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Sensor-based hip control with hybrid neuroprosthesis for walking in paraplegia

Sensor-based hip control with hybrid neuroprosthesis for walking in paraplegia. Curtis S. To, PhD; Rudi Kobetic, MS; Thomas C. Bulea, PhD; Musa L. Audu, PhD; John R. Schnellenberger, MS; Gilles Pinault, MD; Ronald J. Triolo, PhD. Aim

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Sensor-based hip control with hybrid neuroprosthesis for walking in paraplegia

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  1. Sensor-based hip control with hybrid neuroprosthesis for walking in paraplegia Curtis S. To, PhD; Rudi Kobetic, MS; Thomas C. Bulea, PhD; Musa L. Audu, PhD; John R. Schnellenberger, MS; Gilles Pinault, MD; Ronald J. Triolo, PhD

  2. Aim • Test whether hybrid neuroprosthesis (HNP) with exoskeletal variable-constraint hip mechanism (VCHM) + functional neuromuscular stimulation (FNS) controller maintains upright posture with less upper-limb support and improves gait speed. • Compared with isocentric reciprocating gait orthosis (IRGO) or FNS only. • Relevance • Trunk-hip-knee-ankle-foot orthoses (THKAFOs) with hip reciprocator for restoring gait after paralysis from spinal cord injury (SCI) provide upper-body postural support. • However, range of hip flexion is limited with reciprocator to prevent excessive forward trunk lean.

  3. Method • VCHM was incorporated into HNP that utilized: • FNS to power lower-limb movements. • THKAFO to provide support. • HNP was compared with: • FNS only walking • Walking with isocentric reciprocal gait orthosis (IRGO) • HNP without FNS sensor-based controller

  4. Results • Walking with HNP significantly reduced: • Forward lean as compared with FNS-only walking. • Maximum upper-limb forces: • by 42% as compared with IRGO gait. • by 19% as compared with FNS-only gait. • Walking speed increased significantly with VCHM as compared with 1:1 reciprocal coupling and by 15% when using sensor-based FNS controller as compared with HNP with fixed baseline stimulation without controller active.

  5. Conclusion • Sensor-based hip control of the HNP with exoskeletal VCHM and implanted FNS enabled individual with paraplegia with SCI to maintain more erect posture than with stimulated hip and trunk muscles assisted by upper limbs when walking with FNS only and not as erect as when walking with IRGO.

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