Infoscience

Thesis

Development of Walk Assistive Orthoses for Elderly

The proportion of elderly people is rapidly growing and the resources to help them will soon be insufficient. An important difficulty faced by the seniors is locomotion. Among the conditions that may be responsible for gait impairment, the reduced muscular force is one of the most frequent in elderly. This thesis focuses on the design and the evaluation of new solutions for assisting people with reduced vigor. Robotic orthoses are then used to support critical movements required for walking. Over the last two decades, the use of actuated orthotic devices for helping people suffering from gait disorders has been made possible. Recently, autonomous devices have even enabled spinal cord injured patients to walk again by mobilizing their paralyzed limbs. Addressing a completely different population, similar devices have been developed to augment healthy users' capabilities, for instance when heavy loads need to be carried. In this case, the wearer is in charge of the movements and the device simply follows the imposed trajectories. Extra load can then be carried by the exoskeleton without being felt by the user. The walk assistive devices developed as part of this thesis being intended for the elderly, they are at the intersection between these two classes of robotic orthosis. Indeed, most of the seniors who have difficulties to walk are able to move and therefore the mobilization devices are not adapted to them. Even though they need assistance, they surely do not want to have their movements imposed by a robotic device. The performance augmentation exoskeletons cannot help them either, as they simply follow the movements and only reject the external perturbations. A device that follows their movements and that adds the right amount of force when needed is therefore required. In order to achieve the demanding characteristics associated with assistive devices, new actuation solutions based on conventional electric motors are proposed. The combination of specifications in terms of overall weight, required assistance torque, dynamics capabilities or transparency when no support is provided is undeniably challenging. Various mechanisms are therefore presented to address these requirements. Two prototypes based on the proposed solutions are presented. The first one is based on a ball-screw transmission combined with linkages which provides a transmission ratio that is adapted to multiple walk related activities. The second one uses a transmission with clutches and an inversion mechanism which notably limits the losses due to the inertia of the actuation and greatly improves the natural transparency. In order to limit the obstructiveness of the assistive device, we propose to use partial devices that support specific movements. Two studies about the influence of such partial devices on gait are therefore presented. The first one focuses on identifying the potential sources of gait disturbance that orthotic device can induce. The second examines the effects of an assistive controller implemented on one of the developed prototypes. These studies demonstrate that even though the passive influence of a hip assistive orthosis on kinematic patterns is limited, the metabolic cost is increased. A moderate assistance cannot compensate for this undesirable effect but a link between the hip assistance and the ankle trajectory could be established. This is of major importance as the elderly tend to compensate for their weak ankle muscles with their hips.

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