Kinematic modelling of a robotic gait device for early rehabilitation of walking

Mechanical Design and Control System Development of a Rehabilitation Robotic System for Walking With Arm Swing

Background: Interlimb neural coupling implies that arm swing should be included during gait training to improve rehabilitation outcomes. We previously developed several systems for production of walking with arm swing, but the reaction forces on the foot sole during usage of the systems were not satisfactory and there was potential to improve control system performance. This work aimed to design and technically evaluate a novel system for producing walking with synchronised arm and leg movement and with dynamic force loading on the foot soles.

Methods: The robotic system included a passive curved treadmill and a trunk frame, upon which the rigs for the upper and lower limbs were mounted. Ten actuators and servocontrollers with EtherCAT communication protocol controlled the bilateral shoulder, elbow, hip, knee and ankle joints. Impedance control algorithms were developed and ran in an industrial PC. Flexible pressure sensors recorded the plantar forces on the foot soles. The criteria of implementation and responsiveness were used to formally evaluate the technical feasibility of the system.

Results: Using impedance algorithms, the system produced synchronous walking with arm swing on the curved treadmill, with mean RMS angular tracking error <2° in the 10 joint profiles. The foot trajectories relative to the hip presented similar shapes to those during normal gait, with mean RMS displacement error <1.5 cm. A force pattern that started at the heel and finished at the forefoot was observed during walking using the system, which was similar to the pattern from overground walking.

Conclusion: The robotic system produced walking-like kinematics in the 10 joints and in the foot trajectories. Integrated with the curved treadmill, the system also produced walking-like force patterns on the foot soles. The system is considered feasible as far as implementation and responsiveness are concerned. Future work will focus on improvement of the mechanical system for future clinical application.

Models for temporal-spatial parameters in walking with cadence ratio as the independent variable

Accurate models that describe temporal-spatial parameters are desirable in gait estimation and rehabilitation. This study aimed to explore simple but relatively accurate models to describe stride length (SL), speed (SP) and walk ratio (WR) at various cadences. Twenty-four able-bodied participants (16 in a test group and 8 in a validation group) walked at seven cadence ratios (CRs). The individual and group mean SL, SP and WR were studied. Suitable temporal-spatial model structures were proposed and used to approximate the individual SL, SP and WR at various CRs. After the temporal-spatial model structures were found to be feasible, the general temporal-spatial models were analysed using the test group mean SL, SP and WR. Accuracy was assessed using the validation group mean values. Individual approximation accuracies showed that the proposed model structure deduced from the linear SL model was suitable for WR approximation. The linear, deduced quadratic and power functions approximated the individual SL, SP and WR, respectively, with high accuracy. Based on the test group mean SL, SP and WR, the general temporal-spatial models were obtained and produced comparable approximation accuracies in the validation group. The general temporal-spatial models predicted well the individual gait parameters with similar individual errors for both groups. These temporal-spatial models clearly describe SL, SP and especially WR at various cadences. They provide accurate reference data for gait estimation and have potential to guide speed modulation in robot-assisted gait rehabilitation.

Graphical abstract

Development and Feasibility Assessment of a Rotational Orthosis for Walking with Arm Swing

Interlimb neural coupling might underlie human bipedal locomotion, which is reflected in the fact that people swing their arms synchronously with leg movement in normal gait. Therefore, arm swing should be included in gait training to provide coordinated interlimb performance. The present study aimed to develop a Rotational Orthosis for Walking with Arm Swing (ROWAS), and evaluate its feasibility from the perspectives of implementation, acceptability and responsiveness. We developed the mechanical structures of the ROWAS system in SolidWorks, and implemented the concept in a prototype. Normal gait data were used as the reference performance of the shoulder, hip, knee and ankle joints of the prototype. The ROWAS prototype was tested for function assessment and further evaluated using five able-bodied subjects for user feedback. The ROWAS prototype produced coordinated performance in the upper and lower limbs, with joint profiles similar to those occurring in normal gait. The subjects reported a stronger feeling of walking with arm swing than without. The ROWAS system was deemed feasible according to the formal assessment criteria.

Modelling of the toe trajectory during normal gait using circle-fit approximation

This work aimed to validate the approach of using a circle to fit the toe trajectory relative to the hip and to investigate linear regression models for describing such toe trajectories from normal gait. Twenty-four subjects walked at seven speeds. Best-fit circle algorithms were developed to approximate the relative toe trajectory using a circle. It was detected that the mean approximation error between the toe trajectory and its best-fit circle was less than 4 %. Regarding the best-fit circles for the toe trajectories from all subjects, the normalised radius was constant, while the normalised centre offset reduced when the walking cadence increased; the curve range generally had a positive linear relationship with the walking cadence. The regression functions of the circle radius, the centre offset and the curve range with leg length and walking cadence were definitively defined. This study demonstrated that circle-fit approximation of the relative toe trajectories is generally applicable in normal gait. The functions provided a quantitative description of the relative toe trajectories. These results have potential application for design of gait rehabilitation technologies.

Mechanical stimulation of the foot sole in a supine position for ground reaction force simulation

BACKGROUND

To promote early rehabilitation of walking, gait training can start even when patients are on bed rest. Supine stepping in the early phase after injury is proposed to maximise the beneficial effects of gait restoration. In this training paradigm, mechanical loading on the sole of the foot is required to mimic the ground reaction forces that occur during overground walking. A pneumatic shoe platform was developed to produce adjustable forces on the heel and the forefoot with an adaptable timing. This study aimed to investigate the stimulation parameters of the shoe platform to generate walking-like loading on the foot sole, while avoiding strong reflexes.

METHODS

This study evaluated this platform in ten able-bodied subjects in a supine position. The platform firstly produced single-pulse stimulation on the heel or on the forefoot to determine suitable stimulation parameters, then it produced cyclic stimulation on the heel and the forefoot to simulate the ground reaction forces that occur at different walking speeds. The ankle angle and electromyography (EMG) in the tibialis anterior (TA) and soleus (SOL) muscles were recorded. User feedback was collected.

RESULTS

When the forefoot or/and the heel were stimulated, reflexes were observed in the lower leg muscles, and the amplitude increased with force. Single-pulse stimulation showed that a fast-rising force significantly increased the reflex amplitudes, with the possibility of inducing ankle perturbation. Therefore a slow-rising force pattern was adopted during cyclic stimulation for walking. The supine subjects perceived loading sensation on the foot sole which was felt to be similar to the ground reaction forces during upright walking. The EMG generally increased with force amplitude, but no reflex-induced ankle perturbations were observed. The mean change in the ankle joint induced by the stimulation was about 1°.

CONCLUSIONS

The rate of force increase should be carefully adjusted for simulation of walking-like loading on the foot sole. It is concluded that the dynamic shoe platform provides adjustable mechanical stimulation on the heel and the forefoot in a supine position and has technical potential for simulation of ground reaction forces that occur during walking.

Kinetic analysis of supine stepping for early rehabilitation of walking

In order to promote gait restoration in patients who cannot maintain an upright position in the early post-injury phase, a Gait Orthosis for Early Rehabilitation was proposed for supine stepping. Although supine stepping can generate lower-limb joint trajectories which are close to normal gait, the inter-segmental dynamics of supine stepping are believed to be different from those of upright walking. Furthermore, training in a supine position requires a certain loading on the foot to mimic the ground reaction forces, where different loading amplitudes influence the joint dynamics. This work analysed the kinetics of supine stepping with variable loading and investigated structural modifications for the Gait Orthosis for Early Rehabilitation system to address this kinetic difference. Three able-bodied subjects walked overground while their walking performance was recorded. Based on the experimental data, a leg-linkage model was developed to simulate the dynamics of upright walking. This model was then rotated by 90° with different foot loadings to investigate the kinetics of supine stepping. Compared to upright walking, supine stepping had a large kinetic difference at the hip joint due to the supine leg position. The ankle joint during supine stepping was sensitive to the force amplitude simulated on the foot. Thus, the Gait Orthosis for Early Rehabilitation system requires a leg frame to compensate the position change and a shoe platform to activate the leg muscles, especially at the ankle joint. This study provided important structural information for the further development of the Gait Orthosis for Early Rehabilitation system.

Foot trajectory approximation using the pendulum model of walking

Generating a natural foot trajectory is an important objective in robotic systems for rehabilitation of walking. Human walking has pendular properties, so the pendulum model of walking has been used in bipedal robots which produce rhythmic gait patterns. Whether natural foot trajectories can be produced by the pendulum model needs to be addressed as a first step towards applying the pendulum concept in gait orthosis design. This study investigated circle approximation of the foot trajectories, with focus on the geometry of the pendulum model of walking. Three able-bodied subjects walked overground at various speeds, and foot trajectories relative to the hip were analysed. Four circle approximation approaches were developed, and best-fit circle algorithms were derived to fit the trajectories of the ankle, heel and toe. The study confirmed that the ankle and heel trajectories during stance and the toe trajectory in both the stance and the swing phases during walking at various speeds could be well modelled by a rigid pendulum. All the pendulum models were centred around the hip with pendular lengths approximately equal to the segment distances from the hip. This observation provides a new approach for using the pendulum model of walking in gait orthosis design.