Control strategies for a verticalized rehabilitation robot

Caring and rehabilitation of spinal cord injuries have greatly evolved during the twentieth century. Unfortunately standard training still heavily relies on manual mobilization of the patient. Which not only results in short training periods, but also prevents the patient's muscles from contracting, if voluntary control is lost. In order to cope with these issues the Fondation Suisse pour les Cybertheses (FSC) in collaboration with the Laboratoire de Systemes Robotiques (LSRO) from EPFL initiated a three step reeducation project. The main idea is the combination of motorized orthoses and closed loop muscle stimulation in order to enable an active participation of the patient, with a smart muscle control. The three complementary projects are: MotionMaker: stationary device with hip, knee and ankle mobilization combined to muscle stimulation. WalkTrainer: mobile device for true overground deambulation, with leg and pelvis orthoses, active body weight support and muscle stimulation. WalkMaker: lightweight orthosis with muscle stimulation, for enhanced autonomy. This work focuses on the control of the WalkTrainer, both of the motors and the muscle stimulation. First optimal trajectory generation is discussed. For the pelvis a three step strategy is presented. That consists of measuring motions on valid subjects with different parameters, identifying the corresponding model that can then be incorporated in the trajectory generator of the WalkTrainer. Of course the same work could be undertaken for any motion, such as the ones applied to the legs or trunk. Second, a novel off line EMG based muscle model and closed loop stimulation algorithm were developed. The trajectory generation and the muscle stimulation were then combined to obtain a novel, third generation, rehabilitation strategy. That optimizes the afferent feedback of the subject, while allowing an active participation of his musculature. That strategy was successfully tested on 6 paraplegic subjects at the beginning of 2008.

[1]  Thomas Sugar,et al.  Design, implementation and test results of a robust control method for a powered ankle foot orthosis (AFO) , 2008, 2008 IEEE International Conference on Robotics and Automation.

[2]  Daniel Graupe,et al.  Artificial neural network control of FES in paraplegics for patient responsive ambulation , 1994, IEEE Transactions on Biomedical Engineering.

[3]  S.J. Harkema,et al.  An assistive robotic device that can synchronize to the pelvic motion during human gait training , 2005, 9th International Conference on Rehabilitation Robotics, 2005. ICORR 2005..

[4]  Julie Bernhardt,et al.  Balance and mobility outcomes for stroke patients: a comprehensive audit. , 1997, The Australian journal of physiotherapy.

[5]  Manfred Morari,et al.  Automatic gait-pattern adaptation algorithms for rehabilitation with a 4-DOF robotic orthosis , 2004, IEEE Transactions on Robotics and Automation.

[6]  G Németh,et al.  In vivo moment arm lengths for hip extensor muscles at different angles of hip flexion. , 1985, Journal of biomechanics.

[7]  V. Dietz,et al.  Locomotor capacity of spinal cord in paraplegic patients , 1995, Annals of neurology.

[8]  D.J. Reinkensmeyer,et al.  Robotic movement training as an optimization problem: designing a controller that assists only as needed , 2005, 9th International Conference on Rehabilitation Robotics, 2005. ICORR 2005..

[9]  Liberson Wt,et al.  Functional electrotherapy: stimulation of the peroneal nerve synchronized with the swing phase of the gait of hemiplegic patients. , 1961, Archives of physical medicine and rehabilitation.

[10]  S. Lalwani,et al.  Spinal cord injury. , 2011, Journal of neurosurgery. Spine.

[11]  R. Riener,et al.  Model-based control of FES-induced single joint movements , 2001, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[12]  R. Riener,et al.  Patient-cooperative strategies for robot-aided treadmill training: first experimental results , 2005, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[13]  F. Alton,et al.  A kinematic comparison of overground and treadmill walking. , 1998, Clinical biomechanics.

[14]  B. Nigg,et al.  Biomechanics of the musculo-skeletal system , 1995 .

[15]  O. Rettig,et al.  Dynamic assist by carbon fiber spring AFOs for patients with myelomeningocele. , 2008, Gait & posture.

[16]  Michael Goldfarb.  A control-brake orthosis for FES-aided gait , 1994 .

[17]  E. Marsolais,et al.  Synthesis of paraplegic gait with multichannel functional neuromuscular stimulation , 1994 .

[18]  Winfried Mayr,et al.  Evaluation of FES-induced knee joint moments in paraplegics with denervated muscles. , 2005, Artificial organs.

[19]  R Williamson,et al.  Gait event detection for FES using accelerometers and supervised machine learning. , 2000, IEEE transactions on rehabilitation engineering : a publication of the IEEE Engineering in Medicine and Biology Society.

[20]  J P Paul,et al.  Effects of joint motion constraints on the gait of normal subjects and their implications on the further development of hybrid FES orthosis for paraplegic persons. , 1996, Journal of biomechanics.

[21]  M. Ladouceur,et al.  Does Neurorehabilitation Play a Role in the Recovery of Walking in Neurological Populations? a , 1998, Annals of the New York Academy of Sciences.

[22]  Hooman Dejnabadi,et al.  Analysis of gait and coordination for arthroplasty outcome evaluation using body-fixed sensors , 2006 .

[23]  Reymond Clavel,et al.  Pelvic motion measurement during over ground walking, analysis and implementation on the WalkTrainer reeducation device , 2008, 2008 IEEE/RSJ International Conference on Intelligent Robots and Systems.

[24]  M. Granat,et al.  A knee and ankle flexing hybrid orthosis for paraplegic ambulation. , 2003, Medical engineering & physics.

[25]  Bruno Siciliano,et al.  Modeling and Control of Robot Manipulators , 1995 .

[26]  J. F. Yang,et al.  Surface EMG profiles during different walking cadences in humans. , 1985, Electroencephalography and clinical neurophysiology.

[27]  Ivo Locher.  Technologies for system-on-textile integration , 2006 .

[28]  Julia T. Choi,et al.  Adaptation reveals independent control networks for human walking , 2007, Nature Neuroscience.

[29]  R. Kobetic,et al.  Simulation of a functional neuromuscular stimulation powered mechanical gait orthosis with coordinated joint locking , 2005, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[30]  C. Schmitt,et al.  A Study of a Knee Extension Controlled by a Closed Loop Functional Electrical Stimulation , 2004 .

[31]  Yasuhisa Hasegawa,et al.  Intention-based walking support for paraplegia patients with Robot Suit HAL , 2007, Adv. Robotics.

[32]  E. Hurley.  Use of KAFOs for Patients with Cerebral Vascular Accident, Traumatic Brain Injury, and Spinal Cord Injury , 2006 .

[33]  S Hesse,et al.  Electromechanical gait training with functional electrical stimulation: case studies in spinal cord injury , 2004, Spinal Cord.

[34]  HYBRID ORTHOSIS WITH CONTROLLABLE HIP AND KNEE JOINTS AND MULTICHANNEL FES FOR WALKING IN PARAPLEGIA , 2001 .

[35]  P. Peckham,et al.  Functional electrical stimulation for neuromuscular applications. , 2005, Annual review of biomedical engineering.

[36]  John J. Craig Zhu,et al.  Introduction to robotics mechanics and control , 1991 .

[37]  R. Riener,et al.  Using a Robotic Gait Orthosis as Haptic Display - A Perception-Based Optimization Approach , 2007, 2007 IEEE 10th International Conference on Rehabilitation Robotics.

[38]  S. Aito,et al.  Complications during the acute phase of traumatic spinal cord lesions , 2003, Spinal Cord.

[40]  J. Quintern,et al.  A physiologically based model of muscle activation verified by electrical stimulation , 1997 .

[41]  A. Mayr,et al.  Prospective, Blinded, Randomized Crossover Study of Gait Rehabilitation in Stroke Patients Using the Lokomat Gait Orthosis , 2007, Neurorehabilitation and neural repair.

[42]  B. Stansfield,et al.  Sagittal Joint Kinematics, Moments, and Powers Are Predominantly Characterized by Speed of Progression, Not Age, in Normal Children , 2001, Journal of pediatric orthopedics.

[43]  G.E. Loeb,et al.  Multimodal injectable sensors for neural prosthetic proprioception , 2005, Proceedings. 2005 First International Conference on Neural Interface and Control, 2005..

[44]  D. Graupe,et al.  Functional neuromuscular stimulator for short-distance ambulation by certain thoracic-level spinal-cord-injured paraplegics. , 1998, Surgical neurology.

[45]  M. Trew,et al.  Human Movement: An Introductory Text , 2005 .

[46]  Hartmut Witte,et al.  ISB recommendation on definitions of joint coordinate system of various joints for the reporting of human joint motion--part I: ankle, hip, and spine. International Society of Biomechanics. , 2002, Journal of biomechanics.

[47]  Thierry Keller,et al.  Sliding mode closed-loop control of FES controlling the shank movement , 2004, IEEE Transactions on Biomedical Engineering.

[48]  R. Müller,et al.  Modulation of leg muscle activity and gait kinematics by walking speed and bodyweight unloading. , 2006, Gait & posture.

[49]  T. Sinkjaer,et al.  A review of portable FES-based neural orthoses for the correction of drop foot , 2002, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[50]  E. Itoi,et al.  Hybrid functional electrical stimulation with medial linkage knee-ankle-foot orthoses in complete paraplegics. , 2006, The Tohoku journal of experimental medicine.

[51]  D. Graupe.  EMG pattern analysis for patient-responsive control of FES in paraplegics for walker-supported walking , 1989, IEEE Transactions on Biomedical Engineering.

[52]  M. Morari,et al.  Robotic Orthosis Lokomat: A Rehabilitation and Research Tool , 2003, Neuromodulation : journal of the International Neuromodulation Society.

[53]  Richard B Stein.  The plasticity of the adult spinal cord continues to surprise , 2008, The Journal of physiology.

[54]  R. Stein,et al.  Speed and Efficiency in Walking and Wheeling with Novel Stimulation and Bracing Systems After Spinal Cord Injury: A Case Study , 2005, Neuromodulation : journal of the International Neuromodulation Society.

[55]  M. Morari,et al.  Adaptive robotic rehabilitation of locomotion: a clinical study in spinally injured individuals , 2003, Spinal Cord.

[56]  Priscah Mujuru,et al.  Walk for Life: Changing Behaviors Through A Web-based Educational Program for at Risk High School Students , 2007 .

[57]  R Happee,et al.  Inverse dynamic optimization including muscular dynamics, a new simulation method applied to goal directed movements. , 1994, Journal of biomechanics.

[58]  Reymond Clavel,et al.  The WalkTrainer: A Robotic System for Walking Rehabilitation , 2006, 2006 IEEE International Conference on Robotics and Biomimetics.

[59]  N. Hoshimiya,et al.  An approach to a muscle model with a stimulus frequency-force relationship for FES applications. , 1999, IEEE transactions on rehabilitation engineering : a publication of the IEEE Engineering in Medicine and Biology Society.

[60]  Retrospective study of patients using Functional Electrical Stimulation for drop foot correction and increased hip stability , 2004 .

[61]  S.K. Agrawal,et al.  Design of a two degree-of-freedom ankle-foot orthosis for robotic rehabilitation , 2005, 9th International Conference on Rehabilitation Robotics, 2005. ICORR 2005..

[62]  T. Kesar,et al.  Catchlike property of skeletal muscle: Recent findings and clinical implications , 2005, Muscle & nerve.

[63]  David Guiraud,et al.  From neuroprosthetics to implanted FES control architecture , 2008, 2008 IEEE/RSJ International Conference on Intelligent Robots and Systems.

[64]  Richard R Neptune,et al.  Biomechanics and muscle coordination of human walking: part II: lessons from dynamical simulations and clinical implications. , 2003, Gait & posture.

[65]  Ning Lan.  Stability analysis for postural control in a two-joint limb system , 2002, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[66]  V. Dietz,et al.  Effectiveness of automated locomotor training in patients with chronic incomplete spinal cord injury: a multicenter trial. , 2005, Archives of physical medicine and rehabilitation.

[67]  M Goldfarb,et al.  Design of a controlled-brake orthosis for FES-aided gait. , 1996, IEEE transactions on rehabilitation engineering : a publication of the IEEE Engineering in Medicine and Biology Society.

[68]  F. Zajac,et al.  Contributions of the individual ankle plantar flexors to support, forward progression and swing initiation during walking. , 2001, Journal of biomechanics.

[69]  D. Sternad,et al.  Local dynamic stability versus kinematic variability of continuous overground and treadmill walking. , 2001, Journal of biomechanical engineering.

[70]  Christopher L. Vaughan,et al.  Dynamics of human gait , 1992 .

[71]  Yoichi Shimada,et al.  Functional Electrical Stimulation for Spinal Cord Injury , 2004 .

[72]  Robert Riener,et al.  Adaptive support for patient-cooperative gait rehabilitation with the Lokomat , 2008, 2008 IEEE/RSJ International Conference on Intelligent Robots and Systems.

[73]  L. Rochester,et al.  Community ambulation after stroke: how important and obtainable is it and what measures appear predictive? , 2004, Archives of physical medicine and rehabilitation.

[74]  Sunil Kumar Agrawal,et al.  Gravity-Balancing Leg Orthosis and Its Performance Evaluation , 2006, IEEE Transactions on Robotics.

[75]  M. Redfern,et al.  Biomechanics of descending ramps , 1997 .

[76]  Thomas Sinkjær,et al.  Machine learning for real time control of foot-drop correction using natural sensors , 2000 .

[77]  D. Grundy,et al.  ABC of Spinal Cord Injury , 1986 .

[78]  Stanley Salmons,et al.  Functional electrical stimulation of denervated muscles: basic issues. , 2005, Artificial organs.

[79]  Christopher Kirtley,et al.  Clinical Gait Analysis: Theory and Practice , 2006 .

[80]  F. Reynard,et al.  The WalkTrainer—A New Generation of Walking Reeducation Device Combining Orthoses and Muscle Stimulation , 2009, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[81]  E. J. Cheng,et al.  Measured and modeled properties of mammalian skeletal muscle. II. The effectsof stimulus frequency on force-length and force-velocity relationships , 1999, Journal of Muscle Research & Cell Motility.

[82]  Jerry E. Pratt,et al.  The RoboKnee: an exoskeleton for enhancing strength and endurance during walking , 2004, IEEE International Conference on Robotics and Automation, 2004. Proceedings. ICRA '04. 2004.

[83]  YangQuan Chen,et al.  Iterative Learning Control: Convergence, Robustness and Applications , 1999 .

[84]  J. Hidler,et al.  Alterations in muscle activation patterns during robotic-assisted walking. , 2005, Clinical biomechanics.

[85]  K J Hunt,et al.  Comparison of stimulation patterns for FES-cycling using measures of oxygen cost and stimulation cost. , 2006, Medical engineering & physics.

[86]  Bruce H Dobkin,et al.  An Accelerometry-Based Comparison of 2 Robotic Assistive Devices for Treadmill Training of Gait , 2008, Neurorehabilitation and neural repair.

[87]  S. Binder-Macleod,et al.  A predictive fatigue model. II. Predicting the effect of resting times on fatigue , 2002, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[88]  T. Bajd,et al.  Nonlinear modeling of FES-supported standing-up in paraplegia for selection of feedback sensors , 2005, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[89]  Christian Hofer,et al.  Clinical application of an eight channel stimulation system for mobilization of individuals with paraplegia: First results , 2005 .

[90]  Ann B. Ehrlich,et al.  Medical Terminology for Health Professions , 1988 .

[91]  M. Orendurff,et al.  The effect of walking speed on center of mass displacement. , 2004, Journal of rehabilitation research and development.

[92]  M.M. Skelly,et al.  Real-time gait event detection for paraplegic FES walking , 2001, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[93]  W. Durfee,et al.  Estimation of force-activation, force-length, and force-velocity properties in isolated, electrically stimulated muscle , 1994, IEEE Transactions on Biomedical Engineering.

[94]  Sunil Kumar Agrawal,et al.  Gravity Balancing of a Human Leg using an External Orthosis , 2007, Proceedings 2007 IEEE International Conference on Robotics and Automation.

[95]  J. Schouenborg.  Learning in sensorimotor circuits , 2004, Current Opinion in Neurobiology.

[96]  Tadej Bajd,et al.  Sensory supported FES control in gait training of incomplete spinal cord injury persons. , 2005, Artificial organs.

[97]  Simeon P. Patarinski,et al.  Robot force control: A review , 1993 .

[98]  The Effects of Tone-Reducing Orthotics on Walking of an Individual After Incomplete Spinal Cord Injury , 2008, Journal of neurologic physical therapy : JNPT.

[99]  J. Michael,et al.  KAFOs for Ambulation: An Orthotist???s Perspective , 2006 .

[100]  H. Kern,et al.  Muscle fiber regeneration in human permanent lower motoneuron denervation: relevance to safety and effectiveness of FES-training, which induces muscle recovery in SCI subjects. , 2005, Artificial organs.

[101]  S. Binder-Macleod,et al.  Mathematical models for fatigue minimization during functional electrical stimulation. , 2003, Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology.

[102]  D. Reinkensmeyer,et al.  Human-robot cooperative movement training: Learning a novel sensory motor transformation during walking with robotic assistance-as-needed , 2007, Journal of NeuroEngineering and Rehabilitation.

[103]  R J Triolo,et al.  Muscle selection and walking performance of multichannel FES systems for ambulation in paraplegia. , 1997, IEEE transactions on rehabilitation engineering : a publication of the IEEE Engineering in Medicine and Biology Society.

[104]  Peter Gorman.  Neural Prostheses , 1993, Neurology.

[105]  H. Huxley.  Fifty years of muscle and the sliding filament hypothesis. , 2004, European journal of biochemistry.

[106]  A. Arturo Leis,et al.  Atlas of Electromyography , 2000 .

[107]  V Segers,et al.  Kinematics of the transition between walking and running when gradually changing speed. , 2007, Gait & posture.

[108]  R. Riener,et al.  A Novel Mechatronic Body Weight Support System , 2006, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[109]  Aaron M. Dollar,et al.  Lower Extremity Exoskeletons and Active Orthoses: Challenges and State-of-the-Art , 2008, IEEE Transactions on Robotics.

[110]  Carl Schmitt,et al.  Orthèses fonctionnelles à cinématique parallèle et sérielle pour la rééducation des membres inférieurs , 2007 .

[111]  G. Deuschl,et al.  Gait analysis during treadmill and overground locomotion in children and adults. , 1997, Electroencephalography and clinical neurophysiology.

[112]  D. Graupe,et al.  Errata: Walking performance, medical outcomes and patient training in FES of innervated muscles for ambulation by thoracic-level complete paraplegics , 2008 .

[113]  K.J. Hunt,et al.  New results in feedback control of unsupported standing in paraplegia , 2004, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[114]  Thomas G Sugar,et al.  Design of a robotic gait trainer using spring over muscle actuators for ankle stroke rehabilitation. , 2005, Journal of biomechanical engineering.

[115]  J. Bobet,et al.  A simple model of force generation by skeletal muscle during dynamic isometric contractions , 1998, IEEE Transactions on Biomedical Engineering.

[116]  Zlatko Matjacic,et al.  Efficient FES triggering applying Kalman filter during sensory supported treadmill walking , 2008, Journal of medical engineering & technology.

[117]  G. Loeb,et al.  First Clinical Experience with BION Implants for Therapeutic Electrical Stimulation , 2004, Neuromodulation : journal of the International Neuromodulation Society.

[118]  C. Crone,et al.  H-reflexes are smaller in dancers from The Royal Danish Ballet than in well-trained athletes , 2005, European Journal of Applied Physiology and Occupational Physiology.

[119]  K G Pearson,et al.  Neural adaptation in the generation of rhythmic behavior. , 2000, Annual review of physiology.

[120]  R Riener,et al.  Biomechanical model of the human knee evaluated by neuromuscular stimulation. , 1996, Journal of biomechanics.

[121]  Christian Hofer,et al.  Stimulation parameter optimization for FES supported standing up and walking in SCI patients. , 2005, Artificial organs.

[122]  Mark E. Dohring,et al.  Automatic Synchronization of Functional Electrical Stimulation and Robotic Assisted Treadmill Training , 2008, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[123]  Sunil K. Agrawal,et al.  Design of a Novel Two Degree-of-Freedom Ankle-Foot Orthosis , 2007 .

[124]  D. Winter,et al.  EMG profiles during normal human walking: stride-to-stride and inter-subject variability. , 1987, Electroencephalography and clinical neurophysiology.

[125]  P H Peckham,et al.  Physiologic and metabolic changes in white muscle of cat following induced exercise. , 1973, Brain research.

[126]  Alfred D. Grant.  Gait Analysis: Normal and Pathological Function , 2010 .

[127]  T. Oberg,et al.  Basic gait parameters: reference data for normal subjects, 10-79 years of age. , 1993, Journal of rehabilitation research and development.

[128]  Stuart A. Binder‐Macleod,et al.  Switching stimulation patterns improves performance of paralyzed human quadriceps muscle , 2005, Muscle & nerve.

[129]  Günter Hommel,et al.  TORQUE CONTROL OF AN EXOSKELETAL KNEE WITH EMG SIGNALS , .

[130]  Yoshiyuki Sankai,et al.  Power assist method based on Phase Sequence and muscle force condition for HAL , 2005, Adv. Robotics.

[131]  A. Hof,et al.  Speed dependence of averaged EMG profiles in walking. , 2002, Gait & posture.

[132]  W. Rymer,et al.  Therapeutic effects of robotic-assisted locomotor training on neuromuscular properties , 2005, 9th International Conference on Rehabilitation Robotics, 2005. ICORR 2005..

[133]  E. Marsolais,et al.  Implanted functional electrical stimulation system for mobility in paraplegia: a follow-up case report. , 1999, IEEE transactions on rehabilitation engineering : a publication of the IEEE Engineering in Medicine and Biology Society.

[134]  D. Graupe.  An overview of the state of the art of noninvasive FES for independent ambulation by thoracic level paraplegics , 2002, Neurological research.

[135]  J. Fawcett,et al.  Guidelines for the conduct of clinical trials for spinal cord injury as developed by the ICCP panel: spontaneous recovery after spinal cord injury and statistical power needed for therapeutic clinical trials , 2007, Spinal Cord.

[136]  Thierry Keller,et al.  Assessment of finger forces and wrist torques for functional grasp using new multichannel textile neuroprostheses. , 2008, Artificial organs.

[137]  Rahman Davoodi,et al.  Automatic Finite State Control of FES‐Assisted Indoor Rowing Exercise after Spinal Cord Injury , 2002, Neuromodulation : journal of the International Neuromodulation Society.

[138]  William K Durfee,et al.  Design and simulation of a pneumatic, stored-energy, hybrid orthosis for gait restoration. , 2005, Journal of biomechanical engineering.

[139]  S J Dorgan,et al.  A nonlinear mathematical model of electrically stimulated skeletal muscle. , 1997, IEEE transactions on rehabilitation engineering : a publication of the IEEE Engineering in Medicine and Biology Society.

[140]  Reymond Clavel,et al.  Design of a new lower extremity orthosis for overground gait training with the WalkTrainer , 2009, 2009 IEEE International Conference on Rehabilitation Robotics.

[141]  P. Jacobs,et al.  Involuntary stepping after chronic spinal cord injury. Evidence for a central rhythm generator for locomotion in man. , 1994, Brain : a journal of neurology.

[142]  R. Riener,et al.  Journal of Neuroengineering and Rehabilitation Open Access Biofeedback for Robotic Gait Rehabilitation , 2022 .

[143]  C. Braun,et al.  Motor learning elicited by voluntary drive. , 2003, Brain : a journal of neurology.

[144]  A. Behrman,et al.  Neuroplasticity After Spinal Cord Injury and Training: An Emerging Paradigm Shift in Rehabilitation and Walking Recovery , 2006, Physical Therapy.

[145]  A Compston,et al.  Brain repair , 1995, Journal of internal medicine.

[146]  Günter Hommel,et al.  Predicting the intended motion with EMG signals for an exoskeleton orthosis controller , 2005, 2005 IEEE/RSJ International Conference on Intelligent Robots and Systems.

[147]  Giulio Sandini,et al.  Surface EMG for force control of mechanical hands , 2008, 2008 IEEE International Conference on Robotics and Automation.

[148]  G. Loeb,et al.  Micromodular implants to provide electrical stimulation of paralyzed muscles and limbs , 1997, IEEE Transactions on Biomedical Engineering.

[149]  F. Zajac,et al.  Muscle force redistributes segmental power for body progression during walking. , 2004, Gait & posture.

[150]  F. Lacquaniti,et al.  Five basic muscle activation patterns account for muscle activity during human locomotion , 2004, The Journal of physiology.

[151]  J. Norton,et al.  Clinical use of the Odstock dropped foot stimulator: its effect on the speed and effort of walking. , 1999, Archives of physical medicine and rehabilitation.

[152]  E. Marsolais,et al.  Alteration in the force and fatigability of skeletal muscle in quadriplegic humans following exercise induced by chronic electrical stimulation. , 1976, Clinical orthopaedics and related research.

[153]  Robert Riener,et al.  Walking with WALK! , 2008, IEEE Engineering in Medicine and Biology Magazine.

[154]  W. Durfee,et al.  Reducing muscle fatigue in FES applications by stimulating with N-let pulse trains , 1995, IEEE Transactions on Biomedical Engineering.

[155]  S. Hesse,et al.  Gait rehabilitation machines based on programmable footplates , 2007, Journal of NeuroEngineering and Rehabilitation.

[156]  T. Hornby,et al.  Clinical and Quantitative Evaluation of Robotic-Assisted Treadmill Walking to Retrain Ambulation After Spinal Cord Injury , 2005 .

[157]  Thierry Keller,et al.  Surface-Stimulation Technology for Grasping and Walking Neuroprostheses Improving Quality of Life in Stroke/Spinal Cord Injury Subjects with Rapid Prototyping and Portable FES Systems , 2001 .

[158]  Daniel Graupe,et al.  Walking performance, medical outcomes and patient training in FES of innervated muscles for ambulation by thoracic-level complete paraplegics , 2008, Neurological research.

[159]  R B Stein,et al.  Estimating mechanical parameters of leg segments in individuals with and without physical disabilities. , 1996, IEEE transactions on rehabilitation engineering : a publication of the IEEE Engineering in Medicine and Biology Society.

[160]  R. Mann,et al.  A comparison of lower-extremity skeletal kinematics measured using skin- and pin-mounted markers , 1997 .

[161]  S J Dorgan,et al.  A mathematical model for skeletal muscle activated by N-let pulse trains. , 1998, IEEE transactions on rehabilitation engineering : a publication of the IEEE Engineering in Medicine and Biology Society.

[162]  H. Huxley,et al.  Quantitative studies on the structure of cross-striated myofibrils. I. Investigations by interference microscopy. , 1957, Biochimica et biophysica acta.

[163]  P Hunter Peckham,et al.  Electrode fracture rates and occurrences of infection and granuloma associated with percutaneous intramuscular electrodes in upper-limb functional electrical stimulation applications. , 2002, Journal of rehabilitation research and development.

[164]  V. Dietz,et al.  Locomotor activity in spinal man: significance of afferent input from joint and load receptors. , 2002, Brain : a journal of neurology.

[165]  Anthony S Wexler,et al.  Mathematical model that predicts lower leg motion in response to electrical stimulation. , 2006, Journal of biomechanics.

[166]  V. Dietz,et al.  Biofeedback in gait training with the robotic orthosis Lokomat , 2004, The 26th Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[167]  B.T. Smith,et al.  Evaluation of force-sensing resistors for gait event detection to trigger electrical stimulation to improve walking in the child with cerebral palsy , 2002, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[168]  Richard W. Bohannon,et al.  Interrater reliability of a modified Ashworth scale of muscle spasticity. , 1987, Physical therapy.

[169]  Martha Freeman Somers,et al.  Spinal Cord Injury: Functional Rehabilitation , 1992 .

[170]  Simon F. Giszter,et al.  Spinal cord injury: Present and future therapeutic devices and prostheses , 2011, Neurotherapeutics.

[171]  Robert Riener,et al.  Stepping Over Virtual Obstacles with an Actuated Gait Orthosis , 2007, 2007 IEEE Virtual Reality Conference.

[172]  L. Cohen,et al.  Role of voluntary drive in encoding an elementary motor memory. , 2005, Journal of neurophysiology.

[173]  Joseph Hidler,et al.  Limb Alignment and Kinematics Inside a Lokomat Robotic Orthosis , 2006, 2006 International Conference of the IEEE Engineering in Medicine and Biology Society.

[174]  G. Zilvold,et al.  Consistency of surface EMG patterns obtained during gait from three laboratories using standardised measurement technique , 1997 .

[175]  Ronald F. Zernicke,et al.  Gait-related motor patterns and hindlimb kinetics for the cat trot and gallop , 1993, Experimental Brain Research.

[176]  D. Winter.  Biomechanics and motor control of human gait: normal, elderly and pathological - 2nd edition , 1991 .

[177]  P. Tibbetts.  :Cognitive Neuroscience: The Biology of the Mind , 2009 .

[178]  B. Dobkin,et al.  Modulation of locomotor-like EMG activity in subjects with complete and incomplete spinal cord injury. , 1995, Journal of neurologic rehabilitation.

[179]  J. Fawcett,et al.  Guidelines for the conduct of clinical trials for spinal cord injury (SCI) as developed by the ICCP panel: clinical trial outcome measures , 2007, Spinal Cord.

[180]  Reymond Clavel,et al.  Pelvic motion implementation on the WalkTrainer , 2007, 2007 IEEE International Conference on Robotics and Biomimetics (ROBIO).

[181]  R B Stein,et al.  Application of tilt sensors in functional electrical stimulation. , 1996, IEEE transactions on rehabilitation engineering : a publication of the IEEE Engineering in Medicine and Biology Society.

[182]  J. Perry,et al.  Pelvic exercise and gait in hemiplegia. , 1989, Physical therapy.

[183]  J. Duysens,et al.  Speed related changes in muscle activity from normal to very slow walking speeds. , 2004, Gait & posture.

[184]  G. Johnson.  Control of Movement for the Physically Disabled , 2001 .

[185]  J. Rozman,et al.  Selective stimulation of autonomic nerves and recording of electroneurograms in a canine model. , 2008, Artificial organs.

[186]  V. Dietz,et al.  Driven gait orthosis to do locomotor training of paraplegic patients , 2000, Proceedings of the 22nd Annual International Conference of the IEEE Engineering in Medicine and Biology Society (Cat. No.00CH37143).

[187]  Serge Rossignol,et al.  Prominent Role of the Spinal Central Pattern Generator in the Recovery of Locomotion after Partial Spinal Cord Injuries , 2008, The Journal of Neuroscience.

[188]  At L. Hof,et al.  EMG AND MUSCLE FORCE - AN INTRODUCTION , 1984 .

[189]  Patrick Métrailler.  Système robotique pour la mobilisation des membres inférieurs d"une personne paraplégique , 2005 .

[190]  D. Popovic,et al.  Recruitment and Comfort of BION Implanted Electrical Stimulation: Implications for FES Applications , 2007, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[191]  Jochen Quintern,et al.  Stair Ascending and Descending with the Cooperative Neuroprosthesis WALK! , 2003, Neuromodulation : journal of the International Neuromodulation Society.

[192]  D. Graupe,et al.  Neural network control of FES in paraplegics for patient-responsive ambulation , 1994, Proceedings of IEEE International Symposium on Circuits and Systems - ISCAS '94.

[193]  M P Kadaba,et al.  Measurement of lower extremity kinematics during level walking , 1990, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[194]  R Riener,et al.  Patient-driven control of FES-supported standing up and sitting down: experimental results. , 2000, IEEE transactions on rehabilitation engineering : a publication of the IEEE Engineering in Medicine and Biology Society.

[195]  Su Ling Chong,et al.  BIONic WalkAide for correcting foot drop , 2005, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[196]  J. Collins,et al.  Biomechanical gait alterations independent of speed in the healthy elderly: evidence for specific limiting impairments. , 1998, Archives of physical medicine and rehabilitation.

[197]  W. Farahat,et al.  An apparatus for characterization and control of isolated muscle , 2005, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[198]  Roland Siegwart,et al.  Introduction to Autonomous Mobile Robots , 2004 .

[199]  M. Popovic,et al.  Reducing muscle fatigue due to functional electrical stimulation using random modulation of stimulation parameters. , 2005, Artificial organs.

[200]  Howard Jay Chizeck,et al.  Real time gait event detection during FES paraplegic walking , 1997, Proceedings of the 19th Annual International Conference of the IEEE Engineering in Medicine and Biology Society. 'Magnificent Milestones and Emerging Opportunities in Medical Engineering' (Cat. No.97CH36136).