Improving mobility using exosuits - a feasibility study on patients with incomplete spinal cord injury

机动性和独立性是生活质量的关键决定因素。活动能力受限的主要原因是随着年龄的增长，身体能力不可阻挡地下降。此外，影响呼吸系统、循环系统或肌肉骨骼系统的多种疾病也会对身体能力产生强烈影响。此外，神经系统疾病引起的麻痹或瘫痪也会减少活动能力。我们相信，老年人，特别是受损的年轻人和老年人可以从动力运动辅助中受益匪浅，帮助他们克服失去的身体能力。下肢外骨骼和外骨骼服可能提供一种可能的解决方案，以增加用户的移动性。他们有可能将残疾门槛提高到更高的年龄，或者在整个生命过程中避免残疾门槛。工业和研究集中在系统的发展，以协助承载，举起重物，和制造。为了医疗目的，开发了受伤后恢复行走的康复系统和日常生活中辅助行走的系统。这种系统可以包括全腿或单关节辅助。轻量级的单关节辅助在一些运动任务中显示出有希望的优势。特别是所谓的软性外装，在临床康复和老年人日常生活中使用方面显示出很高的潜力。期望的项目旨在测试现有的新型外骨骼原型的前景，以支持从坐姿站立和行走。作为第一个目标群体，为了验证概念，我们选择了不完全性脊髓损伤患者。步行和站立都是这个人群的首要任务。到目前为止，不完全性脊髓损伤患者使用轮椅来弥补行走能力的缺失。但在城市环境中，楼梯和斜坡会限制轮椅的移动。提出的概念结合了轮椅和动力下肢外套的使用。轮椅应该是解决日常生活行动需求的主要工具。如果有必要，患者可以使用外穿服站起来并行走较短的距离。因此，用户将能够挑战台阶和楼梯。此外，站起来有助于增加到达的高度。在1个月的实习期间，计划评估由ETHZ的感觉-运动系统实验室设计的最新版本的外骨骼。在第一阶段，应对健康受试者进行站立和水平行走的辅助和控制测试。在第二阶段，应该在Balgrist大学医院对不完全性脊髓损伤患者进行站立和水平行走测试。除了不完全性脊髓损伤患者之外，其他一些患者群体可能会受益于预期的发展。

Mobility and thus independence are key determinants for quality of life. The main cause for mobility limitations are unstoppable reductions in physical capacity with increasing age. Multiple diseases that affect the respiratory, the circulatory or the musculoskeletal system will have a strong influence on the physical capacity in addition. Also neurological diseases causing paresis or paralysis will reduce mobility. We believe that elderly and especially impaired young and elderly can highly benefit from a powered locomotion assistance that helps to overcome lost physical capacity.Lower limb exoskeletons and exosuits might provide a possible solution to increase user mobility. 0They have the potential to shift the disability threshold to a higher age or to avoid it over the whole life course. Industry and research focused on the development of systems to assist load carrying, lifting of heavy objects, and manufacturing. For medical purposes, rehabilitation systems to regain walking after injury and systems to assist walking in daily life are developed. Such systems can include the whole leg or single joint assistance. Lightweight single joint assistance showed promising advantages for several movement tasks. Especially so called soft exosuits show high potential for clinical rehabilitation and daily life usage for impaired and elderly.The desired project aims at testing the prospects of an existing novel exosuit prototype to support walking and standing up from seated position. As the first target group, for proof of concept, incomplete spinal cord injury patients are selected. Both, walking and standing are the top priorities for this population. So far incomplete SCI patients use wheelchairs to compensate missing walking ability. But stairs and slopes can limit wheelchair mobility in urban environments. The proposed concept combines the use of a wheelchair and a powered lower limb exosuit. The wheelchair should be the main tool to solve daily life mobility requirements. If necessary, the patient can use the exosuit to stand up and walk for shorter distances. Thus the user will be able to challenge steps and stairs. In addition, standing up will help to increase reaching height. During the 1 months of internship it is planned to evaluate the newest version of the exosuit designed by the Sensory-Motor Systems Lab at ETHZ. In a first stage the exosuit assistance and the control should be tested on healthy subjects for standing up and level walking. In the second stage standing up and level walking should be tested with incomplete SCI patients at the University Hospital Balgrist. Next to incomplete SCI patients, several further patient populations might take advantage of the envisioned developments.