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      Cooperative ankle-exoskeleton control can reduce effort to recover balance after unexpected disturbances during walking

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          Abstract

          Background

          In the last two decades, lower-limb exoskeletons have been developed to assist human standing and locomotion. One of the ongoing challenges is the cooperation between the exoskeleton balance support and the wearer control. Here we present a cooperative ankle-exoskeleton control strategy to assist in balance recovery after unexpected disturbances during walking, which is inspired on human balance responses.

          Methods

          We evaluated the novel controller in ten able-bodied participants wearing the ankle modules of the Symbitron exoskeleton. During walking, participants received unexpected forward pushes with different timing and magnitude at the pelvis level, while being supported (Exo-Assistance) or not (Exo-NoAssistance) by the robotic assistance provided by the controller. The effectiveness of the assistive strategy was assessed in terms of (1) controller performance (Detection Delay, Joint Angles, and Exerted Ankle Torques), (2) analysis of effort (integral of normalized Muscle Activity after perturbation onset); and (3) Analysis of center of mass COM kinematics (relative maximum COM Motion, Recovery Time and Margin of Stability) and spatio-temporal parameters (Step Length and Swing Time).

          Results

          In general, the results show that when the controller was active, it was able to reduce participants’ effort while keeping similar ability to counteract and withstand the balance disturbances. Significant reductions were found for soleus and gastrocnemius medialis activity of the stance leg when comparing Exo-Assistance and Exo-NoAssistance walking conditions.

          Conclusions

          The proposed controller was able to cooperate with the able-bodied participants in counteracting perturbations, contributing to the state-of-the-art of bio-inspired cooperative ankle exoskeleton controllers for supporting dynamic balance. In the future, this control strategy may be used in exoskeletons to support and improve balance control in users with motor disabilities.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s12984-022-01000-y.

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          Most cited references33

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          The condition for dynamic stability.

          The well-known condition for standing stability in static situations is that the vertical projection of the centre of mass (CoM) should be within the base of support (BoS). On the basis of a simple inverted pendulum model, an extension of this rule is proposed for dynamical situations: the position of (the vertical projection of) the CoM plus its velocity times a factor (square root l/g) should be within the BoS, l being leg length and g the acceleration of gravity. It is proposed to name this vector quantity 'extrapolated centre of mass position' (XcoM). The definition suggests as a measure of stability the 'margin of stability' b, the minimum distance from XcoM to the boundaries of the BoS. An alternative measure is the temporal stability margin tau, the time in which the boundary of the BoS would be reached without intervention. Some experimental data of subjects standing on one or two feet, flatfoot and tiptoe, are presented to give an idea of the usual ranges of these margins of stability. Example data on walking are also presented.
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            Review of control strategies for robotic movement training after neurologic injury

            There is increasing interest in using robotic devices to assist in movement training following neurologic injuries such as stroke and spinal cord injury. This paper reviews control strategies for robotic therapy devices. Several categories of strategies have been proposed, including, assistive, challenge-based, haptic simulation, and coaching. The greatest amount of work has been done on developing assistive strategies, and thus the majority of this review summarizes techniques for implementing assistive strategies, including impedance-, counterbalance-, and EMG- based controllers, as well as adaptive controllers that modify control parameters based on ongoing participant performance. Clinical evidence regarding the relative effectiveness of different types of robotic therapy controllers is limited, but there is initial evidence that some control strategies are more effective than others. It is also now apparent there may be mechanisms by which some robotic control approaches might actually decrease the recovery possible with comparable, non-robotic forms of training. In future research, there is a need for head-to-head comparison of control algorithms in randomized, controlled clinical trials, and for improved models of human motor recovery to provide a more rational framework for designing robotic therapy control strategies.
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              Human-in-the-loop optimization of exoskeleton assistance during walking.

              Exoskeletons and active prostheses promise to enhance human mobility, but few have succeeded. Optimizing device characteristics on the basis of measured human performance could lead to improved designs. We have developed a method for identifying the exoskeleton assistance that minimizes human energy cost during walking. Optimized torque patterns from an exoskeleton worn on one ankle reduced metabolic energy consumption by 24.2 ± 7.4% compared to no torque. The approach was effective with exoskeletons worn on one or both ankles, during a variety of walking conditions, during running, and when optimizing muscle activity. Finding a good generic assistance pattern, customizing it to individual needs, and helping users learn to take advantage of the device all contributed to improved economy. Optimization methods with these features can substantially improve performance.
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                Author and article information

                Contributors
                c.bayoncalderon@utwente.nl
                a.q.l.keemink@utwente.nl
                m.vanmierlo@utwente.nl
                w.f.rampeltshammer@utwente.nl
                h.vanderkooij@utwente.nl
                e.h.f.vanasseldonk@utwente.nl
                Journal
                J Neuroeng Rehabil
                J Neuroeng Rehabil
                Journal of NeuroEngineering and Rehabilitation
                BioMed Central (London )
                1743-0003
                17 February 2022
                17 February 2022
                2022
                : 19
                : 21
                Affiliations
                [1 ]GRID grid.6214.1, ISNI 0000 0004 0399 8953, Department of Biomechanical Engineering, , University of Twente, ; Enschede, The Netherlands
                [2 ]GRID grid.5292.c, ISNI 0000 0001 2097 4740, Department of BioMechanical Engineering, , Delft University of Technology, ; Delft, The Netherlands
                Author information
                http://orcid.org/0000-0003-1825-1265
                Article
                1000
                10.1186/s12984-022-01000-y
                8851842
                35172846
                9146d2af-cff2-4f25-8fef-4543dccf6d7e
                © The Author(s) 2022

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 18 June 2021
                : 2 February 2022
                Funding
                Funded by: dutch research council nwo
                Award ID: Project number P16-05
                Award Recipient :
                Categories
                Research
                Custom metadata
                © The Author(s) 2022

                Neurosciences
                balance,control,exoskeleton,ankle,human–robot interaction,gait
                Neurosciences
                balance, control, exoskeleton, ankle, human–robot interaction, gait

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