Beyond Human or Robot Administered Treadmill Training

Abstract

The demand for rehabilitation services is growing apace with the graying of the population. This situation creates both a need and an opportunity to deploy technologies such as rehabilitation robotics, and in the last two decades many research groups have deployed variations of this technology for gait rehabilitation. While gait robotic technology is elegant and sophisticated, results so far are mixed. We argue here that much of this technology may be misguided in its focus, providing highly repeatable control of rhythmic movement but ultimately overfocusing on this one aspect of gait. Our approach to lower extremity therapeutic robots is guided by our model of dynamic primitives in locomotion, which posits that walking is a composite of three dynamic primitives including oscillations (rhythmic movements), but also submovements (discrete movements), and mechanical impedances (balance). We developed devices based on the principle that the machine should allow the patient to express those dynamic primitives as much as (s)he can, while accommodating a large spectrum of pathological gaits. In the following, we review four innovative solutions for lower extremity (LE) rehabilitation based on this approach: Anklebot, MIT-Skywalker, Soft Exosuit, and Variable-Friction Cadense Shoes.