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Robot Ankle Foot Orthosis with Auto Flexion Mode for Foot Drop Training on Post-Stroke Patient in Indonesia
Corresponding Author(s) : Dimas Adiputra
Kinetik: Game Technology, Information System, Computer Network, Computing, Electronics, and Control,
Vol. 7, No. 4, November 2022
Abstract
Robot Ankle Foot Orthosis (AFO) has been proven to assist the gait impairment, such as the foot drop. However, development challenge is still remains, such as the trade-off between complexity, functionality and cost. High functionality resulted in high cost, bulky, and complex device. But affordability and simplicity may decrease functionality. Therefore, this research proposed a robot AFO, which has the necessary function of auto dorsi-plantarflexion so it can keep the affordability and simplicity. The robot AFO consists of structure, electronics part and algorithm. The structure is custom made according to the user’s anatomy. A brushless DC (BLDC) motor, Force-Sensing Resistor (FSR) and microcontroller builds the electronic parts. The BLDC motor actuates the flexion, while the FSR detects the gait phase to determine the action. Both are integrated by the microcontroller with the P control algorithm that commands the BLDC motor to generate necessary torque so it rotates in a constant speed. A functionality test has been carried out on the robot AFO, where the robot AFO perform a dorsi-plantarflexion continuously in three conditions, such as no load, 1 Kg load, and foot load. The robot AFO successfully performed a constant velocity rotation in both directions, in all conditions. In the case of 1 Kg load, the maximum angular speed is 0.7 rad/s dorsiflexion and -1.8 rad/s plantarflexion. The torque keeps increasing and decreasing from -0.3 Nm to 4 Nm to keep the angular velocity. The result shows that the robot AFO can perform the necessary function to assist the foot drop training. Functionality test on the gait detection has also been done where it shows that the robot AFO can detect the four gait phases accurately. The robot AFO has been tested and future study should test the robot on a real post-stroke patient to see the effect of the gait control in reality.
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- Pipit Mei Sari, Atika Mira Agniana, and Mohammad Saiful Ardhi, “Trends of ischemic stroke admission during two years of COVID-19 pandemic: A retrospective cross-sectional study at a tertiary hospital in Indonesia,” Bali Medical Journal, vol. 11, no. 2, 2022, doi: https://doi.org/10.15562/bmj.v11i2.3498.
- Yanti Srinayanti, Wina Widianti, Dian Andriani, Fidya Anisa Firdaus, and Henri Setiawan, “Range of Motion Exercise to Improve Muscle Strength among Stroke Patients: A Literature Review,” International Journal of Nursing and Health Services (IJNHS), vol. 4, no. 3, 2021, doi: https://doi.org/10.35654/ijnhs.v4i3.464.
- World Stroke Organization, “Global Stroke Fact Sheet 2022.” [Online]. Available: http://ghdx.healthdata.org/gbd-results-tool
- A. F. W. Ho et al., “Association of ambient air pollution with risk of hemorrhagic stroke: A time-stratified case crossover analysis of the Singapore stroke registry,” Int J Hyg Environ Health, vol. 240, Mar. 2022, doi: 10.1016/j.ijheh.2021.113908.
- R. Xu et al., “Association of short-term exposure to ambient air pollution with mortality from ischemic and hemorrhagic stroke,” Eur J Neurol, vol. 29, no. 7, pp. 1994–2005, Jul. 2022, doi: 10.1111/ene.15343.
- Y. Bae and D. Park, “Immediate Effect of Lower-Leg Kinesio Taping on Ankle Dorsiflexion and Gait Parameters in Chronic Stroke with Foot Drop,” Journal of Stroke and Cerebrovascular Diseases, vol. 31, no. 5, May 2022, doi: 10.1016/j.jstrokecerebrovasdis.2022.106425.
- A. Pramudita Putra, A. Rahmatillah, N. Khafidotur Rodhiyah, and I. Putu Alit Pawana, “COMPUTATIONAL ANALYSIS OF ANKLE-FOOT ORTHOSIS FOR FOOT DROP CASE DURING STANCE PHASE IN GAIT CYCLE,” Journal of Engineering Science and Technology, vol. 17, no. 2, pp. 985–0996, 2022.
- G. Liu, F. Gao, D. Wang, and W.-H. Liao, “Medical applications of magnetorheological fluid: a systematic review-IOPscience Medical applications of magnetorheological fluid: a systematic review,” 2022, doi: 10.1088/1361-665X/ac54e7/meta.
- Di. Adiputra, M. A. A. Rahman, Ubaidillah, and S. A. Mazlan, “Improving passive ankle foot orthosis system using estimated ankle velocity reference,” IEEE Access, vol. 8, pp. 194780–194794, 2020, doi: 10.1109/ACCESS.2020.3033852.
- C. M. Thalman, T. Hertzell, M. Debeurre, and H. Lee, “Multi-degrees-of-freedom soft robotic ankle-foot orthosis for gait assistance and variable ankle support,” Wearable Technologies, vol. 3, p. e18, Aug. 2022, doi: 10.1017/wtc.2022.14.
- J. Inoue et al., “Development of a Gait Rehabilitation Robot Using an Exoskeleton and Functional Electrical Stimulation: Validation in a Pseudo-paraplegic Model,” Prog Rehabil Med, vol. 7, no. 0, p. n/a, 2022, doi: 10.2490/prm.20220001.
- H. Mastrisiswadi and Herianto, “Analisis Kebutuhan Robot Rehabilitasi Pasien Pasca Stroke dengan Menggunakan Metode Kano,” Jurnal Ilmiah Teknik Industri, pp. 151–156, 2016, doi: https://doi.org/10.23917/jiti.v15i2.2331.
- E. Esfandiari, H. Saeedi, A. Ahmadi, M. Jalali, A. Mohammad Pour, and V. Abdollah, “Investigating the effects of conventional thermoplastic ankle-foot and the neoprene ankle-foot orthoses on the kinetics and kinematics of gait in people with foot drop following traumatic injury of the peroneal nerve: A pilot study,” Foot, vol. 50, Mar. 2022, doi: 10.1016/j.foot.2021.101898.
- F. Hasan, Q. Murtaza, M. Varshney, and F. Hasan, “Design and Analysis of a Custom Ankle Foot Orthosis (AFO) with Foot Drop Patient,” 2022, pp. 187–197. doi: 10.1007/978-981-16-2229-8_20.
- D. Adiputra et al., “A review on the control of the mechanical properties of Ankle Foot Orthosis for gait assistance,” Actuators, vol. 8, no. 1. MDPI AG, 2019. doi: 10.3390/act8010010.
- D. Adiputra et al., “Control reference parameter for stance assistance using a passive controlled Ankle Foot Orthosis-A preliminary study,” Applied Sciences (Switzerland), vol. 9, no. 20, Oct. 2019, doi: 10.3390/app9204416.
- D. Adiputra, M. Azizi Abdul Rahman, I. Bahiuddin, Ubaidillah, F. Imaduddin, and N. Nazmi, “Sensor Number Optimization Using Neural Network for Ankle Foot Orthosis Equipped with Magnetorheological Brake,” Open Engineering, vol. 11, no. 1, pp. 91–101, Jan. 2020, doi: 10.1515/eng-2021-0010.
References
Pipit Mei Sari, Atika Mira Agniana, and Mohammad Saiful Ardhi, “Trends of ischemic stroke admission during two years of COVID-19 pandemic: A retrospective cross-sectional study at a tertiary hospital in Indonesia,” Bali Medical Journal, vol. 11, no. 2, 2022, doi: https://doi.org/10.15562/bmj.v11i2.3498.
Yanti Srinayanti, Wina Widianti, Dian Andriani, Fidya Anisa Firdaus, and Henri Setiawan, “Range of Motion Exercise to Improve Muscle Strength among Stroke Patients: A Literature Review,” International Journal of Nursing and Health Services (IJNHS), vol. 4, no. 3, 2021, doi: https://doi.org/10.35654/ijnhs.v4i3.464.
World Stroke Organization, “Global Stroke Fact Sheet 2022.” [Online]. Available: http://ghdx.healthdata.org/gbd-results-tool
A. F. W. Ho et al., “Association of ambient air pollution with risk of hemorrhagic stroke: A time-stratified case crossover analysis of the Singapore stroke registry,” Int J Hyg Environ Health, vol. 240, Mar. 2022, doi: 10.1016/j.ijheh.2021.113908.
R. Xu et al., “Association of short-term exposure to ambient air pollution with mortality from ischemic and hemorrhagic stroke,” Eur J Neurol, vol. 29, no. 7, pp. 1994–2005, Jul. 2022, doi: 10.1111/ene.15343.
Y. Bae and D. Park, “Immediate Effect of Lower-Leg Kinesio Taping on Ankle Dorsiflexion and Gait Parameters in Chronic Stroke with Foot Drop,” Journal of Stroke and Cerebrovascular Diseases, vol. 31, no. 5, May 2022, doi: 10.1016/j.jstrokecerebrovasdis.2022.106425.
A. Pramudita Putra, A. Rahmatillah, N. Khafidotur Rodhiyah, and I. Putu Alit Pawana, “COMPUTATIONAL ANALYSIS OF ANKLE-FOOT ORTHOSIS FOR FOOT DROP CASE DURING STANCE PHASE IN GAIT CYCLE,” Journal of Engineering Science and Technology, vol. 17, no. 2, pp. 985–0996, 2022.
G. Liu, F. Gao, D. Wang, and W.-H. Liao, “Medical applications of magnetorheological fluid: a systematic review-IOPscience Medical applications of magnetorheological fluid: a systematic review,” 2022, doi: 10.1088/1361-665X/ac54e7/meta.
Di. Adiputra, M. A. A. Rahman, Ubaidillah, and S. A. Mazlan, “Improving passive ankle foot orthosis system using estimated ankle velocity reference,” IEEE Access, vol. 8, pp. 194780–194794, 2020, doi: 10.1109/ACCESS.2020.3033852.
C. M. Thalman, T. Hertzell, M. Debeurre, and H. Lee, “Multi-degrees-of-freedom soft robotic ankle-foot orthosis for gait assistance and variable ankle support,” Wearable Technologies, vol. 3, p. e18, Aug. 2022, doi: 10.1017/wtc.2022.14.
J. Inoue et al., “Development of a Gait Rehabilitation Robot Using an Exoskeleton and Functional Electrical Stimulation: Validation in a Pseudo-paraplegic Model,” Prog Rehabil Med, vol. 7, no. 0, p. n/a, 2022, doi: 10.2490/prm.20220001.
H. Mastrisiswadi and Herianto, “Analisis Kebutuhan Robot Rehabilitasi Pasien Pasca Stroke dengan Menggunakan Metode Kano,” Jurnal Ilmiah Teknik Industri, pp. 151–156, 2016, doi: https://doi.org/10.23917/jiti.v15i2.2331.
E. Esfandiari, H. Saeedi, A. Ahmadi, M. Jalali, A. Mohammad Pour, and V. Abdollah, “Investigating the effects of conventional thermoplastic ankle-foot and the neoprene ankle-foot orthoses on the kinetics and kinematics of gait in people with foot drop following traumatic injury of the peroneal nerve: A pilot study,” Foot, vol. 50, Mar. 2022, doi: 10.1016/j.foot.2021.101898.
F. Hasan, Q. Murtaza, M. Varshney, and F. Hasan, “Design and Analysis of a Custom Ankle Foot Orthosis (AFO) with Foot Drop Patient,” 2022, pp. 187–197. doi: 10.1007/978-981-16-2229-8_20.
D. Adiputra et al., “A review on the control of the mechanical properties of Ankle Foot Orthosis for gait assistance,” Actuators, vol. 8, no. 1. MDPI AG, 2019. doi: 10.3390/act8010010.
D. Adiputra et al., “Control reference parameter for stance assistance using a passive controlled Ankle Foot Orthosis-A preliminary study,” Applied Sciences (Switzerland), vol. 9, no. 20, Oct. 2019, doi: 10.3390/app9204416.
D. Adiputra, M. Azizi Abdul Rahman, I. Bahiuddin, Ubaidillah, F. Imaduddin, and N. Nazmi, “Sensor Number Optimization Using Neural Network for Ankle Foot Orthosis Equipped with Magnetorheological Brake,” Open Engineering, vol. 11, no. 1, pp. 91–101, Jan. 2020, doi: 10.1515/eng-2021-0010.