Robotic trunk support assists those with spinal cord injury

January 05, 2020

New York, NY--January 6, 2020--Spinal cord injuries (SCI) can cause devastating damage, including loss of mobility and sensation. Every year, there are an estimated 17,000 new SCIs in the US alone, a rate higher than in most regions of the world. In addition, the rate of SCIs in people 65-years or older is expected to rise in the US, from 13.0% in 2010 to 16.1% by 2020. Data also shows a high survival rate for these patients, who need to function in everyday life but find sitting to be a major challenge.

A Columbia Engineering team has invented a robotic device--the Trunk-Support Trainer (TruST)--that can be used to assist and train people with SCIs to sit more stably by improving their trunk control, and thus gain an expanded active sitting workspace without falling over or using their hands to balance. The study, published today in Spinal Cord Series and Cases, is the first to measure and define the sitting workspace of patients with SCI based on their active trunk control.

"We designed TruST for people with SCIs who are typically wheelchair users," says Sunil Agrawal, the project's PI and professor of mechanical engineering and of rehabilitation and regenerative medicine. "We found that TruST not only prevents patients from falling, but also maximizes trunk movements beyond patients' postural control, or balance limits."

TruST is a motorized-cable driven belt placed on the user's torso to determine the postural control limits and sitting workspace area in people with SCI. It delivers forces on the torso when the user performs upper body movements beyond the postural stability limits while sitting.

The five subjects with SCI who participated in the pilot study were examined with the Postural Star-Sitting Test, a customized postural test that required them to follow a ball with their head and move their trunk as far as possible, without using their hands. The test was repeated in eight directions, and the researchers used the results to compute the sitting workspace of each individual.

The team then tailored the TruST for each subject to apply personalized assistive force fields on the torso while the subjects performed the same movements again. With the TruST, the subjects were able to reach further during the trunk excursions in all eight directions and significantly expand the sitting workspace around their bodies, on an average of about 25% more.

"The capacity of TruST to deliver continuous force-feedback personalized for the user's postural limits opens new frontiers to implement motor learning-based paradigms to retrain functional sitting in people with SCI," says Victor Santamaria, a physical therapist, postdoctoral researcher in Agrawal's Robotics and Rehabilitation Laboratory, and first author of the paper. "We think TruST is a very promising SCI rehab tool."

Agrawal's team is now exploring the use of TruST within a training paradigm to improve the trunk control of adults and children with spinal cord injury. "The robotic platform will be used to train participants with SCI by challenging them to move their trunk over a larger workspace, with TruST providing assist-as-needed force fields to safely bring the subjects back to their neutral sitting posture," says Agrawal. "This force field will be adjusted to the needs of the participants over time as they improve their workspace and posture control."
-end-
About the Study

The study is titled "The robotic Trunk-Support-Trainer (TruST) to measure and increase postural workspace during sitting in people with spinal cord injury."

Authors are: V. Santamaria 1, T. Luna 1, M. Khan 2, S. Agrawal 1, 3

1 Department of Mechanical Engineering, Columbia Engineering
2 Department of Radiology at BWH, Harvard Medical School
3 Department of Rehabilitation and Regenerative Medicine, Columbia University

The study was supported, in part, by New York State research funding, DOH01-C31290GG.

The authors declare that they have no conflict of interest.

LINKS:

Paper: https://www.nature.com/articles/s41394-019-0245-1
DOI: 10.1038/s41394-019-0245-1

Columbia Engineering: http://engineering.columbia.edu/

Sunil Agrawal: https://engineering.columbia.edu/faculty/sunil-agrawal

Agrawal's Robotics and Rehabilitation (ROAR) Laboratory: https://roar.me.columbia.edu/

mechanical engineering: https://me.columbia.edu/

Columbia Engineering

Columbia Engineering, based in New York City, is one of the top engineering schools in the U.S. and one of the oldest in the nation. Also known as The Fu Foundation School of Engineering and Applied Science, the School expands knowledge and advances technology through the pioneering research of its more than 220 faculty, while educating undergraduate and graduate students in a collaborative environment to become leaders informed by a firm foundation in engineering. The School's faculty are at the center of the University's cross-disciplinary research, contributing to the Data Science Institute, Earth Institute, Zuckerman Mind Brain Behavior Institute, Precision Medicine Initiative, and the Columbia Nano Initiative. Guided by its strategic vision, "Columbia Engineering for Humanity," the School aims to translate ideas into innovations that foster a sustainable, healthy, secure, connected, and creative humanity.

Columbia University School of Engineering and Applied Science

Related Spinal Cord Injury Articles from Brightsurf:

Stem cells can help repair spinal cord after injury
Spinal cord injury often leads to permanent functional impairment. In a new study published in the journal Science researchers at Karolinska Institutet in Sweden show that it is possible to stimulate stem cells in the mouse spinal cord to form large amounts of new oligodendrocytes, cells that are essential to the ability of neurons to transmit signals, and thus to help repair the spinal cord after injury.

Spinal cord injury increases risk for mental health disorders
A new study finds adults with traumatic spinal cord injury are at an increased risk of developing mental health disorders and secondary chronic diseases compared to adults without the condition.

Co-delivery of IL-10 and NT-3 to enhance spinal cord injury repair
Spinal cord injury (SCI) creates a complex microenvironment that is not conducive to repair; growth factors are in short supply, whereas factors that inhibit regeneration are plentiful.

IU scientists study link between energy levels, spinal cord injury
A team of researchers from Indiana University School of Medicine, in collaboration with the National Institute of Neurological Disorders and Stroke, have investigated how boosting energy levels within damaged nerve fibers or axons may represent a novel therapeutic direction for axonal regeneration and functional recovery.

UBCO professor simplifies exercise advice for spinal cord injury
Professor Kathleen Martin Ginis says a major barrier to physical activity for people with a spinal cord injury is a lack of knowledge or resources about the amount and type of activity needed to achieve health and fitness benefits.

Robotic trunk support assists those with spinal cord injury
A Columbia Engineering team has invented a robotic device -- the Trunk-Support Trainer (TruST) -- that can be used to assist and train people with spinal cord injuries (SCIs) to sit more stably by improving their trunk control, and thus gain an expanded active sitting workspace without falling over or using their hands to balance.

Does frailty affect outcomes after traumatic spinal cord injury?
A new study has shown that frailty is an important predictor of worse outcome after traumatic spinal cord injury in patients less than 75 years of age.

Sleep and sleepiness 'a huge problem' for people with spinal cord injury
A new study led by a University of Calgary researcher at the Cumming School of Medicine (CSM) finds that fatigue and sleep may need more attention in order to prevent issues like stroke after spinal cord injury.

From spinal cord injury to recovery
Spinal cord injury disconnects communication between the brain and the spinal cord, disrupting control over part of the body.

Transplanting adult spinal cord tissues: A new strategy of repair spinal cord injury
Spinal cord injury repair is one of the most challenging medical problems, and no effective therapeutic methods has been developed.

Read More: Spinal Cord Injury News and Spinal Cord Injury Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.