Mark Vlutters

Center of mass velocity-based predictions in balance recovery following pelvis perturbations during human walking

ABSTRACT In many simple walking models, foot placement dictates the center of pressure location and ground reaction force components, whereas humans can modulate these aspects after foot contact. Because of the differences, it is unclear to what extent predictions made by models are valid for human walking. Yet, both model simulations and human experimental data have previously indicated that the center of mass (COM) velocity plays an important role in regulating stable walking. Here, perturbed human walking was studied to determine the relationship of the horizontal COM velocity at heel strike and toe-off with the foot placement location relative to the COM, the forthcoming center of pressure location relative to the COM, and the ground reaction forces. Ten healthy subjects received mediolateral and anteroposterior pelvis perturbations of various magnitudes at toe-off, during 0.63 and 1.25 m s−1 treadmill walking. At heel strike after the perturbation, recovery from mediolateral perturbations involved mediolateral foot placement adjustments proportional to the mediolateral COM velocity. In contrast, for anteroposterior perturbations, no significant anteroposterior foot placement adjustment occurred at this heel strike. However, in both directions the COM velocity at heel strike related linearly to the center of pressure location at the subsequent toe-off. This relationship was affected by the walking speed and was, for the slow speed, in line with a COM velocity-based control strategy previously applied by others in a linear inverted pendulum model. Finally, changes in gait phase durations suggest that the timing of actions could play an important role during the perturbation recovery. Summary: By perturbing humans during walking, linear relationships are revealed between the resulting movement velocity of the body, and aspects of the ground reaction force.

Rapid limb‐specific modulation of vestibular contributions to ankle muscle activity during locomotion

The vestibular influence on human walking is phase‐dependent and modulated across both limbs with changes in locomotor velocity and cadence. Using a split‐belt treadmill, we show that vestibular influence on locomotor activity is modulated independently in each limb. The independent vestibular modulation of muscle activity from each limb occurs rapidly at the onset of split‐belt walking, over a shorter time course relative to the characteristic split‐belt error‐correction mechanisms (i.e. muscle activity and kinematics) associated with locomotor adaptation. Together, the present results indicate that the nervous system rapidly modulates the vestibular influence of each limb separately through processes involving ongoing sensory feedback loops. These findings help us understand how vestibular information is used to accommodate the variable and commonplace demands of locomotion, such as turning or navigating irregular terrain.

Template model inspired leg force feedback based control can assist human walking

We present a novel control approach for assistive lower-extremity exoskeletons. In particular, we implement a virtual pivot point (VPP) template model inspired leg force feedback based controller on a lower-extremity powered exoskeleton (LOPES II) and demonstrate that it can effectively assist humans during walking. It has been shown that the VPP template model is capable of stabilizing the trunk and reproduce a human-like hip torque during the stance phase of walking. With leg force and joint angle feedback inspired by the VPP template model, our controller provides hip and knee torque assistance during the stance phase. A pilot experiment was conducted with four healthy subjects. Joint kinematics, leg muscle electromyography (EMG), and metabolic cost were measured during walking with and without assistance. Results show that, for 0.6 m/s walking, our controller can reduce leg muscle activations, especially for the medial gastrocnemius (about 16.0%), while hip and knee joint kinematics remain similar to the condition without the controller. Besides, the controller also reduces 10% of the net metabolic cost during walking. This paper demonstrates walking assistance benefits of the VPP template model for the first time. The support of human walking is achieved by a force feedback of leg force applied to the control of hip and knee joints. It can help us to provide a framework for investigating walking assistance control in the future.

Foot placement modulation diminishes for perturbations near foot contact

Whenever a perturbation occurs during walking we have to maintain our balance using the recovery strategies that are available to us. Foot placement adjustment is often considered an important recovery strategy. However, because this strategy takes time it is likely a poor option if the foot is close to contact at the instant a perturbation occurs. The main goal of this study is to gain a better understanding of how humans deal with balance perturbations during walking if foot placement adjustments are constrained by time. Ten healthy subjects walked on an instrumented treadmill and received mediolateral and anteroposterior pelvis perturbations at various instances during the single support phase. The results show that foot placement modulation in the first recovery step following anteroposterior perturbations is fairly invariant of the perturbation magnitude and direction, regardless of the onset instance. For mediolateral perturbations, foot placement adjustments strongly modulate with the perturbation magnitude and direction, but these effects diminish when the perturbation onset is closer to the instant of foot contact. For most perturbations the first recovery step was consistent across subjects for all onset instances. However, in the second step various strategies arose that were not consistent across subjects, nor within subjects, especially for perturbations applied close to foot contact. Despite these different strategies, the COP location following foot contact strongly related to the COM velocity throughout these strategies. The results show that humans have various ways to compensate for limited availability of a foot placement strategy, with strategy selection highly dependent on the instant during the gait phase at which the perturbation is applied.

Are Ankle Muscle Responses in Balance Recovery Hard-Wired?

The ankle joint muscles can contribute to balance during walking by modulating the center of pressure and ground reaction forces through an ankle moment. This is especially effective in the sagittal plane through ankle plantar- or dorsiflexion. If the ankle joints would be physically blocked to make an ankle strategy ineffective, there would be no functional contribution of these muscles to balance during walking, nor would these muscles generate afferent output regarding ankle joint rotation. Consequently, ankle muscle activation for the purpose of balance control would be expected to disappear.

Paretic versus non-paretic stepping responses following pelvis perturbations in walking chronic-stage stroke survivors

BackgroundThe effects of a stroke, such as hemiparesis, can severely hamper the ability to walk and to maintain balance during gait. Providing support to stroke survivors through a robotic exoskeleton, either to provide training or daily-life support, requires an understanding of the balance impairments that result from a stroke. Here, we investigate the differences between the paretic and non-paretic leg in making recovery steps to restore balance following a disturbance during walking.MethodsWe perturbed 10 chronic-stage stroke survivors during walking using mediolateral perturbations of various amplitudes. Kinematic data as well as gluteus medius muscle activity levels during the first recovery step were recorded and analyzed.ResultsThe results show that this group of subjects is able to modulate foot placement in response to the perturbations regardless of the leg being paretic or not. Modulation in gluteus medius activity with the various perturbations is in line with this observation. In general, the foot of the paretic leg was laterally placed further away from the center of mass than that of the non-paretic leg, while subjects spent more time standing on the non-paretic leg.ConclusionsThe findings suggest that, though stroke-related gait characteristics are present, the modulation with the various perturbations remains unaffected. This might be because all subjects were only mildly impaired, or because these stepping responses partly occur through involuntary pathways which remain unaffected by the complications after the stroke.

Towards Exoskeletons with Balance Capacities

Current exoskeletons replay pre-programmed trajectories at the actuated joints. Towards the employment of exoskeletons with more flexible and adaptive behavior, we investigate human balance control during gait. We study human balance control by applying brief force pulses at the pelvis in different directions, with different amplitude, and applied at different phases of the gait phase. The observed changes were dependent on the phase at which the perturbation was applied and the walking velocity. From the results we concluded that foot placement was the dominant strategy in the frontal plane, center of pressure (CoP) modulation in the double support phase was utilized in the sagittal plane, and the duration of the swing and double support phase changed. Without the ability to control the CoP through an ankle torque, humans also used a foot placement strategy in the sagittal plane. The center of pressure with respect to the center of mass at the end of the double support phase was linearly related to velocity of the center of mass at the end of the preceding swing phase, which is in agreement with extrapolated center of mass or capture point based stepping strategies previously applied in simple models.

Joint-Level Responses to Counteract Perturbations Scale with Perturbation Magnitude and Direction

To realize a lower extremity exoskeleton that can provide balance assistance in a natural way, an understanding of human balance control is a necessity. In this study, we investigated how the angle, torque and power of the ankle, knee and hip joints changed in response to balance perturbations during walking. Nine healthy young adults walked on an instrumented treadmill and received pelvis perturbations of various magnitudes and directions at the instance of toe-off right. An open source musculoskeletal modeling package (OpenSim) was used to perform inverse kinematics and inverse dynamics. Subjects modulated the ankle torque in the (left) stance foot with the magnitude and direction of the perturbation. Also in gait phases following foot placement, subjects addressed ankle torques to mitigate the remaining effects of the perturbation. The results presented here support the use of ankle actuation in lower extremity orthoses for natural and cooperative balance control.