Assist-as-needed Hip Exoskeleton Control for Gait Asymmetry Correction via Human-in-the-loop Optimization

Gait asymmetry is a significant clinical characteristic of hemiplegic gait that most stroke survivors suffer, leading to limited mobility and long-term negative impacts on their quality of life. Although a variety of exoskeleton controls have been developed for robot-assisted gait rehabilitation, little attention has been paid to correcting the gait asymmetry of stroke patients following the assist-as-need (AAN) principle, and it is still challenging to properly share control between the exoskeleton and stroke patients with partial motor control. In view of this, this article proposes an AAN hip exoskeleton control with human-in-the-loop optimization to correct gait asymmetry in stroke patients. To realize the AAN concept, an objective function was designed for real-time evaluation of the subject's gait performance and active participation, which considers the variability of natural human movement and guides the online tuning of control parameters on a subject-specific basis. In this way, patients were stimulated to contribute as much as possible to movement, thus maximizing the efficiency and outcomes of post-stroke gait rehabilitation. Finally, an experimental study was conducted to verify the feasibility and effectiveness of the proposed AAN control on healthy subjects with artificial gait impairment. For the first time, the common hypothesis that AAN controls can improve human active participation was validated from the biomechanics viewpoint.