The present invention relates to the field of cable-driven robots, and more specifically to the field of cable-driven robots for locomotor rehabilitation of lower limbs.
Patients suffering from locomotor or neurological dysfunction can be rehabilitated by reproducing movements that are adapted to reeducate partially or completely an affected body part, such as a lower-limb. One type of lower-limb rehabilitation technique consists of assisting a patient in reproducing a natural gait, Another type of lower-limb rehabilitation technique consists of assisting a patient in reproducing various lower-limb movements soliciting various articulations of the lower-limb.
Body Weight Support Treadmill Training (BWSTT) is a locomotor rehabilitation technique consisting of a patient walking on a treadmill with partial relief of body weight in order to rehabilitate a lower limb of the patient. Over the past years, it has been shown that the BWSTT technique for locomotor rehabilitation of lower limbs provides marked advantages over other conventional techniques. Amongst other, BWSTT allows to reproduce a correct and healthy joint movement pattern; it avoids inhibition of mobility caused by a use of prosthesis; it helps synchronization of the two legs and coordination of the walk cycle phases; and it ensures a large number of repetitions of walk cycles.
Another technique does away with the treadmill and assists a patient from a lying position, a standing position or even a sitting position to reproduce appropriate movements soliciting various joints of the lower-limb for training purposes. Such training of the lower-limb can be desirable for preparing the patient in eventually accomplishing a natural gait or other types of lower-limb movements.
However, current robotic devices for the rehabilitation of locomotion consist in exoskeleton-type robots, which impose torques directly at one or more joints of the patient's limbs. According to studies made in patients with neurological conditions following a stroke or a spinal cord injury, the effectiveness of such an approach on locomotor function is shown to be limited. This may be due to the limited flexibility of exoskeleton robots and the difficulty in fitting them to different patients.
In international patent application number PCT/US2015/026941 to Agrawal et al. there is disclosed a cable-driven rehabilitation system for rehabilitation of movement disorders by gait therapy that is either treadmill-based or walker-based. The system is adapted to apply controlled forces simultaneously and directly to the pelvis, the knee or the ankle joints by activating cables that provide limb-flexing moments with low inertia and friction resistance. As specified in the detailed description at paragraph [0073], the system does not used rigid links and joints in order to avoid concerns about precise alignment of the exoskeleton joints and human joints. The system uses adapters such as cuffs presented in FIG. 2. In one example, the exoskeleton has three adapters: a hip adapter, a thigh adapter and a shank adapter, as presented in FIG. 1A. Cables are routed through each adapter, in the example of FIG. 1A, the hip adapter has spaced apart guides to allow the passing of respective cables connected to the thigh adapter and the shank adapter. As further explained in paragraph [0082] of the detailed description, a same cable that terminates at the shank adapter passes through a guide of the thigh adapter so as to apply moments to the shank adapter. Each cable has a respective tension sensor and the sensor generates a signal to permit the motion of the attached limbs of the user to be detected and thereby apply assist-as-needed control of the motion of the user limbs, as described at paragraphs [0080] and [0086]. The cables are activated by respective winches that are driven by a motor placed on a frame as detailed at paragraph [0087]. However, since the adapters are activated by cables that pass through guides of the thigh adapter or hip adapter, the motion range of the limb is restricted. This limits the possible range of therapeutic exercises that can be applied to the limb. Moreover, this system applies an assist-as-needed control of the limb's motion and is not adapted for people that do not have the capacity to perform a minimal gait movement of their limb on their own let alone the capacity to stand.
Therefore, there is a need for a device for locomotor rehabilitation adapted for BWSTT and also adapted for other types of locomotor rehabilitation techniques that are effective without hindering limb movements for reproducing various rehabilitation movements in order to restore or perfect a natural gait or even a specialized gait in a human without necessitating a patient to have the capacity to stand or to perform a minimal gait on his own. Moreover, there is a need for a device for locomotor rehabilitation that can easily be fitted to various patients and that can be reconfigured according to a rehabilitation protocol, while remaining simple to manufacture.
In accordance with one aspect, there is a limb rehabilitation device having a platform, a frame, at least three cables and at least three actuators. The platform is for receiving thereon at least a portion of a limb. The platform has at least three fixed cable positioning attachments. Each of the cables have a platform connection end and an opposite actuator end, and each of the cables are directly connected to a corresponding fixed cable positioning attachment of the platform at the platform connection end. Each of the actuators are mounted on the frame and are adapted to extend or retract a corresponding one of the cables from the actuator end in a straight line between the platform connection end and the actuator end and provide at least three degrees of freedom movement to the platform, according to a rehabilitation protocol.
In accordance with another aspect, there is a method of controlling a limb rehabilitation device by receiving a patient morphology parameter and receiving an exercise command parameter according to a rehabilitation protocol. The method further determines a trajectory according to the patient morphology parameter and the exercise command parameter and controls an actuation system according to the trajectory. The method further includes suspending the platform with at least three controllable links in order to provide at least three degrees of freedom to the platform. Accordingly, the method further includes actuating by extending or retracting at least one controllable link and thereby displacing at least one portion of the platform.
In accordance with yet another aspect, there is a limb rehabilitation device kit having a longitudinal platform, at least three cables and at least three actuators. The platform is adapted to receive and support at least a portion of a limb. The platform has at least three fixed cable positioning attachments. The cables are adapted to connect to one of the fixed cable positioning attachments of the platform. The actuators are adapted to drive the cables.
Further features and advantages of the present invention will become apparent from the following detailed description, taken in combination with the appended drawings, in which:
It will be noted that throughout the appended drawings, like features are identified by like reference numerals.
Presented in
The cable-robot 100 of
Notice that the segments 104a and 104b have a longitudinal shape adapted to supportively receive thereon a limb of the patient.
Since each platform is made of two segments interconnected by a passive rotary joint, the robot 100 is adapted to provide a trajectory composed of two independent motions. It shall however be understood that in some cases a trajectory composed of two independent motions can be undesirable and that the passive rotary joint is replaceable by a non-passive rotary joint or by a fixed joint depending on the rehabilitation protocol.
According to one embodiment and as further presented in
In
As further presented in
It shall be understood that the cable-robot 100 is adapted to guide the patient in reproducing lower limb movements according to a rehabilitation protocol soliciting a single limb (i.e. either a left limb or a right limb) or both limbs at once. Therefore, although the present cable-robot 100 is adapted to solicit both limbs of the patient at once, it shall be understood that the cable-robot 100 can have a reduced set of actuators and cables to guide only a single platform 102. Moreover, although the present cable-robot 100 is adapted to solicit a hip joint, a knee joint and an ankle joint independently or as a combination thereof, it shall be noted that the cable-robot 100 can have a reduced set of actuators and cables to solicit only a single joint or a single combination of joints.
According to one embodiment, the cable-robot 100 has a treadmill 112 to facilitate a walking motion of the lower limbs such for Body Weight Support Treadmill Training (BWSTT). It shall however be noticed that for certain lower-limb exercises, the treadmill 112 is not required and the cable-robot 100 can be positioned directly on a fixed floor or any other suitable surface.
Presented in
According to one embodiment and as further presented in
Each cable 110a, 110b, 110c and 110d is passed through the respective cable guide 302a, 302b, 302c and 302d such as a pulley of radius rjk, where jϵ{1,2,3,4} and k identifies a right and left side.
Each platform is divided in two parts, such as the lower leg segment 104a and the foot segment 104b articulated around the passive rotary joint. In task space, the robot 100 is adapted to produce a translation and rotation movement of the entire platform 102 and also produce a rotation of the foot segment 104b relative to the lower leg segment 104a, without restriction according to the articulatory movements of a human being.
Both segments 104a and 104b are adapted to produce a translation in their X-Y plane and a rotation around their Z axis. The reference frames {Xc1,Yc1,Zc1} and {Xc2,Yc2,Zc2}, of both segments 104a and 104b, are located at the rotary joint with their origin at the same location and the Z axis in the same direction.
Notice that
According to one embodiment, the parameters of the cable-driven robot 100 having a right platform 102, as presented in
According to one embodiment, the cable-robot 100 of
P
1K
=[−a
4k
,e
4k
,b
k
]; P
2K
=[−a
4k
,e
4k
+e
5k
,b
k];
P
3K
=[−a
4k
,e
4k
+e
5k
+e
6k
,b
k
]; P
4K
=[e
8k
−a
4k
,−e
7k
,b
k].
In addition, each corresponding cable is attached to an associated lower-leg segment 104a or foot segment 104b at cable attachment points Vi with respect to the associated segment reference (Xc1,Xc1,Zc1) or (Xc2,Yc2,Zc2):
V
1K
=[−e
2k
,e
1k/2,0]; V2K=[e3k−e2k,e1k/2,0];
V
3K
=[−e
9k sin(θ7k),e9k cos(θ7k)−e1k/2,0]; V4K=[e3k/2−e2k,−elk/2,0].
According to another aspect, a lower-limb model is used as a reference in order to allow a clinician to define desired movements and also to validate the behavior of the cable-robot 100. This is done by comparing positions and orientations of several reference points of the model with respective reference points of the platform 102, as concurrently presented in
According to one embodiment, presented in
In
The lower-limbs of a patient are modelled as two parallel kinematic chains 414a and 414b linked to a rigid frame 416. Each of these kinematic chains 414a and 414b is composed of three segments 402,404 and 406 and three joints 408, 410 and 412, as presented in
Since there is symmetry between the two kinematic chains 414a and 414b, subscript k is used in the equations. This subscript is replaced by r in the equations concerning the right kinematic chain 414a. The subscript l refers to the left kinematic chain 414b. The distance bk is replaced by br for the right side and −bl for the left side.
According to one embodiment, the rehabilitation movements considered are with respect to joints 408, 410 and 412 rotating according to θ3k, θ4k or θ7k and the movements of the leg is restricted to the X-Y plane (i.e sagittal plane), as presented in
A skilled person will understand that in other instances, as further presented in
According to one embodiment and further referring to
Further referring to
where s. and c. correspond respectively to sin(⋅) and cos(⋅).
At the end of the kinematic chain k (recall that k is r or l—right or left), the direct kinematics is given by:
where β1=−a3kS3k+4k−7k+a2kc3k+4k+a1kc3k and β2=−a3kc3k+4k−7k+a2ks3k+4k+a1ks3k.
According to one embodiment,
According to another aspect, the cable-driven robot 100 is configured to allow a patient to be rehabilitated in a horizontal position such as a supine position, in order to allow rehabilitation of a patient while lying with the face up and fully support the patient. The supine position configuration may be better adapted for rehabilitating a lower limb of a patient having severe neurological conditions and that is unable to actively move his own limb. Moreover, the supine position may be preferred for rehabilitating a patient according to a rehabilitation protocol that requires lateral movement of the lower limb. However in some instances, it might be desirable to perform rehabilitation movements while the patient is lying in a prone position (i.e. lying with the face down) or side position (i.e. lying on a side). The cable-driven robot 100 is configurable to allow such prone position or side position exercise movements, as well, while fully supporting the patient.
Presented in
As presented in
For instance, in order to guide a patient to reproduce an abduction movement or an abduction movement of the lower-limb all five cables associated to the lower-leg segment 804a are operated to drive the segment 804a accordingly. Moreover, in order to guide a patient to reproduce an internal or an external rotation of the ankle all three cables associated to the foot segment 804b are operated to drive the segment 804b accordingly.
It shall be understood that the actuation system 806 can have a reduced number of actuators and associated cables, when only a restricted number of lower limb movements need to be performed, without departing from the cable-robot 100. For instance, the first pair of actuators can be replaced by a single actuator and/or the second pair of actuators can be replaced by a single actuator and/or the third pair of actuators can be replaced by a single actuator. Moreover, a given pair of actuators, such as the third pair of actuators can be removed, without departing from the cable-robot 100.
Further presented in
Presented in
According to one embodiment, the cable-robot 100 of
P
1
=[−b
10
−b
8
,−b
1
,b
0
]; P
2
=[b
7
±b
9
,−b
2
,b
0];
P
3
=[−b
10
−b
8
,b
3
,b
0
]; P
4
=[b
7
+b
9
,b
4
,b
0];
P
5=[0,0,b0−b11]; P6=[b9,b6,b0];
P
7
=[−b
10
,b
5
,b
0
]; P
8=[0,b3+b12,b0−b11].
In addition, each corresponding cable is attached to an associated lower-leg segment 804a or foot segment 804b at cable attachment points Vi with respect to the associated segment reference (Xc1,Yc1,Zc1) or (Xc2,Yc2,Zc2):
V
1
=[−e
2
,e
5
,−e
1/2]; V2=[−e2,e5,e1/2];
V
3
=[e
4
−e
2
,e
5
,−e
1/2]; V4=[e4−e2,e5,e1/2];
V
5
=[−e
2/2,0,0]; V6=[e3,0,e1/2];
V
7
=[e
3,0,−e1/2]; V8=[e3,0,0].
Presented in
According to one embodiment, there is a control system 1300 adapted to control the limb rehabilitation device 1200 as presented in
According to one embodiment, as presented in
According to one embodiment, the user interface 1302 is adapted to allow a clinician to input patient morphology parameters and to input exercise parameters such as a target limb portion, an amplitude, an angle, a speed and a number of cycles.
According to yet another embodiment, the user interface 1302 is adapted to allow a clinician to input patient morphology parameters and select a predefined exercise.
According to yet another embodiment, the user interface 1302 is adapted to allow a clinician to input patient morphology parameters, to input exercise parameters and to input patient articulatory restrictions. The trajectory validator 1306 is adapted to verify or modify the trajectory generated according to the patient morphology parameters and the patient articulatory restrictions.
Presented in
In one embodiment, the kit 1400 further includes an upper body support 1410 and a frame 1412, as presented in
The cable-driven robot 100 of
Additionally, since the robot 100 is actuated by a cable system, it has the flexibility to absorb various secondary limb movements from the patient. Also, the robot 100 architecture and components are light and economical to produce.
A skilled person shall understand that the platform 102 or 802 can have any suitable shape or form without departing from the cable-robot. For instance, the platform 102 or 802 can have only the lower-leg segment in order to receive only a lower-leg of a patient. Moreover, the platform 102 or 802 can have an additional segment in order to receive an upper-leg of a patient.
Although the cable-robot 100 is described as being suitable for rehabilitating a lower limb, it shall be understood that the cable-robot 100 can also be used for rehabilitating other parts of the human body related to an upper limb region, a trunk region, etc. Moreover, the cable-robot 100 can also be suitable for rehabilitating limbs of various types of animals.
A skilled person would understand that although the cable-robot described herein has actuators that are motors adapted to wind or unwind an associated cable, other variations of actuators that are capable of extending or retracting a cable length are possible without departing from the present cable-robot. Moreover, it shall further be understood by the skilled person that the cable can be replaced by any other suitable type of link such as a cord, chain, wire, etc. that can be controllably retracted or extended.
It shall further be understood that the rehabilitation protocol is not only restricted to a locomotor rehabilitation protocol but could also include other types of rehabilitation protocols such as a neurological rehabilitation protocol. Moreover, the rehabilitation protocol can provide a lower limb recovery therapy, a lower limb strengthening therapy, a lower limb locomotor therapy or any other suitable type of therapy.
The embodiments of the invention described above are intended to be exemplary only. The scope of the invention is therefore intended to be limited solely by the scope of the appended claims.
The present application claims priority of U.S. Provisional Patent Application No. 62/259,219, filed on Nov. 24, 2015, the contents of which are hereby incorporated.
Filing Document | Filing Date | Country | Kind |
---|---|---|---|
PCT/CA2016/051376 | 11/24/2016 | WO | 00 |
Number | Date | Country | |
---|---|---|---|
62259219 | Nov 2015 | US |