Wireless Instrumented Crutches for Force and Tilt Monitoring in Lower Limb Rehabilitation (original) (raw)
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2015 6th International Workshop on Advances in Sensors and Interfaces (IWASI), 2015
Powered exoskeletons have proven to be a reliable solution to provide mobility to persons with spinal cord injury (SCI), but how users can learn to manage these devices is still an open issue. The training required to learn how to use an exoskeleton for assisted walking is currently based on a subjective evaluation of gait by the patient and his therapist, with a trial and error approach that increases the time and effort required to reach an efficient walking rate. To provide therapists information on the training progress, as well as on upper limb involvement in assisted gait, a measurement system was developed, by instrumenting Lofstrand crutches and integrating them with the sensing framework commonly found in gait analysis laboratories. Each crutch is composed of three strain-gauge bridges for measuring axial and shear forces, a conditioning circuit with transmission modules, a tri-axial accelerometer, and a power management circuit with two batteries. Data are transmitted wirelessly via Bluetooth to a personal computer, avoiding any interference with the user's gait. To estimate upper limbs' internal forces, an inverse dynamics analysis of the measurement results was performed on a biomechanical model developed by the authors. Internal forces acting on shoulders, elbow and neck were computed, to assess loads on the joints, as well as torques acting on the system degrees of freedom, due to the muscular activity of the subject. The presented approach was applied to Rewalk © users at different stages of their training, and with different walking performances. The paper presents the description of the measurement system, as well as an example of the results of these case studies, showing how this solution could be used to quantify important parameters to guide the user training during assisted gait.
— Powered exoskeletons can be used by the persons with complete spinal cord injury to achieve bipedal locomotion again. The training required before being able to efficiently operate these orthotics, however, is currently based on the subjective assessments of the patient performance by his therapist , without any quantitative information about the internal loads or assistance level. To solve this issue, a sensor system was developed, combining the traditional gait analysis systems, such as ground reaction force platforms and motion capture systems, with Lofstrand crutches instrumented by the authors. To each crutch three strain-gauge bridges were applied, to measure both axial and shear forces, as well as conditioning circuits with transmission modules and a triaxial accelerometer. An inverse dynamics analysis, on a simplified biomechanical model of the patient wearing the exoskeleton, is proposed by the authors as a tool to assess both the internal forces acting on shoulders, elbow, and neck of the patient, as well as the loads acting on joints. The same analysis was also used to quantify the assistance provided to the patient during walking, in terms of vertical forces applied by the therapist to the exoskeleton. The tests showed a therapist assistance contribution reported as a fraction of the subject body weight up to 40% with an average close to 0% and a standard deviation value of 14%. This paper presents the description of the measurement system, of the post-processing analysis, as well as the results of the proposed approach applied to a single Rewalk user during training.
Smart portable rehabilitation devices
Journal of neuroengineering and rehabilitation, 2005
The majority of current portable orthotic devices and rehabilitative braces provide stability, apply precise pressure, or help maintain alignment of the joints with out the capability for real time monitoring of the patient's motions and forces and without the ability for real time adjustments of the applied forces and motions. Improved technology has allowed for advancements where these devices can be designed to apply a form of tension to resist motion of the joint. These devices induce quicker recovery and are more effective at restoring proper biomechanics and improving muscle function. However, their shortcoming is in their inability to be adjusted in real-time, which is the most ideal form of a device for rehabilitation. This introduces a second class of devices beyond passive orthotics. It is comprised of "active" or powered devices, and although more complicated in design, they are definitely the most versatile. An active or powered orthotic, usually employs so...
Wireless Instrumented Crutches for Force and Movement Measurements for Gait Monitoring
IEEE Transactions on Instrumentation and Measurement, 2015
This paper describes the design, development, and characterization of two wireless instrumented crutches for gait monitoring in order to provide clinicians quantitative parameters of upper limbs' contributions during walking. These parameters could be used to teach orthopedic patients to correctly use these supports and minimize problems connected to their usage. These instrumented crutches allow monitoring axial forces and shear forces, tilt angles, and time of impact on the ground in real time. Each crutch is composed of three strain-gauge bridges for measuring axial and shear forces, a conditioning circuit with transmission module, a triaxial accelerometer, a power management circuit, two batteries, and a biofeedback. The data are wirelessly transmitted via Bluetooth without needing any further readout unit, from the crutches to a personal computer, where the data are processed and displayed by a program created in LabVIEW. Each instrumented crutch was tested to assess the response of the accelerometer and the three strain-gauge bridges using a setup designed ad hoc. The mean experimental standard deviation was about 42 mV for axial forces corresponding to about 8 N and about 35 mV for shear forces corresponding to about 4 N. Hysteresis, linearity, and drift were calculated, and the obtained accuracy was about 8-9 N for axial forces and 4-5 N for shear forces. Furthermore, the crutches were tested during a walking activity of ten healthy subjects along a straight path for several trials. These crutches were used for a common analysis usually reported in the literature for weight bearing evaluation. The subjects were monitored performing a nonweight bearing (NWB) and a partial weight bearing (PWB) during a three-point gait. The results showed a mean of 102% ± 16% for NWB tests and a mean of 19% ± 14% for 10% PWB tests; these values are in agreement with similar studies in the literature. The simplicity that includes only constitutive strain gauges and a separable circuit board allows the achievement of the objectives of simplicity, ease of use, and noninvasiveness. Therefore, these crutches could be used as a support tool for controlling the use of crutches during walking not only in hospitals but also at home.
DESIGN AND IMPLEMENTATION OF A MECHATRONIC SYSTEM FOR LOWER LIMB MEDICAL REHABILITATION
International Journal of Modern Manufacturing Technologies, 2012
The design and implementation of a new mechatronic system for lower limb rehabilitation is presented in this paper. The medical rehabilitation of the knee joint will be focused in this paper, because their injuries are characterized by a high degree of importance. The system applies a closed loop rehabilitation protocol, diagnosis - treatment - feedback from the patient, and allows a real time recuperative progress recording for the patient, using a database that stores the patient’s evolution. The mechatronic system evaluates the patient's recovery based on the joint angular positions variation and also based on normal and tangential forces developed during the interaction between the human foot and the rehabilitation system. The normal and tangential forces can highlight the disease’s gravity and also the rehabilitation progress. The results obtained from the experimental testes performed on a healthy subject and patient provides valuable information concerning the main parameters (angle, forces) involved in rehabilitation process appreciation and also, demonstrate the system’s efficiency.
The rehabilitation monitoring is a method to access and identify human body events and the measurements of dynamic and motion parameters involving the lower part of the body. This significant method is widely used in rehabilitation, sports and health diagnostic towards improving the quality of life. Thus, this research focuses on the development of a portable shoe integrated with wireless MEMS-based and recent microelectronic based system. It goes with the custom design package includes ultrasonic sensor, Inertia Measurement Unit (IMU), Xbee wireless signal transmission, microcontroller and power supply unit. The shoe system was tested and proven to satisfy the human movement analysis based on gait parameters which include foot clearance and foot orientation. From this research, it is found that the system was able to measure the movement parameter wirelessly with ease and efficient. Hence, to conclude this system can be used as the best method for real life rehabilitation monitoring system.
The Evolution of Devices and Systems Supporting Rehabilitation of Lower Limbs
International Journal of Applied Mechanics and Engineering, 2015
This paper presents the process of development, as well as examples of devices and systems supporting rehabilitation of the human lower extremities, developed independently over the years in many parts of the world. Particular emphasis was placed on indicating, which major groups of devices supporting kinesitherapy of the lower limbs can be distinguished, what are the important advantages and disadvantages of particular types of solutions, as well as what directions currently dominating in development of rehabilitation systems may be specified. A deeper analysis and comparison of several selected systems was also conducted, resulting in gathering the outcomes in two tables. They focused on a few features of mechanical design, especially the devices’ kinematic structures, and devices’ additional functions associated with, among others, interaction, as well as diagnosis of the limb's state and the progress of rehabilitation.
N eXOS – The design, development and evaluation of a rehabilitation system for the lower limbs
Mechatronics, 2009
Recent years have seen the development of a number of automated and semi-automated systems to support physiotherapy and rehabilitation. These deploy a range of technologies from highly complex purpose built systems to approaches based around the use of industrial robots operating either individually or in combination for applications ranging from stroke rehabilitation to mobility enhancement. The NeXOS project set out to investigate an approach to the rehabilitation of the lower limbs in a way which brought together expertise in engineering design and mechatronics with specialists in rehabilitation and physiotherapy.The result is prototype of a system which is potentially capable in operating in a number of modes from fully independent to providing direct support to a physiotherapist during manipulation of the limb. Designed around a low cost approach for an implementation ultimately capable of use in a patients home using web-based strategies for communication with their support team, the prototype NeXOS system has validated the adoption of an integrated approach to its development. The paper considers this design and development process and provides the results from the initial tests with physiotherapists to establish the operational basis for clinical implementation.
Exoskeleton - wearable devices. Literature review
MATEC Web of Conferences
Exoskeletons are companion devices that help a person to perform various daily activities. These can range from work to medical rehabilitation. The type of activity performed depend on the construction and control of the exoskeleton, so that some devices are for only one arm, others for both, can be driven by motors directly or through cables. Exoskeletons can be driven based on information received from position, force, speed sensors or by using EMG, EEG signals. Exoskeleton wearable devices began to appear around 1980, as an aid in physical work, in the handling of various heavy objects. Over time, they also covered the preventive-rehabilitation medical side, in order to reduce muscle pain or to restore specific movements, attenuated or even missing following accidents or diseases of the muscles. The paper presents an overview of the exoskeletons developed for the human arm.