WO2024081367A1 - Exosquelette linéaire pour réduire la force de contact du genou - Google Patents

Exosquelette linéaire pour réduire la force de contact du genou Download PDF

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Publication number
WO2024081367A1
WO2024081367A1 PCT/US2023/035034 US2023035034W WO2024081367A1 WO 2024081367 A1 WO2024081367 A1 WO 2024081367A1 US 2023035034 W US2023035034 W US 2023035034W WO 2024081367 A1 WO2024081367 A1 WO 2024081367A1
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WO
WIPO (PCT)
Prior art keywords
exoskeleton
linear
pole
force
set forth
Prior art date
Application number
PCT/US2023/035034
Other languages
English (en)
Inventor
Patrick SLADE
Scott L. Delp
Nicholas Miguel ROBLES
Original Assignee
The Board Of Trustees Of The Leland Stanford Junior University
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by The Board Of Trustees Of The Leland Stanford Junior University filed Critical The Board Of Trustees Of The Leland Stanford Junior University
Publication of WO2024081367A1 publication Critical patent/WO2024081367A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H1/00—Apparatus for passive exercising; Vibrating apparatus; Chiropractic devices, e.g. body impacting devices, external devices for briefly extending or aligning unbroken bones
    • A61H1/02—Stretching or bending or torsioning apparatus for exercising
    • A61H1/0237—Stretching or bending or torsioning apparatus for exercising for the lower limbs
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H3/00—Appliances for aiding patients or disabled persons to walk about
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H3/00—Appliances for aiding patients or disabled persons to walk about
    • A61H3/02—Crutches
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B23/00—Exercising apparatus specially adapted for particular parts of the body
    • A63B23/035—Exercising apparatus specially adapted for particular parts of the body for limbs, i.e. upper or lower limbs, e.g. simultaneously
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/50—Prostheses not implantable in the body
    • A61F2/68—Operating or control means
    • A61F2/70—Operating or control means electrical
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H3/00—Appliances for aiding patients or disabled persons to walk about
    • A61H2003/007—Appliances for aiding patients or disabled persons to walk about secured to the patient, e.g. with belts
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/16—Physical interface with patient
    • A61H2201/1602—Physical interface with patient kind of interface, e.g. head rest, knee support or lumbar support
    • A61H2201/164—Feet or leg, e.g. pedal
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/16—Physical interface with patient
    • A61H2201/1602—Physical interface with patient kind of interface, e.g. head rest, knee support or lumbar support
    • A61H2201/164—Feet or leg, e.g. pedal
    • A61H2201/1642—Holding means therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/16—Physical interface with patient
    • A61H2201/1602—Physical interface with patient kind of interface, e.g. head rest, knee support or lumbar support
    • A61H2201/165—Wearable interfaces
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/16—Physical interface with patient
    • A61H2201/1657—Movement of interface, i.e. force application means
    • A61H2201/1664—Movement of interface, i.e. force application means linear
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/50—Control means thereof
    • A61H2201/5058—Sensors or detectors
    • A61H2201/5061—Force sensors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/50—Control means thereof
    • A61H2201/5058—Sensors or detectors
    • A61H2201/5064—Position sensors
    • A61H2201/5066—Limit switches
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/50—Control means thereof
    • A61H2201/5058—Sensors or detectors
    • A61H2201/5084—Acceleration sensors

Definitions

  • This invention relates to exoskeletons.
  • the invention relates to linear exoskeletons.
  • Knee osteoarthritis is a condition where cartilage loss and bone spur development in the knee cause people significant pain. Knee osteoarthritis is the most common cause of adult musculoskeletal pain. This pain occurs when the knee is put under loads, such as walking and running, when there has been loss of articular cartilage in the knee and the development of bone spurs due to age and continual use of the leg. If the cartilage structure becomes damaged, repetitive loads during walking can further degrade the cartilage, causing a negative spiral in cartilage health (for reference, see FIG. 1 in priority document).
  • the present invention provides a linear exoskeleton for reducing knee contact force.
  • the linear exoskeleton has a pole with a distal end and a proximal end.
  • the pole is a linear carbon pole.
  • the pole is positioned at a lateral side of the person.
  • the linear exoskeleton further has a shoe attachment at the distal end of the pole and capable to be attached to a shoe.
  • the attachment to the shoe is adjustable.
  • a carriage is positioned near the proximal end of the pole, such that the pole is capable of moving relative to the carriage in up and down position.
  • the linear exoskeleton further has a thigh strap near the proximal end of the pole, such that the thigh strap is capable to be affixed the pole to a person thigh and capable of positioning the pole adjacent to a person’s leg.
  • a mechanical assembly is positioned at the proximal end of the pole, such that the mechanical assembly is mechanically connected to the carriage.
  • a motor then controls the relative distance between the assembly and the carriage, therewith capable of controlling an assistive force to the person and therewith capable of reducing a knee contact force of the person while the person is executing a leg movement and in contact with a ground surface.
  • the linear exoskeleton has a sensor for sensing contact with the ground surface.
  • sensors are an Adafruit LSM9DS1 Accelerometer + Gyro + Magnetometer 9-DOF.
  • the linear exoskeleton has a sensor for sensing the assistive force by the pole.
  • a sensor for sensing the assistive force by the pole.
  • Example of a sensor is a Futek Model LCM200 Ultra-Light Miniature Universal
  • the linear exoskeleton has a controller for controlling the motor according to a desired force contact profile of the leg movement and receiving feedback from one or more sensors regarding the assistive force and ground contact.
  • the controller further has a first calibration module for static calibration of the controller when no leg movement or ground contact is experienced.
  • the controller further has a second calibration module for dynamic calibration of the controller during execution of the leg movement.
  • the controller further has an input of body weight of the person and an algorithm to scale the desired force contact profile.
  • the controller further has a scaling factor and an algorithm to scale the desired force contact profile.
  • the controller further has input from one or more sensors and an algorithm to determine a type of leg movement, a desired force contact profile and a scaling factor to scale the desired force profile.
  • FIG. 1 shows according to an exemplary embodiment of the invention a linear exoskeleton worn by a person.
  • the linear exoskeleton applies a vertical force to offload the knee by lifting the person with a strap on their thigh and applying the reaction force directly into the ground.
  • the exoskeleton has a carriage attached to a strap on the thigh.
  • the carriage rolls along a carbon tube that runs from the hip down to the foot, where it attaches to the shoe.
  • the carbon tube transmits force to the carriage with a Bowden cable that runs over a pulley attached to the top of the carbon tube.
  • a motor (not shown in the figure) applies a force to the cable.
  • FIG. 2 shows according to an exemplary embodiment a side view of the linear exoskeleton assembly.
  • FIG. 3 shows according to an exemplary embodiment the linear exoskeleton applying force to the leg by using a motor to wind a cord.
  • This cord travels through a sheath, or Bowden cable, to transmit forces directly to the linear exoskeleton.
  • the cable sheath terminates on a carriage, which slides along the pole of the exoskeleton.
  • the cable runs over a pulley mounted on top of the exoskeleton pole, and terminates on the other side of the carriage with a load cell sensor that measures the force the device is applying to the exoskeleton.
  • the strap attached to the carriage transmits force to the person’s thigh.
  • FIG. 4 shows according to an exemplary embodiment a closeup on the foot assembly of the linear exoskeleton.
  • the force through the thigh strap is transferred down the tube directly to the ground, completely offloading the leg.
  • the inertial measurement unit (IMU) is attached at the base of the pole to detect when the foot is on the ground and where the foot is within the gait cycle.
  • the foot support places force outside the foot print, improving mediolateral stability of the person by widening their support beyond the foot outline.
  • FIG. 5 shows according to an exemplary embodiment ground reaction forces between the foot and ground during walking on level-ground, incline, and decline.
  • the linear exoskeleton force profiles follow a similar shape, scaled to a specified level of assistance.
  • FIG. 6 shows according to an exemplary embodiment a force profile applied by the linear exoskeleton with each step.
  • the force profile is proportional to the force the person applies to the ground.
  • FIG. 7 shows according to an exemplary embodiment the linear exoskeleton controller withe linear exoskeleton sensors (force measurement sensors and inertial measurement unit), the motor that applies the force, and the software controlling the exoskeleton.
  • FIG. 8 shows according to an exemplary embodiment assistance through the linear exoskeleton reducing the knee contact force proportionally to the amount of assistance applied.
  • R, G, B, M indicators indicate the bold lines.
  • the present invention is a wearable robotic device, called linear exoskeleton.
  • the linear exoskeleton applies active assistance to reduce the knee contact forces during walking.
  • FIG. 1 shows an embodiment of the linear exoskeleton while attached by a person. Individual components of the linear exoskeleton are shown as well for this embodiment.
  • the objective of the exoskeleton is to reduce knee contact force by using a motor to apply forces between a strap on the thigh and the ground. The force applied is controllable.
  • the exoskeleton itself has a linear actuator type design, with a carriage that slides along a carbon pole (FIG. 2).
  • the motor pulls a tether to apply force and slide the carriage along the carbon pole (FIG. 3).
  • the linear exoskeleton applies force to the leg by using the motor to wind a cord.
  • This cord travels through a sheath, or a Bowden cable, to transmit forces directly to the linear exoskeleton.
  • the Bowden cable sheath terminates on a carriage, which slides along the carbon pole of the linear exoskeleton.
  • the cable runs over a pulley mounted on top of the exoskeleton pole, and terminates on the other side of the carriage with a load cell sensor that measures the force the device is applying to the exoskeleton.
  • the motor attempts to wind in the cable on the exoskeleton, raising the carriage upwards toward the top of the carbon pole.
  • the strap attached to the carriage transmits force to the person’s thigh.
  • the force through the thigh strap is transferred down the carbon pole directly to the ground, offloading the leg (FIG. 4).
  • the position of the load application relative to the foot can be altered.
  • the motor could be placed directly on the carriage or separately on another location of the body, such as in a fanny pack on the lower back.
  • the previously described Bowden cable sheath would run between the motor and the carriage, regardless of the placement of the motor.
  • An Inertial Measurement Unit is attached at the base of the pole to detect when the foot is on the ground and where the foot is within the gait cycle.
  • the foot support places force outside the foot print, improving mediolateral stability of the person by widening their support beyond the foot outline.
  • the placement of the foot support, where the linear exoskeleton comes in contact with the ground relative to the foot, could be actively changed to improve stability with a gantry system, slide, or other electro-mechanical apparatus.
  • the linear exoskeleton applies forces to assist walking prescribed by a force profile applied by the leg during walking, and scaled to the desired assistance level (FIG. 5).
  • the force profile When walking on an incline, the force profile has a lower first peak and higher second peak.
  • the force profile When walking on a decline, the force profile has a higher first peak and a lower second peak. This is accomplished through sensors to know where a person is in their stance (starts when the heel strikes the ground and ends when the toe comes off).
  • the sensors to track leg position are an IMU at the bottom of the carbon pole, but different types sensors could accomplish the same objective (e.g. a switch or a physical contact sensor in the shoe, a force sensor in the shoe, a pressure sensor in the shoe, an IMU on leg, EMG recording on leg, etc.).
  • a person turns on the device, and stands still for the linear exoskeleton to perform a static calibration (reeling in cord slack in the device).
  • a person then starts walking, wherein during the first steps (e.g. 6 steps) a dynamic calibration is performed to estimate the average time for each gait cycle.
  • the idea is to take the average time of the past few steps to estimate the time one would think the current step will take. Based on the amount of time that has passed in the current step one could then compute what percent completed the step is (gait cycle percent) and then apply the corresponding force from the prescribed profile.
  • the linear exoskeleton constantly calibrates based on the measured force from the load cell sensor on the carriage and the expected force profile.
  • the assistance force profile is parameterized to be proportional to the natural ground reaction force between the foot and the ground during normal walking (or another type of movement such as running).
  • the proportion of assistance is specified between 0% and 100%.
  • An example of this is shown for a level-ground walking profile with 40% assistance of a person that weighs approximately 150 pounds (FIG. 6).
  • a linear exoskeleton controller applies this desired force profile by commanding a motor value to the motor and measuring the force applied to the exoskeleton using e.g. the load cell sensor on the exoskeleton, which is used as feedback to the controller (FIG. 7).
  • An IMU sensor placed on the bottom of the pole is used to detect when the foot is in contact with the ground, and where the foot is during the step (referred to as the percent step phase, or percent stance phase).
  • the IMU could measure acceleration, angular velocity, and magnetic field in 3D to provide this information.
  • FIG. 8 shows result of an applied force which reduces the knee contact force approximately proportionally to how much assistance is applied by the user. For example, applying assistance of 30% of the person’s body weight reduces the total knee contact force by approximately 30%.

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  • Health & Medical Sciences (AREA)
  • General Health & Medical Sciences (AREA)
  • Physical Education & Sports Medicine (AREA)
  • Epidemiology (AREA)
  • Pain & Pain Management (AREA)
  • Rehabilitation Therapy (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Rehabilitation Tools (AREA)

Abstract

L'invention concerne un dispositif robotique portable, appelé exosquelette linéaire. L'exosquelette linéaire applique une aide active pour réduire les forces de contact du genou pendant la marche. L'objectif de l'exosquelette est de réduire la force de contact du genou en faisant appel à un moteur pour appliquer des forces entre une sangle sur la cuisse et le sol. La force appliquée peut être régulée. L'exosquelette lui-même a une conception de type actionneur linéaire, avec un chariot qui coulisse le long d'un bâton en carbone.
PCT/US2023/035034 2022-10-12 2023-10-12 Exosquelette linéaire pour réduire la force de contact du genou WO2024081367A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US202263415585P 2022-10-12 2022-10-12
US63/415,585 2022-10-12

Publications (1)

Publication Number Publication Date
WO2024081367A1 true WO2024081367A1 (fr) 2024-04-18

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PCT/US2023/035034 WO2024081367A1 (fr) 2022-10-12 2023-10-12 Exosquelette linéaire pour réduire la force de contact du genou

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Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20100036302A1 (en) * 2008-08-07 2010-02-11 Honda Motor Co., Ltd. Walking assistance device
US20110040216A1 (en) * 2005-03-31 2011-02-17 Massachusetts Institute Of Technology Exoskeletons for running and walking
US20120259259A1 (en) * 2009-12-15 2012-10-11 Zakrytoe Aktsionernoe Obschestvo Nauchno- Proizvodstvenny Tsentr "Ogonek" Method for correcting pathological configurations of segments of the lower extremities and device for realizing same
US20150173993A1 (en) * 2012-09-17 2015-06-25 President And Fellows Of Harvard College Soft exosuit for assistance with human motion

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20110040216A1 (en) * 2005-03-31 2011-02-17 Massachusetts Institute Of Technology Exoskeletons for running and walking
US20100036302A1 (en) * 2008-08-07 2010-02-11 Honda Motor Co., Ltd. Walking assistance device
US20120259259A1 (en) * 2009-12-15 2012-10-11 Zakrytoe Aktsionernoe Obschestvo Nauchno- Proizvodstvenny Tsentr "Ogonek" Method for correcting pathological configurations of segments of the lower extremities and device for realizing same
US20150173993A1 (en) * 2012-09-17 2015-06-25 President And Fellows Of Harvard College Soft exosuit for assistance with human motion

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