COMET

For example, treadmill-based devices require permanent installation in a room while mobile overground body weight support systems require a moving frame that hinders physical access of therapists to patients. Within previous projects, Dr. Vallery’s team and their collaborators at the Shirley Ryan Ability Lab (SRALab, fka Rehabilitation Institute of Chicago) demonstrated feasibility of a new type of actuation principle that enables wearable balance assistance: gyroscopic actuators that can be integrated in unobtrusive wearables like backpacks, to provide balance-assisting or balance-challenging moments on a person’s body in a finely controlled way. Preliminary data confirms
that using a gyroscopic backpack can make balancing either harder or easier for individuals, depending on the controller. This actuation principle may now enable innovative types of training that can be integrated in a collaborative way into clinical practice.

The specific aims of this project are:

Aim 1: To develop lightweight and unobtrusive active balance-assisting wearables that can be used in a versatile fashion during diverse balance exercises and activities of daily living, and that adapt to the user’s capabilities. The ergonomic design will be based on the specific requirements of stroke survivors (enabling donning/doffing the apparatus with less help from therapists, reducing weight). Depending on therapeutic aims and automated monitoring of the patient’s progress, the device will provide moments that increase or decrease the challenge of maintaining balance during activities such as sitting, making transfers, standing, or walking. These developments will be completed with close interaction between engineers and clinicians at Erasmus/Rijndam, who will iteratively evaluate updated device versions in controls and individuals post-stroke and provide feedback.

Aim 2: To iteratively evaluate the design, the adaptive algorithms, and the user interface regarding usability and effectiveness, within pilot studies. Training protocols will semi-automatically follow the individual’s progress in an adaptive way and target specific deficits, but with an interface that allows the supervising therapist to adjust key parameters in a collaborative way. Iterative testing in a clinical environment will allow identifying and testing which features are most suitable to use in a cost function for the adaptation. The main goal of this phase is to provide high-level feedback to allow further optimization of the device functionality, aiming to maximize user activity and to tailor the applied gyroscopic moments to individual ability and training goals. Stability and adaptability will be assessed, hypothesizing that individuals using GyroBalance will be more stable and experience less near-fall events.

Aim 3: To integrate the balance-assisting wearables and collaborative therapy strategies into a larger observational study on uptake at the Shirley Ryan AbilityLab. Individuals will receive training with the gyroscopic assistive devices as part of their routine therapy at SRALab. Clinical uptake patterns of the gyroscopic assistive devices will be quantitatively and qualitatively analyzed as part of a larger observational study to be conducted at SRALab. Information on gait stability and activity based on the backpack’s sensors will also be collected.