Development of KIINCE: A kinetic feedback-based robotic environment for study of neuromuscular coordination and rehabilitation of human standing and walking

J Rehabil Assist Technol Eng. 2018 Sep 20:5:2055668318793585. doi: 10.1177/2055668318793585. eCollection 2018 Jan-Dec.

Abstract

Introduction: The objective of this article is to introduce the robotic platform KIINCE and its emphasis on the potential of kinetic objectives for studying and training human walking and standing. The device is motivated by the need to characterize and train lower limb muscle coordination to address balance deficits in impaired walking and standing.

Methods: The device measures the forces between the user and his or her environment, particularly the force of the ground on the feet (F) that reflects lower limb joint torque coordination. In an environment that allows for exploration of the user's capabilities, various forms of real-time feedback guide neural training to produce F appropriate for remaining upright. Control of the foot plate motion is configurable and may be user driven or prescribed. Design choices are motivated from theory of motor control and learning as well as empirical observations of F during walking and standing.

Results: Preliminary studies of impaired individuals demonstrate the feasibility and potential utility of patient interaction with kinetic immersive interface for neuromuscular coordination enhancement.

Conclusion: Applications include study and rehabilitation of standing and walking after injury, amputation, and neurological insult, with an initial focus on stroke discussed here.

Keywords: Biofeedback; design requirements; evaluation; gait rehabilitation; neurorehabilitation; rehabilitation devices; robot-assisted rehabilitation; stroke rehabilitation.