Orthoses

Engineering Discovery Days 2024

Katie Landwehr News, Outreach , , , ,

The University of Washington College of Engineering re-launched Engineering Discovery Days this spring. Discovery Days has been a signature outreach event for over 100 years, providing fun and enriching hands-on experiences for students, teachers, and families from across the state. Discovery Days is also an opportunity for our community of UW Engineering students, staff, and faculty to share their passion for engineering with the next generation of innovators.

The UW Biomechanics Faculty put together an exhibit titled “Biomechanics Assemble! From Exoskeletons to Cytoskeletons” with the goal of demonstrating how we study movement and forces in humans and cells at UW.

Two people stand outside, one with a robotic leg, holding a sign reading, "The Human Body: The Ultimate Machine." Both wear "Engineering" shirts. Trees and an event tent are in the background.
A person wearing an exoskeleton suit stands facing a small group of people in a room with various individuals and equipment.
Two people engaged in a discussion while one is wearing a 3D printed prosthetic hand.
Two people fist bumping. One person is wearing a 3D printed prosthetic hand.
A person in a lab wearing an exoskeleton, ready to teach students about biomechanics research.
A woman instructing a child how to use a 3D printed prosthetic hand to pick up a small bottle
A group of students standing around while one is wearing a 3D printed prosthetic hand
A group of students standing around while one is wearing a 3D printed prosthetic hand

The Steele Lab along with the Ingraham Lab hosted two booths. Each booth featured hand-on activities and games for students to engage with.

The first booth features an ensemble of exoskeletons and assistive devices, including the Biomotum Spark and 3D printed prosthetic hands.

The second booth featured two games for students to engage with, including “Myodino” using Delsys EMG sensors, and “UltraLeap Ring Sorting” VR game using the UltraLeap hand tracking technology.

In this lab, we think the human body is “The Ultimate Machine” and we were so excited to share HOW we study the human body at Discovery Days 2024.

A woman showing a young student how to play the game "MyoDino" by activating forearm muscles
A man placing an EMG sensor on the forearm of a young student
A small group of people standing around watching a student play MyoDino on a laptop
A small group of students standing around looking at a laptop as a woman explains how to play the "UltraLeap Ring Sorting"
A small group of students standing a laptop while a student plays the "UltraLeap Ring Sorting"
A small group of students standing a laptop while a person wearing an exoskeleton plays the "UltraLeap Ring Sorting"

NL Zaino, Z McKee, CD Caskey, KM Steele, HA Feldner (2024) “Perceptions and experiences of first mobility aid provision for young children with cerebral palsy in the United States: a mixed-methods study”

Katie Landwehr JournalArticle, News, Publications , , , ,

Journal Article in Disability and Rehabilitation: Assistive Technology 

This research provides insights into the lived experiences of clinicians and caregivers of young children with CP regarding the prescription, provision, use and impact of first mobility aids, specifically ankle foot orthoses and walkers/gait trainers.

Caregiver views of impact of first orthoses (n = 8) and walkers (n = 4). Proportional bar graph depicting caregiver perceptions on the impacts of their child’s ankle foot orthoses and/or walkers on various activities.Aim: The purpose of this study was to establish and understand the provision process and impacts of first mobility aids for children with cerebral palsy (CP) in the United States – specifically orthoses, walkers and gait-trainers.

Methods: We performed a mixed-methods study including surveys and semi-structured interviews of caregivers of young children with CP (n = 10) and clinicians who work with young children with CP (n = 29). We used content analysis for the surveys and inductive coding for the interviews.

Results: Four themes emerged: (1) first mobility aids have mixed impacts and use patterns, (2) there is varied caregiver education and understanding about mobility aids, (3) clinician knowledge, consistency and connection impact care and (4) numerous access barriers exist for families, and there are still opportunities for improvement across all domains.

Interpretation: This study not only provides researchers and clinicians with an understanding of the current status of the prescription and provision process in the United States, but also offers suggestions for improvements of the process and mobility aids themselves. These results have implications for future research, mobility aid, design and the provision process of first mobility aids.

2020 Center for Translational Muscle Research

Dr. Steele MotorControl, Orthoses, Outreach, Presentation , , , , ,

How can we decipher human movement?

CTMR: White text on purple background, UW Center for Translational Muscle ResearchOur skeletal muscles have amazing structure. They provide elegant and efficient actuation to move and explore our worlds. But how do we understand how muscles produce movement?

Dr. Steele presents at the inaugural research symposium for the University of Washington Center for Translational Muscle Research. Her presentation shares examples for how we can use musculoskeletal simulation as a tool to connect muscle biology, dynamics, and mobility.

Slides | Transcript

MC Rosenberg, BS Banjanin, SA Burden, KM Steele (2020) “Predicting walking response to ankle exoskeleton using data driven models”

Elijah JournalArticle, News , , , , , ,

Journal Article in The Royal Society:

This work highlights the potential of data-driven models grounded in dynamical systems theory to predict complex individualized responses to ankle exoskeletons., without requiring explicit knowledge of the individual’s physiology or motor control

silhouette walking on left with purple lines and projections on right elipsoids and colored spheres

Aim: Evaluate the ability of three classes of subject-specific phase-varying (PV) models to predict kinematic and myoelectric responses to ankle exoskeletons during walking, without requiring prior knowledge of specific user characteristics.

Method: Data from 12 unimpaired adults walking with bilateral passive ankle exoskeletons were captured. PV, linear PV (LPV), and nonlinear PV (NPV) models leveraged Floquet theory to kinematics and muscle activity in response to three exoskeleton torque conditions.

Results: The LPV model’s predictions were more accurate than the PV model when predicting less than 12.5% of a stride in the future and explained 49–70% of the variance in hip, knee and ankle kinematic responses to torque. The LPV model also predicted kinematic responses with similar accuracy to the more-complex NPV model. Myoelectric responses were challenging to predict with all models, explaining at most 10% of the variance in responses.

Interpretation: This work highlights the potential of data-driven PV models to predict complex subject-specific responses to ankle exoskeletons and inform device design and control.

B Nguyen, N Baicoianu, D Howell, KM Peters, KM Steele (2020) “Accuracy and repeatability of smartphone sensors for measuring shank-to-vertical angle” Prosthetics & Orthotics International

Dr. Steele HuskySTEPS, JournalArticle, Orthoses, UbiquitousRehabilitation , , , , , ,

Journal Article in Prosthetics & Orthotics International

Example of how the smartphone app was used for this research. The top images show a black smartphone attached with a running arm band to the side or front of the shank - the two positions tested in this research. The middle figure shows the placement of the reflective markers for 3D motion analysis to evaluate the accuracy of the smartphone measurements. Markers were placed on the lateral epicondyle of the knee, lateral maleolus of the ankle, tibial tuberosity, and the distal tibia. Blacklight was used to mark the position of each marker and hide the position from the clinicians. The bottom panel shows screenshots from the app. The first screen is used to align the device and has arrows at the top and bottom that remind the clinician which anatomical landmarks should be used to align the device while displaying the shank-to-vertical angle in real time. The second screenshot shows an example of the calculated shank-to-vertical angle while someone was walking. The average is shown with a bold black line, with all other trials shown in blue and excluded trials (e.g., when someone was stopping or turning) that deviated more than one standard deviation from other trials are shown in red. There is also text below the graph that provides summary measures, like shank-to-vertical angle in mid stand and cadence (steps/min). The results can be exported as a picture or sent via e-mail using the app.
A) Smartphone positioning on the front or side of the shank. B) Reflective markers on the the tibial tuberosity (TT) – distal tibia (DT) and lateral epicondyle (LE) – lateral malleolus (LM) were used to compare the accuracy of the smartphone to traditional motion capture. UV markings were used to keep placement of these markers constant while blinding clinicians. C) Sample screenshots of the mobile application, including the set-up screen and results automatically produced after a walking trial.

Background

Assessments of human movement are clinically important. However, accurate measurements are often unavailable due to the need for expensive equipment or intensive processing. For orthotists and therapists, shank-to-vertical angle (SVA) is one critical measure used to assess gait and guide prescriptions. Smartphone-based sensors may provide a widely-available platform to expand access to quantitative assessments.

Objectives

Assess accuracy and repeatability of smartphone-based measurement of SVA compared to marker-based 3D motion analysis.

Method

Four licensed clinicians (two physical therapists and two orthotists) measured SVA during gait with a smartphone attached to the anterior or lateral shank surface of unimpaired adults.  We compared SVA calculated from the smartphone’s inertial measurement unit to marker-based measurements. Each clinician completed three sessions/day on two days with each participant to assess repeatability.

Results

Average absolute differences in SVA measured with a smartphone versus marker-based 3D motion analysis during gait were 0.67 ± 0.25° and 4.89 ± 0.72°, with anterior or lateral smartphone positions, respectively. The inter- and intra-day repeatability of SVA were within 2° for both smartphone positions.

Conclusions

Smartphone sensors can be used to measure SVA with high accuracy and repeatability during unimpaired gait, providing a widely-available tool for quantitative gait assessments.

Try it out!

The app for monitoring shank-to-vertical angle is available for you to download and use on either Android or iOS smartphone. Please complete THIS SURVEY which will then send you an e-mail with instructions for installation and use. This app is not an FDA approved medical device and should be used appropriately.