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Title: Development of a Soft Inflatable Exosuit for Knee Flexion Assistance
Wearable robotics has shown to be effective for assisting in activities of daily living and restoring motor functions. The objective of this research is to develop a soft robotic exosuit for knee flexion assistance during normal walking and validate its ability to reduce the efforts of the knee flexor muscles: biceps femoris (BF) and semitendinosus (SM). The exosuit is powered by an inflatable curved fabric actuator with the capability to generate flexion torques at the knee joint. An analytical model to characterize the torque of the proposed actuator is derived and validated experimentally. It is found that the analytical torque model precisely matches the experimental results such that the highest root mean square error (RMSE) obtained is 1.237 Nm while the lowest is 0.188 Nm. In addition, the derived model outperformed a benchmark torque model such that its minimum and maximum RMSEs are approximately 90% and 70% less than the benchmark model respectively. A prototype of the knee exosuit is fabricated and tested on one healthy subject with different operating conditions to assist knee flexion during normal walking. The results show that by choosing the appropriate timing of inflation, the exosuit can reduce the electromyography activity of the BF and the SM by 32% and 23%, respectively, without impeding the knee extensor muscle or reducing the knee's range of motion.  more » « less
Award ID(s):
1828010
NSF-PAR ID:
10432758
Author(s) / Creator(s):
; ;
Date Published:
Journal Name:
2022 9th IEEE RAS/EMBS International Conference for Biomedical Robotics and Biomechatronics (BioRob)
Page Range / eLocation ID:
1 to 6
Format(s):
Medium: X
Sponsoring Org:
National Science Foundation
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    Methods

    Ten healthy young adults walked at 1.25 m s−1for four 10-min discrete bouts, each comprising baseline, exposure to active exosuit-applied resistance, and post-active sections. In each bout, a different force magnitude was applied based on individual baseline ankle torques. The peak resistance torque applied by the exosuit was 0.13 ± 0.01, 0.19 ± 0.01, 0.26 ± 0.02, and 0.32 ± 0.02 N m kg−1, in the LOW, MED, HIGH, and MAX bouts, respectively.

    Results

    (1) Across all bouts, participants increased peak ipsilateral biological ankle torque by 0.13–0.25 N m kg−1(p < 0.001) during exosuit-applied resistance compared to corresponding baselines. Additionally, ipsilateral soleus activity during stance increased by 5.4–11.3% (p < 0.05) in all but the LOW bout. (2) In the HIGH and MAX bouts, vertical ground reaction force decreased on the ipsilateral limb while increasing on the contralateral limb (p < 0.01). Secondary analysis found that the force magnitude that maximized increases in biological ankle torque without significant changes in limb loading varied by subject. (3) Finally, peak ipsilateral plantarflexion angle increased significantly during post-exposure in the intermediate HIGH resistance bout (p < 0.05), which corresponded to the greatest average increase in soleus activity (p > 0.10).

    Conclusions

    Targeted resistance of ankle plantarflexion during stance by an exosuit consistently increased local ipsilateral plantarflexor effort during active resistance, but force magnitude will be an important parameter to tune for minimizing the involvement of the unresisted joints and limb during training.

     
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    Graft placement is a modifiable and often discussed surgical factor in anterior cruciate ligament (ACL) reconstruction (ACLR). However, the sensitivity of functional knee mechanics to variability in graft placement is not well understood.

    Purpose:

    To (1) investigate the relationship of ACL graft tunnel location and graft angle with tibiofemoral kinematics in patients with ACLR, (2) compare experimentally measured relationships with those observed with a computational model to assess the predictive capabilities of the model, and (3) use the computational model to determine the effect of varying ACL graft tunnel placement on tibiofemoral joint mechanics during walking.

    Study Design:

    Controlled laboratory study.

    Methods:

    Eighteen participants who had undergone ACLR were tested. Bilateral ACL footprint location and graft angle were assessed using magnetic resonance imaging (MRI). Bilateral knee laxity was assessed at the completion of rehabilitation. Dynamic MRI was used to measure tibiofemoral kinematics and cartilage contact during active knee flexion-extension. Additionally, a total of 500 virtual ACLR models were created from a nominal computational knee model by varying ACL footprint locations, graft stiffness, and initial tension. Laxity tests, active knee extension, and walking were simulated with each virtual ACLR model. Linear regressions were performed between internal knee mechanics and ACL graft tunnel locations and angles for the patients with ACLR and the virtual ACLR models.

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    Conclusion:

    This study provides clinical evidence from patients who underwent ACLR and from complementary modeling that functional postoperative knee mechanics are sensitive to graft tunnel locations and graft angle. Of the factors studied, the sagittal angle of the ACL was particularly influential on knee mechanics.

    Clinical Relevance:

    Early-onset osteoarthritis from altered cartilage loading after ACLR is common. This study shows that postoperative cartilage loading is sensitive to graft angle. Therefore, variability in graft tunnel placement resulting in small deviations from the anatomic ACL angle might contribute to the elevated risk of osteoarthritis after ACLR.

     
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