A hybrid neuroprosthesis (HNP) was developed with the goal of providing improved gait to individuals with paraplegia relative to existing assistive gait systems. The HNP is an approach to restoring gait by combining a lower extremity exoskeleton with functional neuromuscular stimu-lation (FNS). Individually, exoskeletons apply constraints for support, but provide limited step length and depend on upper extremity actions on a walker for forward propulsion. Conversely, FNS mobilizes the limbs through electrical pulses to paralyzed muscles. However, muscles targeted for stimulation quickly fatigue and provide inadequate postural support. The HNP was designed to functionally combine the sup-portive features of the exoskeleton and joint mobility of FNS. Controllable knee and hip joint mechanisms were developed to support the user while allowing for functional motion from FNS for forward progression. These mechanisms were optimized for maximal torque when supporting a joint and minimal resistance when driven by FNS. A closed-loop controller based on sensor measurements of joint dynamics was developed to synchronize exoskeletal operation with muscle stimulus activity. The objectives were to modulate joint constraints to provide continual support to the user while minimizing the deleterious effects of the constraints on joint mobility, deactivate stimulus to target muscles when certain exoskeletal constraints are engaged to allow the target muscles to rest, and modulate FNS from baseline levels to achieve functi-onal joint positions. The operational response of the controller and mechanisms were characterized through simulation, bench, and able-bodied testing. Implementation of the HNP with an individual with paraplegia respectively showed a 40 % and 16 % reduction in maximum exerted upper extremity forces relative to exoskeleton-only and FNS-only gait. Step lengths were shown to be comparable between HNP and FNS-only gait. When comparing the HNP with and without the FNS modulation, the average gait speed was increased by 16 % with FNS modulation due to a 10 % increase in the hip range of motion. Reductions in muscle activity were feasible when the exoskeletal constraints were enabled. Future work to optimize joint coordination or apply an active mechanism to the exoskeleton to assist hip extension may improve postural control and forward progression.

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This monograph is presented to further a discussion that has persisted for decades, namely: Is it possible to reduce the weight of the combat load on the in-fantry soldier that will allow for nearly unimpeded speed and tempo in foot mobile operations? Since the mid-1990’s the Marine Corps has advanced future operating concepts that seek to achieve the promise of maneuver warfare, that is, the capability to maneuver against the weaknesses of an adversary so rapidly that they are unable to respond to the multiple threats presented across the battlefield, thus shattering their cohesion and decision making ability. An impediment to achieving this endstate has been the fact that foot mobile infantry forces are so overloaded with equipment that they have been unable to maneuver at the desired speed and with the desired distribution on the battlefield to achieve this maneuver effect. Through the ages three solutions have been attempted to reduce the load on the average infantryman: reduce the weight of equipment, transfer the load to some vehicle or beast of burden, and improve individual fitness and endurance. Even as the weight of individual components is decreasing, more pieces of equipment are being added to the combat load for communications, target acquisition, navigation, self protection, and night operating capability. Organizational loads are also increasing as infantry companies are now being given command and control responsibilities that were once reserved for a battalion or higher. There-fore, it is time to explore another alternative to weight mitigation that has never been tried before: wearable exoskeleton technology. The Marine Corps has acknowledged that not enough aviation or vehicles assets exist to move the force in the initial stages of a forcible entry operation, thus, the Marine Corps needs to provide every Marine with the capability to carry the load in the form of some wearable mechani-cal augmentation, which is what an exoskeleton provides.

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Статья посвящена обзору технических средств и методов регистрации электричес-ких сигналов с нервных волокон, возможных для применения в современных системах управления протезами. Авторами проведен сравнительный анализ различных конструкций имплантируемых микроэлектродов и материалов, из которых они изготавливаются, предложена классификация микроэлектродов. Рассмотрены основные проблемы регистра-ции нейросигналов и возможные пути их решения. Микроэлектродный массив; имплантируемый микроэлекртод; регис-трация нейросигнала

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ARECENT U.S. National Academy of Engineering and Institute of Medicine study (Building a Better Delivery System: A New Engineering/Health Care Partnership, National Academy Press, 2005) advocated the applications of system engineering tools and information/communication technologies to improve the quality and productivity of the healthcare system. Mechatronics design principle provides a synergistic integration of information, computation, and electromechanical device and systems, which plays an important role in advancing healthcare at both the device and system levels.

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Цель исследования: создание комплексной программы восстановления ходьбы у больных с инсультом с использованием роботизированных механотренажеров. В исследование включены пациенты в остром периоде инсульта, неспособные к самостоятельной ходьбе (средний возраст 59±10,4 года); 53 больных в основной группе и 25 — в контрольной. Среднее время от начала заболевания до начала проведения занятий с использованием роботизированных механотренажеров составило 14±1,6 суток и определялось адекватностью функциональных проб. Программа реабилитации включала ежедневные 30-минутные занятия лечебной физкультурой. Больные основной группы, в отличие от контрольной, получали также 20-минутные тренировки на роботизированных механотренажерах Motomed Viva 2 и Gait Trainer 1 (GT1), cопровождавшиеся непрерывным мониторингом артериального давления и частоты сердечных сокращений. Количество занятий на GT1 составило от 5 до 12, в среднем 7±1 занятие. После проведенного комплексного восстановительного лечения у пациентов основной группы по сравнению с контрольной отмечена достоверно (р<0,01) лучшая динамика по шкалам устойчивости стояния, функциональных категорий ходьбы, Берга, Бартел; все пациенты этой группы стали способны ходить с опорой или полностью самостоятельно. В основной группе достоверно (р<0,05) уменьшилось число больных с нарушениями проприоцептивной чувствительности (с 37,7 до 9,4%) и атаксией в нижних конечностях (с 37 до 11,3%), в контрольной группе динамики по этим показателям не было. Сделан вывод, что комплексное использование рефлекторной кинезотерапии и роботизированной механотерапии у больных в остром периоде инсульта позволяет увеличить функциональную активность и повысить уровень самообслуживания уже к моменту выписки из стационара.

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