Wearable technologies最新文献

Telerehabilitation and robotics, either traditional rigid or soft, have been extensively studied and used to improve hand functionality after a stroke. However, a limited number of devices combined these two technologies to such a level of maturity that was possible to use them at the patients' home, unsupervised. Here we present a novel investigation that demonstrates the feasibility of a system that integrates a soft inflatable robotic glove, a cloud-connected software interface, and a telerehabilitation therapy. Ten chronic moderate-to-severe stroke survivors independently used the system at their home for 4 weeks, following a software-led therapy and being in touch with occupational therapists. Data from the therapy, including automatic assessments by the robot, were available to the occupational therapists in real-time, thanks to the cloud-connected capability of the system. The participants used the system intensively (about five times more movements per session than the standard care) for a total of more than 8 hr of therapy on average. We were able to observe improvements in standard clinical metrics (FMA +3.9 ± 4.0, p < .05, COPM-P + 2.5 ± 1.3, p < .05, COPM-S + 2.6 ± 1.9, p < .05, MAL-AOU +6.6 ± 6.5, p < .05) and range of motion (+88%) at the end of the intervention. Despite being small, these improvements sustained at follow-up, 2 weeks after the end of the therapy. These promising results pave the way toward further investigation for the deployment of combined soft robotic/telerehabilitive systems at-home for autonomous usage for stroke rehabilitation.

Falls due to stumbles are a major cause of injury for many populations, and as such interventions to reduce fall risk have been a key focus of rehabilitation research. However, dedicated stumble recovery assistance in a powered lower-limb exoskeleton has yet to be explored as a fall mitigation intervention. Thus young, healthy adults () were recruited for a stumble recovery experiment to test the efficacy of knee exoskeleton stumble recovery assistance in improving an impaired stumble recovery response (i.e., the elevating strategy response). Leg weights were attached unilaterally to each participant's shank to simulate walking and stumble recovery impairment, and a unilateral powered knee exoskeleton was worn on the same leg for walking and stumble recovery assistance. Ultimately, knee exoskeleton stumble recovery assistance served to improve participants' elevating limb kinematics (i.e., increase thigh and knee motion) and reduce overall fall risk (i.e., reduce trunk motion and improve foot placement) during responses relative to their impaired response (i.e., with the leg weights and no assistance), and relative to their response while receiving only walking assistance. This initial exploration provides a first indication that knee exoskeleton stumble recovery assistance is a viable approach to improving an impaired stumble recovery response, which could serve two important use cases: (1) a safety mechanism for existing exoskeleton wearers, who may be less capable of recovering from stumbles due to the added weight or joint impedance of the device; (2) an external stumble recovery aid for fall-prone populations, such as the elderly or stroke survivors.

This article examines the feasibility of employing a cold-gas thruster (CGT), intended as a backpack-wearable device, for purposes of arresting backward falls, and in particular describes a supervisory controller that, for some motion described by an arbitrary combination of center-of-mass angle and angular velocity, both detects an impending fall and determines when to initiate thrust in the CGT in order to arrest the impending fall. The CGT prototype and the supervisory controller are described and experimentally assessed using a rocking block apparatus intended to approximate a backward-falling human. In these experiments, the CGT and supervisory controller restored upright stability to the rocking block in all experiment cases that would have otherwise resulted in a fall without the CGT assistance. Since the controller and experiments employ a reduced-order model of a falling human, the authors also conducted a series of simulations intended to examine the extent to which the controller might remain effective in the case of a multi-segment human. The results of these simulations suggest that the CGT controller would be nearly as effective on a multi-segment falling human as on the reduced-order model.

This article describes a novel approach to the control of a powered knee prosthesis where the control system provides passive behavior for most activities and then provides powered assistance only for those activities that require them. The control approach presented here is based on the categorization of knee joint function during activities into four behaviors: resistive stance behavior, active stance behavior, ballistic swing, and non-ballistic swing. The approach is further premised on the assumption that healthy non-perturbed swing-phase is characterized by a ballistic swing motion, and therefore, a replacement of that function should be similarly ballistic. The control system utilizes a six-state finite-state machine, where each state provides different constitutive behaviors (concomitant with the four aforementioned knee behaviors) which are appropriate for a range of activities. Transitions between states and torque control within states is controlled by user motion, such that the control system provides, to the extent possible, knee torque behavior as a reaction to user motion, including for powered behaviors. The control system is demonstrated on a novel device that provides a sufficiently low impedance to enable a strictly passive ballistic swing-phase, while also providing sufficiently high torque to offer powered stance-phase knee-extension during activities such as step-over stair ascent. Experiments employing the knee and control system on an individual with transfemoral amputation are presented that compare the functionality of the power-supplemented nominally passive system with that of a conventional passive microprocessor-controlled knee prosthesis.

Back overuse injuries are a significant problem in the U.S. Army, responsible for nearly a quarter of musculoskeletal injuries. Back exosuits are wearable devices that relieve musculoskeletal strain, make lifting easier, and could potentially reduce Soldier overuse injuries. But published studies have not evaluated exosuits during realistic field operations to assess acceptability to Soldiers. We tested a back exosuit on field artillery Soldiers during a field training exercise. Afterward, Soldiers completed a survey to quantify their satisfaction, intent to use, and performance impact of the exosuit. Feedback was overwhelmingly positive: Approximately 90% of Soldiers reported that exosuits increased their ability to perform their duties, and 100% said that if the exosuit were further developed and made available to them, they would be likely to wear it. These numerical survey results indicated that exosuits can provide a practical and acceptable way to assist lifting and augment physical performance during realistic Army operations without interfering with other duties.

The ability to accurately identify human gait intent is a challenge relevant to the success of many applications in robotics, including, but not limited to, assistive devices. Most existing intent identification approaches, however, are either sensor-specific or use a pattern-recognition approach that requires large amounts of training data. This paper introduces a real-time walking speed intent identification algorithm based on the Mahalanobis distance that requires minimal training data. This data efficiency is enabled by making the simplifying assumption that each time step of walking data is independent of all other time steps. The accuracy of the algorithm was analyzed through human-subject experiments that were conducted using controlled walking speed changes on a treadmill. Experimental results confirm that the model used for intent identification converges quickly (within 5 min of training data). On average, the algorithm successfully detected the change in desired walking speed within one gait cycle and had a maximum of 87% accuracy at responding with the correct intent category of speed up, slow down, or no change. The findings also show that the accuracy of the algorithm improves with the magnitude of the speed change, while speed increases were more easily detected than speed decreases.

Passive ankle-foot prostheses are light-weighted and reliable, but they cannot generate net positive power, which is essential in restoring the natural gait pattern of amputees. Recent robotic prostheses addressed the problem by actively controlling the storage and release of energy generated during the stance phase through the mechanical deformation of elastic elements housed in the device. This study proposes an innovative low-power active prosthetic module that fits on off-the-shelf passive ankle-foot energy-storage-and-release (ESAR) prostheses. The module is placed parallel to the ESAR foot, actively augmenting the energy stored in the foot and controlling the energy return for an enhanced push-off. The parallel elastic actuation takes advantage of the amputee's natural loading action on the foot's elastic structure, retaining its deformation. The actuation unit is designed to additionally deform the foot and command the return of the total stored energy. The control strategy of the prosthesis adapts to changes in the user's cadence and loading conditions to return the energy at a desired stride phase. An early verification on two transtibial amputees during treadmill walking showed that the proposed mechanism could increase the subjects' dorsiflexion peak of 15.2% and 41.6% for subjects 1 and 2, respectively, and the cadence of about 2%. Moreover, an increase of 26% and 45% was observed in the energy return for subjects 1 and 2, respectively.

Passive exosuits have been vastly researched in the past decade for lifting tasks to alleviate the mechanical loading on the spine and reduce the lower back muscle activities in lifting tasks. Despite promising advantages of exosuits, factors such as comfort directly influence the user's acceptability of such body-worn devices. Exosuits' routing/anchoring points, which transmit device-to-body forces, remain the leading cause of discomfort among users. In the present study, we sought to investigate the effect of the routing element, that is, the "moment arm," in altering the device-to-body forces and perceived discomfort. We first presented a simplified human-exosuit model to establish insight into the effect of the moment arm on the device-to-body forces acting at the shoulder (F_S) and waist (F_W). Further, an experimental investigation was conducted on 10 participants with six different exosuit moment arm configurations (C1, C2, C3, C4, C5, and C6) to investigate their effect on the device-to-body forces, perceived discomfort, and muscle activity using a passive back-assist exosuit emulator in a lifting/lowering task. Configuration C4 was found to be most beneficial in reducing device-to-body forces at the shoulder and waist by up to 44.6 and 22.2%, respectively, during lifting. Subjective scores also comprehended with the device-to-body forces, indicating that C4 produces significantly less discomfort for participants. The outcome of the study illustrates the importance of selecting an appropriate moment arm configuration for passive back support exosuits in alleviating the device-to-body forces and perceived discomfort.

Standing up using one leg is a challenging task for those with a transfemoral amputation, particularly for elderly users with a low activity level. Active prostheses are generally not accessible to this group and available passive prostheses do not support standing up. This article presents the design and evaluation of the "Energy Restoring Intelligent Knee" (ERiK), which stores energy during sit-down in a pneumatic cylinder and returns it during stand-up. We hypothesized that the system would reduce the time needed to perform transitions and also enable higher load sharing by the prosthetic leg. However, the results of an experimental study with seven participants with transfemoral amputation contradict these hypotheses: the participants could neither move faster nor make more use of the prosthetic leg to share their body weight during transitions. We observed that a major obstacle to the useful functionality of the leg was the absence of ankle dorsiflexion - the foot tended to slip during stand-up initiation, such that only low pre-pressures and therefore support levels could be set. The rather binary action of the pneumatics also complicated movement initiation. The lessons learned from this study may be helpful to those seeking to create better designs in the future.