Development of a Passive Elastic Exoskeleton for Gait Rehabilitation

描述(申请人提供)：脊髓损伤或中风患者的功能活动能力和生活质量通常可以通过一种名为跑步机训练的康复技术来改善，在这种技术中，由人类治疗师或电动外骨骼提供机械步态辅助。不幸的是，治疗师辅助的跑步机训练是劳动密集型的，而电动外骨骼对许多诊所来说可能昂贵得令人望而却步，并且可能以一种不能最大限度地促进患者康复的方式提供帮助。此外，这两种方法都限制患者在临床环境中只能在跑步机上行走，而不是在更具功能相关性的情况下在地面上行走。拟议项目的长期目标是开发一种创新的步态康复装置，该装置成本低，比目前的康复技术更有效。如果成功，步态功能有限的人群将被提供一种更负担得起的步态康复方法，使他们能够在更真实的、非临床情况下练习辅助行走。我们基于动态步行模型的模拟开发了一种新型的被动弹性外骨骼，这一策略在步行机器人的设计中被证明是成功的，这种机器人比传统工程设计的两足机器人更便宜、更高效。我们假设，我们的被动外骨骼将提供机械辅助，使行走变得更容易，从而减少步态所需的肌肉活动和能量成本。目前建议的具体目标是优化我们被动弹性外骨骼的设计，并确定健康的人体受试者是否能够适应由此产生的机械辅助的行走模式，肌肉活动和能量成本的显著降低证明了这一点。我们将进行一系列四个实验，研究不同被动外骨骼设计参数对健康受试者步态的影响，目的是优化有效的步态辅助。这些实验还将提供对健康人类在步态过程中适应新的机械环境的过程的洞察。我们预计，我们优化的设备将使行走变得更加轻松，使能量成本降低10%，推动腿部摆动的肌肉活动减少30%。除了可能推动为中度运动受限患者开发低成本步态辅助设备外，拟议项目的发现还可能建议更有效的步态控制方法，这可能有助于改善更严重限制患者的动力外骨骼。 公共卫生相关性：步态康复通常可以改善中风或脊髓损伤患者的功能活动能力，但现有的康复技术劳动密集型或昂贵。我们建议开发一种低成本的机械装置，使这些患者更容易行走，使他们在自然条件下练习行走的同时获得步态康复的好处。这一过程的第一步是测试我们的设备是否有助于健康受试者的行走，这表明我们的设备减少了能量需求和腿部肌肉活动。

DESCRIPTION (provided by applicant): The functional mobility and quality of life of patients who have suffered a spinal cord injury or stroke can often be improved with a rehabilitation technique termed treadmill training, in which mechanical gait assistance is delivered either by human therapists or powered exoskeletons. Unfortunately, therapist-assisted treadmill training is labor intensive, while powered exoskeletons may be prohibitively expensive for many clinics and may deliver assistance in a way that does not maximize patient recovery. In addition, both of these methods restrict patients to walking on a treadmill in a clinical setting, rather than walking over ground in a more functionally relevant context. The long-term goal of the proposed project is to develop an innovative gait rehabilitation device that is low-cost and more effective than current rehabilitation techniques. If successful, populations with limited gait function would be provided a more affordable method of gait rehabilitation that could allow them to practice assisted walking in more real world, non-clinical situations. We have developed a novel passive elastic exoskeleton based on simulations of a dynamic walking model, a strategy which has proven successful in the design of walking robots that are much cheaper and more energetically efficient than traditionally engineered bipedal robots. We hypothesize that our passive exoskeleton will provide mechanical assistance that will make walking easier, thus reducing the muscle activity and energetic cost required during gait. The specific aim of the current proposal is to optimize the design of our passive elastic exoskeleton, and determine if healthy human subjects are able to adapt their walking patterns to the resultant mechanical assistance, as evidenced by significant decreases in muscle activity and energetic cost. We will perform a series of four experiments which will investigate the effects of varying the parameters of our passive exoskeleton design on the gait of healthy subjects, with the goal of optimizing effective gait assistance. These experiments will also provide insight into the process by which healthy humans adapt to a novel mechanical context during gait. We anticipate that our optimized device will make walking significantly easier, allowing a 10% decrease in energetic cost and a 30% decrease in the muscle activity powering leg swing. In addition to possibly motivating the development of a low-cost gait assistive device for patients with moderate locomotor limitations, the findings of the proposed project may also suggest more efficient methods for controlling gait which could be useful in the improvement of powered exoskeletons for patients with more severe limitations. PUBLIC HEALTH RELEVANCE: Gait rehabilitation can often improve the functional mobility of patients who have suffered a stroke or spinal cord injury, but existing rehabilitation techniques are labor intensive or expensive. We propose the development of a low-cost mechanical device that will make walking easier for these patients, allowing them to reap the benefits of gait rehabilitation while practicing walking under natural conditions. The first step in this process is testing whether our device assists walking in healthy subjects, as indicated by reductions in energetic demand and muscle activity of the legs.