Computer-aided orthosis design to improve walking performance in children with Duchenne muscular distrophy and cerebral palsy

Orthoses have the potential to improve walking abilities for children
with neuromuscular disorders such as Duchenne muscular dystrophy
and cerebral palsy (CP). Yet selecting the optimal orthoses for a
patient is challenging given the heterogeneity of gait impairments. As
a result, improvements in walking due to orthotic use are very
variable. For example, orthoses improved gait speed in 48% but the
walking pattern in only 27% of about 400 children with CP. While
clinical practice mostly relies on passive orthoses, the emergence of
powered orthoses, which provide added joint power, opens new
perspectives for orthotic treatment when muscle weakness is the
main problem. However, using these technological developments to
the benefit of patients requires more effective methods for orthosis
design. The need for hardware prototyping and lengthy testing has
hindered the design of orthoses tailored to an individual’s needs. We
will combine two powerful tools to create a breakthrough in orthotic
treatment. First, our recent developments in model-based simulation
of human walking enable computer-aided design of orthoses. The
effect of an orthosis on the gait pattern can be evaluated in silico (on
computer), allowing us to test a wide range of orthotic designs for
each child. Second, our recently acquired exoskeleton emulator, a
hardware device that can be programmed to mimic different orthoses
designs, allows us to test optimal designs without the need for
hardware prototyping