Symbitron Exoskeleton: Design, Control, and Evaluation of a Modular Exoskeleton for Incomplete and Complete Spinal Cord Injured Individuals.

In this paper, we present the design, control, and preliminary evaluation of the Symbitron exoskeleton, a lower limb modular exoskeleton developed for people with a spinal cord injury. The mechanical and electrical configuration and the controller can be personalized to accommodate differences in impairments among individuals with spinal cord injuries (SCI). In hardware, this personalization is accomplished by a modular approach that allows the reconfiguration of a lower-limb exoskeleton with ultimately eight powered series actuated (SEA) joints and high fidelity torque control. For SCI individuals with an incomplete lesion and sufficient hip control, we applied a trajectory-free neuromuscular control (NMC) strategy and used the exoskeleton in the ankle-knee configuration. For complete SCI individuals, we used a combination of a NMC and an impedance based trajectory tracking strategy with the exoskeleton in the ankle-knee-hip configuration. Results of a preliminary evaluation of the developed hardware and software showed that SCI individuals with an incomplete lesion could naturally vary their walking speed and step length and walked faster compared to walking without the device. SCI individuals with a complete lesion, who could not walk without support, were able to walk with the device and with the support of crutches that included a push-button for step initiation Our results demonstrate that an exoskeleton with modular hardware and control allows SCI individuals with limited or no lower limb function to receive tailored support and regain mobility.

Neuromuscular Controller Embedded in a Powered Ankle Exoskeleton: Effects on Gait, Clinical Features and Subjective Perspective of Incomplete Spinal Cord Injured Subjects.

Powered exoskeletons are among the emerging technologies claiming to assist functional ambulation. The potential to adapt robotic assistance based on specific motor abilities of incomplete spinal cord injury (iSCI) subjects, is crucial to optimize Human-Robot Interaction (HRI). Achilles, an autonomous wearable robot able to assist ankle during walking, was developed for iSCI subjects and utilizes a NeuroMuscular Controller (NMC). NMC can be used to adapt robotic assistance based on specific residual functional abilities of subjects. The main aim of this pilot study was to analyze the effects of the NMC-controlled Achilles, used as an assistive device, on chronic iSCI participants' performance, by assessing gait speed during 10-session training of robot-aided walking. Secondary aims were to assess training impact on participants' motion, clinical and functional features and to evaluate subjective perspective in terms of attitude towards technology, workload, usability and satisfaction. Results showed that 5 training sessions were necessary to significantly improve robot-aided gait speed on short paths and consequently to optimize HRI. Moreover, the training allowed participants who initially were not able to walk for 6 minutes, to improve gait endurance during Achilles-aided walking and to reduce perceived fatigue. Improvements were obtained also in gait speed during free walking, thus suggesting a potential rehabilitative impact, even if Achilles-aided walking was not faster than free walking. Participants' subjective evaluations indicated a positive experience.

Gait training with Achilles ankle exoskeleton in chronic incomplete spinal cord injury subjects.

Powered exoskeletons (EXOs) have emerged as potential devices for Spinal Cord Injury (SCI) to support the intervention of physical therapists during therapy (rehabilitation EXOs) as well as to assist lower limb motion during the daily life (assistive EXOs). Although the ankle is considered a key joint for gait restoration after SCI, very few ankle exoskeletons were developed and tested in incomplete SCI (iSCI) population. Among those, the Achilles ankle exoskeleton is the only one embedding a Controller inspired by the neuromuscular system (NeuroMuscular Controller, NMC). In a previous study we demonstrated that a period dedicated to train iSCI subjects in using the Achilles EXO as an assistive aid, improved robot-aided walking speed and surprisingly also generated a positive trend in free walking speed on long and short distances thus suggesting a possible unexpected rehabilitation effect. To further investigate this result, a case-control longitudinal study was conducted in the present work. The aim of this study was to test the hypothesis that Achilles-aided training could improve performance of free walking of chronic iSCI people more than conventional intensity-matched gait rehabilitation. Before and after conventional and robot-aided rehabilitation a number of variables were analyzed, including spatiotemporal parameters, joint kinematics, ground reaction forces, muscle force, spasticity and its related symptoms, balance and personal experience about the training. Results showed that only the NMC-controlled Achilles training allowed participants to significantly walk faster, with a longer step length and a reduced gait cycle time. A slight force and spasticity improvements were also experienced. In terms of subjects' personal experience, Achilles training was perceived more interesting and less physically demanding than conventional rehabilitation.

From cineradiography to biorobots: an approach for designing robots to emulate and study animal locomotion.

Robots are increasingly used as scientific tools to investigate animal locomotion. However, designing a robot that properly emulates the kinematic and dynamic properties of an animal is difficult because of the complexity of musculoskeletal systems and the limitations of current robotics technology. Here, we propose a design process that combines high-speed cineradiography, optimization, dynamic scaling, three-dimensional printing, high-end servomotors and a tailored dry-suit to construct Pleurobot: a salamander-like robot that closely mimics its biological counterpart, Pleurodeles waltl Our previous robots helped us test and confirm hypotheses on the interaction between the locomotor neuronal networks of the limbs and the spine to generate basic swimming and walking gaits. With Pleurobot, we demonstrate a design process that will enable studies of richer motor skills in salamanders. In particular, we are interested in how these richer motor skills can be obtained by extending our spinal cord models with the addition of more descending pathways and more detailed limb central pattern generator networks. Pleurobot is a dynamically scaled amphibious salamander robot with a large number of actuated degrees of freedom (DOFs: 27 in total). Because of our design process, the robot can capture most of the animal's DOFs and range of motion, especially at the limbs. We demonstrate the robot's abilities by imposing raw kinematic data, extracted from X-ray videos, to the robot's joints for basic locomotor behaviours in water and on land. The robot closely matches the behaviour of the animal in terms of relative forward speeds and lateral displacements. Ground reaction forces during walking also resemble those of the animal. Based on our results, we anticipate that future studies on richer motor skills in salamanders will highly benefit from Pleurobot's design.

Flexibility of the axial central pattern generator network for locomotion in the salamander.

In tetrapods, limb and axial movements are coordinated during locomotion. It is well established that inter- and intralimb coordination show considerable variations during ongoing locomotion. Much less is known about the flexibility of the axial musculoskeletal system during locomotion and the neural mechanisms involved. Here we examined this issue in the salamander Pleurodeles waltlii, which is capable of locomotion in both aquatic and terrestrial environments. Kinematics of the trunk and electromyograms from the mid-trunk epaxial myotomes were recorded during four locomotor behaviors in freely moving animals. A similar approach was used during rhythmic struggling movements since this would give some insight into the flexibility of the axial motor system. Our results show that each of the forms of locomotion and the struggling behavior is characterized by a distinct combination of mid-trunk motor patterns and cycle durations. Using in vitro electrophysiological recordings in isolated spinal cords, we observed that the spinal networks activated with bath-applied N-methyl-d-aspartate could generate these axial motor patterns. In these isolated spinal cord preparations, the limb motor nerve activities were coordinated with each mid-trunk motor pattern. Furthermore, isolated mid-trunk spinal cords and hemicords could generate the mid-trunk motor patterns. This indicates that each side of the cord comprises a network able to generate coordinated axial motor activity. The roles of descending and sensory inputs in the behavior-related changes in axial motor coordination are discussed.

Soft artificial tactile sensors for the measurement of human-robot interaction in the rehabilitation of the lower limb.

A new and alternative method to measure the interaction force between the user and a lower-limb gait rehabilitation exoskeleton is presented. Instead of using a load cell to measure the resulting interaction force, we propose a distributed measure of the normal interaction pressure over the whole contact area between the user and the machine. To obtain this measurement, a soft silicone tactile sensor is inserted between the limb and commonly used connection cuffs. The advantage of this approach is that it allows for a distributed measure of the interaction pressure, which could be useful for rehabilitation therapy assessment purposes, or for control. Moreover, the proposed solution does not change the comfort of the interaction; can be applied to connection cuffs of different shapes and sizes; and can be manufactured at a low cost. Preliminary results during gait assistance tasks show that this approach can precisely detect changes in the pressure distribution during a gait cycle.

A connectionist central pattern generator for the aquatic and terrestrial gaits of a simulated salamander.

This article investigates the neural mechanisms underlying salamander locomotion, and develops a biologically plausible connectionist model of a central pattern generator capable of producing the typical aquatic and terrestrial gaits of the salamander. It investigates, in particular, what type of neural circuitry can produce and modulate the two locomotor programs identified within the salamander's spinal cord; namely, a traveling wave of neural activity for swimming and a standing wave for trotting. A two-dimensional biomechanical simulation of the salamander's body is developed whose muscle contraction is determined by the locomotion controller simulated as a leaky-integrator neural network. While the connectivity of the neural circuitry underlying locomotion in the salamander has not been decoded for the moment, this article presents the design of a neural circuit that has a general organization corresponding to that hypothesized by neurobiologists. In particular, the locomotion controller is based on a body central pattern generator (CPG) corresponding to a lamprey-like swimming controller, and is extended with a limb CPG for controlling the salamander's limbs. The complete controller is developed in three stages: first the development of segmental oscillators, second the development of intersegmental coupling for the making of a lamprey-like swimming CPG, and finally the development of the limb CPG and its coupling to the body CPG. A genetic algorithm is used to determine the parameters of the neural circuit for the different stages, given a high-level description of the desired state space trajectories of the different subnetworks. A controller is thus developed that can produce neural activities and locomotion gaits very similar to those observed in the real salamander. By varying the tonic (i.e. non-oscillating) excitation applied to the network, the speed, direction and type of gait can be varied.

Evolution and development of a central pattern generator for the swimming of a lamprey.

This article describes the design of neural control architectures for locomotion using an evolutionary approach. Inspired by the central pattern generators found in animals, we develop neural controllers that can produce the patterns of oscillations necessary for the swimming of a simulated lamprey. This work is inspired by Ekeberg's neuronal and mechanical model of a lamprey [11] and follows experiments in which swimming controllers were evolved using a simple encoding scheme [25, 26]. Here, controllers are developed using an evolutionary algorithm based on the SGOCE encoding [31, 32] in which a genetic programming approach is used to evolve developmental programs that encode the growing of a dynamical neural network. The developmental programs determine how neurons located on a two-dimensional substrate produce new cells through cellular division and how they form efferent or afferent interconnections. Swimming controllers are generated when the growing networks eventually create connections to the muscles located on both sides of the rectangular substrate. These muscles are part of a two-dimensional mechanical simulation of the body of the lamprey in interaction with water. The motivation of this article is to develop a method for the design of control mechanisms for animal-like locomotion. Such a locomotion is characterized by a large number of actuators, a rhythmic activity, and the fact that efficient motion is only obtained when the actuators are well coordinated. The task of the control mechanism is therefore to transform commands concerning the speed and direction of motion into the signals sent to the multiple actuators. We define a fitness function, based on several simulations of the controller with different commands settings, that rewards the capacity of modulating the speed and the direction of swimming in response to simple, varying input signals. Central pattern generators are thus evolved capable of producing the relatively complex patterns of oscillations necessary for swimming. The best solutions generate traveling waves of neural activity, and propagate, similarly to the swimming of a real lamprey, undulations of the body from head to tail propelling the lamprey forward through water. By simply varying the amplitude of two input signals, the speed and the direction of swimming can be modulated.