Gait Trainer with Reinforcement

Suyash Ugare, Sagar Karur, Sagar Medikeri, Sunita Shiratti, B.L.Desai.
suyashugare@gmail.com sagar2day@gmail.com sagar.medikeri@gmail.com sunitas@bvb.edu bldesai@bvb.edu

Department of Electronics and Communication Engineering, B.V.Bhoomaraddi College of Engineering and Technology, Hubli, India.

Abstract — Mental retardation or impairment is a complex and challenging problem. As much as 40% of all mentally challenged individuals suffer from physical disability. Gait disorders alone account for 25% of the disabilities. If these individuals are not treated effectively, chances of them getting crippled for life are high. By developing a low-cost and better alternative to the traditional gait training process, we are addressing this challenge. The prototype presented here, envisages that training processes for patients become interactive, more like a game rather than like a course or a routine regime which patients and in particular, children dislike. Such training tools enhance the confidence and control in patients, greatly increasing their chances of recovery. Keywords — gait training, reinforcement, mental retardation.

for exceptional children and physiotherapy departments to train the subjects. Gait trainer with reinforcement is an improved version of the parallel bar gait trainer. II. PARALLEL BAR GAIT TRAINER The usual method of treatment for the gait related problems is using the assistive devices. One such device is using the assistance of parallel bar for gait training. The subjects are trained to correct their walking posture. Fig. 1 shows a usual parallel bar gait trainer. There are parallel bars on two sides of the platform which can be adjusted in height and width depending on the physique of the child. A divider is placed at the centre of the walking platform which virtually divides the platform into two sections, so that the subject does not cross legs (not shown in figure). The subject supports himself to the parallel bars and walks along the board to and fro. During movement the motor nerves are stimulated, so that there is a development in subject’s motor reflexes. Thus the gait training helps in improving motor reflexes [8].
Adjustable Parallel bars

I. INTRODUCTION Two abilities are essential for a person to have proper walking posture. The first, equilibrium, is the ability to assume upright posture and maintain balance. The second is locomotion, the ability to initiate and maintain rhythmic stepping. There are situations where there is a need for correcting an individual’s gait. A person's gait is a pattern of stepping or walking that is specific to an individual. Gait training is used to correct the gait of an individual. Subject may have dysfunction in the lower part of the body. This dysfunction may be due to spasticity (the presence of abnormal involuntary muscular contractions), ataxia (loss of muscular coordination), muscle weakness, deformity or physical injuries due to accidents [7]. The aforementioned problems are usually associated with incorrect development of the motor skills. These incorrect motor reflexes decrease the ability of a person to have a fine control over their body muscles or there are no proper motor reflexes. Cerebral Palsy is a condition where there is a possibility of the significant problems related to muscular coordination, speech, vision, seizures and hearing. There is a need to improve the reflexes of the subject. In conditions, that affect the gait of a person, the gait training is preferred choice over surgery. Assistive devises are used in gait training. These devises include parallel bar gait trainer, gait trainer/walker, paediatric gait trainer, crutches, etc. These gait trainers are used in schools

Fig. 1 Usual parallel bar gait trainer.

III. NEED FOR REINFORCEMENT The parallel bar gait training is carried on the subject for months so that the gait of an individual is corrected to some extent. This monotonous training is disliked by the subjects. It does not have any interest provoking features. So, after a few

sessions, subjects (patients) and children, in particular tend to lose interest in the treatment. Thus, the treatment process turns out to be relatively slow. Thus the actual need is a training device which is able of creating interest in the gait training, by reinforcing the subject towards the treatment. Since the treatment is used mainly for children and children love playing games, a training device which takes the form of a game will be effective in achieving this objective. Studies have provided physiologic evidence that behaviour is motivated by primary rewards such as those produced by stimulation of the reward system. Stimulation of this system provides a potent motivation for learning and performing other tasks [1]. Also, Skinner's research provides the proof for the simple fact of life: behaviour that is rewarded is more likely to recur [10]. Lights and sounds can be used as a reward (stimulant) to the subjects’ mind. This will keep the child involved in the training session. The lights and sound provide the necessary reinforcement to the children. Thus including the lights and sound in the gait trainer will make training sessions more effective. The lights will act as visual reinforcement and the sound will act as an auditory reinforcement. Both auditory and visual reinforcement motivate the subject to involve in the training. GAIT TRAINER WITH REINFORCEMENT DETAILS The Trainer is divided into two entities as shown the Fig 2. , namely1. The Walking Platform 2. The Control Unit and the User Interface IV.

connection. The outputs of all sensors connect to the inputs of the 16:1 multiplexer in the Control Unit. The connector pin diagram is given in Fig. 3. The entire platform will be approximately 8’×2’.
Vcc Gnd LEDs Sensor Output Fig. 3 Tile connector pin diagram.

1) Model of the tile: The top view of each tile on the plywood base is shown in Fig. 4. Each tile consists of five spring-bush arrangement. It consists of four strips of LEDs for illumination and two switches.

Walking Platform Fig. 4 Top view of the tile.

The Control Unit and the User Interface

Interface Cable

Fig. 2 Gait Trainer with Reinforcement showing Control Unit and Walking Platform.

A. WALKING PLATFORM The Walking Platform consists of 16 tiles arranged in an 8×2 fashion. Each tile is a translucent acrylic sheet of dimensions 11”×11” and thickness 6mm. Each tile is maintained at a small height above the plywood base in order to house switches and lights beneath it. Switches are used to detect if a tile has been stepped and lights (arrays of high intensity White LEDs) are used for illumination. Each tile is internally wired and a 4-pin connector is available for external

Fig. 5 Spring and bush arrangement below the tile.

2) Spring-bush arrangement: The Fig. 5 shows the design of the support below the tile. The support is made up of two hard-plastic bushes and a mechanical spring. The design is such that the two bushes limit the compression of the spring

to 2mm so that the switches change state when pressed, but don’t get damaged physically. There is one more advantage of using springs. They are designed such that minimum weight (approximately) has to be put up on the tile. This will ensure that the subject will not put the body weight on the bars but will put it on legs. B. Control Unit and User Interface The Control Unit consists of circuitry which enables continuous polling of the switches and driving circuitry to glow the LEDs underneath the tile. It also has audio playback circuitry which plays the recorded sounds and an audio amplifier to drive the speaker. Cables are used to establish communication between the control unit and walking platform. 1) Working of Control Unit A microcontroller (AT89S52) controls the functioning of the system. The switches of all the 16 tiles are multiplexed to the controller. The multiplexed data is read by the controller. The microcontroller polls the switches of all the tiles sequentially. First, the controller checks the status of the switches in the first tile. If this tile has not been stepped, the polling proceeds to the next tile and so on. If a particular tile has been stepped, the microcontroller detects it and latches the select lines of the multiplexer to the decoder thus activating the LEDs below the stepped tile. This decoded data is also used to play the sound corresponding to that tile. After this is done, polling proceeds to the next tile. Sounds are recorded before hand in a record-playback IC. Thus, whenever any tile is stepped, corresponding lights and sounds are activated. This is the basic mode operation of the Trainer. Basic mode operation is summarized in the flowchart shown in Fig 6.
Basic mode

Guided mode

Glow a tile

No Is glowing tile stepped? Yes Glow next tile in the sequence Fig. 7 Operation of guided mode

V. CONCLUSION A. Discussion on outcomes Studies have shown that there is a considerable improvement in gait velocity of the subject when auditory and visual reinforcements are used during the training sessions. The proposed model has been tested in USHAS, school for exceptional children. We justify it by the study conducted by a mental health and research institute which shows that without reinforcement the subject took about 40 seconds to walk over the platform, whereas with auditory and visual reinforcements subject takes 29 seconds [6]. Thus, training with reinforcement shows that there will be significant improvement in the gate velocity. B. Further Developments 1. In the prototype proposed here, all the tiles are on a common platform and portability is restricted. Making the platform modular in tile structure will have two advantages. One, it will make the trainer portable. Two, if the algorithm is made compatible to any number of tiles, then the user will have flexibility to configure the system to any number of tiles as per his requirement. 2. Incorporating an electronic display board will have much better visual reinforcement. The display board makes the trainer more interactive and can also be used to enhance cognitive learning among subjects. 3. Facility can be provided to let the operator program the sequence in which guided mode operates. ACKNOWLEDGMENTS We take this opportunity to express our sincere thanks to Mr. Raghavendra Okade and Mrs. Roopa Okade from USHAS, a school for exceptional children, for the sparkling idea that they gave us. While designing the model, feedback and suggestions were taken from Dr. Kiran, & Dr. Sanjay, from USHAS. We are overwhelmed for their immense support. We convey our thanks to Asst. Prof. V. N. Sanagoudar for guidance in designing the mechanical structure. We also

Initialize i=1

i-th tile stepped? No

Yes Glow corresponding tile and play sound

Increment i by 1. Set i=1 if i=16 Fig. 6 Operation of basic mode.

Another mode of operation of the Trainer is called as guided mode, wherein a tile is lit initially indicating the subject to walk towards it and step on it. The sound of this tile is played only when this particular tile is stepped and not otherwise. Guided mode is summarised in the flowchart shown in Fig 7.

extend our sincere thanks to Mr. Naveen Jha, Director of Deshpande Centre for Social Entrepreneurship, for financial assistance. We thank Dr. Ashok Shettar, Principal of B. V. Bhoomaraddi College of Engineering and Technology, for his fantastic support and encouragement. We take pleasure in mentioning one name separately, Ajay Bhat for his mammoth contribution in this project. We would like to thank the entire crew of our Electronics and Communication Department, for their cooperation. Lastly, we also would like to thank our student friends Karthik Kulkarni, Khuram.Syed, Gouri Yalagach, Deepika and Gangamma for initiating this project. REFERENCES
[1] William F.Ganong, Review of Medical Physiology, 21st ed. [2] Muhammad Ali Mazidi, Janice Gillispie Mazidi, Rolin D.Mckinlay, The 8051 Microcontroller and Embedded Systems, 2nd ed., Pearson Edition. [3] Robert L.Boylestad, Louis Nashelsky, Electronic Devices and Circuiy Theory, 6th ed., PHI. [4] Donald D. Givone, Digital Principles and Design, 4th ed., Tata Mcgraw-Hill. [5] Joseph Edward Shigley, Charles R. Mischke, Thomas Brown, Standard Handbook of Machine Design, 3rd ed., Tata Mcgraw-Hill. [6] NIMH (National Institute of Mental Health, Secunderabad) Newsletter, Vol. 21, Issue 3, December 2008. [7] (2009) Encyclopaedia. [Online]. Available: http://www.enotes.com/nursing-encyclopedia/gait-training. [8] (2009) Encyclopaedia. [Online]. Available: http://www.enotes.com/nursing-encyclopedia/reflexes. [9] (2009) Encyclopaedia. [Online]. Available: http://www.enotes.com/nursing-encyclopedia/ fine-motor-skills. [10] (2009) Encyclopaedia. [Online]. Available: http://www.enotes.com/nursing-encyclopedia/learningtheory.

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