An Implantable Variable Length Actuator for Modulating in Vivo Musculo-Tendon Force in a Bipedal Animal Model

Mobility, a critical factor in quality of life, is often rehabilitated using simplistic solutions, such as walkers. Exoskeletons (wearable robotics) offer a more sophisticated rehabilitation approach. However, non-adherence to externally worn mobility aids limits their efficacy. Here, we present the concept of a fully implantable assistive limb actuator that overcomes non-adherence constraints, and which can provide high-precision assistive force. In a bipedal animal model (fowl), we have developed a variable length isometric actuator (measuring ϕ9 x 30 mm) that is able to be directly implanted within the leg via a bone anchor and tendon fixation, replacing the lateral gastrocnemius muscle belly. The actuator is able to generate isometric force similar to the in vivo force of the native muscle, designed to generate assistive torque at the ankle and reduce muscular demand at no additional energy cost. The device has a stroke of 10 mm that operates up to 770 mm/s (77 stroke lengths/s), capable of acting as a clutch (disengaging when needed) and with a tunable slack length to modulate the timing and level of assistive force during gait. Surgical techniques to attach the actuator to the biological system, the Achilles tendon and tibia, have been established and validated using survival surgeries and cadaveric specimens.