Feasibility of novel gait training with robotic assistance : dynamic entrainment to mechanical perturbation to the ankle

Abstract

Rehabilitation of human motor function is an issue of the utmost significance, and the demand for the effective rehabilitation service is even growing with the graying of the population. Robotic technology has provided promising ways to assist recovery of the motor function of upper extremities. In contrast, current robotic therapy for lower extremities has shown inferior efficacy. In this thesis, the source of the limited efficacy of current robotic walking therapy is addressed. Essential mechanical components for robustly stable walking are identified as energy dissipation and proper compensation. Based on these essential components, design criteria of effective robotic walking therapy are suggested as foot-ground interaction and ankle actuation. A novel strategy of robot aided walking therapy reflecting the design criteria is proposed; dynamically entraining human gait with periodic ankle torque from a robot. Experiments with normal subjects and neurologically impaired subjects support the feasibility of the proposed rehabilitation strategy. The gait period of subjects entrain to the periodic mechanical perturbation with a measurable basin of entrainment, and the entrainment always accompanies phase-locking so that the mechanical perturbation assists propulsion. These observations are affected neither by auditory feedback nor by a distractor task for normal subjects, and consistently observed in impaired subjects. A highly simplified one degree of freedom walking model without supra-spinal control or an intrinsic self-sustaining neural oscillator (a rhythmic pattern generator) encapsulated the essence of these observations. This suggests that several prominent limit-cycle features of human walking may stem from peripheral mechanics mediated by simple afferent feedback without significant involvement of supra-spinal control or central pattern generator. The competence of the highly simplified model supports that the proposed entrainment therapy may be effective for a wide range of neurological impairments.