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Sit-to-stand and stand-to-sit assistance for paraplegic patients with CUHK-EXO exoskeleton

Published online by Cambridge University Press:  27 November 2017

Bing Chen
Affiliation:
School of Mechanical Engineering, Hefei University of Technology, Hefei, P.R. China. E-mail: chbing@ort.cuhk.edu.hk Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, P.R. China. E-mails: kaimingchan@cuhk.edu.hk, lawsw@ort.cuhk.edu.hk
Chun-Hao Zhong
Affiliation:
Department of Mechanical and Automation Engineering, The Chinese University of Hong Kong, Hong Kong, P.R. China. E-mails: chzhong@mae.cuhk.edu.hk, mahao.thume@gmail.com, gx.personal@gmail.com
Hao Ma
Affiliation:
Department of Mechanical and Automation Engineering, The Chinese University of Hong Kong, Hong Kong, P.R. China. E-mails: chzhong@mae.cuhk.edu.hk, mahao.thume@gmail.com, gx.personal@gmail.com
Xiao Guan
Affiliation:
Department of Mechanical and Automation Engineering, The Chinese University of Hong Kong, Hong Kong, P.R. China. E-mails: chzhong@mae.cuhk.edu.hk, mahao.thume@gmail.com, gx.personal@gmail.com
Lai-Yin Qin
Affiliation:
Department of Biomedical Engineering, The Chinese University of Hong Kong, Hong Kong, P.R. China. E-mail: annaqin097@gmail.com
Kai-Ming Chan
Affiliation:
Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, P.R. China. E-mails: kaimingchan@cuhk.edu.hk, lawsw@ort.cuhk.edu.hk
Sheung-Wai Law
Affiliation:
Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, P.R. China. E-mails: kaimingchan@cuhk.edu.hk, lawsw@ort.cuhk.edu.hk
Ling Qin*
Affiliation:
Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, P.R. China. E-mails: kaimingchan@cuhk.edu.hk, lawsw@ort.cuhk.edu.hk
Wei-Hsin Liao*
Affiliation:
Department of Mechanical and Automation Engineering, The Chinese University of Hong Kong, Hong Kong, P.R. China. E-mails: chzhong@mae.cuhk.edu.hk, mahao.thume@gmail.com, gx.personal@gmail.com
*
*Corresponding authors. E-mails: qin@ort.cuhk.edu.hk, whliao@cuhk.edu.hk
*Corresponding authors. E-mails: qin@ort.cuhk.edu.hk, whliao@cuhk.edu.hk

Summary

In this paper, we introduce a lower extremity exoskeleton CUHK-EXO that is developed to help paraplegic patients, who have lost the motor and sensory functions of their lower limbs to perform basic daily life motions. Since the sit-to-stand and stand-to-sit (STS) motion is the first step for paraplegic patients toward walking, analysis of the exoskeleton's applicability to the STS motion assistance is performed. First, the human-exoskeleton system (HES) is modeled as a five-link model during the STS motion, and the center of pressure (COP) on the ground and center of gravity of the whole system are calculated. Then, a description of the CUHK-EXO hardware design is presented, including the mechatronics design and actuator selection. The COP position is an important factor indicating system balance and wearer's comfort. Based on the COP position, a trajectory online modification algorithm (TOMA) is proposed for CUHK-EXO to counteract disturbances, stabilize system balance, and improve the wearer's comfort in the STS motion. The results of STS motion tests conducted with a paraplegic patient demonstrate that CUHK-EXO can provide a normal reference pattern and proper assistive torque to support the patient's STS motion. In addition, a pilot study is conducted with a healthy subject to verify the effectiveness of the proposed TOMA under external disturbances before future clinical trials. The testing results verify that CUHK-EXO can counteract disturbances, and help the wearer perform the STS motion safely and comfortably.

Type
Articles
Copyright
Copyright © Cambridge University Press 2017 

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References

1. World Health Organization, Media Center, Spinal cord injury. Available at http://www.who.int/mediacentre/factsheets/fs384/en/ (Accessed May 25, 2016).Google Scholar
2. Dryden, D. M., Saunders, L. D., Rowe, B. H., May, L. A., Yiannakoulias, N., Svenson, L. W., Schopflocher, D. P. and Voaklander, D. C., “Utilization of health services following spinal cord injury: A 6-year follow-up study,” Spinal Cord 42 (9), 513525 (2004).Google Scholar
3. McKinley, W. O., Jackson, A. B., Cardenas, D. D. and DeVivo, M. J., “Long-term medical complications after traumatic spinal cord injury: A regional model systems analysis,” Arch. Phys. Med. Rehab. 80 (11), 14021410 (1999).CrossRefGoogle ScholarPubMed
4. Chen, B., Ma, H., Qin, L. Y., Gao, F., Chan, K. M., Law, S. W., Qin, L. and Liao, W. H., “Recent developments and challenges of lower extremity exoskeletons,” J. Orthopaed. Trans. 5, 2637 (2016).CrossRefGoogle ScholarPubMed
5. Scivoletto, G., Mancini, M., Fiorelli, E., Morganti, B.1 and Molinari, M., “A prototype of an adjustable advanced reciprocating gait orthosis (ARGO) for spinal cord injury (SCI),” Spinal Cord 41 (3), 187191 (2003).Google Scholar
6. Copilusi, C., Ceccarelli, M. and Carbone, G., “Design and numerical characterization of a new leg exoskeleton for motion assistance,” Robotica 33 (05), 11471162 (2015).CrossRefGoogle Scholar
7. Talaty, M., Esquenazi, A. and Briceño, J. E., “Differentiating Ability In Users Of The Rewalktm Powered Exoskeleton: An Analysis Of Walking Kinematics,” Proceedings of the 2013 IEEE International Conference on Rehabilitation Robotics (ICORR), Seattle, USA, IEEE (2013) pp. 1–5.Google Scholar
8. Mertz, L., “The next generation of exoskeletons: Lighter, cheaper devices are in the works,” IEEE Pulse 3 (4), 5661 (2012).Google Scholar
9. Tsukahara, A., Hasegawa, Y., Eguchi, K. and Sankai, Y., “Restoration of gait for spinal cord injury patients using HAL with intention estimator for preferable swing speed,” IEEE Trans. Neural Syst. Rehab. Eng. 23 (2), 308318 (2015).Google Scholar
10. Murray, S. A., Ha, K. H., Hartigan, C. and Goldfarb, M., “An assistive control approach for a lower-Limb exoskeleton to facilitate recovery of walking following stroke,” IEEE Trans. Neural Syst. Rehab. Eng. 23 (3), 441449 (2015).CrossRefGoogle ScholarPubMed
11. Collinger, J. L., Boninger, M. L., Bruns, T. M., Curley, K., Wang, W. and Weber, D. J., “Functional priorities, assistive technology, and brain-computer interfaces after spinal cord injury,” J. Rehab. Res. Dev. 50 (2), 145 (2013).Google Scholar
12. Brown-Triolo, D. L. et al., “Consumer perspectives on mobility: Implications for neuroprosthesis design,” J. Rehab. Res. Dev. 39 (6), 659670 (2002).Google Scholar
13. Tsukahara, A., Kawanishi, R., Hasegawa, Y. and Sankai, Y., “Sit-to-stand and stand-to-sit transfer support for complete paraplegic patients with robot suit HAL,” Adv. Robot. 24 (11), 16151638 (2010).Google Scholar
14. Mefoued, S., Mohammed, S., Amirat, Y. and Fried, G., “Sit-to-Stand Movement Assistance Using An Actuated Knee Joint Orthosis,” Proceedings of the 2012 IEEE RAS & EMBS International Conference on Biomedical Robotics and Biomechatronics (BioRob), Roma, Italy, IEEE (2012) pp. 1753–1758.Google Scholar
15. Karavas, N., Ajoudani, A., Tsagarakis, N., Saglia, J., Bicchi, A. and Caldwell, D., “Tele-Impedance Based Stiffness And Motion Augmentation For A Knee Exoskeleton Device,” Proceedings of the 2013 IEEE International Conference on Robotics and Automation (ICRA), Karlsruhe, Germany, IEEE (2013) pp. 2194–2200.Google Scholar
16. Huo, W., Mohammed, S., Amirat, Y. and Kong, K., “Active Impedance Control of A Lower Limb Exoskeleton to Assist Sit-to-Stand Movement,” Proceedings of the 2016 IEEE International Conference on Robotics and Automation (ICRA), Stockholm, Sweden, IEEE (2016) pp. 3530–3536.Google Scholar
17. Han, Y., Zhu, S. Q., Zhou, Z., Shi, Y. and Hao, D. B., “Research on a multimodal actuator-oriented power-assisted knee exoskeleton,” Robotica 35 (9), 19061922 (2017).Google Scholar
18. Onen, U., Botsali, F. M., Kalyoncu, M., Tınkır, M., Yılmaz, N. and Sahin, Y., “Design and actuator selection of a lower extremity exoskeleton,” IEEE/ASME Trans. Mechatr. 19 (2), 623632 (2014).CrossRefGoogle Scholar
19. Unluhisarcikli, O., Pietrusinski, M., Weinberg, B., Bonato, P. and Mavroidis, C., “Design and Control of A Robotic Lower Extremity Exoskeleton for Gait Rehabilitation,” Proceedings of the 2011 IEEE International Conference on Intelligent Robots and Systems (IROS), San Francisco, CA, USA, IEEE (2012) pp. 4893–4898.Google Scholar
20. Kirtley, C., CGA Normative Gait Database, Hong Kong Polytechnic University. Available at: http://www.clinicalgaitanalysis.com/data/ (Accessed February 15, 2017).Google Scholar
21. Chen, B., Ma, H., Qin, L. Y., Guan, X., Chan, K. M., Law, S. W., Qin, L. and Liao, W. H., “Design of A Lower Extremity Exoskeleton for Motion Assistance in Paralyzed Individuals,” Proceedings of the 2015 IEEE International Conference on Robotics and Biomimetics (ROBIO), Zhuhai, China, IEEE (2015) pp. 144–149.Google Scholar
22. Gurfinkel, V. S., Ivanenko, Y. P., Levik, Y. S. and Babakova, I. A., “Kinesthetic reference for human orthograde posture,” Neuroscience 68 (1), 229243 (1995).Google Scholar
23. Goswami, A., “Postural stability of biped robots and the foot-rotation indicator (FRI) point,” Int. J. Robot. Res. 18 (6), 523533 (1999).CrossRefGoogle Scholar
24. Ito, S. and Kawasaki, H., “A Standing Posture Control Based on Ground Reaction Force,” Proceedings of the 2000 IEEE/RSJ International Conference on Intelligent Robots and Systems, IEEE, (2000) pp. 1340–1345.Google Scholar
25. Rajasekaran, V., Aranda, J., Casals, A. and Pons, J. L., “An adaptive control strategy for postural stability using a wearable robot,” Robot. Auton. Syst. 73, 1623 (2015).Google Scholar
26. Winter, D. A., Biomechanics and Motor Control of Human Movement, 4th ed. (Hoboken, NJ, USA: Wiley, 2009).CrossRefGoogle Scholar
27. Mefoued, S., Mohammed, S. and Amirat, Y., “Knee Joint Movement Assistance Through Robust Control of An Actuated Orthosis,” Proceedings of the 2011 IEEE/RSJ International Conference on Intelligent Robots and Systems, San Francisco, USA, IEEE (2011) pp. 1749–1754.Google Scholar