Development of a Modular Soft Exosuit Platform Suitable for Community-Based Neurorehabilitation

项目总结/摘要 中风是全球长期残疾的主要原因。然而，尽管作出了广泛的恢复努力， 显著的身体活动不足仍然是处于中风恢复的慢性阶段的个体的象征， 导致健康和生活质量下降。为了使中风后康复更好地定位， 更多的体力活动，训练剂量不足和生态有效性差等因素，限制了 基于临床的步态训练的有效性，必须克服。基于社区的康复方法可以 克服这些限制;然而，他们能够利用的步行练习量本质上是 受到中风后典型的行走能力降低的限制。事实上，最近的研究表明，尽管 虽然中风后行走活动有所改善，但中风后的个人仍然主要保持久坐不动。 社区步行项目。因此，迫切需要康复技术， 诊所和真实的世界之间的差距，并促进在突出的背景下， 这是诱导依赖经验的神经可塑性所必需的。 针对这一需求，我们正在开发轻便且不显眼的软穿戴机器人（exosuits） 适合中风后社区康复。Exosuits使用创新的力量传输， 锚在身体上的保形织物和近端安装的、重量轻的、基于缆线的致动系统 来产生辅助的关节力。自适应控制算法使用来自最少数量的 传感器指示援助的时间。这些创新的可穿戴机器人有可能增加 个人对社区援助的能力。事实上，我们已经通过初步的 基于密尔的研究表明，踝关节辅助外装护具在一个病人中产生瘫痪肢体功能恢复。 这种方式可以诱导步态对称，减少行走的能量消耗，并增加行走的稳定性。 与在上半个世纪占主导地位的刚性外骨骼相比，外骨骼服提供了部分的 通过一个轻型平台（总重量<3公斤，包括电机和电池）提供帮助， 功率（<100 W），可以单侧使用，不会给佩戴者带来不自然的步态。机器护甲 该技术非常适合于帮助中风后有残留的步态障碍的人， 步行能力。这个以技术开发为重点的项目旨在建造步态恢复机器衣， 模块化组件，可以很容易地组装，以满足个人的不同需求 中风后这个项目将优化现有的踝关节，膝盖，和髋关节模块，已经经历了>1000小时 对>130名健康和受损受试者进行测试，供临床和社区中风后患者使用， 设置.这项工作将由工程师，临床医生和研究人员组成的多学科团队完成。 从患者和其他利益相关者那里收集的定性和定量数据将为所有人提供信息。 发展

Project Summary/Abstract Stroke is the leading cause of long-term disability worldwide. However, despite extensive rehabilitation efforts, marked physical inactivity remains emblematic of individuals in the chronic phase of stroke recovery and contributes to poor health and quality of life. For poststroke rehabilitation to be better positioned to enable more physical activity, factors such as insufficient training dosage and poor ecological validity, which limit the effectiveness of clinic-based gait training, must be overcome. Community-based rehabilitation approaches can overcome these limitations; however, the amount of walking practice that they are able to leverage is inherently limited by the reduced walking capacity typical after stroke. Indeed, recent work has shown that despite producing some improvement in poststroke walking activity, individuals still remain largely sedentary after community-based walking programs. A critical need thus exists for rehabilitation technologies that bridge the gap between the clinic and the real world and facilitate the massed walking practice in salient contexts that is necessary to induce experience-dependent neuroplasticity. In response to this need, we are developing lightweight and unobtrusive soft wearable robots (exosuits) suitable for community-based rehabilitation after stroke. Exosuits use innovative force-transmitting, conformal textiles that anchor to the body and proximally-mounted, lightweight, cable-based actuation systems to generate assistive joint forces. Adaptive control algorithms that use signals from the minimum number of sensors direct the timing of assistance. These innovative wearable robots have the potential to increase an individual's capacity for community ambulation. Indeed, we have demonstrated through preliminary treadmill-based studies that an ankle-assisting exosuit produces paretic limb functional restoration in a manner that induces gait symmetry, reduces the energy cost of walking, and increases walking stability. In contrast to the rigid exoskeletons that have dominated the last half century, exosuits provide partial assistance through a lightweight platform (<3kg overall, including motors and batteries) that requires low power (<100W), can be used unilaterally, and does not impose an unnatural gait on the wearer. The exosuit technology is ideally suited to assisting the impaired gait of individuals poststroke who have residual walking capacity. This technology development-focused project seeks to build gait-restorative exosuits made of modular components that can be easily assembled to serve the heterogeneous needs of individuals poststroke. This project will optimize existing ankle, knee, and hip modules that have undergone >1000 hours of testing on >130 healthy and impaired subjects for use by persons poststroke in clinical- and community- settings. This work will be completed by a multidisciplinary team of engineers, clinicians, and researchers. Qualitative and quantitative data gathered from patients and other stakeholders will inform all development.