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Description
Locomotion is of prime importance in enabling human beings to effectively respond
in space and time to meet different needs. Approximately 2 million Americans live
with an amputation with most of those amputations being of the lower limbs. To
advance current state-of-the-art lower limb prosthetic devices, it is necessary to adapt
performance at a level of intelligence seen in human walking. As such, this thesis
focuses on the mechanisms involved during human walking, while transitioning from
rigid to compliant surfaces such as from pavement to sand, grass or granular media.
Utilizing a unique tool, the Variable Stiffness Treadmill (VST), as the platform for
human walking, rigid to compliant surface transitions are simulated. The analysis of
muscular activation during the transition from rigid to different compliant surfaces
reveals specific anticipatory muscle activation that precedes stepping on a compliant
surface. There is also an indication of varying responses for different surface stiffness
levels. This response is observed across subjects. Results obtained are novel and
useful in establishing a framework for implementing control algorithm parameters to
improve powered ankle prosthesis. With this, it is possible for the prosthesis to adapt
to a new surface and therefore resulting in a more robust smart powered lower limb
prosthesis.
in space and time to meet different needs. Approximately 2 million Americans live
with an amputation with most of those amputations being of the lower limbs. To
advance current state-of-the-art lower limb prosthetic devices, it is necessary to adapt
performance at a level of intelligence seen in human walking. As such, this thesis
focuses on the mechanisms involved during human walking, while transitioning from
rigid to compliant surfaces such as from pavement to sand, grass or granular media.
Utilizing a unique tool, the Variable Stiffness Treadmill (VST), as the platform for
human walking, rigid to compliant surface transitions are simulated. The analysis of
muscular activation during the transition from rigid to different compliant surfaces
reveals specific anticipatory muscle activation that precedes stepping on a compliant
surface. There is also an indication of varying responses for different surface stiffness
levels. This response is observed across subjects. Results obtained are novel and
useful in establishing a framework for implementing control algorithm parameters to
improve powered ankle prosthesis. With this, it is possible for the prosthesis to adapt
to a new surface and therefore resulting in a more robust smart powered lower limb
prosthesis.
ContributorsObeng, Ruby Afriyie (Author) / Artemiadis, Panagiotis (Thesis advisor) / Santello, Marco (Thesis advisor) / Lee, Hyunglae (Committee member) / Arizona State University (Publisher)
Created2019
Description
Human walking has been a highly studied topic in research communities because of its extreme importance to human functionality and mobility. A complex system of interconnected gait mechanisms in humans is responsible for generating robust and consistent walking motion over unpredictable ground and through challenging obstacles. One interesting aspect of human gait is the ability to adjust in order to accommodate varying surface grades. Typical approaches to investigating this gait function focus on incline and decline surface angles, but most experiments fail to address the effects of surface grades that cause ankle inversion and eversion. There have been several studies of ankle angle perturbation over wider ranges of grade orientations in static conditions; however, these studies do not account for effects during the gait cycle. Furthermore, contemporary studies on this topic neglect critical sources of unnatural stimulus in the design of investigative technology. It is hypothesized that the investigation of ankle angle perturbations in the frontal plane, particularly in the context of inter-leg coordination mechanisms, results in a more complete characterization of the effects of surface grade on human gait mechanisms. This greater understanding could potentially lead to significant applications in gait rehabilitation, especially for individuals who suffer from impairment as a result of stroke. A wearable pneumatic device was designed to impose inversion and eversion perturbations on the ankle through simulated surface grade changes. This prototype device was fabricated, characterized, and tested in order to assess its effectiveness. After testing and characterizing this device, it was used in a series of experiments on human subjects while data was gathered on muscular activation and gait kinematics. The results of the characterization show success in imposing inversion and eversion angle perturbations of approximately 9° with a response time of 0.5 s. Preliminary experiments focusing on inter-leg coordination with healthy human subjects show that one-sided inversion and eversion perturbations have virtually no effect on gait kinematics. However, changes in muscular activation from one-sided perturbations show statistical significance in key lower limb muscles. Thus, the prototype device demonstrates novelty in the context of human gait research for potential applications in rehabilitation.
ContributorsBarkan, Andrew (Author) / Artemiadis, Panagiotis (Thesis advisor) / Lee, Hyunglae (Committee member) / Marvi, Hamidreza (Committee member) / Arizona State University (Publisher)
Created2016
Description
Fall accident is a significant problem associated with our society both in terms of economic losses and human suffering [1]. In 2016, more than 800,000 people were hospitalized and over 33,000 deaths resulted from falling. Health costs associated with falling in 2016 yielded at 33% of total medical expenses in the US- mounting to approximately $31 billion per year. As such, it is imperative to find intervention strategies to mitigate deaths and injuries associated with fall accidents. In order for this goal to be realized, it is necessary to understand the mechanisms associated with fall accidents and more specifically, the movement profiles that may represent the cogent behavior of the locomotor system that may be amendable to rehabilitation and intervention strategies. In this light, this Thesis is focused on better understanding the factors influencing dynamic stability measure (as measured by Lyapunov exponents) during over-ground ambulation utilizing wireless Inertial Measurement Unit (IMU).
Four pilot studies were conducted: the First study was carried out to verify if IMU system was sophisticated enough to determine different load-carrying conditions. Second, to test the effects of walking inclinations, three incline levels on gait dynamic stability were examined. Third, tested whether different sections from the total gait cycle can be stitched together to assess LDS using the laboratory collected data. Finally, the fourth study examines the effect of “stitching” the data on dynamic stability measure from a longitudinally assessed (3-day continuous data collection) data to assess the effects of free-range data on assessment of dynamic stability.
Results indicated that load carrying significantly influenced dynamic stability measure but not for the floor inclination levels – indicating that future use of such measure should further implicate normalization of dynamic stability measures associated with different activities and terrain conditions. Additionally, stitching method was successful in obtaining dynamic stability measure utilizing free-living IMU data.
Four pilot studies were conducted: the First study was carried out to verify if IMU system was sophisticated enough to determine different load-carrying conditions. Second, to test the effects of walking inclinations, three incline levels on gait dynamic stability were examined. Third, tested whether different sections from the total gait cycle can be stitched together to assess LDS using the laboratory collected data. Finally, the fourth study examines the effect of “stitching” the data on dynamic stability measure from a longitudinally assessed (3-day continuous data collection) data to assess the effects of free-range data on assessment of dynamic stability.
Results indicated that load carrying significantly influenced dynamic stability measure but not for the floor inclination levels – indicating that future use of such measure should further implicate normalization of dynamic stability measures associated with different activities and terrain conditions. Additionally, stitching method was successful in obtaining dynamic stability measure utilizing free-living IMU data.
ContributorsMoon, Seong Hyun (Author) / Lockhart, Thurmon Eddy (Thesis advisor) / Lee, Hyunglae (Committee member) / Honeycutt, Claire (Committee member) / Arizona State University (Publisher)
Created2017
Description
This thesis work presents two separate studies:The first study assesses standing balance under various 2-dimensional (2D) compliant environments simulated using a dual-axis robotic platform and vision conditions. Directional virtual time-to-contact (VTC) measures were introduced to better characterize postural balance from both temporal and spatial aspects, and enable prediction of fall-relevant directions. Twenty healthy young adults were recruited to perform quiet standing tasks on the platform. Conventional stability measures, namely center-of-pressure (COP) path length and COP area, were also adopted for further comparisons with the proposed VTC. The results indicated that postural balance was adversely impacted, evidenced by significant decreases in VTC and increases in COP path length/area measures, as the ground compliance increased and/or in the absence of vision (ps < 0.001). Interaction effects between environment and vision were observed in VTC and COP path length measures (ps ≤ 0.05), but not COP area (p = 0.103). The estimated likelihood of falls in anterior-posterior (AP) and medio-lateral (ML) directions converged to nearly 50% (almost independent of the foot setting) as the experimental condition became significantly challenging.
The second study introduces a deep learning approach using convolutional neural network (CNN) for predicting environments based on instant observations of sway during balance tasks. COP data were collected from fourteen subjects while standing on the 2D compliant environments. Different window sizes for data segmentation were examined to identify its minimal length for reliable prediction. Commonly-used machine learning models were also tested to compare their effectiveness with that of the presented CNN model. The CNN achieved above 94.5% in the overall prediction accuracy even with 2.5-second length data, which cannot be achieved by traditional machine learning models (ps < 0.05). Increasing data length beyond 2.5 seconds slightly improved the accuracy of CNN but substantially increased training time (60% longer). Importantly, averaged normalized confusion matrices revealed that CNN is much more capable of differentiating the mid-level environmental condition.
These two studies provide new perspectives in human postural balance, which cannot be
interpreted by conventional stability analyses. Outcomes of these studies contribute to the advancement of human interactive robots/devices for fall prevention and rehabilitation.
ContributorsPhan, Vu Nguyen (Author) / Lee, Hyunglae (Thesis advisor) / Peterson, Daniel (Committee member) / Marvi, Hamidreza (Committee member) / Arizona State University (Publisher)
Created2021
Description
Low back pain (LBP) is the most common symptom leading to hospitalization and medical assistance. In the US, LBP is the fifth most prevalent case for visiting hospitals. Approximately 2.06 million LBP incidents were reported during the timeline between 2004 and 2008. Globally, LBP occurrence increased by almost 200 million from 1990 to 2017. This problem is further implicated by physical and financial constraints that impact the individual’s quality of life. The medical cost exceeded $87.6 billion, and the lifetime prevalence was 84%. This indicates that the majority of people in the US will experience this symptom. Also, LBP limits Activities of Daily Living (ADL) and possibly affects the gait and postural stability. Prior studies indicated that LBP patients have slower gait speed and postural instability. To alleviate this symptom, the epidural injection is prescribed to treat pain and improve mobility function. To evaluate the effectiveness of LBP epidural injection intervention, gait and posture stability was investigated before and after the injection. While these factors are the fundamental indicator of LBP improvement, ADL is an element that needs to be significantly considered. The physical activity level depicts a person’s dynamic movement during the day, it is essential to gather activity level that supports monitoring chronic conditions, such as LBP, osteoporosis, and falls. The objective of this study was to assess the effects of Epidural Steroid Injection (ESI) on LBP and related gait and postural stability in the pre and post-intervention status. As such, the second objective was to assess the influence of ESI on LBP, and how it influences the participant’s ADL physical activity level. The results indicated that post-ESI intervention has significantly improved LBP patient’s gait and posture stability, however, there was insufficient evidence to determine the significant disparity in the physical activity levels. In conclusion, ESI depicts significant positive effects on LBP patients’ gait and postural parameters, however, more verification is required to indicate a significant effect on ADL physical activity levels.
ContributorsMoon, Seong Hyun (Author) / Lockhart, Thurmon (Thesis advisor) / Honeycutt, Claire (Committee member) / Peterson, Daniel (Committee member) / Lee, Hyunglae (Committee member) / Soangra, Rahul (Committee member) / Arizona State University (Publisher)
Created2023
Description
The Soft Robotic Hip Exosuit (SR-HExo) was designed, fabricated, and tested in treadmill walking experiments with healthy participants to gauge effectivity of the suit in assisting locomotion and in expanding the basin of entrainment as a method of rehabilitation. The SR-HExo consists of modular, compliant materials to move freely with a user’s range of motion and is actuated with X-oriented flat fabric pneumatic artificial muscles (X-ff-PAM) that contract when pressurized and can generate 190N of force at 200kPa in a 0.3 sec window. For use in gait assistance experiments, X-ff-PAM actuators were placed anterior and posterior to the right hip joint. Extension assistance and flexion assistance was provided in 10-45% and 50-90% of the gait cycle, respectively. Device effectivity was determined through range of motion (ROM) preservation and hip flexor and extensor muscular activity reduction. While the active suit reduced average hip ROM by 4o from the target 30o, all monitored muscles experienced significant reductions in electrical activity. The gluteus maximus and biceps femoris experienced electrical activity reduction of 13.1% and 6.6% respectively and the iliacus and rectus femoris experienced 10.7% and 27.7% respectively. To test suit rehabilitative potential, the actuators were programmed to apply periodic torque perturbations to induce locomotor entrainment. An X-ff-PAM was contracted at
the subject’s preferred gait frequency and, in randomly ordered increments of 3%, increased up to 15% beyond.
Perturbations located anterior and posterior to the hip were tested separately to assess impact of location on entrainment characteristics. All 11 healthy participants achieved entrainment in all 12 experimental conditions in both
suit orientations. Phase-locking consistently occurred around toe-off phase of the gait cycle (GC). Extension perturbations synchronized earlier in the gait cycle (before 60% GC where peak hip extension occurs) than flexion perturbations (just after 60% GC at the transition from full hip extension to hip flexion), across group averaged results. The study demonstrated the suit can significantly extend the basin of entrainment and improve transient response compared to previously reported results and confirms that a single stable attractor exists during gait entrainment to unidirectional hip perturbations.
ContributorsBaye-Wallace, Lily (Author) / Lee, Hyunglae (Thesis advisor) / Marvi, Hamidreza (Committee member) / Berman, Spring (Committee member) / Arizona State University (Publisher)
Created2021
Description
While wearable soft robots have successfully addressed many inherent design limitations faced by wearable rigid robots, they possess a unique set of challenges due to their soft and compliant nature. Some of these challenges are present in the sensing, modeling, control and evaluation of wearable soft robots. Machine learning algorithms have shown promising results for sensor fusion with wearable robots, however, they require extensive data to train models for different users and experimental conditions. Modeling soft sensors and actuators require characterizing non-linearity and hysteresis, which complicates deriving an analytical model. Experimental characterization can capture the characteristics of non-linearity and hysteresis but requires developing a synthesized model for real-time control. Controllers for wearable soft robots must be robust to compensate for unknown disturbances that arise from the soft robot and its interaction with the user. Since developing dynamic models for soft robots is complex, inaccuracies that arise from the unmodeled dynamics lead to significant disturbances that the controller needs to compensate for. In addition, obtaining a physical model of the human-robot interaction is complex due to unknown human dynamics during walking. Finally, the performance of soft robots for wearable applications requires extensive experimental evaluation to analyze the benefits for the user. To address these challenges, this dissertation focuses on the sensing, modeling, control and evaluation of soft robots for wearable applications. A model-based sensor fusion algorithm is proposed to improve the estimation of human joint kinematics, with a soft flexible robot that requires compact and lightweight sensors. To overcome limitations with rigid sensors, an inflatable soft haptic sensor is developed to enable gait sensing and haptic feedback. Through experimental characterization, a mathematical model is derived to quantify the user's ground reaction forces and the delivered haptic force. Lastly, the performance of a wearable soft exosuit in assisting human users during lifting tasks is evaluated, and the benefits obtained from the soft robot assistance are analyzed.
ContributorsQuiñones Yumbla, Emiliano (Author) / Zhang, Wenlong (Thesis advisor) / Berman, Spring (Committee member) / Lee, Hyunglae (Committee member) / Marvi, Hamid (Committee member) / Sugar, Thomas (Committee member) / Arizona State University (Publisher)
Created2023
Description
One of the long-standing issues that has arisen in the sports medicine field is identifying the ideal methodology to optimize recovery following anterior cruciate ligament reconstruction (ACLR). The perioperative period for ACLR is notoriously heterogeneous in nature as it consists of many variables that can impact surgical outcomes. While there has been extensive literature published regarding the efficacy of various recovery and rehabilitation topics, it has been widely acknowledged that certain modalities within the field of ACLR rehabilitation need further high-quality evidence to support their use in clinical practice, such as blood flow restriction (BFR) training. BFR training involves the application of a tourniquet-like cuff to the proximal aspect of a limb prior to exercise; the cuff is inflated so that it occludes venous flow but allows arterial inflow. BFR is usually combined with low-intensity (LI) resistance training, with resistance as low as 20% of one-repetition maximum (1RM). LI-BFR has been used as an emerging clinical modality to combat postoperative atrophy of the quadriceps muscles for those who have undergone ACLR, as these individuals cannot safely tolerate high muscular tension exercise after surgery. Impairments of the quadriceps are the major cause of poor functional status of patients following an otherwise successful ACLR procedure; however, these impairments can be mitigated with preoperative rehabilitation done before surgery. It was hypothesized that the use of a preoperative LI-BFR training protocol could help improve postoperative outcomes following ACLR; primarily, strength and hypertrophy of the quadriceps. When compared with a SHAM control group, subjects who were randomized to a BFR intervention group made greater preoperative strength gains in the quadriceps and recovered quadriceps mass at an earlier timepoint than that of the SHAM group aftersurgery; however, the gains made in strength were not able to be maintained in the 8-week postoperative period. While these results do not support the use of LI-BFR from the short-term perspective after ACLR, follow-up data will be used to investigate trends in re-injury and return to sport rates to evaluate the efficacy of the use of LI-BFR from a long-term perspective.
ContributorsGlattke, Kaycee Elizabeth (Author) / Lockhart, Thurmon (Thesis advisor) / McDaniel, Troy (Committee member) / Banks, Scott (Committee member) / Peterson, Daniel (Committee member) / Lee, Hyunglae (Committee member) / Arizona State University (Publisher)
Created2022
Description
There are many inconsistencies in the literature regarding how to estimate the Lyapunov Exponent (LyE) for gait. In the last decade, many papers have been published using Lyapunov Exponents to determine differences between young healthy and elderly adults and healthy and frail older adults. However, the differences in methodologies of data collection, input parameters, and algorithms used for the LyE calculation has led to conflicting numerical values for the literature to build upon. Without a unified methodology for calculating the LyE, researchers can only look at the trends found in studies. For instance, LyE is generally lower for young adults compared to elderly adults, but these values cannot be correlated across studies to create a classifier for individuals that are healthy or at-risk of falling. These issues could potentially be solved by standardizing the process of computing the LyE.
This dissertation examined several hurdles that must be overcome to create a standardized method of calculating the LyE for gait data when collected with an accelerometer. In each of the following investigations, both the Rosenstein et al. and Wolf et al. algorithms as well as three normalization methods were applied in order to understand the extent at which these factors affect the LyE. First, the a priori parameters of time delay and embedding dimension which are required for phase space reconstruction were investigated. This study found that the time delay can be standardized to a value of 10 and that an embedding dimension of 5 or 7 should be used for the Rosenstein and Wolf algorithm respectively. Next, the effect of data length on the LyE was examined using 30 to 1300 strides of gait data. This analysis found that comparisons across papers are only possible when similar amounts of data are used but comparing across normalization methods is not recommended. And finally, the reliability and minimum required number of strides for each of the 6 algorithm-normalization method combinations in both young healthy and elderly adults was evaluated. This research found that the Rosenstein algorithm was more reliable and required fewer strides for the calculation of the LyE for an accelerometer.
This dissertation examined several hurdles that must be overcome to create a standardized method of calculating the LyE for gait data when collected with an accelerometer. In each of the following investigations, both the Rosenstein et al. and Wolf et al. algorithms as well as three normalization methods were applied in order to understand the extent at which these factors affect the LyE. First, the a priori parameters of time delay and embedding dimension which are required for phase space reconstruction were investigated. This study found that the time delay can be standardized to a value of 10 and that an embedding dimension of 5 or 7 should be used for the Rosenstein and Wolf algorithm respectively. Next, the effect of data length on the LyE was examined using 30 to 1300 strides of gait data. This analysis found that comparisons across papers are only possible when similar amounts of data are used but comparing across normalization methods is not recommended. And finally, the reliability and minimum required number of strides for each of the 6 algorithm-normalization method combinations in both young healthy and elderly adults was evaluated. This research found that the Rosenstein algorithm was more reliable and required fewer strides for the calculation of the LyE for an accelerometer.
ContributorsSmith, Victoria (Author) / Lockhart, Thurmon E (Thesis advisor) / Spano, Mark L (Committee member) / Honeycutt, Claire F (Committee member) / Lee, Hyunglae (Committee member) / Peterson, Daniel S (Committee member) / Arizona State University (Publisher)
Created2019
Description
This dissertation aimed to evaluate the effectiveness and drawbacks of promising fall prevention strategies in individuals with stroke by rigorously analyzing the biomechanics of laboratory falls and compensatory movements required to prevent a fall. Ankle-foot-orthoses (AFOs) and functional electrical stimulators (FESs) are commonly prescribed to treat foot drop. Despite well-established positive impacts of AFOs and FES devices on balance and gait, AFO and FES users fall at a high rate. In chapter 2 (as a preliminary study), solely mechanical impacts of a semi-rigid AFO on the compensatory stepping response of young healthy individuals following trip-like treadmill perturbations were evaluated. It was found that a semi-rigid AFO on the stepping leg diminished the propulsive impulse of the compensatory step which led to decreased trunk movement control, shorter step length, and reduced center of mass (COM) stability. These results highlight the critical role of plantarflexors in generating an effective compensatory stepping response. In chapter 3, the underlying biomechanical mechanisms leading to high fall risk in long-term AFO and FES users with chronic stroke were studied. It was found that AFO and FES users fall more than Non-users because they have a more impaired lower limb that is not fully addressed by AFO/FES, therefore leading to a more impaired compensatory stepping response characterized by increased inability to generate a compensatory step with paretic leg and decreased trunk movement control. An ideal future AFO that provides dorsiflexion assistance during the swing phase and plantarflexion assistance during the push-off phase of gait is suggested to enhance the compensatory stepping response and reduce more falls. In chapter 4, the effects of a single-session trip-specific training on the compensatory stepping response of individuals with stroke were evaluated. Trunk movement control was improved after a single session of training suggesting that this type of training is a viable option to enhance compensatory stepping response and reduce falls in individuals with stroke. Finally, a future powered AFO with plantarflexion assistance complemented by a trip-specific training program is suggested to enhance the compensatory stepping response and decrease falls in individuals with stroke.
ContributorsNevisipour, Masood (Author) / Honeycutt, Claire (Thesis advisor) / Sugar, Thomas (Thesis advisor) / Artemiadis, Panagiotis (Committee member) / Abbas, James (Committee member) / Lee, Hyunglae (Committee member) / Arizona State University (Publisher)
Created2019