Tatiana Luna

Squatting is a dynamic task that is often done for strengthening and improving balance. Most squat training systems partially support body weight. However, one of the benefits of a squat exercise is efficiently distributing the body weight among the feet while maintaining stability. Several studies have shown how squatting and redistributing body weight among the feet can improve balance. The goals of this study are: (i) to show a robotic device that is transparent for studying human behavior during the squatting task, (ii) to investigate how ground reaction forces can be altered among the feet by applying a pelvic force during squatting. Seven able bodied adults underwent three squat conditions, squatting eight times per test. The first two conditions are a baseline set of squats followed by the third condition where participants received a constant lateral force on their pelvis. We use a cable-driven Robotic Upright Stand Trainer, RobUST, to deliver the lateral force on a pelvic belt. The lateral force was 5% of participants’ body weight. Results show that a lateral force on the pelvis can significantly redistribute participants’ ground reaction forces by increasing the symmetry index from 11.2% to 35.7% and increasing the lateral center of pressure amplitude from.07 to 0.18. The results also show that the pelvic lateral force did not add variability to the natural squat motion between repetitions, as measured by the coefficient of variability. These results are promising for future squat training paradigms to redistribute ground reaction forces and encourage specific weight distribution patterns.

Moving from a seated position to a standing position is essential for performing daily functional tasks. However, a sit-to-stand task may lead to falls in people with neuromotor disorders. Previous studies have shown that perturbation-based training can improve individuals’ reactive control and reduce the risk of falls. However, few studies have investigated individuals’ reactive control while transitioning from sit-to-stand. The present study aims to understand how ten healthy adults react to physical perturbations when transitioning from sitting to standing. We delivered two types of perturbations to the participants. In one condition, we used a cable-driven robotic system to displace the user’s pelvis. In the second condition, we used a treadmill to displace the participants’ support surface. A set of perturbations were delivered until participants failed to maintain balance. The type of perturbation delivered, i.e., force applied on the pelvis or displacement of the support surface, was randomized within each set. In addition, the direction of the perturbation, i.e., anterior or posterior, was also randomized within each set. Joint angles, ground reaction forces, and muscle activity using surface electromyography were measured to characterize their balance control strategies. Our results show that perturbation directions had the most distinguishable change among participants. Participants also required an increase in trunk movement to stabilize as the perturbation intensities increased. These results provide important insights for designing future sit-to-stand perturbation-based training in individuals prone to falling.

An ambulatory elder with SCI, AIS C, balance deficits, and right ankle-foot-orthosis participated. RobUST-intervention comprised six 90 min-sessions of postural tasks with pelvic assistance and trunk perturbations. We collected three baselines and two 1 week post-training assessments—after the first four sessions (PT1) and after the last two sessions (PT2). We measured Berg Balance Scale (BBS), four-stage balance test (4SBT)—including a 30 s-window with and without vision—standing workspace area, and reactive balance (measured as body weight%). Kinematics, center-of-pressure (COP), and electromyography (EMG) were analyzed to compute root-mean-square-COP (RMS-COP), the margin of stability (MoS), ankle range of motion, and integrated EMG (iEMG) normalized to baseline. The Borg Rating of Perceived Exertion (BRPE), and change in the Mean Arterial Pressure (MAP) and heart rate (HR) compared with baseline were collected to address training tolerance. A 2SD-bandwidth method was selected for data interpretation. The maximum BBS was achieved (1-point improvement). In the 4SBT, the participant completed 30 s (baseline = 20 s) with reduced balance variability during semi-tandem position without vision (RMS-COP baseline = 50.32 ± 2 SD = 19.64 mm; PT1 = 21.29 mm; PT2 = 19.34 mm). A trend toward increase was found in workspace area (baseline = 996 ± 359 cm²; PT1 = 1539 cm²; PT2 = 1138 cm²). The participant tolerated higher perturbation intensities (baseline mean = 25%body weight, PT2 mean = 44% body weight), and on average improved his MoS (3 cm), ankle range of motion (4°), and gluteus medius activity (iEMG = 10). RobuST-intervention was moderate-sort of hard (BRPE = 3–4). A substantial reduction in MAP (9%) and HR (30%) were observed. In conclusion, RobUST-intervention might be effective in ambulatory SCI.

This paper presents a novel robotic system to characterize and retrain reaching in rats. This robot is intended to be a research platform for rehabilitation of forelimb movements in rats. In this paper, we focus on the design of this robotic system. We present the design requirements, mathematical models, and details of the physical device. A parallel mechanism with a special

In people with severe neuromotor deficits of trunk and lower extremities, regaining balance in standing is often performed in rehabilitation with manual assistance, rigid body supports or by the use of handrails. To investigate and further expand postural control training in standing, we developed a Robotic Upright Stand Trainer (RobUST). In this study, we used RobUST to deliver trunk perturbations while simultaneously providing postural assistive forces on the pelvis in 10 able-bodied adults. Posture control responses with 'pelvic support' was then compared to 'no support' and 'hand supported' standing, with and without assistance from RobUST. We characterize postural imbalance with kinematic displacements and center of pressure (COP) outcomes, such as amplitude and root mean square of the excursions of COP. Surface electromyography (sEMG) was also applied to investigate muscle control. We additionally investigated ground reaction and handrail forces during standing to analyze how postural strategies and muscle mechanisms with 'pelvic support' via RobUST would differ from standing with 'no support' and with the 'handrail support'. Our results show that during perturbations, pelvic assistive support decreased kinematic and COP excursions compared to standing with no support. The pelvic assistance from RobUST showed similar level of COP changes as the use of handrail support but without reducing muscle activity or ground reaction forces. As expected, the maximum level of postural stability was observed when participants used the handrail and received pelvic assistive forces. In conclusion, RobUST demonstrates potential as a training device since it enhances postural balance without significantly removing muscular control mechanisms that are of interest in re-training postural control strategies in standing.

This paper presents a novel robotic system to characterize and retrain reaching in rats. This robot is intended to be a research platform for the rehabilitation of forelimb movements in rats. In this paper, we focus on the design of this robotic system. We present the design requirements, mathematical models, and details of the physical device. A parallel mechanism with a special alignment of the component chains is used to accommodate observed reaching motions of a rat’s forelimb. Additionally, we demonstrate the use of this robot to record forelimb trajectories. Three healthy rats were used to record repeated reaching motions while the robot applied nearly zero force. We believe that this robotic system can be used in future training studies with rats who have impaired arm motions due to a neurological insult.

Study design Cross-sectional study. Objectives To measure and expand the sitting workspace of participants with spinal cord injury (SCI) with the Trunk-Support-Trainer (TruST). Setting Columbia University. Methods TruST is a motorized-cable belt placed around the torso. Participants performed maximal trunk excursions along eight directions, radiating in a star-shape, to define their seated postural limits and workspace area (cm²). TruST was configured to apply “assist-as-needed” forces when the trunk moved beyond these postural limits. Kinematics were collected to examine trunk control. The clinical features of the sample (n = 5) were documented by neurological injury, dynamometry, the American Spinal Injury Association Impairment Scale, and Spinal Cord Independence Measure-III. Results Statistical significance was examined with paired t-tests. TruST successfully recreated the postural limits of participants and expanded their active sitting workspace (Mean: 123.3 ± SE: 42.8 cm², p < 0.05). Furthermore, participants improved their trunk excursions to posterior (Mean: 5.1 ± SE: 0.8 cm, p < 0.01), right (Mean: 3.1 ± SE: 1.1 cm, p < 0.05), and left (Mean: 5.0 ± SE: 1.7 cm, p = 0.05) directions with TruST-force field. Conclusions TruST can accurately define and expand the active seated workspace of people with SCI during volitional trunk movements. The capacity of TruST to deliver continuous force-feedback at the user’s postural limits opens new frontiers to implement motor learning-based paradigms to retrain functional sitting in people with SCI.

Functional rehabilitation of patients with spinal cord injury remains a current challenge. Training these patients to successfully stand is the first step towards restoring advanced skills such as walking. To address this need, we have developed a novel robotic stand trainer that can apply controlled forces on the trunk and the pelvis of a user, while controlling the knee angle. The stand trainer utilizes cables to apply assistive, resistive, or perturbation forces at the trunk, pelvis, and the knees, simultaneously. We have conducted a human study to validate the system. In this study, we applied multi-direction perturbation forces either at the pelvis or the trunk while assist-as-needed forces were applied to the other segment to keep balance. This study characterizes the human kinematics and measures of balance under the perturbations and assistive forces on the human body. Results shows that the level of force-field assistance (trunk or pelvis) directly affects the motion of the trunk, pelvis, and center of pressure. This provides a quantitative framework to restore balance in patients while providing assistance only when needed. This stand trainer can potentially free up therapists to attend to higher level rehabilitation goals and objectively assist patients to engage in interventions that challenge both their musculoskeletal and sensorimotor impairments.