• Proceedings of the Korean Society of Precision Engineering Conference
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• 2004.10a
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• pp.1137-1142
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• 2004

Walking training is one of the most important rehabilitation processes with paralysis patient. Walking training by using an orthosis can help advancing a patient's independent level. However, existing orthoses have some serious demerit of mechanical problem that the knee joint is locked in the state where it is completely extended, which increases energy consumption and fatigue. For this reason, it is suggested, for more practical orthosis, that the knee joint should be placed and it should have capability of suspending patient's weight. In this paper, 1-DOF walking orthosis which compensates the demerit of the existing orthosis and secures patient's mobility has been proposed. New orthosis has been designed under the following two premises. First, the knee joint of the orthosis was designed fold in order for the orthosis to move in a walking pattern similar to that of a normal person. Second, the knee joint was designed to extend during the swing phase and lock safely during the stance phase.

• Journal of Institute of Control, Robotics and Systems
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• v.16 no.10
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• pp.948-956
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• 2010

The purpose of this study was to test the effectiveness of a prototype KAFO (Knee-Ankle-Foot Orthosis) powered by two artificial pneumatic muscles during walking. We had previously built powered AFO (Ankle-Foot Orthosis) and KO (Knee Orthosis) and used it effectively in studies on assistance of plantaflexion and knee extension motion. Extending the previous study to a KAFO presented additional challenges related to the assistance of gait motion for rehabilitation training. Five healthy males were performed gait motion on treadmill wearing KAFO equipped with artificial pneumatic muscles to power ankle plantaflexion and knee extension. Subjects walked on treadmill at 1.5 km/h under four conditions without extensive practice: 1) without wearing KAFO, 2) wearing KAFO with artificial muscles turned off, 3) wearing KAFO powered only in plantaflexion under feedforward control, and 4) wearing KAFO powered both in plantaflexion and knee extension under feedforward control. We collected surface electromyography, foot pressure and kinematics of ankle and knee joint. The experimental result showed that a muscular strength of wearing KAFO powered plnatarfexion and knee extension under feedforward control was measured to be lower due to pneumatic assistance and foot pressure of wearing KAFO powered plnatarfexion and knee extension under feedforward control was measured to be greater due to power assistance. In the result of motion analysis, the ankle angle of powered KAFO in terminal stance phase was found a peak value toward plantaflexion and there were difference of maximum knee flexion range among condition 2, 3 and 4 in mid-swing phase. The current orthosis design provided plantaflexion torque of ankle jonit in terminal stance phase and knee extension torque of knee joint in mid-swing phase.

• Journal of Korean Physical Therapy Science
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• v.27 no.3
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• pp.35-44
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• 2020

Background: This study was to confirm the effect and feasibility of knee extension assist orthosis (KEAO) on balance and gait in subacute stroke patients. Design: Case study. Methods: The subjects of the study were 4 subacute stroke patients, who had an onset period of less than 6 months. The limit of stability (LOS) and berg balance scale (BBS), timed up and go test (TUG) were used to verify the dynamic balance ability, static balance ability, and gait ability pre and post and after wearing the knee extension assist orthosis (KEAO). In addition, the satisfaction survey was to confirm the feasibility of the knee extension assist orthosis (KEAO) through the to Korean quebec user evaluation of satisfaction assistive technology 2.0 (K-QUEST 2.0). Results: After the wearing on KEAO, the distance for the limit of stability decreased by mean 541.25±240.46 mm2, and the score on the berg balance scale improved by mean 5±2.71 point, and the time for the timed up and go test deceased by mean 3.75±1.71 second. The stability and durability were found to be full score, and the control, ease, effectiveness were some high score, and the size, weight, comfort were some low score in the satisfaction and feasibility. Conclusion: The knee extension assist orthosis (KEAO) produce in this study was improved the static balance ability, dynamic balance ability and gait ability of subacute stroke patients, and the satisfaction and feasibility were high in the stability, durability and effectiveness of the user.

• Journal of Institute of Control, Robotics and Systems
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• v.17 no.8
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• pp.814-823
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• 2011

Nowadays many neurological diseases such as stroke and Parkinson diseases are continually increasing. Orthotic devices as well as exoskeletons have been widely developed for supporting movement assistance and therapy of patients. Robotic knee orthosis can compensate stiff-knee gait of the paralyzed limb and can provide patients consistent assistance at wearable environments. With keeping a robotic orthosis wearable, however, it is not easy to develop a compact and safe actuator with fast rotation and high torque for consistent supports of patients during walking. In this paper, we propose a novel kinematic model for a robotic knee orthosis to drive a knee joint with independent actuation during swing and stance phases, which can allow an actuator with fast rotation to control swing motions and an actuator with high torque to control stance motions, respectively. The suggested kinematic model is composed of a hamstring device with a slide-crank mechanism, a quadriceps device with five-bar/six-bar links, and a patella device for knee covering. The quadriceps device operates in five-bar links with 2-dof motions during swing phase and is changed to six-bar links during stance phase by the contact motion to the patella device. The hamstring device operates in a slider-crank mechanism for entire gait cycle. The kinematics and velocity/force relations are analyzed for the quadriceps and hamstring devices. Finally, the adequate actuators for the suggested kinematic model are designed based on normal gait requirements. The suggested kinematic model will allow a robotic knee orthosis to use compact and light actuators with full support during walking.

• Journal of Institute of Control, Robotics and Systems
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• v.17 no.10
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• pp.1021-1028
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• 2011

The objective of this paper is to optimize the design parameters of a novel mechanism for a robotic knee orthosis. The feature of the proposed knee othosis is to drive a knee joint with independent actuation during swing and stance phases, which can allow an actuator with fast rotation to control swing motions and an actuator with high torque to control stance motions, respectively. The quadriceps device operates in five-bar links with 2-DOF motions during swing phase and is changed to six-bar links during stance phase by the contact motion to the patella device. The hamstring device operates in a slider-crank mechanism for entire gait cycle. The suggested kinematic model will allow a robotic knee orthosis to use compact and light actuators with full support during walking. However, the proposed orthosis must use additional linkages than a simple four-bar mechanism. To maximize the benefit of reducing the actuators power by using the developed kinematic design, it is necessary to minimize total weight of the device, while keeping necessary actuator performances of torques and angular velocities for support. In this paper, we use a SGA (Simple Genetic Algorithm) to minimize sum of total link lengths and motor power by reducing the weight of the novel knee orthosis. To find feasible parameters, kinematic constraints of the hamstring and quadriceps mechanisms have been applied to the algorithm. The proposed optimization scheme could reduce sum of total link lengths to half of the initial value. The proposed optimization scheme can be applied to reduce total weight of general multi-linkages while keeping necessary actuator specifications.

• Journal of Biomedical Engineering Research
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• v.31 no.3
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• pp.217-226
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• 2010

The lower limb orthosis with a pneumatic rubber actuator, which is intended for the assistance and the enhancement of muscular activities of lower limbs was developed in this study. Compared to other knee extension assistive devices being developed by other researchers, our device is designed especially for the elderly people and intended only for slight assistance so that the subjects can keep their muscular strength. For the effectiveness of system, muscular activities of major muscles in lower limbs during sit-to-stand (STS) and squat motion were measured and analyzed. Subjects were performed the STS and squat motion with and without lower limb orthosis. We made comparison muscular activities between with and without lower limb orthosis. Lower limb orthosis was controlled using muscular stiffness force feedback that is controlled by muscular activities of the measured muscle from force sensor. For analysis of muscular activities, electromyography of the subjects was measured during STS and squat motion, and these were measured using MP 150(BIOPAC Systems, Inc.). Muscles of interest were rectus femoris(RF), vastus lateralis(VL), vastus medialis(VM) and vastus intermedius(VI) muscles in lower limbs of the right side. A biodex dynamometer was used to measure the maximal concentric isokinetic strength of the knee extensors of wearing and not wearing orthosis on right side. The test were performed using the concentric isokinetic mode of test with the velocity set at 60°/s for muscles around the knee joints. The experimental result showed that muscular activities in lower limbs wearing orthosis using muscular stiffness force of a vastus medialis muscle was reduced and knee extension torque of an knee joint wearing lower limb orthosis was increased. With this, we confirmed the effectiveness of the developed lower limb orthosis.

• Journal of Biomedical Engineering Research
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• v.22 no.4
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• pp.359-368
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• 2001

A new knee-ankle-foot-orthosis(KAFO) which uses an automatically-controlled electromechanical wrap spring clutch for the knee joint was developed in the present study. It was found that the output voltage from the foot switches of the developed KAFO was proportionally increased with respect to the applied load. The output voltage from the infrared sensor also decreased as the knee flexion angle increased. The knee joint system for the new KAFO weighs only 780g lighter than any other commercially available developed system. In addition, the solenoid reduces the reaction time for the automatic control of the knee joint. The static torque of the clutch was measured for three persons, and it satisfied the normal knee extension moment during the pre-swing. Three-dimensional gait analyses for three different gait patterns (normal gait, locked-knee gait, controlled-knee gait) from five normal subjects were conducted. Controlled-knee gait showed the maximum knee flexion angle of 40.56$\pm9.55^{\circ}$ and the maximum knee flexion moment of 0.20$\pm$0.07Nm/kg at similar periods in the normal gait. Our KAFO system satisfies both stability during stance phase and free knee flexion during the swing phase at the proper period during the gait cycle. Therefore, our KAFO system would be very useful in various low extremity orthotic applications.

• Proceedings of the Korean Society of Precision Engineering Conference
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• 2009.06a
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• pp.69-70
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• 2009

• Physical Therapy Korea
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• v.20 no.1
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• pp.64-73
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• 2013

The purposes of this study were to develop a new orthosis controlling ankle and knee joint motion during the gait cycle and to identify the effects of the newly designed orthosis on gait kinematics and tempospatial parameters, including coordination of the extremities in stroke patients. Fifteen individuals who had sustained a stroke, onset was 16 months, participated in this study. Before application of the measurement equipment the subjects were accustomed to walking on the ankle-foot orthosis (AFO) or stance control knee with knee flexion assisted-oil damper ankle-foot orthosis (SCKAFO) for 5 minutes. Fifteen patients were investigated for 45 days with a 3-day interval between sessions. Measurements were walking in fifteen stroke with hemiparesis on the 3D motion analysis system. Comparison of AFO and SCKAFO are gait pattern. The difference between the AFO and SCKAFO conditions was significant in the gait velocity, step length of the right affected side, stance time of both legs, step-length asymmetry ratio, single-support-time asymmetry ratio, ${\phi}$-thigh angle and ${\phi}$-shank angle in the mid swing (p<.001). Using a SCKAFO in stroke patients has shown similar to normal walking speeds can be attained for walking efficiency and is therefore desirable. In this study, the support time of the affected leg with the SCKAFO was longer than with the AFO and the asymmetry ratio of single support time decreased by more than with the AFO. This indicates that the SCKAFO was effective for improving gait symmetry, single-support-time symmetry. This may be due to the decrease of gait asymmetry. Thus, the newly designed SCKAFO may be useful for promoting gait performance by improving the coordination of the extremity and decreasing gait asymmetry in chronic stroke patients.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.5
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• pp.275-283
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• 2016

In this study, three knee-orthoses (dial lock type, medium size, right side) were used for a quality level test (static bending test and solidity test of the locking system) of the knee-orthosis locking system. In the static bending test, a smaller maximum load was observed in samples A and C compared to the reference standard value (KS P 8408 standard value: 1000 N, sample A: 865 N, sample C: 833 N). In addition, in the solidity test of the locking system, a smaller maximum load was observed in the all samples compared to the referenced standard value (KS P 8411 standard value: 200 N, sample A: 41 N, sample B: 97 N, sample C: 54 N). Korean industrial standards for knee-orthoses and systematic test methods are lacking. Therefore, a systematic management plan for knee-orthoses is required. The result of the current study showed that a systematic management plan for the knee-orthosis locking system is required. In particular, the development of a quantitative and objective test method is needed. The findings of the current study may be useful for monitoring the quality of the knee-orthosis locking system and may provide foundational information for the development of a quantitative and objective test method.