A Soft Wearable Robotic Ankle-Foot-Orthosis for Post-Stroke Patients

We propose a soft robotic ankle-foot-orthosis for post-stroke patients, which is inexpensive, lightweight, easy to wear, and capable of gait assistance for rehabilitation not only in the clinic but also in daily life. The device includes a 3D-printed flexible brace and an ankle supportthat allows natural flexion and extension of the ankle but provides support in the vertical direction preventing the structure from buckling. A bi-directional tendon-driven actuator was used for assisting both dorsiflexion and plantarflexion. The device also contains a wearable gait sensing module for measuring the leg trajectory and the foot pressures in real time for feedback control. Since the device is powered by a rechargeable battery and communicates with the main controller wirelessly, it is fully untethered, making it mobile and comfortable. Using the measured sensor data and the biomechanics of the legs, the real-time gait phase is detected, and then a gait assistance algorithm for both dorsiflexion and plantarflexion provides an accurate prediction of a control phase and timing although there are variations in the gait trajectories among individuals. As a feasibility test, the walking experiment was conducted with a post-stroke patient. The result showed improvement in both gait propulsion and foot-drop prevention.

[1]  Gong Chen,et al.  A review of lower extremity assistive robotic exoskeletons in rehabilitation therapy. , 2013, Critical reviews in biomedical engineering.

[2]  Kyu-Jin Cho,et al.  A Novel Slack-Enabling Tendon Drive That Improves Efficiency, Size, and Safety in Soft Wearable Robots , 2017, IEEE/ASME Transactions on Mechatronics.

[3]  J. Hidler,et al.  Multicenter Randomized Clinical Trial Evaluating the Effectiveness of the Lokomat in Subacute Stroke , 2009, Neurorehabilitation and neural repair.

[4]  B. Salzman Gait and balance disorders in older adults. , 2010, American family physician.

[5]  Conor J. Walsh,et al.  Multi-joint actuation platform for lower extremity soft exosuits , 2014, 2014 IEEE International Conference on Robotics and Automation (ICRA).

[6]  Chitralakshmi K. Balasubramanian,et al.  Anterior-Posterior Ground Reaction Forces as a Measure of Paretic Leg Contribution in Hemiparetic Walking , 2006, Stroke.

[7]  A. Esquenazi,et al.  Safety and tolerance of the ReWalk™ exoskeleton suit for ambulation by people with complete spinal cord injury: A pilot study , 2012, The journal of spinal cord medicine.

[8]  Yong-Lae Park,et al.  Smart pneumatic artificial muscle actuator with embedded microfluidic sensing , 2013, 2013 IEEE SENSORS.

[9]  Günes Yavuzer,et al.  Effects of ankle-foot orthoses on hemiparetic gait , 2003, Clinical rehabilitation.

[10]  Corcoran Pj,et al.  Effects of plastic and metal leg braces on speed and energy cost of hemiparetic ambulation. , 1970 .

[11]  Yong-Lae Park,et al.  Design and Fabrication of Soft Artificial Skin Using Embedded Microchannels and Liquid Conductors , 2012, IEEE Sensors Journal.

[12]  Conor J. Walsh,et al.  A Lightweight and Efficient Portable Soft Exosuit for Paretic Ankle Assistance in Walking After Stroke , 2018, 2018 IEEE International Conference on Robotics and Automation (ICRA).

[13]  M. Latash Neurophysiological basis of movement , 1998 .

[14]  Conor J. Walsh,et al.  A soft exosuit for patients with stroke: Feasibility study with a mobile off-board actuation unit , 2015, 2015 IEEE International Conference on Rehabilitation Robotics (ICORR).

[15]  Ann Hallemans,et al.  3D joint dynamics of walking in toddlers A cross-sectional study spanning the first rapid development phase of walking. , 2005, Gait & posture.

[16]  Yong-Lae Park,et al.  Design of flat pneumatic artificial muscles , 2017 .

[17]  Shin-Ichi Izumi,et al.  Improving gait stability in stroke hemiplegic patients with a plastic ankle-foot orthosis. , 2009, The Tohoku journal of experimental medicine.

[18]  C. Walsh,et al.  A soft robotic exosuit improves walking in patients after stroke , 2017, Science Translational Medicine.

[19]  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.

[20]  M. Lindén,et al.  Gait Analysis, Normal and Pathological Function, 2nd ed. J. Perry, J.M. Burnfield, Slack Inc., 576 pages, ISBN 978-1-55642r-r766-4 , 2011 .

[21]  J. J. Gil,et al.  Lower-Limb Robotic Rehabilitation: Literature Review and Challenges , 2011, J. Robotics.