Evaluation of Optimal Control Approaches for Predicting Active Knee-Ankle-Foot-Orthosis Motion for Individuals With Spinal Cord Injury

Míriam Febrer-Nafría, Benjamin J. Fregly, Josep M. Font-Llagunes

Abstract: Gait restoration of individuals with spinal cord injury can be partially achieved using active orthoses or exoskeletons. To improve the walking ability of each patient as much as possible, it is important to personalize the parameters that define the device actuation. This study investigates whether using an optimal control-based predictive simulation approach to personalize pre-defined knee trajectory parameters for an active knee-ankle-foot orthosis (KAFO) used by spinal cord injured (SCI) subjects could potentially be an alternative to the current trial-and-error approach. We aimed to find the knee angle trajectory that produced an improved orthosis-assisted gait pattern compared to the one with passive support (locked knee). We collected experimental data from a healthy subject assisted by crutches and KAFOs (with locked knee and with knee flexion assistance) and from an SCI subject assisted by crutches and KAFOs (with locked knee). First, we compared different cost functions and chose the one that produced results closest to experimental locked knee walking for the healthy subject (angular coordinates mean RMSE was 5.74°). For this subject, we predicted crutch-orthosis-assisted walking imposing a pre-defined knee angle trajectory for different maximum knee flexion parameter values, and results were evaluated against experimental data using that same pre-defined knee flexion trajectories in the real device. Finally, using the selected cost function, gait cycles for dif...