Powered ankle exoskeletons that apply assistive torques with optimized timing and magnitude can reduce metabolic cost by ∼10% compared to normal walking. However, finding individualized optimal control parameters is time consuming and must be done independently for different walking modes (e.g., speeds, slopes). Thus, there is a need for exoskeleton controllers that are capable of continuously adapting torque assistance in concert with changing locomotor demands. One option is to use a biologically inspired, model-based control scheme that can capture the adaptive behavior of the human plantarflexors during natural gait. Here, based on previously demonstrated success in a powered ankle-foot prosthesis, we developed an ankle exoskeleton controller that uses a neuromuscular model (NMM) comprised of a Hill type musculotendon driven by a simple positive force feedback reflex loop. To examine the effects of NMM reflex parameter settings on (i) ankle exoskeleton mechanical performance and (ii) users’ physiological response, we recruited nine healthy, young adults to walk on a treadmill at a fixed speed of 1.25 m/s while donning bilateral tethered robotic ankle exoskeletons. To quantify exoskeleton mechanics, we measured exoskeleton torque and power output across a range of NMM controller Gain (0.8–2.0) and Delay (10–40 ms) settings, as well as a High Gain/High Delay (2.0/40 ms) combination. To quantify users’ physiological response, we compared joint kinematics and kinetics, ankle muscle electromyography and metabolic rate between powered and unpowered/zero-torque conditions. Increasing NMM controller reflex Gain caused increases in average ankle exoskeleton torque and net power output, while increasing NMM controller reflex Delay caused a decrease in net ankle exoskeleton power output. Despite systematic reduction in users’ average biological ankle moment with exoskeleton mechanical assistance, we found no NMM controller Gain or Delay settings that yielded changes in metabolic rate. Post hoc analyses revealed weak association at best between exoskeleton and biological mechanics and changes in users’ metabolic rate. Instead, changes in users’ summed ankle joint muscle activity with powered assistance correlated with changes in their metabolic energy use, highlighting the potential to utilize muscle electromyography as a target for on-line optimization in next generation adaptive exoskeleton controllers.

While fine manual dexterity develops over time, the extent to which children show independent control of their digits in each hand and the impact of perinatal brain injury on this individuation have not been well quantified. Our goal in this study was to assess and compare finger force and movement individuation in 8–14 year old children with hemiplegic cerebral palsy (hCP; n = 4) and their typically developing peers (TD; n = 10). We evaluated finger force individuation with five independent load cells and captured joint movement individuation with video tracking. We observed no significant differences in individuation indices between the dominant and non-dominant hands of TD children, but individuated force and movement were substantially reduced in the paretic versus non paretic hands of children with hCP ( p < 0.001). In TD participants, the thumb tended to have the greatest level of independent control. This small sample of children with hCP showed substantial loss of individuation in the paretic hand and some deficits in the non-paretic hand, suggesting possible benefit from targeted training of digit independence in both hands for children with CP.

Objective: Entrepreneurship and innovative product design in health care requires expertise in finding and evaluating diverse types of information from a multitude of sources to accomplish a number of tasks, such as securing regulatory approval, developing a reimbursement strategy, and navigating intellectual property. The authors sought to determine whether an intensive, specialized information literacy training program that introduced undergraduate biomedical engineering students to these concepts would improve the quality of the students’ design projects. We also sought to test whether information literacy training that included active learning exercises would offer increased benefits over training delivered via lectures and if this specialized information literacy training would increase the extent of students’ information use.Methods: A three-arm cohort study was conducted with a control group and two experimental groups. Mixed methods assessment, including a rubric and citation analysis, was used to evaluate program outcomes by examining authentic artifacts of student learning.Results: Student design teams that received information literacy training on topics related to medical entrepreneurship and health care economics showed significantly improved performance on aspects of project performance relevant to health care economics over student design teams that did not receive this training. There were no significant differences between teams that engaged in active learning exercises and those that only received training via lectures. Also, there were no significant differences in citation patterns between student teams that did or did not receive specialized information literacy training.Conclusions: Information literacy training can be used as a method for introducing undergraduate health sciences students to the health care economics aspects of the medical entrepreneurship life cycle, including the US Food and Drug Administration regulatory environment, intellectual property, and medical billing and reimbursement structures.