Ankle and Foot Orthoses (AFOs) are biomedical devices designed to target and guide the movement of the foot. Dorsiflexion is the movement that brings the toes closer to the body. Ankle and foot dorsiflexors consists of the tiabilis anterior; the extensor, halluces longus; and the extensor, digitrum longus. All three muscles assist the ankle in properly orienting the foot during walking by ensuring the foot clears the ground in the swing phase of the gait cycle, and firmly plants during the stance phase.
Damage to these muscles or to the nerves surrounding them can lead to severely impaired walking if not properly treated. If these three muscles are weakened by nerve injury, muscular atrophy, or disease, equinovarus deformity can result. Multiple Sclerosis (MS) is one of a variety of neural muscular diseases that affect the muscular movement in the lower extremities and require the use of an AFO. Impaired walking is also known as steppage gait, or “foot drop.” Affected individuals cannot complete the full range of dorsiflexion in the foot while walking, and often compensate by swinging the hip and knee in an exaggerated fashion in an attempt to keep the foot from catching on the ground during the swing phase of the gait cycle. These overcorrections made by the patient results in an abnormal gait, which can then later lead to discomfort. Foot drop can cause an individual a severe amount of pain over time. This may include back, hip and knee problems, as well as an increased probability of falling, tripping or damaging the foot even further during walking. This condition is typically treated through physical therapy, and providing the user with a rigid brace to prevent the foot from dropping as gait training is performed.
Existing devices to assist sufferers of foot drop aim to brace the ankle at the standard 90-degree angle during the stance phase. This prevents the ankle from buckling when a load is applied, and holds the foot up to prevent drag during the swing phase of the gait cycle. However, these devices can be uncomfortable and only supply rigid support rather than providing dynamic assistance to the user throughout the cycle in order to promote muscle growth.
Many of these braces are rigid and hold the ankle joint firmly in place while the user is wearing the device, and do not allow for movement at the ankle joint. While many similar types of solutions exist on the market today, many of these solutions do not address the disturbance to the gait cycle as the user wears the device. These braces hold the ankle in place but overlook the importance of allowing the user to move his or her ankle naturally as he or she walks.
The easily conformable design associated with soft robotics performs well when paired with the complex biomechanics of the body. Soft robotics have been proven in the past to be a successful approach to rehabilitative devices when used in the context of soft exosuits, specifically for the lower body.
Soft robotics can be utilized to provide the active support necessary to correct the user's foot drop while allowing the user to strengthen ability to lift the foot which will ideally lead to a greater recovery than only the use of a static orthosis. In addition to the added support, this orthosis may also be significantly more comfortable to wear than its rigid counterparts.
The disclosure herein describes a soft robotic ankle-foot orthosis (AFO) exosuit for the purpose of correcting ankle orientation to aide in the restoration of a natural gait cycle in individuals suffering from foot drop. The exosuit may include a soft, pneumatically controlled actuator made from a thermally-bonded material encased in an inextensible fabric, and may be controlled off of a portable pump and on-board logic controller. The soft AFO exosuit uses force sensitive resistive (FSR) sensors embedded in custom insoles to detect what stage of the gait cycle the user is in, as well as IMU sensors to ensure the angle of the foot is sufficient to clear the floor.
The AFO's individual components were tested to ensure that they would provide the necessary forces needed for foot stability and for lifting the foot during the swing phase. The system as a whole was tested both on a designed test platform and on a test participant. The AFO was able to supply the needed forces when the user walked at a slow pace such as for a patient recovering from an injury.
In one embodiment, a soft robotic ankle-foot orthosis exosuit includes a brace to be worn on a user's foot, a first soft actuator, a second soft actuator, and a pneumatic system. The first soft actuator is coupled to the brace so that it is positioned proximate a top of the user's foot. The second soft actuator is also coupled to the brace and is to be positioned proximate a side of the user's foot. The pneumatic system changes an internal pressure of the first soft actuator and the second soft actuator.
In another embodiment, a soft robotic ankle-foot orthosis exosuit includes a brace to be worn on a user's foot, sensors coupled to the brace, a first soft actuator, a second soft actuator, and a pump. The first soft actuator is coupled to the brace and provides dorsiflexion assistance to the user's foot. The second soft actuator is coupled to the brace and limits inversion or eversion of the user's foot. The pump is in fluid communication with the first soft actuator and the second soft actuator. The pump is adjusts an internal pressure of the first soft actuator and an internal pressure of the second soft actuator based on measurements from the sensors.
In yet another embodiment, a soft robotic ankle-foot orthosis exosuit includes a brace to be worn on a user's foot, an actuator array, a first side actuator, a second side actuator, and a pneumatic system. The actuator array is coupled to the brace proximate a top of the user's foot. The actuator array includes multiple interconnected fluid bladders. The first side actuator is coupled to a first side of the brace, and the second side actuator is coupled to a second side of the brace. The pneumatic system is supported by the user away from the brace. The pneumatic system substantially uniformly changes an internal pressure in the interconnected fluid bladders and substantially uniformly changes an internal pressure in the first and second side actuators.
Other aspects of the disclosure will become apparent by consideration of the detailed description and accompanying drawings.
Before any embodiments of the disclosure are explained in detail, it is to be understood that the disclosure is not limited in its application to the details of construction and the arrangement of components set forth in the following description or illustrated in the following drawings. The disclosure is capable of other embodiments and of being practiced or of being carried out in various ways. Also, it is to be understood that the phraseology and terminology used herein is for the purpose of description and should not be regarded as limiting. Use of “including” and “comprising” and variations thereof as used herein is meant to encompass the items listed thereafter and equivalents thereof as well as additional items. Use of “consisting of” and variations thereof as used herein is meant to encompass only the items listed thereafter and equivalents thereof. Unless specified or limited otherwise, the terms “mounted,” “connected,” “supported,” and “coupled” and variations thereof are used broadly and encompass both direct and indirect mountings, connections, supports, and couplings.
In general, the present disclosure relates to a device that allows the user to regain control of the dorsiflexion in the user's foot while walking, all while avoiding interference with the user's natural gait cycle to prevent further injuries to the body during rehabilitation of the ankle.
As shown in
Side actuators 18 are placed on either side of the ankle, across the joint at the talus. Each side actuator 18 branches off to reach the bottom of the calcaneus and then down the inner and outer edges of the foot to reach the first and fifth metatarsals, respectively (i.e., the side actuator 18 splits to simultaneously reach the front and rear of the foot). The side actuators 18 act as an ankle wrap brace and inflate in order to provide support and stability to the patient. The side actuators 18 limit inversion or eversion caused by supination or pronation of the ankle (e.g., which may be seen in cases of ankle instability). In the illustrated embodiment, each of the side actuators 18 is made from a single fluid bladder.
A bending actuator or actuator array 22 is placed on the front of the sock 14 between the side actuators 18. As shown in
In the illustrated embodiment, each actuator 18, 22 is made from a Thermoplastic Polyurethane (TPU) material which is thermally bonded to create an airtight seal. This forms an air bladder (e.g., bladder 24), which is then encased in an inextensible fabric (e.g., 40D Ripstop Nylon) of the same net shape as the TPU air bladder. The TPU material has a low tensile strength and cannot withstand being inflated over a maximum pressure (e.g., 40 kPa). Encasing the bladder 24 in an inextensible fabric creates a single actuator 18, 22 that may be inflated up to the limits of the inextensible fabric. As a result, each actuator 18, 22 can be over pressurized to create a rigid structure.
The exosuit 10 also includes force sensors 30 (e.g., force sensitive resistive (FSR) sensors) in order to inflate and exhaust the actuators 18, 22 at the correct times and pressures. In the illustrated embodiment, four force sensors 30 are coupled to the bottom of the sock 14 to detect the placement of the foot. Two force sensors 30 are disposed below the ball of the foot and two force sensors 30 are disposed below the heel. The placement of the force sensors 30 allows the exosuit 10 to determine where the user's weight is distributed.
The exosuit 10 also includes Inertial Measurement Units 34 (IMUs). In the illustrated embodiment, one IMU 34 is coupled to the exosuit 10 proximate the top of the foot, and one IMU 34 is coupled to the exosuit 10 proximate the shin. The IMUs 34 communicate with one another in order to read the difference in angle between them at any point in the gait cycle.
Additionally, the exosuit 10 may include an air pressure sensor (not shown). In the illustrated embodiment, a control box 38 is coupled to a user's waist (e.g., on a waist belt 40). The control box 38 may house the air pressure sensor and a pump (not shown), which together make up a pneumatic system. This minimizes weight on the foot and decreases circuitry complexity. Conduit 42 (e.g., plastic tubing) provides fluid communication between the pump and the actuators 18, 22.
Together, the sensors 30, 34 form a control system designed to monitor where the user is at every point of the gait cycle. The IMUs 34 monitor the angle between the foot and the leg to ensure that the foot is not extended. The rear force sensors 30 inform the system of heel strike and stance phase in combination with the front force sensors 30 which detect stance phase and push off. These sensor values are communicated to the air pressure sensor and the pump in order to adjust an internal pressure in the side actuators 18 and the front actuator array 22. The pump provides a fluid (e.g., air) to the actuators 18, 22 through the conduit 42, and the air pressure sensor monitors the internal pressure of each actuator 18, 22. This helps to ensure that each actuator 18, 22 is properly inflated at each phase of the gait cycle (e.g., heel strike, stance phase, push off, and swing phase). For example, the side actuators 18 inflate and the front actuator array 22 deflates at the beginning of heel strike. During stance phase, the side actuators 18 maintain their inflated state. At push off, the side actuators 18 are exhausted to a deflated state and the front actuator array 22 inflates. Finally, during the swing phase, front actuator array 22 maintains its inflated state.
As shown in
Pads 60 are coupled to the sock 54, and assist in limiting slippage between the sock 54 and the skin of the user. The pads 60 assists in maintaining the shape of the sock 54. In the illustrated embodiment, the exosuit 50 includes two pads 60, one positioned proximate each ankle. A strap 62 (e.g., a Velcro strap) wraps around the sock 54 and couples the pads 60 against the sock 54 and the user's leg. In other embodiments, the pads 60 may be secured to the sock 54 in other ways, or the exosuit 50 may not include pads.
A portion of the sock 54 may also be made from an inextensible fabric (e.g., nylon). In the illustrated embodiment, the base of the sock 54 (i.e., proximate the sole of the shoe 56), is made from the inextensible fabric and provides a point to couple sensors 66A-66D to the sock 54. The inextensible fabric also reduces slippage between the sock 54, shoe 56, and sensors 66A-66D.
The sensors 66A-66D are coupled to the sock 54 and positioned proximate the sole of the shoe 56. In the illustrated embodiment, the sensors 66A-66D are force sensors (e.g., FSR sensors) and detect the placement of the foot by reading ground reaction forces (GRF). Two FSR sensors 66A, 66B are disposed below the ball of the foot, and two FSR sensors 66C, 66D are disposed below the heel. The FSR sensors 66A-66D allows the exosuit 50 to determine where the user's weight is distributed.
The exosuit 50 includes variable stiffness or side actuators 70, which are coupled to the sock 54 on either side of the ankle. The side actuators 70 give support to the ankle to prevent ankle buckling during the heel strike phase of the gait cycle. The side actuators 70 also assist in ensuring proper proprioception before planting the foot on the ground. The side actuators 70 also work together to orient the ankle during each phase of the gait cycle. A conduit 72 (e.g., a plastic tube) extends from a side of each side actuator 70, and provides a fluid pathway into each respective side actuator 70.
The exosuit 50 also includes a dorsiflexion actuator or actuator array 74 that is coupled to the front of the sock 54 (i.e., proximate the laces of the shoe 56) and between the side actuators 70. The actuator array 74 may be a single fluid bladder, or may be a series of interconnect fluid bladders 75. The actuator array 74 creates a bending moment when inflated, and assists a user in the motion of lifting his or her toes toward the body. A conduit 76 (e.g., a plastic tube) extends from the actuator array 74, and provides a fluid pathway into the actuator array 74.
In the illustrated embodiment, each actuator 70, 74 is made from 70 D (Denier) Ripstop Nylon coated in TPU, although other material may be used. Two layers of fabric are stacked on top of one another, with the TPU sides facing one another. The layers are then coupled together (e.g., using a heated soldering iron). The actuators 70, 74 may be substantially similar to the respective actuators 18, 22 of the exosuit 10.
As shown in
The timing of each section of actuator activation may be determined by thresholds within the control system on each of the sensors (e.g., 30, 66A-66D). These thresholds may be tuned to provide accurate timing for the different periods in the gait cycle for the each user. These thresholds may be tuned differently depending on the weight, foot size, and foot shape, of a different user. As shown in
As shown in
T=PLL
F
w (1)
where P is the input pressure, L is the length of the contact between two actuators, Lf is the length of the lever arm, and w is the width of the contact area between each bladder 24, 75.
As shown in
x
deflection
=FL
3/3EI (2)
where F is the force of the ankle acting against the actuator, L is the length of the side actuator, E is the Young's Modulus of 40 D Ripstop Nylon, and I is,
I=¼πr4 (3)
where r is the radius of the actuator 18, 70. The only variable value is the radius, and so increasing the radius of the actuator 18, 70 will decrease the overall deflection when a force F is applied.
As shown in
L
approx(θf)=√{square root over (Lh2+Lf2−2LhLf cos θf)} (4)
where θfoot is there current ankle angle and ranges from 95°≤θf≤145° (see e.g.,
F=L
f sin φ (5)
where, φ is the angle between the F vector and its vertical component. The angle φ is obtained assuming the foot has an upward slope of 25° in the neutral position, which is subtracted off the right angle produced between the ground and the vertical force vector. The resulting maximum force to achieve the desired contraction percentage for the actuator is estimated as
where Li is the initial length of the actuator array 22, 74 prior to inflation (see e.g.,
where, θ1 is the half angle between the center line of the unit and the edge (see e.g.,
As shown in
The dimensions of the actuator array 22, 74 were optimized to maximize contraction percentage while minimizing the internal volume of the actuator array 22, 74. The contraction was observed while varying three parameters individually while holding all other parameters constant the ratio of the height to the width of each unit (h), the gap on either side of the seam connecting each unit (g) and the internal operating pressure (P) of the actuator array 22, 74. It was assumed that these three parameters would have the greatest impact on the overall contraction ratio and are varying sequentially as specified.
The parameter h was evaluated, with the height/width ratio of each unit with all other parameters held constant. First, h was varied from 0.1:1 to a 1:1 ratio. As shown in
g(x)=W/x2 (10)
where, W is the width of the actuator array 22, 74. The gap/width ratio was evaluated from 1:1 to 6:1, at which point the tolerances achievable given the current manufacturing processes was no longer feasible.
To verify the predictions made in the analytical models, both the actuator array 22, 74 and side actuators 18, 70 were tested for torque and stiffness, respectively. As shown in
As shown in
As shown in
A constant pressure test was performed with the actuator array 22, 74 on the UTM 94, with pressure held constant at the maximum of 200 kPa throughout the entirety of the test. The actuator array 22, 74 was clamped at both ends, with a load cell 98 affixed to the top end. At the start of the test, the top clamp 98 was released and allowed to move freely downward to measure the contraction of the actuator array 22, 74, as well as the pulling force generated. The clamp X was released from its position, moved downward until the force measured reads ON, then moved back to its original fixed position. This was repeated cyclically for three trials for the actuator array 22, 74. A total displacement of 43.1 mm±0.5 mm was observed, or a contraction of 32.3%, compared to the 36.5% predicted assuming ideal contraction of each unit to form a perfect circle.
As shown in
The side actuator 18, 70 was evaluated under constant pressure of 150 kPa, with increasing load applied at the end of the cantilevered end. The angle of deflection of the side actuator 18, 70 was measured each time load is added, and this was repeated for three iterations. It was found that the side actuator 18, 70 can stay under 10±0.17° deflection with a load of 1 Kg applied at the tip. The side actuator 18, 70 was also assessed with constant load with varying pressures. The system was pre-loaded with 1 kg, the equivalent of 1.2 Nm of torque with the actuator fully deflated. This was roughly 12% of the maximum ankle torque during rapid buckling The side actuator 18, 70 was then inflated in increments of 10 kPa up to 150 kPa with the constant load still in effect. A deflection from a fully bend actuator at 90° to 12.0±0.46° state of deflection was observed.
As shown in
As shown in
The exosuit 10, 50 was worn by a user in order to confirm that the exosuit 10, 50 worked in practice. The tester walked the length of the test area at a slow pace emulating a patient going through physical therapy that might not be able to walk quickly. As the tester walked, the data from all of the sensors (e.g., the FSR 30, the IMU 34, and the air pressure sensors) was logged. This data can be seen in
As shown in
The embodiment(s) described above and illustrated in the figures are presented by way of example only and are not intended as a limitation upon the concepts and principles of the present disclosure. As such, it will be appreciated that variations and modifications to the elements and their configuration and/or arrangement exist within the spirit and scope of one or more independent aspects as described.
This application claims priority to U.S. Application No. 62/663,910, filed Apr. 27, 2018, the entire contents of which are incorporated herein by reference.
Number | Date | Country | |
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62663910 | Apr 2018 | US |