Walking is the most common form of mobility in humans. For lower limb mobility impairments, a common treatment is to prescribe an ankle-foot orthosis (AFO) or brace, which is a passive device designed to resist undesired ankle-foot motion. Recent advances in actuator technology have led to the development of active AFOs (AAFOs). However, these devices are generally too bulky for everyday use and are limited to applications such as gait training for rehabilitation. The aim of this research was to investigate the feasibility of developing a novel Active Ankle-Foot Stabilizer (AAFS). The design criteria were mainly based on the strengths and limitations of existing AFOs. The sagittal plane functional requirements were determined using simulated gait data for elderly individuals and drop foot patients; however, it is intended that the device would be suitable for a wider range of disabilities including ankle sprains. A model of the foot was introduced to modify the moment of a deficient ankle where young healthy adult kinematics and kinetics were assumed. A moment deficit analysis was performed for different gait periods resulting in an AAFS model with two components: a linear rotational spring to modify the ankle joint rotational stiffness, and a torque source. The frontal plane functional requirements for the AAFS were modeled as a linear rotational spring which responded to particular gait events. A novel Variable Rotational Stiffness Actuator (VSRA) AFO was also investigated. It consisted of an actuated spring medial and lateral to the ankle to control sagittal plane ankle stiffness and a passive leafspring posterior to the ankle to control frontal plane ankle stiffness. Due to high forces and profile limitations, a spring and rotation actuator that satisfied the design criteria could not be developed, resulting in an infeasible design. Considering the high forces and moments required by the AAFS, a pneumatic approach was adopted. A novel Airbeam AFO, which consisted of a shank cuff and a foot plate to which airbeams were attached proximally and distally to the ankle, was examined. The joint rotational stiffness of the ankle would be controlled by the inflation of these individual cylindrical airbeams. To satisfy the functional requirements, the airbeam diameters and pressures were too large to meet the design criteria and were unrealistic for a portable device. Finally, a Pneumatic Sock AFO, which proved to best satisfy the functional requirements within the design criteria, was examined. The design consisted of an inner sock worn on the ankle, surrounded by anterior, posterior, medial, and lateral bladders which inflate against outer fabric shells. Although promising, the Pneumatic Sock AFO requires further investigation in regards to manufacturing and behaviour characterization before a functional prototype can be developed. Mechanical test methods to characterize the behaviour of the Pneumatic Sock AFO in the sagittal and frontal planes were developed including the control components required, the configuration of a test rig, and test procedures.

Ankle foot orthosis (AFO) stiffness affects ankle range of motion but can also provide energy storage and return to improve mobility. To perform multiple activities during the day, a person may want to change their AFO stiffness to meet their activity’s demand. Carrying multiple AFO and changing the AFO is inconvenient and could discourage users from engaging in multiple activities. This thesis developed a new quick-release mechanism (QRM) that allows users to easily change posterior strut elements to change AFO stiffness. The QRM attaches to the AFO and requires no tools to operate. The new QRM includes a quick-release key, weight-bearing pin, receptacle anchor, and immobilization pin. A prototype was modelled with SolidWorks and simulated with SolidWorks Simulation. The QRM was designed to have no mechanical failure during intense activities such as downhill walking and running. Unlike a solid screw connection, the QRM needed an additional part to eliminate unsecured motion related to clearance between the quick release key and receptacle anchor. Mechanical test results and measurement data demonstrated no deformation on each part after mechanical testing. User testing revealed that, although the quick release mechanism can be locked or unlocked rapidly, the person’s posture when operating can facilitate strut swapping. A learning effect occurred by repeated practice. The Quick Release AFO (QRAFO) prototype verified the manufacturing feasibility of the QRAFO design. Overall, the novel quick release AFO improved strut swapping time without sacrificing device strength.

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Background: This study, the first of its kind, originated with the need for a brace (an ankle foot orthosis), to constrain ankle plantarflexion and dorsiflexion within a motion threshold of <5°. A conventional thermoplastic, solid brace failed during a quasi-static loading study, informing the investigation and development of an experimental carbon composite brace, maximizing stiffness and proximity of shank and foot cylindrical shells to provide the required degree of control. Methods: Two experiments were conducted: a quasi-static loading study, using cadaveric limbs (n = 2), and a gait study with healthy subjects (n = 14). Conditions tested were STOP, FREE, and CONTROL. Data for all studies were collected using six motion-capture cameras (Vicon, Oxford, UK; 120 Hz) tracking bone-anchored markers (cadaveric limbs) and skin-anchored markers (subjects). In the quasi-static loading study, loading conditions were congruent with the gait study. Study 1 involved a quasi-static loading analysis using cadaveric limbs, compared motion data from a conventional thermoplastic solid brace and the experimental brace. Study 2 involved quantifying ankle plantarflexion and dorsiflexion in subjects during treadmill walking, in brace STOP, FREE, and CONTROL conditions. Findings: The experimental brace in STOP condition consistently constrained ankle plantarflexion and dorsiflexion below the motion threshold of <5°, across all studies. Interpretation: Collectively, these findings demonstrate (1) that a conventional thermoplastic, solid brace was ineffective for clinical applications that required significant motion control, and (2) that ankle motion control is most effective when considered as a relationship between the brace, the ankle-foot complex, and the external forces that affect them both.

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An orthosis, or orthotic device is used to straighten or correct the posture of part of the body. A foot orthosis (FO) is the subject of study for this dissertation. A FO is situated between the foot and the midsole of the shoe and replaces the insole. Foot orthoses (FOs) are intended to prevent or aid in the recovery of injury by acting to redistribute pressure experienced by the plantar surface of the foot as well as cause adjustments to the relative positions of the foot's bones during standing and gait. Traditional methods for developing a FO require extensive skilled manual labour and are highly dependent on subjective input. Modern FO development methods have sought to address these issues through the use of computer driven technological advancements. Foot scanners record geometry, computer aided design (CAD) software is used to develop the FO geometry, and automated manufacturing tools are used to either fabricate the FO or fabricate a mould about which the FO can be formed. A variety of modern solutions have successfully automated the process, however, it remains highly subjective. Skilled manual labour has merely been replaced with equally subjective skilled computer labour. In particular, adjustments to the foot are made with basic deformation functions to the static surface foot models generated by modern digitizers. To improve upon this, a model that describes the mechanics and properties of the various tissues of the foot is required. Such a model will also be useful for validating and optimizing FO designs prior to fabrication through simulation of weight-bearing conditions. Given the deformable characteristics of the tissues of the foot, the finite element (FE) modeling method is appropriate. The FE foot model has become a common medical and engineering tool in recent years. Its application, however, has primarily been limited to research as few clinical applications warrant the development cost. High cost stems from the MRI or CT scan and the skilled labour required to assemble the model for FE analysis. Consequently, the FE modeling approach has previously been out of reach for the application of FO development. The solution proposed and implemented was to map a detailed generic FE foot model to an inexpensive surface scan obtained from a modern digitizer. The mapping accurately predicted anatomical geometry and resulted in simulation models that can be used in the FO development process first to carry out postural adjustments prescribed by a practitioner and second in a validation step where a FO design can be tested prior to fabrication. In addition to simulation tools, novel complementary tools were developed for designing and fabricating FOs. The simulation, design, and fabrication tools were incorporated into a novel, seven step FO development process. The proposed process is beneficial to FO development as it reduces the required subjective input from practitioners and lab technicians and allows for the validation of potential FO designs prior to fabrication. Future work is required to improve computational efficiency of the FE foot models and to fully automate the process to make it commercially viable. In addition to FOs, the proposed approach also presents opportunities for improving other orthoses and prostheses for the human body.

The Ottawalk-Speed (OWS) orthosis prevents knee collapse in stumble situations. The purpose of this study was to develop a virtual stumble perturbation to measure OWS response to a knee collapse when walking. A new split speed perturbation was developed for the CAREN virtual reality system. This perturbation induced a stumble with increased knee flexion for five able-bodied participants, with either a hopping or stopping recovery strategy. Three knee-ankle-foot orthosis users were subjected to five stumble trials while wearing the OWS. OWS participants used a straight-legged recovery strategy, and extended the knee through recovery weight acceptance. Therefore, the split speed perturbation was not appropriate to measure OWS response to a stumble since knee collapse did not occur. The OWS allowed free knee motion during gait. Further study is required to measure OWS response during a stumble with a knee collapse event.

After a stroke, gait and balance are often affected and an orthosis is typically required to facilitate postural control. This study has been conducted to examine how the Range of Motion in an Ankle-Foot-Orthosis (AFO) impacts on stroke patients’ dynamic balance. It was hypothesized that better dynamic balance would be recorded when individuals were wearing a flexible AFO. The tests that was used in this study were the Timed Up and Go test (TUG), and the Center of Pressure (CoP)/Center of Mass (CoM) inclination angle, both in Anterior-Posterior (AP) and Medio-Lateral (ML) planes. The three patients participating in this study were all users, or had been users of AFO’s, and during the study they were asked to wear a customized AFO with the possibility to change the settings to open, flexible and rigid ankle joints. The order was randomized within each patient. No clear pattern was observed across all patients, either in the TUG test or CoP/CoM inclination angles. Further studies are required to explore the impact that AFO flexibility has on dynamic balance in individuals who have had a stroke.

The Ottawalk-Speed (OWS) orthosis prevents knee collapse in stumble situations. The purpose of this study was to develop a virtual stumble perturbation to measure OWS response to a knee collapse when walking. A new split speed perturbation was developed for the CAREN virtual reality system. This perturbation induced a stumble with increased knee flexion for five able-bodied participants, with either a hopping or stopping recovery strategy. Three knee-ankle-foot orthosis users were subjected to five stumble trials while wearing the OWS. OWS participants used a straight-legged recovery strategy, and extended the knee through recovery weight acceptance. Therefore, the split speed perturbation was not appropriate to measure OWS response to a stumble since knee collapse did not occur. The OWS allowed free knee motion during gait. Further study is required to measure OWS response during a stumble with a knee collapse event.

abstract: The human ankle is a critical joint required for mobility and stability of the body during static and dynamic activity. The absence of necessary torque output by the ankle due to neurological disorder or near-fatal injury can severely restrict locomotion and cause an inability to perform daily tasks. Physical Human-Robot Interaction (pHRI) has explored the potential of controlled actuators to positively impact human joints and partly restoring the required torque and stability at the joint to perform a task. However, a trade-off between agility and stability of the control technique of these devices can reduce the complete utilization of the performance to create a desirable impact on human joints. This research focuses on two control techniques of an Active Ankle Foot Orthosis (AFO) namely, Variable Stiffness (VS) and Variable Damping (VD) controllers to modulate ankle during walking. The VS controller is active during the stance phase and is used to restore the ankle trajectory of healthy participants that has been altered by adding a dead-weight of 2 Kgs. The VD controller is active during the terminal stance and early-swing phase and provides augmentative force during push-off that results in increased propulsion and stabilizes the ankle based on user-intuitions. Both controllers have a positive impact on Medial Gastrocnemius (GAS) muscle and Soleus (SOL) muscle which are powerful plantar - flexors critical to propulsion and kinematic properties during walking. The VS controller has recorded an 8.18% decrease in GAS and an 9.63 % decrease in SOL muscle activity during the stance phase amongst participants while decreasing mean ankle position error by 22.28 % and peak ankle position error by 17.43%. The VD controller demonstrated a 7.59 % decrease in GAS muscle and a 10.15 % decrease in SOL muscle activity during push-off amongst the participants while increasing the range-of-motion (ROM) by 7.84 %. Comprehensively, the study has shown a positive impact on ankle trajectory and the corresponding muscle effort at respective stages of the controller activity. / Dissertation/Thesis / Masters Thesis Mechanical Engineering 2020