop and test a novel, smart and portable Active Knee Rehabilitation Orthotic Device (AKROD) designed to train stroke patients to correct knee hyperextension during stance and stiff-legged gait (defined as reduced knee flexion during swing). The knee brace will provide variable damping and torque actuator capabilities controlled in ways that we hypothesize foster motor recovery in stroke patients. Two different components of the device will be developed: a resistive (variable damper) and an active (torque actuator) component. The variable damper component of the brace will be used to facilitate knee flexion during stance by providing resistance to knee buckling. Furthermore, the knee brace will be used to assist in knee control during swing, i.e. to allow patients to achieve adequate knee flexion for toe clearance and adequate knee extension in preparation to heel strike. The torque actuator component will be used to encourage patients to actively extend the knee during midto-terminal stance, facilitate knee flexion during initial swing, and again encourage knee extension during mid-to-terminal swing. Algorithms for establishing appropriate control of the knee brace will be developed. Using data from both normal volunteers and hemiplegic stroke survivors, we will create training programs for the knee orthosis to assist patients in re-establishing a natural gait pattern.The intellectual merit of the proposed project is the major enhancement of gait retraining in stroke patients and considerable improvement of orthotic intervention in the home and community settings. A wearable and portable smart training orthosis, as the one developed and tested in this project, could be used by patients throughout daily activities, with constant reinforcement of the targeted gait pattern. This constant reinforcement of gait retraining in a real-world environment has the potential to provide more effective and faster gait retraining, improving one's ability to ambulate. The educational, broader impact and outreach activities of this project include: the initiation of undergraduate students in research, the establishment of collaborative projects in biomedical engineering and robotics with the science and technology high schools of Massachusetts, the organization of a conference special session, a seminar series and a webpage on portable and wearable rehabilitation devices, the performance of graduate and undergraduate student internships in industry, and, in partnership with NU's School of Technological Entrepreneurship (STE), the organization of a one semester I-cubator (student)project on market analysis and business planning for new technologies on wearable active knee orthoses. This 3-year GOALI project will be performed jointly by Northeastern University (NU) of Boston, MA, Spaulding Rehabilitation Hospital (SRH) of Boston, MA (a Harvard Medical School affiliated institution) and WGI Inc. of Southwick, MA.