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Soft Exosuit for Post-Stroke Gait Retraining

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Soft Exosuit for Post-Stroke Gait Retraining

This video explains how exosuit technology, developed at the Wyss Institute for Biologically Inspired Engineering, applied to ankle movements helps patients post-stroke regain a more normal gait. Credit: Rolex Awards/Wyss Institute at Harvard University

A Lightweight and Efficient Portable Soft Exosuit for Paretic Ankle Assistance in Walking after Stro

ICRA 2018 Spotlight Video
Interactive Session Wed AM Pod C.6
Authors: Bae, Jaehyun; Siviy, Christopher; Rouleau, Michael; Menard, Nicolas; O'Donnell, Kathleen; Galiana, Ignacio; Athanassiu, Maria; Ryan, Danielle; Bibeau, Christine; Sloot, Lizeth; Kudzia, Pawel; Ellis, Terry; Awad, Louis; Walsh, Conor James
Title: A Lightweight and Efficient Portable Soft Exosuit for Paretic Ankle Assistance in Walking after Stroke

Abstract:
Hemiparetic gait after stroke is typically asymmetric and energetically inefficient. A major contributor to walking deficits is impaired paretic ankle function. Impaired paretic ankle plantarflexion (PF) reduces forward propulsion symmetry and impaired paretic ankle dorsiflexion (DF) diminishes ground clearance during swing. We have developed soft wearable robots (soft exosuits) to assist paretic PF and DF during walking after stroke. Through experimental studies with poststroke patients, we have demonstrated that exosuits can improve forward propulsion symmetry and ground clearance in walking, ultimately reducing the metabolic cost of walking. This paper presents an optimized soft exosuit aimed at use in clinical gait training for patients poststroke. The optimized exosuit is lightweight, easy to don and doff, and capable of efficiently delivering mechanical assistance to the paretic ankle. This paper focuses on the optimized controller that can deliver well-timed consistent ankle assistance to patients. A preliminary study was performed using this exosuit with three poststroke patients with heterogeneous gait patterns. Results showed that compared to a previously published controller, more consistent assistive force profiles could be delivered to individuals poststroke while consuming 50% less electrical power. Additionally, a preliminary biomechanical assessment was performed during overground walking.
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Simulated Gait Therapy Session With ReStore Soft Exo-Suit Device

This device is currently in clinical study and not yet commercially available. The participants in this video are demonstrating the technology. The device provides powered dorsi and plantaflexion assistance during key parts of the gait cycle to enhance walking ability. The device is intended to be used by a therapist during the rehabilitation of individuals with lower limb impairments due to stroke.

EKSO Bionic Suit for Gait Training Stroke Patients

Full story: ( EKSO Bionic Exoskeleton Successfully Used to Improve Gait After Stroke--@Medgadget)
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Mobility Enhancing Soft Exosuit at Harvard

Next generation wearable robots for enhancing mobility of healthy individuals and restoring mobility of those with physical disabilities via a more conformal and unobtrusive interface to the human body. To learn more visit the Harvard Biodesign Lab website at

Muscle Activation During Gait animation credit: K. Oberhofer, K. Mithraratne, N. S. Stott, I. A. Anderson (2009). Anatomically-based musculoskeletal modeling: prediction and validation of muscle deformation during walking. The Visual Computer, 25(9), 843 – 851

A Lightweight Soft Exosuit for Gait Assistance

Targeting a specific set of applications where a wearer needs some partial assistance from a robot, Researchers from the Harvard Biodesign Lab ( are pursuing a new paradigm: the use of soft clothing-like exosuits. An exosuit does not contain any rigid elements, so the wearer's bone structure must sustain all the compressive forces normally encountered by the body -- plus the forces generated by the exosuit. The suit, which is composed primarily of specially designed fabrics, can be significantly lighter than an exoskeleton since it does not contain a rigid structure. It also provides minimal restrictions to the wearer's motions, avoiding problems relating to joint misalignment. Ongoing work to optimize the suit design and make it portable is funded by DARPA's Warrior Web Program.
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Soft Arm Compliant Exoskeleton

More info on our research on:

ReWalk : Exoskeleton Suit to Help Stroke Patients Walk

ReWalk Robotics today debuted the prototype of its Restore soft suit exoskeleton designed to aid stroke survivors.

The company presented the prototype alongside collaborators from Harvard University’s Wyss Institute for Biologically Inspired Engineering, and said it would focus on the suit as a “core company goal” for the fiscal year.

“We are thrilled with the progress of the Restore system, which will provide life changing technology to a whole new class of patients facing mobility issues. With the prototype finished, we are eager to begin clinical studies and pursue regulatory approvals so that these systems can be provided to millions of patients who can benefit from access to the device,” CEO Larry Jasinki said in a prepared statement.

ReWalk said it is working with the Wyss Institute to develop lightweight designs for clinical studies, as well as to pursue regulatory clearance and commercialization of the device for the global market. The 1st application will be for stroke survivors, followed by devices designed for individuals with multiple sclerosis and other applications.

The Restore system is designed to transmit power to key joints of the legs with cable technology, powered by software and mechanics similar to those used in its ReWalk exoskeleton.

In April, shares in ReWalk Robotics dropped nearly 4% after an analyst with Barclays downgraded the stock, citing “lack of tangible progress” and increased competition from other players in the robot-assisted rehabilitation market.

Robotic walking training for stroke patients – Video abstract [ID 114102]

Video abstract of a review paper “Robot-assisted gait training for stroke patients: current state of the art and perspectives of robotics” published in the open access journal Neuropsychiatric Disease and Treatment by Morone G, Paolucci S, Cherubini A, et al.

Abstract: In this review, we give a brief outline of robot-mediated gait training for stroke patients, as an important emerging field in rehabilitation. Technological innovations are allowing rehabilitation to move toward more integrated processes, with improved efficiency and less long-term impairments. In particular, robot-mediated neurorehabilitation is a rapidly advancing field, which uses robotic systems to define new methods for treating neurological injuries, especially stroke. The use of robots in gait training can enhance rehabilitation, but it needs to be used according to well-defined neuroscientific principles. The field of robot-mediated neurorehabilitation brings challenges to both bioengineering and clinical practice. This article reviews the state of the art (including commercially available systems) and perspectives of robotics in poststroke rehabilitation for walking recovery. A critical revision, including the problems at stake regarding robotic clinical use, is also presented.

Read the review paper here:

This Robot Exosuit Helps Stroke Patients Walk

Technology is offering a new hope for stroke victims who have difficulty walking.

About 80 percent of people who suffer strokes lose normal function of a limb and many have a hard time walking. But a new ankle-assisting exosuit could help them regain their stride.

The innovation involves small motors that activate as the patient walks, helping them move more symmetrically.

Similar systems have already been developed in the past, but they've confined patients to a treadmill. With this suit, patients can continue their rehabilitation outside of a clinic setting.

The suit has proved successful in a recent study, and researchers are now looking at ways to further develop the technology to focus on other joints, like the hip and knee.

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Multi-joint actuation platform for soft exosuits

Lab-based actuation platform for performing human subjects experiments with soft wearable robots.

“Robots for Neurorehabilitation and Assistance of Gait” Dr. Robert Riener (NEUROTECHNIX 2015)

Keynote Title: Robots for Neurorehabilitation and Assistance of Gait
Keynote Lecturer: Robert Riener
Presented on: 17/11/2015, Lisbon, Portugal
Abstract: Lower-limb exoskeletons can be very useful to restore walking abilities in two ways. First, they can be used as assistive devices to support elders or patients with gait impairments in daily life situations. Second, they can promote neurorehabilitation as training devices after neurological injuries such as spinal cord injury (SCI), traumatic brain injury and stroke. However, current solutions are still too bulky, too heavy and, thus, too inconvenient to use. Furthermore, torque induction into the human body joints is tricky, and often leads to mechanical stress in the attachment points and/or in the human joints as well as unwanted movements of the exoskeleton with respect to the human limbs. These disadvantages lead to unsatisfactory performance and discomfort. In this talk I will present current solutions and future trends of stationary gait training robots as well as wearable exoskeleton devises that can be used for training and assistance in daily life.
Presented at the following Conference: NEUROTECHNIX, International Congress on Neurotechnology, Electronics and Informatics
Conference Website: neurotechnix.org/
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Testing a soft exoskeleton

A longstanding quest to augment human performance with robotic exoskeletons takes a softer approach. Read more:

Robotic Assistive Device for Hemiplegic Stroke Gait Training

Autonomous Multi-Joint Soft Exosuit for Assistance with Walking Overground

ICRA 2018 Spotlight Video
Interactive Session Wed AM Pod C.5
Authors: Lee, Sangjun; Karavas, Nikolaos; Quinlivan, Brendan; Ryan, Danielle; Perry, David; Eckert-Erdheim, Asa; Murphy, Patrick; Greenberg Goldy, Taylor; Menard, Nicolas; Athanassiu, Maria; Kim, Jinsoo; Lee, Giuk; Galiana, Ignacio; Walsh, Conor James
Title: Autonomous Multi-Joint Soft Exosuit for Assistance with Walking Overground

Abstract:
Soft exosuits are a new approach for assisting with human locomotion, which applies assistive torques to the wearer through functional apparel. In this paper, we present a new version of autonomous multi-joint soft exosuit for gait assistance, particularly designed for overground walking. The soft exosuit assists with ankle plantarflexion, hip flexion, and hip extension, equally distributing the forces between ankle plantarflexion and hip flexion. A mobile actuation system was developed to generate high assistive forces, and Bowden cables are used to transmit the forces to the exosuit. A sensor harness connects two load cells and three IMUs per leg that are used to measure real-time data for a controller that commands desired force profiles as a function of the walking cycle. In addition, a control adaptation method was developed which adjusts control parameters while walking on irregular surfaces. In preliminary studies, the proposed method substantially improved the force consistency while walking over uneven terrain. Specifically, the number of steps where the peak force deviated from the target force decreased from 100 to 57 out of 250 steps, and RMS error for the peak force decreased from 90.0 N to 76.6 N with respect to 300 N target force. Also, a two-subject case study on country-course walking demonstrated the potential of this soft exosuit to improve human energy economy while walking overground.
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Soft Exosuit for Running

Building upon previous soft exosuit technology, researchers at the Wyss Institute and Harvard SEAS have developed a soft exosuit for running. This exosuit applies forces to the hip joint using thin, flexible wires, assisting the muscles during each stride. Using an off-board actuation system, compared to not wearing the exosuit, this exosuit can reduce the metabolic cost of running by 5.4%.

Watch a robotic exoskeleton help a stroke patient walk

DARPA-backed tech could decrease recovery time.

Read more:

Hablamos con ... Soft Exosuits

Hablamos con ... ignacio Galiana, Experto en Soft Exosuits

Stroke Robot Rehabilitation

Patients recovering from a stroke face difficult challenges with regaining full mobility and strength. At the Feinstein Institute for Medical Research, Dr. Bruce Volpe and his colleagues are using robotics to help stroke survivors relearn skills that were lost to them. These training techniques have demonstrated significant advantages in movement outcomes when compared to standard techniques.

For more information on stroke robot rehabilitation and other research at the Feinstein Institute visit

Post Stroke Gait (3 yrs Post R mca infarct+Decompressive Craniotomy): Gait and Postural Disturbances

3 years after a R middle cerebral artery stroke followed by a decompressive craniotomy due to swelling( Her axial T1 MRI presented at the beginning and end of the video) . Amazingly after extensive neurorehab she is able to ambulate. Though lack of proprioception and sensory input from the affected side combined with an inability to adequately achieve hip flexion/abduction, knee extension/flexion and dorsiflexion of foot are the main causes of such gaits. malalignment of the shoulder girdle, and impaired core muscles cause a C shaped posture in the upper body and trunk. Also, fear of falling is noted here, especially when the unaffected arm is sticking out (walking on the wire phenomenon), and hypertonacity of dorsiflexor antagonists is noted. This patient did not have a posterior stroke to have cerebellar balance related signs, but the unsteady gait is mainly due to the fear of falling which is caused by history of previous falls, and as mentioned above lack of sufficient sensory input from the affected side.

MRI image was created and viewed by OsiriX

StrokeSciences.Com

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