Robotic Orthoses for Gait Rehabilitation

描述（由申请人提供）：我们开发了一种动力踝足矫形器，可以帮助人类行走。踝足矫形器具有人工气动肌肉，其响应于比目鱼肌激活（即，成比例的肌电控制）提供足底屈肌扭矩。我们专注于踝关节的机器人辅助，因为站立时的跖屈是行走时机械动力的主要来源，与神经残疾患者的行走能力直接相关。佩戴矫形器的神经系统完好的受试者迅速调整其肌肉激活模式以补偿由矫形器提供的增加的机械功率。我们建议确定不完全脊髓损伤的受试者是否受益于使用动力矫形器练习行走。我们的初步数据表明，比例肌电控制提供了一个强大的刺激重塑肌肉激活模式的不完全脊髓损伤的受试者。矫形器有效地使肌肉更强壮。这为神经系统提供了增强的本体感受反馈，将肌肉募集与关节运动联系起来。这种创新的方法是独特的，因为其他机器人康复设备依赖于外部代理（即计算机）来控制机械辅助的时间和幅度，而不是像我们提出的那样依赖于患者自己的神经系统。我们将测量H反射，肌电图，运动学，动力学和代谢成本的个人不完全脊髓损伤之前和之后的八个星期的练习步行与矫形器。结果将提供足够的数据来设计一个扩展的随机临床试验的动力矫形器。公共卫生相关性：我们将研究不完全脊髓损伤的人在腿上戴着机器人支架行走，以确定支架是否可以改善他们的行走能力。研究结果可能会导致新的机器人疗法，用于改善脊髓损伤或中风后的康复。

DESCRIPTION (provided by applicant): We have developed a powered ankle-foot orthosis that can assist human walking. The ankle-foot orthosis has an artificial pneumatic muscle providing plantar flexor torque in response to soleus muscle activation (i.e. proportional myoelectric control). We focus on robotic assistance for the ankle because plantar flexion during stance is a major source of mechanical power during walking and is directly related to walking ability in individuals with neurological disability. Neurologically intact subjects wearing the orthoses rapidly adapt their muscle activation patterns to compensate for the added mechanical power provided by the orthoses. We propose to determine if subjects with incomplete spinal cord injury benefit from practice walking with the powered orthoses. Our preliminary data suggest that proportional myoelectric control provides a powerful stimulus for re-shaping muscle activation patterns in subjects with incomplete spinal cord injury. The orthosis effectively makes the muscle stronger. This provides the nervous system with enhanced proprioceptive feedback linking muscle recruitment to joint motion. This innovative approach is unique as other robotic rehabilitation devices rely on an external agent (i.e. a computer) to control the timing and magnitude of mechanical assistance rather than the patient's own nervous system as we propose. We will measure H-reflexes, electromyography, kinematics, kinetics, and metabolic cost in individuals with incomplete spinal cord injury before and after eight weeks of practice walking with the orthoses. The results will provide sufficient data to design an extended randomized clinical trial of the powered orthosis. PUBLIC HEALTH RELEVANCE: We will study people with incomplete spinal cord injury walking with robotic braces on their legs to determine if the braces can improve their walking ability. The results may lead to new robotic therapies for improving rehabilitation after spinal cord injury or stroke.