Design of a customizable, modular pediatric exoskeleton for rehabilitation and mobility

Powered exoskeletons for gait rehabilitation and mobility assistance are currently available for the adult population and hold great promise for children with mobility limiting conditions. Described here is the development and key features of a modular, lightweight and customizable powered exoskeleton for assist-as-needed overground walking and gait rehabilitation. The pediatric lower-extremity gait system (PLEGS) exoskeleton contains bilaterally active hip, knee and ankle joints and assist-as-needed shared control for young children with lower-limb disabilities such as those present in the Cerebral Palsy, Spina Bifida and Spinal Cord Injured populations. The system is comprised of six joint control modules, one at each hip, knee and ankle joint. The joint control module, features an actuator and motor driver, microcontroller, torque sensor to enable assist-as-needed control, inertial measurement unit and system monitoring sensors. Bench-testing results for the proposed joint control module are also presented and discussed.

[1]  Erin E. Butler,et al.  Neurologic Correlates of Gait Abnormalities in Cerebral Palsy: Implications for Treatment , 2017, Front. Hum. Neurosci..

[2]  A. Meyer-Heim,et al.  Improvement of walking abilities after robotic-assisted locomotion training in children with cerebral palsy , 2009, Archives of Disease in Childhood.

[3]  Sylvia Ounpuu,et al.  Natural Progression of Gait in Children With Cerebral Palsy , 2002, Journal of pediatric orthopedics.

[4]  J. Bonar Physical Therapy for Children , 1995 .

[5]  A. Meyer-Heim,et al.  Robotic-assisted treadmill therapy improves walking and standing performance in children and adolescents with cerebral palsy. , 2010, European journal of paediatric neurology : EJPN : official journal of the European Paediatric Neurology Society.

[6]  Jose L. Contreras-Vidal,et al.  Multiple Kernel Based Region Importance Learning for Neural Classification of Gait States from EEG Signals , 2017, Front. Neurosci..

[7]  Keng Peng Tee,et al.  Continuous Role Adaptation for Human–Robot Shared Control , 2015, IEEE Transactions on Robotics.

[8]  P. Grimaud [Cerebral palsy]. , 1972, Pediatrie.

[9]  Shahid Hussain,et al.  An Adaptive Wearable Parallel Robot for the Treatment of Ankle Injuries , 2014, IEEE/ASME Transactions on Mechatronics.

[10]  José Luis Pons Rovira,et al.  Hybrid therapy of walking with Kinesis overground robot for persons with incomplete spinal cord injury: A feasibility study , 2015, Robotics Auton. Syst..

[11]  Carol L. Baym,et al.  Functional Mobility Improved After Intensive Progressive Resistance Exercise in an Adolescent With Spina Bifida , 2018, Pediatric physical therapy : the official publication of the Section on Pediatrics of the American Physical Therapy Association.

[12]  Elena Garcia,et al.  A lower-limb exoskeleton for gait assistance in quadriplegia , 2012, 2012 IEEE International Conference on Robotics and Biomimetics (ROBIO).

[13]  Atilla Kilicarslan,et al.  A robust adaptive denoising framework for real-time artifact removal in scalp EEG measurements , 2016, Journal of neural engineering.

[14]  Hermano Igo Krebs,et al.  Robot-Aided Neurorehabilitation: A Pediatric Robot for Ankle Rehabilitation , 2015, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[15]  Wei Meng,et al.  Recent development of mechanisms and control strategies for robot-assisted lower limb rehabilitation , 2015 .

[16]  S. Hesse,et al.  Improved Gait After Repetitive Locomotor Training in Children with Cerebral Palsy , 2011, American journal of physical medicine & rehabilitation.

[17]  Nobuhiko Haga,et al.  Physical Therapy for Children with Spina Bifida , 2014 .

[18]  Gian Maria Gasparri,et al.  An Untethered Ankle Exoskeleton Improves Walking Economy in a Pilot Study of Individuals With Cerebral Palsy , 2018, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[19]  B. Dan,et al.  A report: the definition and classification of cerebral palsy April 2006 , 2007, Developmental medicine and child neurology. Supplement.

[20]  J. Gage,et al.  An update on the treatment of gait problems in cerebral palsy. , 2001, Journal of pediatric orthopedics. Part B.

[21]  Hubert Labelle,et al.  Spinal cord injury in the pediatric population: a systematic review of the literature. , 2011, Journal of neurotrauma.

[22]  L. Vogel,et al.  Recommendations for mobility in children with spinal cord injury. , 2013, Topics in spinal cord injury rehabilitation.

[23]  Diane L. Damiano,et al.  A lower-extremity exoskeleton improves knee extension in children with crouch gait from cerebral palsy , 2017, Science Translational Medicine.

[24]  Hyung-Soon Park,et al.  A Robotic Exoskeleton for Treatment of Crouch Gait in Children With Cerebral Palsy: Design and Initial Application , 2017, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[25]  William Z Rymer,et al.  Reducing robotic guidance during robot-assisted gait training improves gait function: a case report on a stroke survivor. , 2013, Archives of physical medicine and rehabilitation.

[26]  Russell S Kirby,et al.  Prevalence of cerebral palsy, co‐occurring autism spectrum disorders, and motor functioning – Autism and Developmental Disabilities Monitoring Network, USA, 2008 , 2014, Developmental medicine and child neurology.

[27]  L. Zambrano,et al.  Prevalence and Characterization of the Cerebral Palsy in Maceió, a Northeast City of Brazil , 2018 .

[28]  Eduardo Rocon de Lima,et al.  CPWalker: Robotic platform for gait rehabilitation in patients with Cerebral Palsy , 2016, 2016 IEEE International Conference on Robotics and Automation (ICRA).

[29]  G. Colombo,et al.  Feasibility of robotic‐assisted locomotor training in children with central gait impairment , 2007, Developmental medicine and child neurology.