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Biomechanical engineer for robotic healthcare solutions

Periodic Reporting for period 1 - e-walk (Biomechanical engineer for robotic healthcare solutions)

Reporting period: 2017-09-29 to 2018-09-28

A Neuromuscular Disease (NMD) is a disorder that affects the motor nerve cells in the central nervous system (brain, spinal cord, cranial nerves) and peripheral nervous system (autonomic nervous system, neuromuscular junction and muscles). There are 4 million children affected by NMDs worldwide, around 800,000 in Europe. Within NMD, the most common dystrophy is Duchenne Muscular Dystrophy (DMD), which affects 1 in every 3,500 to 5,000 children and is characterised by progressive weakness of the pelvic waist in children from 2 to 3 years. One can also quote Spinal Muscular Atrophy (SMA), a disease of the motor neurons of the spinal cord, that although has less incidence than DMD (between 1/6,000-1/10,000) is more life-threatening.
When the absence of mobility becomes chronic (permanent sitting) the child suffers from a number of physical and psychological complications (scoliosis, respiratory and circulatory difficulties, depression, social isolation), which is added to the patient’s disease symptoms and significantly accelerates the loss of health. The key is maintaining the walking ability for improving their quality of life and slowing down the deterioration caused by permanent sitting. Marsi Bionics offers Wearable Gait Exoskeletons as an effective 24/7 in-house therapy solution for allowing NMD children to walk.

Marsi Bionics R&D activities, as well as its innovative paediatric exoskeletons, are focused on NMD children with SMA (the most life-threatening NMD) and DMD (the most common NMD disease).
Our first paediatric prototype ATLAS 2020 is assisted by a supporting frame that provides postural balance during walking, standing up and sitting down manoeuvres. We are currently making technical progress and incorporating to our new model - ATLAS 2030 - dynamic balance control. Taking into account the loss of mobility due to progressive muscles weakness, ATLAS 2030 will assist the patient as needed, thus adapting to the variable symptoms and walking patterns of each NMD and children.

The overall objectives of the project were:
• To develop a balance biometric control system for innovative gait assistive robotic technologies.
• To develop an effective and robust ergonomics to be implemented in the exoskeleton structure.

through the opportunity of recruiting a biomechanical engineer.

The main conclusions of the action have been that the recruitment and the incorporation to our team of an individual highly qualified in ergonomics and biomechanics of locomotion to analyse the motor dysfunctions in SMA and DMD, analyzing patterns such as stability, mobility and synergies in joints and muscles has been a great opportunity to improve our gait exoskeletons as an alternative therapy, allowing to delay the complications arising from losing walking ability. Modular and flexible designs that are key in ATLAS 2030, taking into account the variety of patients that we intend to assist have been tackled. ATLAS 2030 design must allow not only adaptability in size to adapt the exoskeleton to the body, but also must comply with the different pathological patterns and other side effects affecting children with NMDs. For this purpose, the skills and contribution of the expert in gait biomechanics have been essential for this project.
The Innovation Associate has worked together with Marsi Bionics researchers, clinicians and patients, under the leadership of our Chief Technical Officer and Clinical Advisory team during the project execution period. An initial definition of the overall system architecture has been delivered, establishing interfacing requirements for the different subsystems and a detailed description of system technical specifications to adapt the system to the users’ needs has been provided. Additionally, the Innovation Associate has built a biomechanical gait laboratory, and a motion capture system was purchased and installed in the gait laboratory for pre-clinical trials performance.

The valuable medical Biomechanics knowledge of the Innovation Associate has been crucial for carrying out this WP. Biomechanics simulation technology has allowed to digitally record human movements in real-time using high-speed infrared cameras, and 3D image rendering algorithms have provided high-quality visualisation for the end user. The results of this modelling enable to achieve the first steps towards the provision of dynamic self-balancing capabilities and an improved ergonomic structure of ATLAS exoskeleton and to carry out pre-clinical studies followed by a series of iterative testing and refinement cycles to achieve the ATLAS prototype version with an improved design, ergonomics and balance capabilities.

In terms of results dissemination, it is worth to highlight also the high scientific production of the IA during the project execution as well as de communication and dissemination activities lead by him in terms of conferences attendance, most of them through invited talks, such as the Horasis Seminar held in Málaga (Spain) and IROS 2018 Congress (an International Conference on Intelligent Robots and Systems).
As NMD children undergo progressive muscle weakness, the challenge is not just limited to getting the ability of dynamic balance control to ATLAS 2030 paediatric exoskeleton, but to assist the child at keeping both his thorax upright and his gait pattern. The recruitment of an expert with knowledge in lower limb locomotion and skills dealing with children with walking disabilities has helped Marsi Bionics to overcome this ambitious challenge.

Innovation associate recruitment has helped us to achieve our R&D planned step for this past year: modular exoskeletons provided with dynamic balance control, the first versatile and adaptable to symptomatology in-house device using the profitable ARES technology and medical biomechanics (ergonomics, adaptability and safe motion capability).
The achievement of this goal has led to a great impact on the patient health, on the increment of target users by covering a wider range of pathologies and on a worthy decrease in health costs. Therefore, ATLAS 2030 potentially would increment Marsi Bionics sales in the near future and will boost the creation of both, directly and indirectly, new jobs. One of it has been already created, the Responsible of the Gait Analysis Laboratory.

The active contribution of ideas and results from the Innovation Associate together with the rest of R&D and innovation team developed during his stay has led on the one hand to quality publications and contributions in congresses and had to position Marsi Bionics at the forefront of robotics for healthcare. The innovative ideas from the Innovation Associate to expanding rehabilitation to home and activities of daily living by using ATLAS 2030 has transformed our ambitious ideas into a strong, innovative project, creating a new 24*7 rehabilitation model.
ATLAS 2030 paediatric exoskeleton