LAUSR

Abstract Walking impairment due to spinal cord injury can be improved using active orthoses, together with some type of external support such as crutches for balance. This study explores how optimal control problem formulation affects the ability to generate dynamically consistent crutch walking simulations with active orthosis assistance that closely reproduce experimental data. The investigation compares eight optimal tracking problem formulations using a torque-driven full-body skeletal model of a healthy subject walking with active knee-ankle-foot orthoses and forearm crutches. We have found that small adjustments to ground reactions are required to achieve convergence, tracking of joint instead of marker coordinates significantly improves convergence, and minimising joint jerks instead of joint accelerations has only a minor effect on the problem convergence. These results provide guidance for future work that seeks to develop predictive optimal control simulations that can identify orthosis control parameters that maximise improvement in walking function on an individual patient basis.