Exoskeleton assistance optimization for Charcot-Marie-Tooth patients based on customized forward predictive simulation.

Charcot-Marie-Tooth (CMT) disease causes gait abnormalities like foot-drop. While powered orthoses can assist, their effectiveness varies. This study optimized ankle torque assistance for CMT patients using forward predictive simulation with customized musculoskeletal models. Gait data from patients informed model customization, improving simulation accuracy. The optimized assistive torque profile, applied to a patient-specific model, reduced simulated metabolic cost by 9.9% compared to normal walking and significantly decreased soleus and gastrocnemius activity. This simulation framework provides guidance for exoskeleton assistance and the design of assistive devices for CMT patients.