The Trunk-Support Trainer (TruST) has been developed by a team at the New York university to assist the hundreds of thousands of people worldwide who suffer from injuries to the spinal cord, which carries information from the brain to the rest of the body.
These patients have a high survival rate, but find everyday activities a major challenge. The TruST system has been designed to help them sit in a wider range of positions without falling over or having to use their hands to balance.
“We designed TruST for people with SCIs (spinal cord injuries) who are typically wheelchair users,” explains Sunil Agrawal, professor of mechanical engineering and of rehabilitation and regenerative medicine. "We found that TruST not only prevents patients from falling, but also maximises trunk movements beyond patients' postural control, or balance limits.”
The system comprises a motorised, cable-driven belt placed around the user’s torso to determine their postural control limits. When the user performs upper body movements beyond those limits – the point at which they would normally lose balance or fall – the system steps in and delivers forces to keep them stable.
A pilot study examined five patients with a customised postural sitting test that required them to follow a ball with their head, without using their hands. They did this both with and without a customised force-feedback through the TruST system, and it was discovered that robotic assistance enabled them to move about 25 per cent more.
“The capacity of TruST to deliver continuous force-feedback personalised 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."
The next step for the research team is to develop a training paradigm using TruST to improve the trunk control of people with spinal cord injuries. "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."
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