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Étude de la modélisation de la spasticité et de l’interaction patient-exosquelette dans le cadre de la paralysie cérébrale de l’enfant

Authors: Otmani, Sabrina;

Étude de la modélisation de la spasticité et de l’interaction patient-exosquelette dans le cadre de la paralysie cérébrale de l’enfant

Abstract

La paralysie cérébrale (PC) spastique est une pathologie qui touche près d’un enfant sur 500 à la naissance. Cette pathologie crée de nombreux problèmes moteurs notamment lors de la marche comme des mouvements involontaires due à une hypertonie musculaire appelée aussi spasticité. Chaque paralysie cérébrale a sa propre sévérité mesurée par différentes échelles. Actuellement, très peu d’aides motrices sont disponibles pour les enfants, le marché des assistances robotisées se focalisant principalement sur les adultes (anthropométrie constante et pathologie peu évolutive).L’objectif du projet EXOKID, dont cette thèse est issue, est donc de permettre à davantage d’enfants atteints de paralysie cérébrale d’avoir accès à un système robotisé à anthropométrie adaptée. Ce système doit pouvoir évoluer en fonction de leur croissance et de l’évolution de leur pathologie afin d’améliorer leur marche tant dans un contexte de rééducation au sein de structures adaptées que dans leur mobilité quotidienne.L’enfant, atteint de cette paralysie cérébrale, doit être pris en charge le plus tôt possible. Le but est de permettre à ce que l’enfant apprenne à marcher : en effet, la plasticité cérébrale des enfants est plus importante que celle des adultes et permet potentiellement à l’enfant d’apprendre rapidement, malgré d’éventuelles lésions cérébrales.Deux sœurs jumelles, dont l’une est atteinte de PC spastique, ont été étudiées. Cette gémellité nous a permis d’avoir des anthropométries proches et d’utiliser les données de la jumelle saine comme référence pour améliorer la marche spastique de sa sœur.Cette thèse s’articule ainsi autour de deux grands champs : la biomécanique et la robotique. Une étude de l’impact de paralysie cérébrale spastique sur la marche humaine a été réalisée. Cette étude a été suivie par une modélisation de la marche spastique et de l’interaction entre un enfant atteint de PC spastique et un exosquelette dans le but d’améliorer la cinématique de l’enfant.Cette thèse a abouti à la modélisation personnalisée d’une marche spastique ainsi que d’un premier contrôle de cette marche, par le biais d’une interaction exosquelette-humain, afin de la faire converger vers une marche plus saine.

Spastic cerebral palsy is a pathology that affects nearly one child in 500 at birth.This pathology creates numerous motor problems, particularly when walking, suchas involuntary movements due to muscular hypertonia, also called spasticity. Eachcerebral palsy has its own severity measured by different scales. Currently, very fewmotor aids are available for children, as the market for robotic aids focuses mainlyon adults (constant anthropometry and pathology that does not evolve much). Theobjective of the EXOKID project, from which this thesis stems, is therefore to allowmore children with cerebral palsy to have access to a robotic system with adaptedanthropometry. This system must be able to evolve according to their growth andthe evolution of their pathology in order to improve their walking both in the contextof rehabilitation within adapted structures and in their daily mobility. The child,suffering from this cerebral palsy, must be taken in charge as soon as possible. Theaim is to enable the child to learn to walk : indeed, the cerebral plasticity of childrenis more important than that of adults and potentially allows the child to learnquickly, despite possible cerebral lesions.Two twin sisters, one of whom has spastic PC, were studied. This twinhood allowedus to have close anthropometries and to use the data of the healthy twin as areference to improve the spastic gait of her sister. This thesis is thus articulatedaround two main fields : biomechanics and robotics. A study of the impact of spasticcerebral palsy on human walking was carried out. This study was followed by amodelling of a spastic walking and the interaction between a child suffering fromspastic cerebral palsy and an exoskeleton with the aim of improving the child’skinematics. This thesis resulted in the personalised modelling of a spastic gait anda first control of this gait, through an exoskeleton-human interaction, in order tomake it converge towards a healthier gait.

Keywords

Enfant, Paralysie Cerebrale, Interaction, Cerebral Palsy, Spasticite, [INFO.INFO-RB] Computer Science [cs]/Robotics [cs.RO], Robotics, Modelling, Exoskeleton, [INFO.INFO-RB]Computer Science [cs]/Robotics [cs.RO], Biomechanics, Modelisation, Spasticity, Robotique, Child, Biom´ecanique, Exosquelette

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citations
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
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