With that exoskeleton, we want to improve the quality of life for children with CP. CP stands for cerebral palsy and is a neurological disorder that interferes with the cooperation between the central nervous system and the muscles. Therefore, children with CP have a harder time walking and that problem is being remedied within MOTION through the use and development of rehabilitation technology.
Active exoskeletons for mobility rehabilitation already exist for adults, but such rehabilitation technologies are not yet readily available for children.
Children with CP have a typical walking pattern as a result of their cerebral palsy: they walk on their toes and their knees are somewhat saggy. In addition, they have little strength to propel their foot off the ground and their balance is impaired. Because of this different way of walking, their musculoskeletal system deforms, which is the whole of our bones, tendons, joints, ligaments, muscles, nerves and blood vessels in our body. This deformation causes mobility problems later in life.
The traditional ankle-foot orthoses (AFOs) currently on the market already solve some of those problems, but they block the repulsion of the foot. In order to facilitate this, Mobilab & Care developed an active AFO with a motor. The motor provides extra force, which gives the muscles some help and makes it easier for the foot to bounce off.
The amount of power needed differs from person to person, as do the dimensions of the leg. Therefore, it is important that each active AFO is personalized so that the AFO fits snugly around the lower limb and does not cause friction or pressure in the wrong places.
Mobilab & Care is deploying its expertise on orthopedic rehabilitation technology and 3D printing in this project. First, Mobilab & Care is in charge of developing the technology of the active AFO. Moreover, we are testing the exoskeleton ourselves: first on healthy adults, then on healthy children and then on children with CP. Testing is therefore done both in the lab at Mobilab & Care and in a clinical setting, namely in Pulderbos and at UZ Pellenberg. Thirdly, we are implementing our knowledge and technology into clinical practice.
To begin with, the phases during walking of a healthy person were examined. This mapped out what happens during each phase of walking. Different phases include, for example, when the foot touches the ground, when the foot lands on the ground, when the foot bounces off….
A detection system was used to detect all those gait phases during different types of walking: normal walking, walking with an AFO and simulated walking like someone with CP. The latter involved the test subject walking on the tips of his toes and landing with his flat foot instead of on the heel.
With this information about what the ankle does during which gait phase and what the difference is in the gait phases between someone with and without a disability, further work was done. The aim is now for the motor to recognize these different phases and to provide the right amount of power during the appropriate phases. This will be thoroughly tested in the near future.
The research is still in progress!
The active AFO can also be linked to an exoskeleton around the hip and one around the knee. The development of these joints is taking place with our partners.