Design of a 6-DOF Robotic Gait Training System With Closed-Chain Foot Initiated Kinematics Control

Author(s):  
Wei Liu ◽  
John Kovaleski ◽  
Marcus Hollis

Robotic assisted rehabilitation, taking advantage of neuroplasticity, has been shown to be helpful in regaining some degree of gait performance. Robot-applied movement along with voluntary efferent motor commands coordinated with the robot allows optimization of motion training. We present the design and characteristics of a novel foot-based 6-degree-of-freedom (DOF) robot-assisted gait training system where the limb trajectory mirrored the normal walking gait. The goal of this study was to compare robot-assisted gait to normal walking gait, where the limb moved independently without robotics. Motion analysis was used to record the three-dimensional kinematics of the right lower extremity. Walking motion data were determined and transferred to the robotic motion application software for inclusion in the robotic trials where the robot computer software was programmed to produce a gait pattern in the foot equivalent to the gait pattern recorded from the normal walking gait trial. Results demonstrated that ankle; knee and hip joint motions produced by the robot are consistent with the joint motions in walking gait. We believe that this control algorithm provides a rationale for use in future rehabilitation, targeting robot-assisted training in people with neuromuscular disabilities such as stroke.

Author(s):  
Andy Chien ◽  
Fei-Chun Chang ◽  
Nai-Hsin Meng ◽  
Pei-Yu Yang ◽  
Ching Huang ◽  
...  

Abstract Purpose Robot-assisted gait rehabilitation has been proposed as a plausible supplementary rehabilitation strategy in stroke rehabilitation in the last decade. However, its exact benefit over traditional rehabilitation remain sparse and unclear. It is therefore the purpose of the current study to comparatively investigate the clinical benefits of the additional robot-assisted training in acute stroke patients compared to standard hospital rehabilitation alone. Methods Ninety acute stroke patients (< 3 month) were recruited. All participants received the standard hospital neurorehabilitation comprises 45–60 min sessions daily for 3 weeks. Sixty patients also received an additional 30 min of robot-assisted gait training with the HIWIN MRG-P100 gait training system after each of the standard neurorehabilitation session. Outcome measures included: 1. Berg Balance Scale (BBS); 2. Brunnstrom Stage; 3. Pittsburgh Sleep Quality Index and 4. Taiwanese Depression Questionnaire (TDQ) which were assessed pre-treatment and then after every five training sessions. Results Both groups demonstrated significant improvement pre- and post-treatment for the BBS (robotic group p = 0.023; control group p = 0.033) but no significant difference (p > 0.1) between the groups were found. However, the robotic training group had more participants demonstrating larger BBS points of improvement as well as greater Brunnstrom stage of improvement, when compared to the control group. No significant within and between group statistical differences (p > 0.3) were found for Pittsburgh Sleep Quality Index and Taiwanese Depression Questionnaire. Conclusion The addition of robotic gait training on top of standard hospital neurorehabilitation for acute stroke patients appear to produce a slightly greater improvement in clinical functional outcomes, which is not transferred to psychological status.


2021 ◽  
Vol 29 (03) ◽  
pp. 126-131
Author(s):  
Okasha Anjum ◽  
Hajra Ameer Shaikh ◽  
Nida Waheed ◽  
Syeda Wajeeha Raza Zaidi

Efficacy Of Robot-assisted Physiotherapy For Pain Management In Neurological Disorders-A Systematic Review Abstract Background: Neurological disorders (ND) are ranked as the leading cause of death and disability around the globe and the escalating burden summons the advancements in the treatment strategies hence this systematic review aimed to fill the knowledge gap regarding the efficacy of robot-assisted physiotherapy (RAPT) for pain management in ND. Methodology: Scientific trials were sought by an extensive search via electronic databases mainly PubMed, PEDro, and Scopus. Randomized controlled trials published from the year 2014 to April 2021, evaluating the potential effects of RAPT for pain management in ND were included in the review. The quality appraisal of the RCTs was analyzed via Cochrane tool for assessing risk of bias. Results: The Majority of the trials reported the effectiveness of RAPT using PARO robot, Armeo spring, Gloreha robot, and robotic Lokomat gait training system in significantly improving pain of ND such as stroke, dementia, phantom syndrome, and spinal cord injuries. Conclusions: Large body of evidence suggested RAPT as a potential solution in improving pain of various ND however further rigorous trials are necessary to draw conclusive recommendations. Keywords: Neurological disorders, pain, physiotherapy management, rehabilitation, robot-assisted physiotherapy, robotics


2021 ◽  
Author(s):  
Dongxu Zhang ◽  
Youyi Lu ◽  
Fengze Sun ◽  
Di Wang ◽  
Xingjun Bao ◽  
...  

Abstract Background: Horseshoe kidney (HSK) have always been a challenge for urologists depending on its particular anatomy. We report a case of renal tumor in a patient with HSK, who underwent tumor resection by retroperitoneal robot-assisted laparoscopic partial nephrectomy. Case Presentations: A 47-year-old man presented to our hospital with a solid renal mass. Computed tomography urography (CTU) showed a 4.3 × 4.4 cm mass in the upper pole of the right kidney. Patients received a retroperitoneal robot-assisted laparoscopic partial nephrectomy on basis of three-dimensional (3D) reconstructions.Conclusion: The present case report highlights the feasibility of robot-assisted laparoscopic partial nephrectomy for horseshoe kidney, and the advantages of preoperative 3D reconstructions.


2019 ◽  
Vol 19 (02) ◽  
pp. 1940018
Author(s):  
ANDY CHIEN ◽  
FU-HAN HSIEH ◽  
CHING HUANG ◽  
FEI-CHUN CHANG ◽  
NAI-HSIN MENG ◽  
...  

One-third of stroke survivors fail to regain independent ambulation and strokes have been identified as a significant source of long-term disability and a tremendous health burden. Robot-assisted gait rehabilitation is gaining traction and advocators for its inclusion as part of the routine post-stroke rehabilitation program are on the increase. However, despite the recent technological advances in the development and design of better robotics, the research evidence on the best model of robotic training remains sparse and unclear. It is therefore the aim of the current study to comparatively investigate the clinical feasibility and efficacy of a recently developed HIWIN Robotic Gait Training System (MRG-P100) combined with the use of a lab-developed MBS-E100 EMG system as a controller on facilitating the development of an appropriate gait pattern for motor impaired subacute stroke patients. The results indicated that due to the heterogeneity of stroke-induced changes in muscle characteristics, an “auto-fit” algorithm was required to allow constant monitoring and updating of the appropriate threshold based on EMG signals captured during previous gait cycle in order to determine the desired muscle activation threshold for the current gait cycle. Eighteen participants were tested using the new auto-fit algorithm and results demonstrated a significantly more fluent and physiologically appropriate gait pattern.


2013 ◽  
Vol 31 (2) ◽  
pp. 104
Author(s):  
H.K.Y. Luk ◽  
C.Y.L. Chao ◽  
D.K.W. Chau ◽  
P.M.Y. Lau ◽  
G.H.F. Mak

2020 ◽  
Vol 9 (9) ◽  
pp. 2813
Author(s):  
So Young Joo ◽  
Seung Yeol Lee ◽  
Yoon Soo Cho ◽  
Kuem Ju Lee ◽  
Cheong Hoon Seo

This study investigated the effects of robot-assisted gait training (RAGT) on gait function in burn patients. Briefly, 40 burn patients were randomly divided into an RAGT group or a conventional training (CON) group. SUBAR® (Cretem, Korea) is a wearable robot with a footplate that simulates normal gait cycles. The RAGT group underwent 30 min of robot-assisted training using SUBAR® with 30 min of conventional physiotherapy once a day, 5 days a week for 12 weeks. Patients in the CON group received 30 min of overground gait training and range-of-motion (ROM) exercises twice a day for 5 days a week for 12 weeks. The RAGT group and the CON group underwent 60 min of training per day. The intervention frequency and duration did not differ between the RAGT group and the CON group. The main outcomes were functional ambulatory category (FAC); 6-min walking test (6MWT); visual analogue scale (VAS) during gait movement; ROM; and isometric forces of bilateral hip, knee, and ankle muscles before and after 12 weeks of training. The results of the VAS, FAC, and 6MWT (8.06 ± 0.66, 1.76 ± 0.56, and 204.41 ± 85.60) before training in the RAGT group improved significantly (4.41 ± 1.18, 4.18 ± 0.39, and 298.53 ± 47.75) after training (p < 0.001, p < 0.001, and p < 0.001). The results of the VAS, FAC, and 6MWT (8.00 ± 1.21, 1.75 ± 0.58, and 220.94 ± 116.88) before training in the CON group improved significantly (5.00 ± 1.03, 3.81 ± 1.05, and 272.19 ± 110.14) after training (p < 0.001, p < 0.001, and p = 0.05). There were differences in the improvement of results of the VAS, FAC, and 6MWT between groups after training, but they were not statistically significant (p = 0.23, p = 0.14, and p = 0.05). The isometric strengths of the right hip extensor (p = 0.02), bilateral knee flexor (p = 0.04 in the right, and p = 0.001 in the left), bilateral knee extensor (p = 0.003 in the right, and p = 0.002 in the left), bilateral ankle dorsiflexor (p = 0.04 in the right, and p = 0.02 in the left), and bilateral ankle plantarflexor (p = 0.001 in the right, and p = 0.008 in the left) after training were significantly improved compared with those before training in the RAGT group. The ROMs of the right knee extension (p = 0.03) and bilateral ankle plantarflexion (p = 0.008 in the right, and p = 0.03 in the left) were significantly improved compared with measurements before training in the RAGT. There were no significant differences of the isometric strengths and ROMs of the bilateral hip, knee, and ankle muscles after training in the CON group. There were significant improvements in the isometric strengths of the left knee flexor (p = 0.01), left ankle dorsiflexor (p = 0.01), and left ankle plantarflexor (p = 0.003) between the two groups. The results suggested that RAGT is effective to facilitate early recovery of muscles strength after a burn injury. This is the first study to evaluate the effectiveness of RAGT in patients with burns compared with those receiving conventional training. The absence of complications in burn patients provides an opportunity to enlarge the application area of RAGT.


2008 ◽  
Vol 2 (3) ◽  
Author(s):  
Zhiming Ji ◽  
Yazan Manna

Gait training is a major part of neurological rehabilitation. Robotic gait training systems provide paraplegic patients with consistent, labor-saving, and adjustable physical therapy over traditional manual trainings. However the high cost and social-technical concerns on safe operation currently limit their availability to only a few large rehabilitation institutions. This paper describes the synthesis of a linkage mechanism for gait pattern generation in a sagittal plane. The synthesis of the mechanism starts with the definition of a closed ankle trajectory obtained from normative gait data. The synthesis process we developed includes (1) construction of the desired ankle trajectory, (2) formulation of an objective function to be used for linkage optimization, (3) development of a procedure for transforming an initial guess to a starting set of design variables for optimization, and (4) development of a point-matching process needed for implementation. A set of stature-referenced parameters was successfully produced for a crank-rocker mechanism to generate the desired gait path. A simple linkage mechanism can be used as the pattern generator in a gait training system, and the presented process has been used to synthesize a linkage for a specific gait pattern.


2021 ◽  
Author(s):  
Haeun Yum ◽  
Hyang Kim ◽  
Taeyong Lee ◽  
Moon Seok Park ◽  
Seung Yeol Lee

Abstract Background: Stationary cycling is commonly used for postoperative rehabilitation of physical disabilities, but few studies have focused on the three-dimensional (3D) kinematics of rehabilitation. This study aimed to elucidate the three-dimensional lower limb kinematics of musculoskeletally healthy people and the effect of sex and age on kinematics using a controlled bicycle configuration.Methods: Thirty-one healthy adults participated in the study. The stationary cycle positioning was standardized using the LeMond method by setting the saddle height to 85.5% of the participant’s inseam. The participants maintained a pedaling rate of 10–12 km/h, and the average value of three successive cycles of the right leg was used for analysis. The pelvis, hip, knee, and ankle joint motions during cycling were evaluated in the sagittal, coronal, and transverse planes. Kinematic data were normalized to 0–100% of the cycling cycle. The Kolmogorov-Smirnov test, Mann-Whitney U test, Kruskal-Wallis test, and k-fold cross-validation were used to analyze the data.Results: In the sagittal plane, the cycling ranges of motion (ROMs) were 1.6° (pelvis), 43.9° (hip), 75.2° (knee), and 26.9° (ankle). The coronal plane movement was observed in all joints, and the specific ROMs were 6.6° (knee) and 5.8° (ankle). There was significant internal and external rotation of the hip (ROM: 11.6°), knee (ROM: 6.6°), and ankle (ROM: 10.3°) during cycling. There was no difference in kinematic data of the pelvis, hip, knee, and ankle between sexes (p = 0.12 to 0.95) and among ages (p = 0.11 to 0.96) in all anatomical planes.Conclusions: The kinematic results support the assertion that cycling is highly recommended for comprehensive musculoskeletal rehabilitation. These results may help clinicians choose a target recovery ROM based on healthy and non-elite individuals and issue suitable guidelines to patients.


2016 ◽  
Vol 11 (1) ◽  
Author(s):  
Kazuto Kora ◽  
James Stinear ◽  
Andrew McDaid

Stroke is one of the leading causes of adult physical disability, and rehabilitation and hospitalization costs for stroke are among the highest for all injuries. Current rehabilitation techniques are labor intensive and time consuming for therapists and difficult to perform effectively. Research suggests that starting rehabilitation during the acute or subacute stage of recovery results in better outcomes than therapy delivered in the chronic stage. To improve the gait rehabilitation process, robot-assisted gait rehabilitation has gained much interest over the past years. However, many robot-assisted rehabilitation devices have limitations; one of which is being bulky and complex to handle. Large and expensive devices that require special training to operate are less attractive to clinics and therapists, and ultimately less likely to be available to patients especially at the early stage of stroke. To address these limitations, this research proposes a new gait rehabilitation device called the linkage design gait trainer (LGT). The device is based on a walking frame design with a simple four-bar linkage “end-effector” mechanism to generate normal gait trajectories during general walking and exercise. The design of the four-bar linkage mechanism was optimized for a particular gait pattern. A prototype of the device was developed and tested. The kinematics of the device itself and gait kinematics with and without assistance from the device were recorded and analyzed using an optical motion capture system. The results show the linkage mechanism is able to guide the leg of the user during over ground walking. There were some differences in the hip (20.5 deg RMS) and knee (14.8 deg RMS) trajectory between the person walking with and without the device assistance. The study demonstrated the concept and feasibility of this novel gait training device.


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