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Soft Ankle Exosuit for Correction of Foot Drop

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Soft Ankle Exosuit for Correction of Foot Drop Soft Ankle Exosuit for Correction of Foot Drop A Major Qualifying Project Report: Submitted to the Faculty of WORCESTER POLYTECHNIC INSTITUTE in partial fulfillment of the requirements for the Degree of Bachelor of Science in Mechanical Engineering and Computer Science by Joshua Galang Lauren Morgan-Evans Hannah Yeung Date: April 25, 2019 Worcester Polytechnic Institute Professor Marko Popovic, Advisor Professor Joshua Cuneo, Co-Advisor Professor Selçuk Guçeri, Co-Advisor ABSTRACT Foot drop is a common condition caused by nerve damage, muscular dystrophy, as Well as brain and spinal cord disorders, and is characterized by a difficulty to perform dorsiflexion: the inability to lift the front part of the foot, resulting in a dragging foot. Consequences include slow Walking speed, inefficient gait, balance problems, and the inability to position the foot for heel strike. Although many people suffer from this condition, there is currently no actively powered brace on the market. This project introduces a Wearable, actively poWered device that can be worn beneath regular clothing. The device uses force sensitive resistors (FSR) to deduce the gait phase and an ultrasonic sensor to deduce ground conditions such as obstacles, inclines, and stairs. A lightWeight and compact servo motor placed next to the knee joint actuates the ankle joint through a Bowden cable. 1 ACKNOWLEDGMENTS We would like to express our gratitude to our advisor, Professor Marko Popovic, and our co-advisors Professor Selçuk Güçeri and Professor Joshua Cueno for their guidance and constant dedication to our project’s success. We would also like to thank those who offered invaluable advice and assisted us in completing our project. This includes Professor Karen Troy, Chris Nycz, Kevin, participants in the weekly MQP lab lunches and others who gave valuable feedback and counsel. 2 CONTENTS ABSTRACT 1 ACKNOWLEDGMENTS 2 CONTENTS 3 LIST OF FIGURES 6 CHAPTER 1 7 INTRODUCTION 7 CHAPTER 2 9 BACKGROUND 9 2.1 THE GAIT CYCLE 9 2.1.1 OVERVIEW OF THE GAIT CYCLE 9 2.1.2 THE STANCE PHASE 11 2.1.3 THE SWING PHASE 13 2.2 FOOT DROP 14 2.2.1 DEFINITION OF FOOT DROP 14 2.2.2 CAUSES OF FOOT DROP 14 2.2.3 TREATMENTS FOR FOOT DROP 15 2.2.3.i FUNCTIONAL ELECTRICAL STIMULATION (FES) 15 2.2.3.ii ANKLE FOOT ORTHOSIS (AFO) 15 2.2 INSPIRATION FOR DESIGN 16 2.3.1 EXOSKELETONS 16 2.3.2 SOFT WEARABLE EXOSUITS 17 3 2.3.2 EXISTING EXOSKELETONS 18 CHAPTER 3 20 PROJECT OBJECTIVES 20 CHAPTER 4 21 METHODOLOGY 21 4.1 MATERIALS AND DESIGN 21 4.1.1 SERVO MOTOR 21 4.1.2 BOWDEN CABLE 22 4.1.3 SPOOL 22 4.2 SENSORS AND CONTROL 23 4.2.1 ULTRASONIC SENSOR 23 4.2.2 FORCE-SENSING RESISTORS 24 4.2.3 ARDUINO UNO 24 4.3 SKELETON 25 4.4 PROGRESSION OF DESIGN 25 4.4.1 Initial Design 25 4.4.2 Second Design 27 4.4.3 Final Design 28 CHAPTER 5 29 EXPERIMENTS 29 5.1 ELECTRICAL SYSTEM 29 5.1.1 ARDUINO CODE 29 5.1.2 ELECTRICAL SYSTEM TESTING 29 5.2 FULL SYSTEM 30 5.2.1 FSR EXPERIMENTS 30 5.2.2 ULTRASONIC EXPERIMENTS 31 CHAPTER 6 33 4 KEY FINDINGS 33 6.1 GAIT RESULTS 33 6.2 ULTRASONIC RESULTS 34 6.3 LIMITATIONS 35 6.4 APPLICATIONS 35 CHAPTER 7 36 CONCLUSION 36 REFERENCES 38 APPENDIX A 44 APPENDIX B 45 ARDUINO CODE 45 5 LIST OF FIGURES Figure 1: Complete gait cycle (Streifeneder Ortho Production, 2017) ............................... 9 Figure 2: Functional divisions of the gait cycle according to Perry and Burnfield (2010) (Stöckel et al., 2015) ..................................................................................................... 10 Figure 5: Rewalk Restore Soft-Suit (Heater, 2017) .................................................................. 18 Figure 6: Ankle Exo (Quick, 2015) ................................................................................................... 19 Figure 7: ToWer Pro MG995R Digi Hi Torque Servo Motor (Adafruit, 2019) ............... 21 Figure 8: Servo motor attached to skeleton ................................................................................ 22 Figure 9: Sparkfun HC-SR04 Ultrasonic Distance Sensor ...................................................... 23 Figure 10: Force Sensing Resistor (Pololu, 2019) .................................................................... 24 Figure 11: Arduino Uno Board (Sparkfun, 2019a) .................................................................. 25 Figure 12: Prototype Version 1 ......................................................................................................... 26 Figure 13: Prototype Version 1 ......................................................................................................... 27 Figure 14: Prototype Version 3 ......................................................................................................... 28 Figure 17: Servo positions as a step is taken .............................................................................. 31 Figure 18: Ankle angles during the gait cycle (Richards, Chohan, Erande, 2017) ...... 33 Figure 19: Angle measurements taken from the video .......................................................... 34 Figure 20: Ankle angles from our experiments ......................................................................... 34 6 CHAPTER 1 INTRODUCTION Currently, there exists millions of individuals With gait disabilities Who require the use of an orthosis on a loWer extremity (Russell et al., 1997). In the United States alone, over 300,000 individuals are affected by foot drop, a condition that is characterized by the difficulty or the inability of a person to lift their toes towards their shin (i.e. dorsiflex)(National Institute of Neurological Disorders and Stroke (NINDS), 2019) This type of pathology has a number of causes, including stroke, cerebral palsy, multiple sclerosis, and neurological trauma from an accident or surgical complications (Taylor et al., 1999). One of the most common treatments used in correcting foot drop, that does not involve surgery, is the use of an ankle foot orthosis (AFO). AFOs are braces that are worn on the lower leg and foot to support the ankle and hold the foot and ankle in the proper alignment to counteract the dropping of the foot (Shiel Jr., W. C. 2018). Foot drop patients typically have the ability to plantarflex (i.e the flexing of the foot/toes downwards towards the sole) but suffer from a lack of ability to dorsiflex. The most commonly prescribed AFOs are rigid, uncomfortable, and do not alloW for much dorsi- or plantar flexion. This makes it difficult for patients to ascend/descend stairs, Walk over changes in elevation (e.g. a curb) or to clear certain obstacles within their walking path. Often these individuals find it necessary to change their Walking patterns in order to accomodate for these brace-induced constraints. Consequently, there is an increase in stress in their other joints such as their knees, hips and back, Which leads to the patients facing additional pain and discomfort 7 (Zancan & Arturo, 2004). There noW exists a developing need to create loW-costing, active AFOs that provide adequate stability for ground Walking While accommodating for changes in surface elevation and obstacle clearance. This project explores the design and development of an improved, adaptive and active, soft ankle exosuit (brace) to assist in the correction of foot drop. In Chapter 2, we summarize the background knoWledge relevant to this project. We then state our project objectives in Chapter 3 and, in Chapter 4, introduce the sensors and components used in our device. In Chapter 5, We outline the experiments conducted With our device. In Chapter 6, We review our results and key findings. Finally, we conclude the project with an overview of future work and developments for this device. 8 CHAPTER 2 BACKGROUND 2.1 THE GAIT CYCLE 2.1.1 OVERVIEW OF THE GAIT CYCLE Gait can be described as a "manner of moving the body from one place to another by alternately and repetitively changing the location of the feet" (Smidt, 1990). Many types of gaits exist such as walking, running, skipping and other pathological gaits, hoWever, the main focus of this project is on Walking. A full gait cycle (Figure 1) begins at the heel strike of one foot and continues until the heel strike of the same foot in preparation for the next step (KaWalec, 2017). TWo primary phases are present Within the gait cycle, the stance phase and the sWing phase, Which alternate for each loWer limb (Ekka, 2016). The stance phase characterizes the entire time that a foot is on the ground and the sWing phase, contrarily, covers the entire time that the foot is in the air. Figure 1: Complete gait cycle (Streifeneder Ortho Production, 2017) 9 The gait cycle can also be broken down further into eight distinct events, which delineate each step of the cycle, as shown in Figure 2. The stance phase consists of five events: ● Initial contact (IC) ● Loading response (LR) ● Midstance (MST) ● Terminal stance (TST) ● Preswing (PSW) The swing phase, on the other hand, consists of the other three events: ● Initial swing (ISW) ● Mid swing (MSW) ● Terminal sWing (TSW) Figure 2: Functional divisions of the gait cycle according to Perry and Burnfield (2010) (Stöckel et al., 2015) 10 2.1.2 THE STANCE PHASE The stance phase is the first phase of the gait cycle, and represents 60% of the total cycle. While in this phase, the foot is in contact with the ground and nearly all of the body weight is on the foot. Weight, and contact with the ground, transitions from first the heel, to the full foot, then to the forefoot in order to initiate forWard motion of the body. For
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