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Dose–response relationship of treadmill perturbation-based balance training for improving reactive balance in older adults at risk of falling: results of the FEATURE randomized controlled pilot trial

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European Review of Aging and Physical Activity 2025年第1期22卷 1-17页

作者： Hezel, Natalie Buchner, Theresa Becker, Clemens Bauer, Jürgen M. Sloot, Lizeth H. Steib, Simon Werner, Christian Geriatric Center Medical Faculty Heidelberg Heidelberg University Heidelberg Germany Optimization Robotics and Biomechanics Institute of Computer Engineering Heidelberg University Heidelberg Germany Translational and Clinical Research Institute Newcastle University Newcastle United Kingdom Department of Human Movement Training and Active Aging Institute of Sports and Sports Sciences Heidelberg University Heidelberg Germany Network Aging Research Heidelberg Heidelberg University Heidelberg Germany

Background: The inability to appropriately react to balance perturbations is a common cause of falls. Perturbation-based balance training (PBT) is especially beneficial for improving reactive balance and shows high potential for fall prevention. However, its dose–response relationship, feasibility, and acceptability remain to be determined among older adults at risk of falling. The FEATURE study aimed to compare the efficacy of two treadmill PBT protocols with different session numbers to improve reactive balance, and to evaluate their feasibility and acceptability in this population. Methods: In this randomized controlled pilot trial, 36 older adults at risk of falling were allocated to receive either six (6PBT) or two treadmill PBT sessions (2PBT). Reactive balance in standing (Stepping Threshold Test [STT]) and walking (Dynamic Stepping Threshold Test [DSTT]) was assessed as primary outcome at baseline (T1), post-intervention (T2), and 6-week follow-up (T3). Secondary outcomes included measures on physical, psychological, and cognitive functioning. Feasibility was assessed via PBT adherence, planned perturbations completed, and adverse events;acceptability via questionnaire. Between-group changes over time were compared using repeated-measures analyses of variance with Bonferroni-corrected post-hoc tests. Data analyses followed the intention-to-treat principle. Results: A significant time effect was observed for the DSTT (p = 0.008), with both groups significantly improving from T1 to T2 (ps < 0.01). A significant interaction effect (p = 0.027) revealed that only the 6PBT group maintained these improvements (T1 vs. T3: p < 0.001) and scored significantly higher than the 2PBT group at T3 (p = 0.015). No significant interaction effects were found for the STT or any secondary outcome, but improvements over time were observed for dynamic balance, gait capacity, functional mobility, physical activity, concerns about falling, and executive functioning (time effects: ps

关键词： Dose–response relationship Exercise Falls Feasibility studies Frail older adults Patient acceptance of health care Postural control

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Optimal Push Recovery for Periodic Walking Motions

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IFAC-PapersOnLine 2016年第14期49卷 93-98页

作者： Schemschat, R. Malin Clever, Debora Felis, Martin L. Mombaur, Katja Optimization in Robotics and Biomechanics Interdisciplinary Center for Scientific Computing Heidelberg University Germany

We study how humans performing periodic walking motions react to strong perturbations that are applied in form of pushes from behind. We propose a computational method that allows to generate optimal recovery motions based on a dynamic multi-body model of the human walking process. The assumption is that humans in such a situation would aim to pursue the walking motions while at the same time limiting the effort for the motion. For a given position and velocity in the middle of a periodic walking motion and a given pushing force profile, magnitude and contact point we determine the motion of the human model that minimizes a combined criterion joint torques and a deviation from periodicity. The recovery horizon considered in the multiphase optimal control problem is one step. The optimal control problem is solved using a direct boundary value problem approach based on multiple shooting. We present resulting optimal recovery motions for pushing forces between 150 N and 600 N which all look realistic. The proposed method has potential applications in the computation of push recovery motions for humanoid robots or for elderly humans with physical assistive devices, in each case applied to the respective model. © 2016

关键词： Recovery Anthropomorphic robots Boundary value problems Computational methods Optimal control systems Tugboats Human motions Multi body system dynamics Optimal controls Push recoveries Walking motion

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Optimal control for balance assistance using a robotic rollator 6

Optimal control for balance assistance using a robotic rolla...

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6th IEEE RAS/EMBS International Conference on Biomedical robotics and Biomechatronics, BioRob 2016

作者： Corradi, Davide Ho Hoang, Khai-Long Mombaur, Katja Interdisciplinary Center for Scientific Computing Optimization in Robotics and Biomechanics Group University of Heidelberg Germany

ISBN: (纸本)9781509032877

Research concerning intelligent robotic mobility AIDS for elderly people is raising in importance due to the prediction of the increase in the average age of the population in the near future and the consequent lack in professional care that can be expected. Such devices could provide not only navigational and cognitive assistance, but also enhanced physical support, for example when the patient is standing up or losing balance while walking or standing. This work considers a robotic rollator equipped with actuated handles which are capable of motions on the sagittal plane. The aim is to develop a methodology, based on optimal control and rigid body models of the user and of the device, to compute optimal handle trajectories to help the user regain an upright, balanced posture starting from perturbed initial conditions while standing without walking. Handle trajectories for different initial perturbations of the patient are computed for the MOBOT project rollator device and presented. © 2016 IEEE.

关键词： Intelligent robots

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Gait performance indicators for elderly humans interacting with robotic mobility assistance devices 14

Gait performance indicators for elderly humans interacting w...

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14th IEEE/RAS-EMBS International Conference on Rehabilitation robotics, ICORR 2015

作者： Hoang, Khai-Long Ho Corradi, Davide Delbasteh, Sascha Mombaur, Katja Interdisciplinary Center for Scientific Computing Optimization in Robotics and Biomechanics Group University of Heidelberg Heidelberg69115 Germany

ISBN: (纸本)9781479918072

Robotic mobility assistance devices provide a purposeful and adaptive support for elderly humans. To achieve assistance which is specifically adapted to the individual needs and capabilities of the user, the device should be capable of estimating the overall gait performance as well as the current state of the subject on-line. Information gathered by on-board sensors could be exploited to obtain, amongst other values, the interaction forces, positions and velocities of the subject. Although in principle it would be desirable to obtain whole-body motion information of the precision of data collected by marker-based motion capture systems, this is not possible by the on-board sensors and computational units. It is generally also not acceptable to make subjects wear additional accessories during the every-day usage of the device. In this paper, we present methods to identify gait parameters based on easily accessible on-line sensor information. We derive temporo-spatial gait performance indicators which can be used by robotic mobility aid platforms to evaluate the performance of the user and apply individualized user-Adaptive assistance strategies. By analyzing the correlation between these parameters we propose a set of gait performance indicators and derive performance classes that can be used in combination or isolated. © 2015 IEEE.

关键词： Benchmarking

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Optimal design of a physical assistive device to support sit-to-stand motions

Optimal design of a physical assistive device to support sit...

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2015 IEEE International Conference on robotics and Automation, ICRA 2015

作者： Ho Hoang, Khai-Long Mombaur, Katja D. Interdisciplinary Center for Scientific Computing Optimization in Robotics and Biomechanics Group University of Heidelberg Heidelberg69115 Germany

ISBN: (纸本)9781479969234

The MOBOT∗ project aims to develop assistive devices that support elderly patients with mobility disabilities during gait and sit-to-stand (STS) transfer. The device is supposed to help such patients to maintain an independent life through mobility as well as to regain basic life skills since self-effort is encouraged. Situation-adapted optimal assistance will be provided by the device both proactively and adaptively through behavior-based and context-aware robot control based on multimodal action recognition. The design of such a device, including the choice of actuators, which can provide the desired level of support without losing balance, is a challenging task. For these design choices, in particular STS motions have to be considered since they are more demanding for both the patient and the device. In this paper, we present a model-based optimization approach to this design task, using direct multiple shooting optimal control methods. They are applied to simultaneously determine optimal states and controls as well as the optimal mechanical design parameters of the assistive device that provide optimal STS assistance to subjects from a range of body heights and weights that represents the MOBOT target group. © 2015 IEEE.

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Inverse optimal control based identification of optimality criteria in whole-body human walking on level ground

Inverse optimal control based identification of optimality c...

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IEEE/RAS-EMBS International Conference on Biomedical robotics and Biomechatronics (BioRob)

作者： Debora Clever R. Malin Schemschat Martin L. Felis Katja Mombaur Optimization in Robotics & Biomechanics (ORB) University of Heidelberg

ISBN: (纸本)9781509032884

Understanding the underlying concepts of human locomotion is important for many fields of research. Based on the assumption that human motions are optimal, we propose an inverse optimal control (IOC) based approach to identify the optimality criteria in human walking. To this end, human walking is modeled as a non-linear optimal control problem with a linear combination of elementary optimality functions as objective and a hybrid dynamics multi-body system as constraints. The developed IOC-framework is set up in a modular way and exploits the natural bi-level structure of the problem. It allows for a great flexibility in the choice of outer optimization techniques and inner dynamic models. In the present work, we use the developed IOC approach to identify weights of seven elementary criteria for seven walking motions captured from six different subjects. The considered optimality criteria address the minimization of joint torques for four sets of joints, head stabilization, the step length, and the step frequency. For all trials the algorithm performs successfully. Even though the identified weights differ observably between subjects, which explains the different walking styles, the correlation matrix gives rise to the hypothesis that there exists a significant correlation of optimality across subjects. The identification of optimality criteria in human walking is a very important issue for all disciplines, where a prediction of human behavior is needed. For example in medical applications to improve therapies or to develop new mobility devices, in sport science to improve training plans or in humanoid robotics to develop new walking strategies.

关键词： Legged locomotion Optimal control Dynamics Mathematical model optimization Computational modeling Motion segmentation

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A new template model for optimization studies of human walking on different terrains

A new template model for optimization studies of human walki...

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IEEE-RAS International Conference on Humanoid Robots

作者： Debora Clever Katja Mombaur Optimization in Robotics & Biomechanics (ORB) University of Heidelberg

Human movement, as for example human gait, can be considered as an optimal realization of some given task. If the optimization criteria for different types of gait were known, this knowledge could help to improve robot motion generation and control, also for complex walking motions on slopes or stairs. Unfortunately, in general the criteria for which the naturally performed human motion is optimal, are not known. Therefore, in this article we study the relevance of different measurable quantities in human locomotion based on human motion capture data and a new template model that is able to capture the main dynamical characteristics we are interested in. To this end we introduce a three dimensional actuated walking model, with an upper body, two actuated legs and two point-masses as feet. Taking into account single and double support phases and the impact at touch down, the model is suitable to reproduce realistic three dimensional center of mass and swing foot trajectories even in constrained environments. In this article, we focus on walking up and down stairs and compare the observed quantities.

关键词： Legged locomotion Foot Trajectory Solid modeling Optimal control Computational modeling optimization

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Optimal control for balance assistance using a robotic rollator

Optimal control for balance assistance using a robotic rolla...

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IEEE/RAS-EMBS International Conference on Biomedical robotics and Biomechatronics (BioRob)

作者： Davide Corradi Khai-Long Ho Hoang Katja Mombaur Optimization in Robotics and Biomechanics Group University of Heidelberg

ISBN: (纸本)9781509032884

Research concerning intelligent robotic mobility aids for elderly people is raising in importance due to the prediction of the increase in the average age of the population in the near future and the consequent lack in professional care that can be expected. Such devices could provide not only navigational and cognitive assistance, but also enhanced physical support, for example when the patient is standing up or losing balance while walking or standing. This work considers a robotic rollator equipped with actuated handles which are capable of motions on the sagittal plane. The aim is to develop a methodology, based on optimal control and rigid body models of the user and of the device, to compute optimal handle trajectories to help the user regain an upright, balanced posture starting from perturbed initial conditions while standing without walking. Handle trajectories for different initial perturbations of the patient are computed for the MOBOT project rollator device and presented.

关键词： Optimal control Mathematical model Legged locomotion Force Dynamics Trajectory

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Influence of compliance modulation on human locomotion

Influence of compliance modulation on human locomotion

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IEEE International Conference on robotics and Automation (ICRA)

作者： Yue Hu Katja Mombaur Optimization in Robotics and Biomechanics (ORB) Heidelberg University Heidelberg Germany

Compliance is an important feature of human locomotion, where many studies have focused on the identification of stiffness parameters in order to build new machines, and stiffness is often assumed to be constant. However, it has been shown that during human walking, stiffness profiles are not constant in time and have high modulations in particular when changing walking phases. In order to understand how the constant stiffness assumption influences the walking gait and how much modulation is needed in walking mechanisms to reproduce natural gaits, in this work we focus on the analysis of joint and bi-articular stiffness profiles modulation and the influence of these modulations on the walking motions in different walking environments, i.e. level ground, slope and stairs. The analysis is carried out on periodic steps from motion capture data. mapped on a 14 segments human model with spring damper systems.

关键词： Legged locomotion Modulation Foot Springs Hip Knee Mathematical model

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Modelfactory: A matlab/octave based toolbox to create human body models

arXiv

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arXiv 2018年

作者： Sreenivasa, Manish Harant, Monika University of Wollongong Australia Optimization Robotics and Biomechanics Heidelberg University Germany

Model-based analysis of movements can help better understand human motor control. Here, the models represent the human body as an articulated multi-body system that reects the characteristics of the human being studied. We present an open-source toolbox that allows for the creation of human models with easy-to-setup, customizable configurations. The toolbox scripts are written in Matlab/Octave and provide a command-based interface as well as a graphical interface to construct, visualize and export models. Built-in software modules provide functionalities such as automatic scaling of models based on subject height and weight, custom scaling of segment lengths, mass and inertia, addition of body landmarks, and addition of motion capture markers. Users can set up custom definitions of joints, segments and other body properties using the many included examples as templates. In addition to the human, any number of objects (e.g. exoskeletons, orthoses, prostheses, boxes) can be added to the modeling environment. The ModelFactory toolbox is published as open-source software under the permissive zLib license. The toolbox fulfills an important function by making it easier to create human models, and should be of interest to human movement researchers. Copyright © 2018, The Authors. All rights reserved.

关键词： Exoskeleton (robotics)

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