{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T18:32:12Z","timestamp":1789669932789,"version":"4.0.1"},"reference-count":54,"publisher":"ASME International","issue":"6","license":[{"start":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T00:00:00Z","timestamp":1745798400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.asme.org\/publications-submissions\/publishing-information\/legal-policies"}],"content-domain":{"domain":["asmedigitalcollection.asme.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Robot-assisted gait rehabilitation is an increasingly common therapeutic intervention for enhancing locomotion and improving quality of life for children with lower-limb mobility impairments. However, there are few systems specifically designed for pediatric use, and those that do exist are largely cumbersome, bulky, and noncustom devices that ultimately reduce therapy effectiveness. This paper introduces the Cable-Driven Joint System (CDJS), a novel approach for pediatric gait rehabilitation that addresses these shortcomings in a lightweight and compact robotic device using the patient's professionally fitted orthosis. The CDJS consists of a 2.1\u2009kg actuation unit that is held by a clinician which delivers assistive torques through a Bowden cable transmission to a 0.3\u2009kg joint mounted to user-custom bracing. This work details an actuator benchtop evaluation, demonstrating a peak torque of 20 N\u00b7m, peak velocity of 7.2\u2009rad\/s, bandwidth of 9.7\u2009Hz, and a mass moment of inertia of 58.38\u2009kg cm2. An actuator model was developed and evaluated in simulation, showing a strong correlation with the experimental torque data (R-squared\u2009=\u20090.95) and indicating a transmission efficiency of 72%. In-air gait tracking experiments on an emulated subject showed that the CDJS assisted the subject to track a nominal knee trajectory with an average root-mean-squared error of 2.56\u2009deg at a continuous torque of 1.37 N\u00b7m. These results suggest that the cable-driven actuator meets the design requirements for use in pediatric gait rehabilitation and is ready for implementation in clinical device trials.<\/jats:p>","DOI":"10.1115\/1.4068369","type":"journal-article","created":{"date-parts":[[2025,4,7]],"date-time":"2025-04-07T10:33:34Z","timestamp":1744022014000},"update-policy":"https:\/\/doi.org\/10.1115\/crossmarkpolicy-asme","source":"Crossref","is-referenced-by-count":3,"title":["Design and Validation of a Cable-Driven Joint Actuator for Pediatric Knee Orthoses"],"prefix":"10.1115","volume":"147","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9431-7011","authenticated-orcid":false,"given":"Jason J.","family":"Wiebrecht","sequence":"first","affiliation":[{"name":"Center for Rotating Machinery Dynamics and Control, Washkewicz College of Engineering, Cleveland State University , Cleveland, OH 44115"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0797-7434","authenticated-orcid":false,"given":"Jacob A.","family":"Strick","sequence":"additional","affiliation":[{"name":"Center for Rotating Machinery Dynamics and Control, Washkewicz College of Engineering, Cleveland State University , Cleveland, OH 44115"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan J.","family":"Farris","sequence":"additional","affiliation":[{"name":"Department of Engineering, Messiah University , Mechanicsburg, PA 17055"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerzy T.","family":"Sawicki","sequence":"additional","affiliation":[{"name":"Center for Rotating Machinery Dynamics and Control, Washkewicz College of Engineering, Cleveland State University , Cleveland, OH 44115"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"33","published-online":{"date-parts":[[2025,4,28]]},"reference":[{"key":"2025042810195303000_bib1","unstructured":"Erickson, W., Lee, C., and von Schrader, S., 2023, \u201c2021 Disability Status Report: United States,\u201d Cornell University, Ithaca, NY, accessed Aug. 3, 2024, https:\/\/www.ilr.cornell.edu\/yti\/work"},{"key":"2025042810195303000_bib2","volume-title":"Pediatric Rehabilitation Principles and Practice","year":"2020"},{"issue":"1","key":"2025042810195303000_bib3","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1097\/NPT.0b013e31819800e2","article-title":"A Systematic Review of the Effectiveness of Treadmill Training and Body Weight Support in Pediatric Rehabilitation","volume":"33","year":"2009","journal-title":"J. Neurol. Phys. Ther."},{"key":"2025042810195303000_bib4","first-page":"1","article-title":"Lower Limb Exoskeletons for Pediatric Gait Rehabilitation: A Brief Review of Design, Actuation, and Control Schemes","volume-title":"ICASET","year":"2023"},{"key":"2025042810195303000_bib5","doi-asserted-by":"crossref","first-page":"103960","DOI":"10.1016\/j.medengphy.2023.103960","article-title":"Sensors and Algorithms for Locomotion Intention Detection of Lower Limb Exoskeletons","volume":"113","year":"2023","journal-title":"Med. Eng. Phys."},{"issue":"1","key":"2025042810195303000_bib6","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1515\/pjbr-2020-0021","article-title":"Promoting Inclusiveness in Exoskeleton Robotics: Addressing Challenges for Pediatric Access","volume":"11","year":"2020","journal-title":"Paladyn J. Behav. Rob."},{"issue":"404","key":"2025042810195303000_bib7","doi-asserted-by":"crossref","first-page":"eaam9145","DOI":"10.1126\/scitranslmed.aam9145","article-title":"A Lower-Extremity Exoskeleton Improves Knee Extension in Children With Crouch Gait From Cerebral Palsy","volume":"9","year":"2017","journal-title":"Sci. Transl. Med."},{"key":"2025042810195303000_bib8","doi-asserted-by":"crossref","first-page":"702137","DOI":"10.3389\/frobt.2021.702137","article-title":"A Pediatric Knee Exoskeleton With Real-Time Adaptive Control for Overground Walking in Ambulatory Individuals With Cerebral Palsy","volume":"8","year":"2021","journal-title":"Front. Rob. AI"},{"key":"2025042810195303000_bib9","doi-asserted-by":"crossref","first-page":"103109","DOI":"10.1016\/j.mechatronics.2023.103109","article-title":"Actuator Optimization and Deep Learning-Based Control of Pediatric Knee Exoskeleton for Community-Based Mobility Assistance","volume":"97","year":"2024","journal-title":"Mechatronics"},{"issue":"9","key":"2025042810195303000_bib10","doi-asserted-by":"crossref","first-page":"2870","DOI":"10.1109\/TBME.2021.3083580","article-title":"Biomechanical Comparison of Assistance Strategies Using a Bilateral Robotic Knee Exoskeleton","volume":"68","year":"2021","journal-title":"IEEE Trans. Biomed. Eng."},{"issue":"12","key":"2025042810195303000_bib11","doi-asserted-by":"crossref","first-page":"3312","DOI":"10.1109\/TBME.2023.3282165","article-title":"Reducing Knee Hyperextension With an Exoskeleton in Children and Adolescents With Genu Recurvatum: A Feasibility Study","volume":"70","year":"2023","journal-title":"IEEE Trans. Biomed. Eng."},{"issue":"12","key":"2025042810195303000_bib12","first-page":"1","article-title":"Mitigating Crouch Gait With an Autonomous Pediatric Knee Exoskeleton in the Neurologically Impaired","volume":"146","year":"2024","journal-title":"ASME J. Biomech. Eng."},{"issue":"7","key":"2025042810195303000_bib13","doi-asserted-by":"crossref","first-page":"906","DOI":"10.1109\/TNSRE.2017.2651404","article-title":"WAKE-Up Exoskeleton to Assist Children With Cerebral Palsy: Design and Preliminary Evaluation in Level Walking","volume":"25","year":"2017","journal-title":"IEEE Trans. Neural Syst. Rehabil. Eng."},{"issue":"4","key":"2025042810195303000_bib14","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1016\/j.neucli.2018.12.001","article-title":"Reliability of Maximum Isometric Hip and Knee Torque Measurements in Children With Cerebral Palsy Using a Paediatric Exoskeleton\u2014Lokomat","volume":"49","year":"2019","journal-title":"Neurophysiol. Clin."},{"issue":"1","key":"2025042810195303000_bib15","doi-asserted-by":"crossref","first-page":"215","DOI":"10.3390\/pediatric15010017","article-title":"Benefits of a Wearable Cyborg HAL (Hybrid Assistive Limb) in Patients With Childhood-Onset Motor Disabilities: A 1-Year Follow-Up Study","volume":"15","year":"2023","journal-title":"Pediatr. Rep."},{"issue":"10","key":"2025042810195303000_bib16","doi-asserted-by":"crossref","first-page":"105001","DOI":"10.1115\/1.4051214","article-title":"An Anthropometrically Parameterized Assistive Lower Limb Exoskeleton","volume":"143","year":"2021","journal-title":"ASME J. Biomech. Eng."},{"issue":"4","key":"2025042810195303000_bib17","doi-asserted-by":"crossref","first-page":"138","DOI":"10.3390\/act9040138","article-title":"Design and Evaluation of a Pediatric Lower-Limb Exoskeleton Joint Actuator","volume":"9","year":"2020","journal-title":"Actuators"},{"key":"2025042810195303000_bib18","first-page":"2411","article-title":"Design of a Customizable, Modular Pediatric Exoskeleton for Rehabilitation and Mobility","volume-title":"SMC","year":"2019"},{"key":"2025042810195303000_bib19","article-title":"Mechanical Description of ATLAS 2020, a 10-DOF Paediatric Exoskeleton","volume-title":"International Conference on CLAWAR","year":"2016"},{"key":"2025042810195303000_bib20","article-title":"Adjustability Mechanism for Lower Limb Orthosis","year":"2024"},{"issue":"1","key":"2025042810195303000_bib21","doi-asserted-by":"crossref","first-page":"26","DOI":"10.3390\/robotics12010026","article-title":"Human Factors Assessment of a Novel Pediatric Lower-Limb Exoskeleton","volume":"12","year":"2023","journal-title":"Robotics"},{"issue":"8","key":"2025042810195303000_bib22","doi-asserted-by":"crossref","first-page":"885","DOI":"10.1080\/17483107.2019.1629110","article-title":"A Review of Cable-Driven Rehabilitation Devices","volume":"15","year":"2020","journal-title":"Disabil. Rehabil. Assist. Technol."},{"issue":"13","key":"2025042810195303000_bib23","doi-asserted-by":"crossref","first-page":"2468","DOI":"10.1177\/0954406220952510","article-title":"Control Strategy and Experimental Research of a Cable-Driven Lower Limb Rehabilitation Robot","volume":"235","year":"2021","journal-title":"Proc. Inst. Mech. Eng., Part C: J. Mech. Eng. Sci."},{"issue":"2","key":"2025042810195303000_bib24","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1016\/j.gaitpost.2010.11.016","article-title":"A Cable-Driven Locomotor Training System for Restoration of Gait in Human SCI","volume":"33","year":"2011","journal-title":"Gait Posture"},{"key":"2025042810195303000_bib25","first-page":"299","article-title":"Comparing the Performance of a Cable-Driven Active Leg Exoskeleton (C-ALEX) Over-Ground and on a Treadmill","volume-title":"2018 Seventh IEEE International Conference on Biomedical Robotics and Biomechatronics (Biorob)","year":"2018"},{"issue":"10","key":"2025042810195303000_bib26","doi-asserted-by":"crossref","first-page":"1985","DOI":"10.1109\/TNSRE.2018.2870756","article-title":"An Untethered Ankle Exoskeleton Improves Walking Economy in a Pilot Study of Individuals With Cerebral Palsy","volume":"26","year":"2018","journal-title":"IEEE Trans. Neural Syst. Rehabil. Eng."},{"key":"2025042810195303000_bib27","article-title":"Orthopedic Device Including Protruding Members","year":"2020"},{"issue":"5","key":"2025042810195303000_bib28","doi-asserted-by":"crossref","first-page":"2058","DOI":"10.1109\/TMECH.2017.2718999","article-title":"Biomechanical Design of a Novel Flexible Exoskeleton for Lower Extremities","volume":"22","year":"2017","journal-title":"IEEE\/ASME Trans. Mechatron."},{"key":"2025042810195303000_bib29","article-title":"Soft Exosuit for Assistance With Human Motion","year":"2020"},{"key":"2025042810195303000_bib30","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/j.gaitpost.2018.06.124","article-title":"O 089\u2014A Soft Robotic Exosuit Assisting the Paretic Ankle in Patients Post-Stroke: Effect on Muscle Activation During Overground Walking","volume":"95","year":"2022","journal-title":"Gait Posture"},{"issue":"6454","key":"2025042810195303000_bib31","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1126\/science.aav7536","article-title":"Reducing the Metabolic Rate of Walking and Running With a Versatile, Portable Exosuit","volume":"365","year":"2019","journal-title":"Science"},{"key":"2025042810195303000_bib32","volume-title":"Understanding Motor Development: Infants, Children, Adolescents, Adults","year":"2019"},{"key":"2025042810195303000_bib33","unstructured":"Fryar, C., Carroll, M., Gu, Q., Afful, J., and Ogden, C., 2021, \u201cAnthropometric Reference Data for Children and Adults: United States, 2015\u20132018,\u201d National Center for Health Statistics, Hyattsville, MD, accessed July 6, 2024, https:\/\/www.cdc.gov\/nchs\/products\/index.htm"},{"issue":"1","key":"2025042810195303000_bib34","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1186\/s12984-021-00815-5","article-title":"Systematic Review on Wearable Lower-Limb Exoskeletons for Gait Training in Neuromuscular Impairments","volume":"18","year":"2021","journal-title":"J. NeuroEng. Rehabil."},{"key":"2025042810195303000_bib35","volume-title":"The Biomechanics and Motor Control of Human Gait","year":"1987"},{"issue":"4","key":"2025042810195303000_bib36","doi-asserted-by":"crossref","first-page":"502","DOI":"10.1016\/j.gaitpost.2009.07.119","article-title":"Basic Gait and Symmetry Measures for Primary School-Aged Children and Young Adults Whilst Walking Barefoot and With Shoes","volume":"30","year":"2009","journal-title":"Gait Posture"},{"issue":"6","key":"2025042810195303000_bib37","doi-asserted-by":"crossref","first-page":"060801","DOI":"10.1115\/1.4056919","article-title":"Energy-Efficient Actuator Design Principles for Robotic Leg Prostheses and Exoskeletons: A Review of Series Elasticity and Backdrivability","volume":"18","year":"2023","journal-title":"ASME J. Comput. Nonlinear Dyn."},{"key":"2025042810195303000_bib38","unstructured":"U.S. Department of Defense, 1995, \u201cHuman Engineering Design Guidelines (MIL-HDBK-759C),\u201d Navy Publishing and Printing Office, Philadelphia, PA, accessed July 10, 2024, https:\/\/quicksearch.dla.mil\/qsDocDetails.aspx?ident_number=54086"},{"key":"2025042810195303000_bib39","volume-title":"Introduction to Ergonomics","year":"2009"},{"key":"2025042810195303000_bib40","unstructured":"NASA,\n          1995, \u201cNASA-STD-3000, Volume I, Section 3: Anthropometry and Biomechanics,\u201d National Aeronautics and Space Administration, Houston, TX, accessed Aug. 3, 2024, https:\/\/msis.jsc.nasa.gov\/"},{"key":"2025042810195303000_bib41","first-page":"5927","article-title":"Experimental Characterization of Bowden Cable Friction","volume-title":"ICRA","year":"2014"},{"key":"2025042810195303000_bib42","article-title":"Preliminary Experimental Validation of a Cable-Driven Joint System for Custom Orthoses","volume-title":"EMBC","year":"2024"},{"key":"2025042810195303000_bib43","doi-asserted-by":"crossref","first-page":"13","DOI":"10.3389\/fnbot.2020.00013","article-title":"Modeling and Control of a Cable-Driven Rotary Series Elastic Actuator for an Upper Limb Rehabilitation Robot","volume":"14","year":"2020","journal-title":"Front. Neurorob."},{"issue":"6","key":"2025042810195303000_bib44","doi-asserted-by":"crossref","first-page":"108","DOI":"10.3390\/act10060108","article-title":"Active Loading Control Design for a Wearable Exoskeleton With a Bowden Cable for Transmission","volume":"10","year":"2021","journal-title":"Actuators"},{"key":"2025042810195303000_bib45","doi-asserted-by":"crossref","first-page":"104746","DOI":"10.1016\/j.mechmachtheory.2022.104746","article-title":"Mechanical Design and Friction Modelling of a Cable-Driven Upper-Limb Exoskeleton","volume":"171","year":"2022","journal-title":"Mech. Mach. Theory"},{"issue":"3","key":"2025042810195303000_bib46","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1016\/S0947-3580(98)70113-X","article-title":"Friction Models and Friction Compensation","volume":"4","year":"1998","journal-title":"Eur. J. Control"},{"issue":"9","key":"2025042810195303000_bib47","first-page":"1615","article-title":"Development of a Model Reference Computed Torque Controller for a Human Lower Extremity Exoskeleton Robot","volume":"235","year":"2021","journal-title":"J. Syst. Control Eng."},{"key":"2025042810195303000_bib48","doi-asserted-by":"crossref","first-page":"1399","DOI":"10.3389\/fneur.2019.01399","article-title":"The Effect of Increased Gait Speed on Asymmetry and Variability in Children With Cerebral Palsy","volume":"10","year":"2020","journal-title":"Front. Neurol."},{"issue":"8","key":"2025042810195303000_bib49","doi-asserted-by":"crossref","first-page":"1639","DOI":"10.1016\/j.jbiomech.2008.03.015","article-title":"The Effect of Walking Speed on the Gait of Typically Developing Children","volume":"41","year":"2008","journal-title":"J. Biomech."},{"issue":"1","key":"2025042810195303000_bib50","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1186\/s12984-021-00906-3","article-title":"Review of Control Strategies for Lower-Limb Exoskeletons to Assist Gait","volume":"18","year":"2021","journal-title":"J. NeuroEng. Rehabil"},{"key":"2025042810195303000_bib51","article-title":"Model-Based Assist-as-Needed Control on a Provisional Pediatric Lower-Limb Orthosis","volume-title":"ASME","year":"2023"},{"key":"2025042810195303000_bib52","article-title":"Attachment Mechanism for Powered Lower Limb Orthoses","year":"2025"},{"issue":"4","key":"2025042810195303000_bib53","doi-asserted-by":"crossref","first-page":"044502","DOI":"10.1115\/1.4064435","article-title":"A Novel Gait Event Detection Algorithm Using a Thigh-Worn Inertial Measurement Unit and Joint Angle Information","volume":"146","year":"2024","journal-title":"ASME J. Biomech. Eng."},{"key":"2025042810195303000_bib54","first-page":"1","article-title":"Real-Time Experimental Validation of an Adaptive Gait Event Detection Algorithm","year":"2025","journal-title":"IEEE Sens. J."}],"container-title":["Journal of Biomechanical Engineering"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/asmedigitalcollection.asme.org\/biomechanical\/article-pdf\/147\/6\/064501\/7478776\/bio_147_06_064501.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/asmedigitalcollection.asme.org\/biomechanical\/article-pdf\/147\/6\/064501\/7478776\/bio_147_06_064501.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T10:20:37Z","timestamp":1745835637000},"score":1,"resource":{"primary":{"URL":"https:\/\/asmedigitalcollection.asme.org\/biomechanical\/article\/147\/6\/064501\/1214729\/Design-and-Validation-of-a-Cable-Driven-Joint"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,28]]},"references-count":54,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,6,1]]}},"URL":"https:\/\/doi.org\/10.1115\/1.4068369","relation":{},"ISSN":["0148-0731","1528-8951"],"issn-type":[{"value":"0148-0731","type":"print"},{"value":"1528-8951","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,28]]},"article-number":"064501"}}