De Carvalho Gabriela B, Chandran Vishnu D, Spungen Ann M, Harel Noam Y, Bauman William A, Pal Saikat
Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, New Jersey, United States of America.
Department of Rehabilitation, Hospital for Special Surgery, New York, New York, United States of America.
PLoS One. 2025 Aug 29;20(8):e0322247. doi: 10.1371/journal.pone.0322247. eCollection 2025.
The overall goal of this study was to develop a computational framework to quantify hip, knee, and ankle joint forces during exoskeletal-assisted walking (EAW) in the ReWalk P6.0, an FDA-approved lower-extremity exoskeleton. The first objective was to quantify hip, knee, and ankle joint forces during unassisted walking and compare the results to existing in vivo and simulation data. The second objective was to compute hip, knee, and ankle joint forces from four different approaches to simulate human-robot interactions during EAW. We recorded the three-dimensional motion of one able-bodied participant during unassisted walking and EAW, with simultaneous measurements of (i) marker trajectories, (ii) ground reaction forces, (iii) electromyography, and (iv) exoskeleton encoder data. We developed a subject-specific virtual simulator in OpenSim to reproduce unassisted walking and EAW. Next, we utilized OpenSim's extension, OpenSim Moco, to determine the joint reaction forces at the hips, knees, and ankles during unassisted walking and EAW. The computed peak hip, knee, and ankle joint compressive forces during unassisted walking were 3.42-3.82 body weight (BW), 3.10-3.48 BW, and 4.97-5.83 BW, respectively; these joint forces were comparable to prior in vivo and simulation results. The four approaches to simulate human-robot interactions during EAW resulted in peak compressive forces ranging from 2.98-4.66 BW, 2.82-5.83 BW, and 3.39-3.79 BW at the hip, knee, and ankle joints, respectively. This computational framework provides a low-risk and cost-effective technique to quantify the loading of the long bones and assess fracture risk during EAW in patients with severe bone loss in the lower extremities.
本研究的总体目标是开发一个计算框架，以量化在ReWalk P6.0（一种经美国食品药品监督管理局批准的下肢外骨骼）进行外骨骼辅助行走（EAW）期间的髋、膝和踝关节力。第一个目标是量化无辅助行走期间的髋、膝和踝关节力，并将结果与现有的体内和模拟数据进行比较。第二个目标是通过四种不同方法计算髋、膝和踝关节力，以模拟EAW期间的人机交互。我们记录了一名身体健全的参与者在无辅助行走和EAW期间的三维运动，同时测量了（i）标记轨迹、（ii）地面反作用力、（iii）肌电图和（iv）外骨骼编码器数据。我们在OpenSim中开发了一个特定于个体的虚拟模拟器，以重现无辅助行走和EAW。接下来，我们利用OpenSim的扩展OpenSim Moco来确定无辅助行走和EAW期间髋、膝和踝关节的关节反作用力。无辅助行走期间计算出的髋、膝和踝关节最大压缩力分别为3.42 - 3.82体重（BW）、3.10 - 3.48 BW和4.97 - 5.83 BW；这些关节力与先前的体内和模拟结果相当。在EAW期间模拟人机交互的四种方法导致髋、膝和踝关节的最大压缩力分别为2.98 - 4.66 BW、2.82 - 5.83 BW和3.39 - 3.79 BW。这个计算框架提供了一种低风险且具有成本效益的技术，用于量化下肢严重骨质流失患者在EAW期间长骨的负荷并评估骨折风险。
