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Keywords = robotic ankle–foot orthosis

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17 pages, 5666 KiB  
Article
Mechatronic and Robotic Systems Utilizing Pneumatic Artificial Muscles as Actuators
by Željko Šitum, Juraj Benić and Mihael Cipek
Inventions 2025, 10(4), 44; https://doi.org/10.3390/inventions10040044 - 23 Jun 2025
Viewed by 413
Abstract
This article presents a series of innovative systems developed through student laboratory projects, comprising two autonomous vehicles, a quadrupedal walking robot, an active ankle-foot orthosis, a ball-on-beam balancing mechanism, a ball-on-plate system, and a manipulator arm, all actuated by pneumatic artificial muscles (PAMs). [...] Read more.
This article presents a series of innovative systems developed through student laboratory projects, comprising two autonomous vehicles, a quadrupedal walking robot, an active ankle-foot orthosis, a ball-on-beam balancing mechanism, a ball-on-plate system, and a manipulator arm, all actuated by pneumatic artificial muscles (PAMs). Due to their flexibility, low weight, and compliance, fluidic muscles demonstrate substantial potential for integration into various mechatronic systems, robotic platforms, and manipulators. Their capacity to generate smooth and adaptive motion is particularly advantageous in applications requiring natural and human-like movements, such as rehabilitation technologies and assistive devices. Despite the inherent challenges associated with nonlinear behavior in PAM-actuated control systems, their biologically inspired design remains promising for a wide range of future applications. Potential domains include industrial automation, the automotive and aerospace sectors, as well as sports equipment, medical assistive devices, entertainment systems, and animatronics. The integration of self-constructed laboratory systems powered by PAMs into control systems education provides a comprehensive pedagogical framework that merges theoretical instruction with practical implementation. This methodology enhances the skillset of future engineers by deepening their understanding of core technical principles and equipping them to address emerging challenges in engineering practice. Full article
(This article belongs to the Section Inventions and Innovation in Advanced Manufacturing)
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16 pages, 4491 KiB  
Article
Compensating the Symptomatic Increase in Plantarflexion Torque and Mechanical Work for Dorsiflexion in Patients with Spastic Paresis Using the “Hermes” Ankle–Foot Orthosis
by Karen E. Rodriguez Hernandez, Jurriaan H. de Groot, Eveline R. M. Grootendorst-Heemskerk, Frank Baas, Marjon Stijntjes, Sven K. Schiemanck, Frans C. T. van der Helm, Herman van der Kooij and Winfred Mugge
Prosthesis 2025, 7(1), 12; https://doi.org/10.3390/prosthesis7010012 - 27 Jan 2025
Viewed by 964
Abstract
Background/Objectives: “Hermes” is an ankle–foot orthosis (AFO) with negative stiffness designed to mechanically compensate the symptomatic increase in plantarflexion (PF) torque (i.e., ankle joint torque resistance to dorsiflexion, DF) in patients with spastic paresis. Methods: The effectiveness of “Hermes” was evaluated [...] Read more.
Background/Objectives: “Hermes” is an ankle–foot orthosis (AFO) with negative stiffness designed to mechanically compensate the symptomatic increase in plantarflexion (PF) torque (i.e., ankle joint torque resistance to dorsiflexion, DF) in patients with spastic paresis. Methods: The effectiveness of “Hermes” was evaluated in twelve patients with chronic unilateral spastic paresis after stroke. Using a robotic ankle manipulator, stiffness at the ankle joint was assessed across three conditions: ankle without Hermes (A), ankle with Hermes applying no torque compensation (A+H0%), and ankle with Hermes tuned to compensate 100% of the patients’ ankle joint stiffness (A+H100%). Results: A significant reduction in PF torque was found with Hermes applying compensation (A+H100%) compared to the conditions without Hermes (A) and with Hermes applying no compensation (A+H0%). Furthermore, a significant reduction in positive dorsiflexion work was found with Hermes applying compensation (A+H100%) compared to the condition with Hermes applying no compensation (A+H0%). Hermes did not significantly contribute to additional PF torque or positive work when applying no compensation (A+H0%). Conclusions: The reductions in PF torque achieved with Hermes are comparable to those seen with repeated ankle stretching programs and ankle robot training. Thus, Hermes is expected to assist voluntary dorsiflexion and improve walking in patients with spastic paresis. Full article
(This article belongs to the Special Issue Recent Advances in Foot Prosthesis and Orthosis)
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17 pages, 2893 KiB  
Article
DE-AFO: A Robotic Ankle Foot Orthosis for Children with Cerebral Palsy Powered by Dielectric Elastomer Artificial Muscle
by Vahid Mohammadi, Mohammad Tajdani, Mobina Masaei, Sahel Mohammadi Ghalehney, Samuel C. K. Lee and Ahad Behboodi
Sensors 2024, 24(12), 3787; https://doi.org/10.3390/s24123787 - 11 Jun 2024
Cited by 11 | Viewed by 4621
Abstract
Conventional passive ankle foot orthoses (AFOs) have not seen substantial advances or functional improvements for decades, failing to meet the demands of many stakeholders, especially the pediatric population with neurological disorders. Our objective is to develop the first comfortable and unobtrusive powered AFO [...] Read more.
Conventional passive ankle foot orthoses (AFOs) have not seen substantial advances or functional improvements for decades, failing to meet the demands of many stakeholders, especially the pediatric population with neurological disorders. Our objective is to develop the first comfortable and unobtrusive powered AFO for children with cerebral palsy (CP), the DE-AFO. CP is the most diagnosed neuromotor disorder in the pediatric population. The standard of care for ankle control dysfunction associated with CP, however, is an unmechanized, bulky, and uncomfortable L-shaped conventional AFO. These passive orthoses constrain the ankle’s motion and often cause muscle disuse atrophy, skin damage, and adverse neural adaptations. While powered orthoses could enhance natural ankle motion, their reliance on bulky, noisy, and rigid actuators like DC motors limits their acceptability. Our innovation, the DE-AFO, emerged from insights gathered during customer discovery interviews with 185 stakeholders within the AFO ecosystem as part of the NSF I-Corps program. The DE-AFO is a biomimetic robot that employs artificial muscles made from an electro-active polymer called dielectric elastomers (DEs) to assist ankle movements in the sagittal planes. It incorporates a gait phase detection controller to synchronize the artificial muscles with natural gait cycles, mimicking the function of natural ankle muscles. This device is the first of its kind to utilize lightweight, compact, soft, and silent artificial muscles that contract longitudinally, addressing traditional actuated AFOs’ limitations by enhancing the orthosis’s natural feel, comfort, and acceptability. In this paper, we outline our design approach and describe the three main components of the DE-AFO: the artificial muscle technology, the finite state machine (the gait phase detection system), and its mechanical structure. To verify the feasibility of our design, we theoretically calculated if DE-AFO can provide the necessary ankle moment assistance for children with CP—aligning with moments observed in typically developing children. To this end, we calculated the ankle moment deficit in a child with CP when compared with the normative moment of seven typically developing children. Our results demonstrated that the DE-AFO can provide meaningful ankle moment assistance, providing up to 69% and 100% of the required assistive force during the pre-swing phase and swing period of gait, respectively. Full article
(This article belongs to the Special Issue Sensing Technologies in Medical Robot)
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13 pages, 3257 KiB  
Article
Advancing Exoskeleton Development: Validation of a Robotic Surrogate to Measure Tibial Strain
by Robert L. McGrath, Ciera A. Price, William Brett Johnson and Walter Lee Childers
Bioengineering 2024, 11(5), 490; https://doi.org/10.3390/bioengineering11050490 - 15 May 2024
Viewed by 1752
Abstract
Bone stress injuries are prevalent among athletes and military recruits and can significantly compromise training schedules. The development of an ankle–foot orthosis to reduce tibial load and enable a faster return to activity will require new device testing methodologies capable of capturing the [...] Read more.
Bone stress injuries are prevalent among athletes and military recruits and can significantly compromise training schedules. The development of an ankle–foot orthosis to reduce tibial load and enable a faster return to activity will require new device testing methodologies capable of capturing the contribution of muscular force on tibial strain. Thus, an actuated robotic surrogate leg was developed to explore how tibial strain changes with different ankle–foot orthosis conditions. The purpose of this work was to assess the reliability, scalability, and behavior of the surrogate. A dual actuation system consisting of a Bowden cable and a vertical load applied to the femur via a material testing system, replicated the action-reaction of the Achilles-soleus complex. Maximum and minimum principal strain, maximum shear strain, and axial strain were measured by instrumented strain gauges at five locations on the tibia. Strains were highly repeatable across tests but did not consistently match in vivo data when scaled. However, the stiffness of the ankle–foot orthosis strut did not systematically affect tibial load, which is consistent with in vivo findings. Future work will involve improving the scalability of the results to match in vivo data and using the surrogate to inform exoskeletal designs for bone stress injuries. Full article
(This article belongs to the Section Nanobiotechnology and Biofabrication)
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18 pages, 1699 KiB  
Review
An Overview of Mathematical Methods Applied in the Biomechanics of Foot and Ankle–Foot Orthosis Models
by Hasan Mhd Nazha, Szabolcs Szávai and Daniel Juhre
J 2024, 7(1), 1-18; https://doi.org/10.3390/j7010001 - 22 Dec 2023
Viewed by 2817
Abstract
Ankle–foot orthoses (AFOs) constitute medical instruments designed for patients exhibiting pathological gait patterns, notably stemming from conditions such as stroke, with the primary objective of providing support and facilitating rehabilitation. The present research endeavors to conduct a comprehensive review of extant scholarly literature [...] Read more.
Ankle–foot orthoses (AFOs) constitute medical instruments designed for patients exhibiting pathological gait patterns, notably stemming from conditions such as stroke, with the primary objective of providing support and facilitating rehabilitation. The present research endeavors to conduct a comprehensive review of extant scholarly literature focusing on mathematical techniques employed for the examination of AFO models. The overarching aim is to gain deeper insights into the biomechanical intricacies underlying these ankle–foot orthosis models from a mathematical perspective, while concurrently aiming to advance novel models within the domain. Utilizing a specified set of keywords and their configurations, a systematic search was conducted across notable academic databases, including ISI Web of Knowledge, Google Scholar, Scopus, and PubMed. Subsequently, a total of 23 articles were meticulously selected for in-depth review. These scholarly contributions collectively shed light on the utilization of nonlinear optimization techniques within the context of ankle–foot orthoses (AFOs), specifically within the framework of fully Cartesian coordinates, encompassing both kinematic and dynamic dimensions. Furthermore, an exploration of a two-degree-of-freedom AFO design tailored for robotic rehabilitation, which takes into account the interplay between foot and orthosis models, is delineated. Notably, the review article underscores the incorporation of shape memory alloy (SMA) elements in AFOs and overviews the constitutive elastic, viscoelastic, and hyperelastic models. This comprehensive synthesis of research findings stands to provide valuable insights for orthotists and engineers, enabling them to gain a mathematical understanding of the biomechanical principles underpinning AFO models and fostering the development of innovative AFO designs. Full article
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13 pages, 1564 KiB  
Article
Immediate Effect Evaluation of a Robotic Ankle–Foot Orthosis with Customized Algorithm for a Foot Drop Patient: A Quantitative and Qualitative Case Report
by Dimas Adiputra, Ully Asfari, Ubaidillah, Mohd Azizi Abdul Rahman and Ahmad Mukifza Harun
Int. J. Environ. Res. Public Health 2023, 20(4), 3745; https://doi.org/10.3390/ijerph20043745 - 20 Feb 2023
Cited by 2 | Viewed by 4871
Abstract
This study aims to evaluate the immediate effect of a robotic ankle–foot orthosis developed in previous studies on a foot drop patient. The difference with previous research on AFO evaluation is that this research used a setting based on the patient’s request. The [...] Read more.
This study aims to evaluate the immediate effect of a robotic ankle–foot orthosis developed in previous studies on a foot drop patient. The difference with previous research on AFO evaluation is that this research used a setting based on the patient’s request. The robotic AFO locked the foot position on zero radians during the foot flat until the push-off but generates dorsiflexion with a constant velocity in the swing phase to clear the foot drop. A kinematic and spatiotemporal parameter was observed using the sensors available on the robotic AFO. The robotic successfully assisted the foot drop (positive ankle position of 21.77 degrees during the swing phase and initial contact) with good repeatability (σ2 = 0.001). An interview has also conducted to investigate the qualitative response of the patient. The interview result reveals not only the usefulness of the robotic AFO in assisting the foot drop but also some improvement notes for future studies. For instance, the necessary improvement of weight and balance and employing ankle velocity references for controlling the walking gait throughout the whole gait cycle. Full article
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15 pages, 2035 KiB  
Brief Report
Robotized Knee-Ankle-Foot Orthosis-Assisted Gait Training on Genu Recurvatum during Gait in Patients with Chronic Stroke: A Feasibility Study and Case Report
by Yoko Takahashi, Kohsuke Okada, Tomoyuki Noda, Tatsuya Teramae, Takuya Nakamura, Koshiro Haruyama, Kohei Okuyama, Kengo Tsujimoto, Katsuhiro Mizuno, Jun Morimoto and Michiyuki Kawakami
J. Clin. Med. 2023, 12(2), 415; https://doi.org/10.3390/jcm12020415 - 4 Jan 2023
Cited by 5 | Viewed by 4354
Abstract
Genu recurvatum (knee hyperextension) is a common problem after stroke. It is important to promote the coordination between knee and ankle movements during gait; however, no study has investigated how multi-joint assistance affects genu recurvatum. We are developing a gait training technique that [...] Read more.
Genu recurvatum (knee hyperextension) is a common problem after stroke. It is important to promote the coordination between knee and ankle movements during gait; however, no study has investigated how multi-joint assistance affects genu recurvatum. We are developing a gait training technique that uses robotized knee-ankle-foot orthosis (KAFO) to assists the knee and ankle joints simultaneously. This report aimed to investigate the safety of robotized KAFO-assisted gait training (Experiment 1) and a clinical trial to treat genu recurvatum in a patient with stroke (Experiment 2). Six healthy participants and eight patients with chronic stroke participated in Experiment 1. They received robotized KAFO-assisted gait training for one or 10 sessions. One patient with chronic stroke participated in Experiment 2 to investigate the effect of robotized KAFO-assisted gait training on genu recurvatum. The patient received the training for 30 min/day for nine days. The robot consisted of KAFO and an attached actuator of four pneumatic artificial muscles. The assistance parameters were adjusted by therapists to prevent genu recurvatum during gait. In Experiment 2, we evaluated the knee joint angle during overground gait, Fugl-Meyer Assessment of lower extremity (FMA-LE), modified Ashworth scale (MAS), Gait Assessment and Intervention Tool (G.A.I.T.), 10-m gait speed test, and 6-min walk test (6MWT) before and after the intervention without the robot. All participants completed the training in both experiments safely. In Experiment 2, genu recurvatum, FMA-LE, MAS, G.A.I.T., and 6MWT improved after robotized KAFO-assisted gait training. The results indicated that the multi-joint assistance robot may be effective for genu recurvatum after stroke. Full article
(This article belongs to the Section Clinical Rehabilitation)
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18 pages, 827 KiB  
Article
Performance of Deep Learning Models in Forecasting Gait Trajectories of Children with Neurological Disorders
by Rania Kolaghassi, Mohamad Kenan Al-Hares, Gianluca Marcelli and Konstantinos Sirlantzis
Sensors 2022, 22(8), 2969; https://doi.org/10.3390/s22082969 - 13 Apr 2022
Cited by 17 | Viewed by 3759
Abstract
Forecasted gait trajectories of children could be used as feedforward input to control lower limb robotic devices, such as exoskeletons and actuated orthotic devices (e.g., Powered Ankle Foot Orthosis—PAFO). Several studies have forecasted healthy gait trajectories, but, to the best of our knowledge, [...] Read more.
Forecasted gait trajectories of children could be used as feedforward input to control lower limb robotic devices, such as exoskeletons and actuated orthotic devices (e.g., Powered Ankle Foot Orthosis—PAFO). Several studies have forecasted healthy gait trajectories, but, to the best of our knowledge, none have forecasted gait trajectories of children with pathological gait yet. These exhibit higher inter- and intra-subject variability compared to typically developing gait of healthy subjects. Pathological trajectories represent the typical gait patterns that rehabilitative exoskeletons and actuated orthoses would target. In this study, we implemented two deep learning models, a Long-Term Short Memory (LSTM) and a Convolutional Neural Network (CNN), to forecast hip, knee, and ankle trajectories in terms of corresponding Euler angles in the pitch, roll, and yaw form for children with neurological disorders, up to 200 ms in the future. The deep learning models implemented in our study are trained on data (available online) from children with neurological disorders collected by Gillette Children’s Speciality Healthcare over the years 1994–2017. The children’s ages range from 4 to 19 years old and the majority of them had cerebral palsy (73%), while the rest were a combination of neurological, developmental, orthopaedic, and genetic disorders (27%). Data were recorded with a motion capture system (VICON) with a sampling frequency of 120 Hz while walking for 15 m. We investigated a total of 35 combinations of input and output time-frames, with window sizes for input vectors ranging from 50–1000 ms, and output vectors from 8.33–200 ms. Results show that LSTMs outperform CNNs, and the gap in performance becomes greater the larger the input and output window sizes are. The maximum difference between the Mean Absolute Errors (MAEs) of the CNN and LSTM networks was 0.91 degrees. Results also show that the input size has no significant influence on mean prediction errors when the output window is 50 ms or smaller. For output window sizes greater than 50 ms, the larger the input window, the lower the error. Overall, we obtained MAEs ranging from 0.095–2.531 degrees for the LSTM network, and from 0.129–2.840 degrees for the CNN. This study establishes the feasibility of forecasting pathological gait trajectories of children which could be integrated with exoskeleton control systems and experimentally explores the characteristics of such intelligent systems under varying input and output window time-frames. Full article
(This article belongs to the Special Issue Rehabilitation Robots and Sensors)
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16 pages, 37298 KiB  
Article
Optimal Assistance Timing to Induce Voluntary Dorsiflexion Movements: A Preliminary Study in Healthy Participants
by Jing-Chen Hong, Kazuhiro Yasuda, Hiroki Ohashi and Hiroyasu Iwata
Appl. Sci. 2022, 12(4), 2248; https://doi.org/10.3390/app12042248 - 21 Feb 2022
Cited by 3 | Viewed by 3017
Abstract
Swing-phase dorsiflexion assistance with robotic ankle–foot orthosis could improve toe clearance and limb shortening such that compensatory movements are suppressed. However, facilitating voluntary effort under assistance remains a challenge. In our previous study, we examined assistance effects of swing-phase dorsiflexion with different delay [...] Read more.
Swing-phase dorsiflexion assistance with robotic ankle–foot orthosis could improve toe clearance and limb shortening such that compensatory movements are suppressed. However, facilitating voluntary effort under assistance remains a challenge. In our previous study, we examined assistance effects of swing-phase dorsiflexion with different delay times after toe-off on a dorsiflexion-restricted gait with a high-dorsiflexion assistive system. Results showed that later dorsiflexion assistance could lead to an increase in the tibialis anterior’s surface electromyography but could also deteriorate compensatory movement. Thus, we concluded that there is a suitable assistance timing to simultaneously achieve voluntary effort and optimal gait. In the present research, we derived a method to identify a suitable dorsiflexion assistance delay time via a multiple linear regression analysis on ankle data of stroke patients with a pathological gait with insufficient dorsiflexion. With the identification method, an experiment was conducted on six healthy participants with restricted dorsiflexion. Results showed that the identified assistance timing improved the amplitude of the tibialis anterior’s surface electromyography while also suppressing limb shortening during circumduction and hip hiking. Although a practical study of stroke survivors is required, observations from this research indicate the potential to successfully induce voluntary efforts with the identified dorsiflexion assistance timing. Full article
(This article belongs to the Special Issue Assistive Technology: Biomechanics in Rehabilitation Engineering)
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20 pages, 1500 KiB  
Article
The Actuation System of the Ankle Exoskeleton T-FLEX: First Use Experimental Validation in People with Stroke
by Daniel Gomez-Vargas, Felipe Ballen-Moreno, Patricio Barria, Rolando Aguilar, José M. Azorín, Marcela Munera and Carlos A. Cifuentes
Brain Sci. 2021, 11(4), 412; https://doi.org/10.3390/brainsci11040412 - 24 Mar 2021
Cited by 33 | Viewed by 5497
Abstract
Robotic devices can provide physical assistance to people who have suffered neurological impairments such as stroke. Neurological disorders related to this condition induce abnormal gait patterns, which impede the independence to execute different Activities of Daily Living (ADLs). From the fundamental role of [...] Read more.
Robotic devices can provide physical assistance to people who have suffered neurological impairments such as stroke. Neurological disorders related to this condition induce abnormal gait patterns, which impede the independence to execute different Activities of Daily Living (ADLs). From the fundamental role of the ankle in walking, Powered Ankle-Foot Orthoses (PAFOs) have been developed to enhance the users’ gait patterns, and hence their quality of life. Ten patients who suffered a stroke used the actuation system of the T-FLEX exoskeleton triggered by an inertial sensor on the foot tip. The VICONmotion capture system recorded the users’ kinematics for unassisted and assisted gait modalities. Biomechanical analysis and usability assessment measured the performance of the system actuation for the participants in overground walking. The biomechanical assessment exhibited changes in the lower joints’ range of motion for 70% of the subjects. Moreover, the ankle kinematics showed a correlation with the variation of other movements analyzed. This variation had positive effects on 70% of the participants in at least one joint. The Gait Deviation Index (GDI) presented significant changes for 30% of the paretic limbs and 40% of the non-paretic, where the tendency was to decrease. The spatiotemporal parameters did not show significant variations between modalities, although users’ cadence had a decrease of 70% of the volunteers. Lastly, the satisfaction with the device was positive, the comfort being the most user-selected aspect. This article presents the assessment of the T-FLEX actuation system in people who suffered a stroke. Biomechanical results show improvement in the ankle kinematics and variations in the other joints. In general terms, GDI does not exhibit significant increases, and the Movement Analysis Profile (MAP) registers alterations for the assisted gait with the device. Future works should focus on assessing the full T-FLEX orthosis in a larger sample of patients, including a stage of training. Full article
(This article belongs to the Special Issue Applications of Neurotechnologies in People with Walking Disabilities)
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28 pages, 2940 KiB  
Review
A Review on the Control of the Mechanical Properties of Ankle Foot Orthosis for Gait Assistance
by Dimas Adiputra, Nurhazimah Nazmi, Irfan Bahiuddin, Ubaidillah Ubaidillah, Fitrian Imaduddin, Mohd Azizi Abdul Rahman, Saiful Amri Mazlan and Hairi Zamzuri
Actuators 2019, 8(1), 10; https://doi.org/10.3390/act8010010 - 28 Jan 2019
Cited by 35 | Viewed by 13766
Abstract
In the past decade, advanced technologies in robotics have been explored to enhance the rehabilitation of post-stroke patients. Previous works have shown that gait assistance for post-stroke patients can be provided through the use of robotics technology in ancillary equipment, such as Ankle [...] Read more.
In the past decade, advanced technologies in robotics have been explored to enhance the rehabilitation of post-stroke patients. Previous works have shown that gait assistance for post-stroke patients can be provided through the use of robotics technology in ancillary equipment, such as Ankle Foot Orthosis (AFO). An AFO is usually used to assist patients with spasticity or foot drop problems. There are several types of AFOs, depending on the flexibility of the joint, such as rigid, flexible rigid, and articulated AFOs. A rigid AFO has a fixed joint, and a flexible rigid AFO has a more flexible joint, while the articulated AFO has a freely rotating ankle joint, where the mechanical properties of the AFO are more controllable compared to the other two types of AFOs. This paper reviews the control of the mechanical properties of existing AFOs for gait assistance in post-stroke patients. Several aspects that affect the control of the mechanical properties of an AFO, such as the controller input, number of gait phases, controller output reference, and controller performance evaluation are discussed and compared. Thus, this paper will be of interest to AFO researchers or developers who would like to design their own AFOs with the most suitable mechanical properties based on their application. The controller input and the number of gait phases are discussed first. Then, the discussion moves forward to the methods of estimating the controller output reference, which is the main focus of this study. Based on the estimation method, the gait control strategies can be classified into subject-oriented estimations and phase-oriented estimations. Finally, suggestions for future studies are addressed, one of which is the application of the adaptive controller output reference to maximize the benefits of the AFO to users. Full article
(This article belongs to the Special Issue Low-Profile Compliant Actuators for Wearable Devices)
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