Patent Publication Number: US-10758774-B2

Title: Walk therapy station

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
     This application also claims the benefit of U.S. Provisional Application Serial No. 62/569,378 titled “Natural Assist Simulated Gait Therapy Adjustment System,” filed by Tholkes, et al., on Oct. 6, 2017. 
     This application incorporates the entire contents of the foregoing application(s) herein by reference. 
    
    
     TECHNICAL FIELD 
     Various embodiments relate generally to physical therapy systems. 
     BACKGROUND 
     There are approximately twelve thousand spinal cord injuries (SCI) per year in the United States alone. The average age of an injured person is twenty-eight years old. There are approximately three-hundred thousand people with SCIs in wheelchairs in the United States. In addition to SCIs, there are also many thousands of cases of strokes as well as thousands of cases of multiple sclerosis (MS) diagnoses each year in the United States. Furthermore, many other neurological problems afflict people and confine them to wheelchairs. The numbers of such cases world-wide is commensurately larger yet. 
     Providing such physically afflicted individuals an ability to stand may help maintain and improve their health. Walking therapy may restore function in SCI individuals and in those who have suffered paralyzing strokes. The beneficial results from walking therapy may be enhanced if the paralyzed individual can consistently and regularly perform the therapy. Mental health benefits may accrue as well to SCI individuals who may independently exercise or practice therapy. 
     SUMMARY 
     Apparatus and associated methods relate to a walking therapy station having multiple right linkages and multiple left linkages, where at least one of the right or left linkages is operably coupled to an actuator to transition the station from a standing mode to a walking mode. In an illustrative example, the station may have five right linkages and five left linkages, with a set of knee pads and foot pads. The station may include an actuator operably coupled to transition the station between walking and standing modes, for example. Various embodiments of the station may enable a user who is disabled or paralyzed to transition from sitting position, to a standing position, and then to a walking position, and provide the user with a very accurate gait and walking motion without putting excessive shear and pressure at the contact points between the station and the user. 
     Various embodiments may achieve one or more advantages. For example, some embodiments may provide physical therapy to disabled or paralyzed users to increase their mobility and muscle memory. Some examples may provide for resistance to a user to push their physical stamina and improve the strength of their muscles and level of muscle control. A station may easily allow a paralyzed user to transition into the machine by a walker or wheelchair, for example. Some embodiments may provide for a system that guides a user&#39;s feet through a very natural gait motion with a natural heel strike motion and toe lift motion. Various examples may include multiple support points (such as knee, foot, buttocks, hip, and chest pads) to keep a paralyzed user standing upright. The station may include various sensors to detect positions of a user&#39;s legs and accurately time/calibrate the power delivered by a motor that drives the linkages to simulate a user&#39;s natural gait motion. The station may have, for example, various adjustment features to accommodate users of different heights, weights, or sizes. A frame of the station may advantageously collapse to allow for easy shipping and transportation of the station. Various embodiments may include an actuator to facilitate lifting of an individual from a sitting to a standing position. Some implementations may employ a flywheel to smooth motion of the linkages of the station. Some implementations may be motor-less, which may beneficially allow for users with some mobility to adjust a level of difficulty customized to their needs, and some implementations may include a motor for guiding a paralyzed user through natural gait motions for rehabilitation purposes. 
     Various embodiments may achieve other advantages. For example, some embodiments may promote healthy bones by standing users without individual assistance. Standing therapy may promote skin integrity as well as vital organ functions such as renal functions (e.g., bladder, kidneys). Walking therapy may promote bone integrity, range of motion as well as the benefits mentioned for standing therapy. Physicians and patients may benefit from the tele-rehabilitation aspects of the walking therapy station, for example, and physicians may monitor patient vital systems and may chart patient progress as the patient progresses through their therapy. 
     The details of various embodiments are set forth in the accompanying drawings and the description below. Other features and advantages will be apparent from the description and drawings, and from the claims. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         FIG. 1  depicts a right side elevational view of an exemplary walk therapy station in a sitting mode, a standing mode, and a walking mode. 
         FIG. 2A  depicts a back left perspective view of an exemplary walk therapy station with a housing. 
         FIG. 2B  depicts a front right perspective view of an exemplary walk therapy station with a housing. 
         FIGS. 3A, 3B, and 3C  depict right side elevational views of an exemplary walk therapy station in a sitting mode, a standing mode, and a walking mode, respectively. 
         FIG. 4  depicts a back right perspective detail view of an exemplary actuator system of a walk therapy station. 
         FIG. 5  depicts a left side elevational view of an exemplary walk therapy station. 
         FIG. 6A  depicts a back left side perspective view of an exemplary subsystem of a walk therapy station including a left crank, left-crank resistance-wheel, flywheel, and pretensioner. 
         FIG. 6B  depicts a back left side perspective view of an exemplary position measurement system for a walk therapy station including a position sensor. 
         FIG. 6C  depicts a back left side perspective view of an exemplary height adjustment system of a walk therapy station. 
         FIG. 7  depicts a left side elevational view of an exemplary walk therapy station implementing a motor to drive movement of the knee and foot support linkage system. 
         FIG. 8  depicts a back left side perspective view of an exemplary drive subsystem of a walk therapy station, showing detail of the left crank, motor, left-crank drive-wheel, and pretensioner. 
         FIG. 9  depicts a block diagram view of a walk therapy station computing and control system. 
     
    
    
     Like reference symbols in the various drawings indicate like elements. 
     DETAILED DESCRIPTION OF ILLUSTRATIVE EMBODIMENTS 
       FIG. 1  depicts a right side elevational view of an exemplary walk therapy station in a sitting mode, a standing mode, and a walking mode. A walk therapy station  100  may be employed to provide standing and walking therapies to a mobility-impaired individual. Various aspects of the walk therapy station  100  may be similar to various aspects of the natural assist simulated gait therapy adjustment system (NASGTAS) disclosed in U.S. Provisional Application Ser. No. 62/569,378, titled “Natural Assist Simulated Gait Therapy Adjustment System,” filed by Alan Tholkes, et al., on Oct. 6, 2017, the entire contents of which are incorporated herein by reference. From left to right, a walk therapy station  100  is shown in a sitting mode  100 A, a standing mode  100 B, and a walking mode  100 C. A user  102  may enter the walk therapy station  100  while the station is in the sitting mode  100 A. For example, the user  102  may transfer into the walk therapy station from a wheelchair. In the sitting mode  100 A, the legs of the user  102  are supported and aligned by a knee and foot support system  105 . The knee and foot support system  105  includes a set of linkages and knee/foot pads (described further below), which are uniquely designed to emulate a natural walking motion of the user  100  for a very accurate gait/walking motion without putting excessive shear and pressure at the user contact points on the station. When transitioning from the sitting mode  100 A to the standing mode  100 B, a seat positioning system  110  is used to raise the user  102  up from a sitting position to a standing position. Examples of seat positioning systems are described with reference to, for example, at least FIG. 7 of PCT Application PCT/US17/46788 titled “Natural Assist Simulated Gait Therapy Adjustment System,” filed by Alan Tholkes, et al., on Aug. 14, 2017, the entire contents of which are incorporated herein by reference. When transitioning from the standing mode  100 B to the walking mode  100 C, an actuator-linkage system  115  is used to set a first (right) foot position of the user  102  to a position that is 180° out of phase with a second (left) foot position of the user. For users with a physical disability that affects user&#39;s control of their leg muscles, the actuator-linkage system  115  may advantageously transition the physically disabled user from a standing to a walking position quickly and easily to maximize the amount of time the user can spend performing highly beneficial physical therapy. Therapy may be provided to individuals using canes or walkers, for example. Also, those with spinal cord injuries, multiple sclerosis, Parkinson&#39;s, stroke hip and knee replacements or the senior population may find benefit in standing and/or walking therapies provided by the walk therapy station. The walk therapy station may be compact and may be used in the home environment (e.g., living room, bedroom). 
       FIG. 2A  depicts a back left perspective view of an exemplary walk therapy station with a housing. A walk therapy station  200  (with a housing) includes a frame  205 . The frame  205  supports a knee and foot support linkage system  210 . Mechanically coupled to the support linkage system  210  are a set of knee pads  215  configured to support a user&#39;s knee joint. Mechanically coupled to the support linkage system  210  are a set of foot pedals  220  configured to support a user&#39;s foot. The station  200  includes a seat  225 , which may be a component of the seat positioning system  110  depicted in  FIG. 1  and detailed in  FIG. 3B  below. The station  200  includes a back support  230 , which may give a user back support while sitting in the station  200  during a sitting mode. The station  200  includes a set of arm rests  235 , which may be mechanically coupled to the frame  205 . The station includes a housing  240  configured as a protective barrier to house various components of the station  200  (e.g., electronics, a motor, actuators). 
     The station  200  includes a pair of upper support members  245  that may be mechanically coupled to the frame  205 . Mechanically coupled to each upper support member  245  is a hip pad  250  configured to properly align a user&#39;s hips while inhabiting the station  200  during a standing mode. Mechanically coupled to each upper support member  245  is a handle bar  255 , which may be a heart-rate monitor handle bar. Mechanically coupled to the frame  205  is a chest pad  260  configured to properly align a user&#39;s chest and upper body while inhabiting the station  200  during a standing mode. Supported by the frame  205  is a user interface device  265 , which may be a tablet or touch screen computer, for example. Mechanically coupled to the support linkage system  210  are a pair of handle bars  270  that perform opposing oscillatory motion when a user is practicing walking in the station  200 . The station  200  includes several wheels  272  used for transporting the station  200 . 
     The controls of the station  200  may control actuation of a stand-to-walk (SWM) mechanism and/or a sit-to-stand mechanism. For example, the control that operates an actuator to lift a user from sitting to standing and the control to operate the actuator that transitions the user from standing to walking may be located in the front area of the station  200  (e.g., the two switches below front support pad  260  and on the right side of the station  200  in  FIG. 2A ). Each switch may be positioned so the user can access them from either a sitting or a standing position. 
       FIG. 2B  depicts a front right perspective view of an exemplary walk therapy station with a housing. The hip pad  250  may be pivotably coupled to the frame  205 . The angular position of hip pad  250  may be (pivotably/hingedly) selectively adjustable using a hip pad plunger  275  configured to lock the hip pad  250  into a position. Selective adjustment of the hip pad  250  position may allow for customization of the station  200  for people having varying hip dimensions. The forward or backward position of the chest pad  260  may be selectively adjustable using a chest pad plunger  285 . The chest pad plunger  285  may lock the chest pad  260  into place by configuring an extension distance of a telescoping chest pad extension member  280 , which is mechanically coupled to the frame  205 . The height of each foot pedal  220  may be selectively adjustable using a foot pedal plunger  290 . Various plungers may be spring-loaded plungers, for example. The frame  205  includes a front section  205 A and a back section  205 B. In some examples, the front and back frame sections may decoupleable, such that the front section  205 A may be disconnected from the back section  205 B. Such disconnection may advantageously allow for compact and efficient transportation of a collapsed station  200 . 
       FIGS. 3A, 3B, and 3C  depict right side elevational views of an exemplary walk therapy station in a sitting mode, a standing mode, and a walking mode, respectively. The walk therapy station  100  includes the seat  225 . Initially, a user  102  may transition into the seat  225  of the station  100  from a wheelchair, cane, walker, or from a standing position, for example. The seat  225  is hingedly coupled to a scissors linkage subsystem that is included with a seat positioning system  110 . The station  100  is configured to transition between a sitting position (shown here in  FIG. 3A ) and a standing position (shown in  FIG. 3B ). 
     The knee and foot support system  105  includes a number of linkages configured to support and dictate the movement patterns of the legs and feet of the user  102 . At least some of the linkages (and their coupling points) on the right side of the  105  system may substantially mirror the linkages on the left side of the system  105  (and vice-versa). The support system  105  includes a first linkage  300  pivotably coupled at a proximal end to a frame  205  of the station  100 . The support system  105  includes a second linkage  305  pivotably coupled at a proximal end to the frame  205 . In the depicted example, the coupling point between the first linkage  300  and the frame  205  is located behind the coupling point between the second linkage  305  and the frame  205 . A third linkage  310  is pivotably coupled at a proximal end to a distal end of the first linkage  300 . A knee pad  215  is mechanically coupled to either or both of the first and the third linkages at a location proximate to the pivotal coupling point between the first and third linkages. The first, second, and third linkages  300 ,  305 ,  310  may be oriented in a substantially vertical orientation during sitting/standing modes  100 A,  100 B of the station  100 . A fourth linkage  315  is pivotably coupled at a proximal end to a distal end of the second linkage  305 . The fourth linkage  315  is also pivotably coupled at a point along a length of the fourth linkage  315  to a point along a length of the third linkage  310 . The fourth linkage  315  may be oriented in a substantially horizontal orientation during sitting/standing/walking modes  100 A,  100 B,  100 C of the station  100 . A fifth linkage  320  is pivotably coupled at a proximal end to a distal end of the fourth linkage  315 . The fifth linkage  320  is mechanically coupled (via an intermediate linkage  325 ) to a fixed rotational axis  335 , which may be coaxially aligned with a crankshaft, for example. Operably coupled to the fifth linkage  320  is an actuator  330 , which may be a linear actuator, for example. The design, couplings, and layout of the support system  105  may advantageously provide a mobility-impaired individual with a range of motion for their legs and feet that closely mimics a natural walking/gait motion of the individual, thus allowing the individual to receive physical therapy using the station  100  to train their leg and feet muscles for proper gait motion. 
       FIG. 3B  depicts a right side elevation view of the user within an exemplary walk therapy system in a standing mode, where the user is standing after the seat is raised but before active therapy. In this exemplary depiction, the station  100  has raised the user  102  to a standing position by employment of the seat positioning system  110 . The seat positioning system  110  is configured to lift the user in such a manner to substantially minimize any shifting/shearing of the buttocks of the user  102  across the surface of the seat  225 . The station  100  includes a pair of knee saddles  215 . The knee saddles  215  stabilize the knees of the user  102 , as the seat  225  is transitioned between the sitting position and the standing position. Once fully transitioned to the standing position, the user is securely positioned within the station by the following support points: foot pedals  220 , knee saddles  215 , seat  225 , hip pads  250 , and chest pad  260 . 
     In various embodiments, the scissors linkage subsystem of the seat positioning system  110  (for raising a person from a sitting position to a standing position) may be included in a sit-to-stand transmission system. Such sit-to-stand transmission systems are described, for example, in at least FIG. 2, in U.S. patent application Ser. No. 14/529,568, titled “Multi-Modal Gait-Based Non-Invasive Therapy Platform,” filed by Alan Tholkes on Oct. 31, 2014, the entire disclosure of which is hereby incorporated by reference. The scissors linkage subsystem of the seat positioning system  110  is disclosed in detail, for example, in at least FIGS. 5C, 6A and 7, with reference to application serial No. PCT/US17/46788, titled “Natural Assist Simulated Gait Therapy Adjustment System,” filed by Alan Tholkes, et al., on Aug. 14, 2017, the entire disclosure of which is hereby incorporated by reference. 
     In an exemplary embodiment, the lifting of the seat  225  and the user&#39;s body seated in the seat may be performed using various lifting mechanisms. An opening module may be used to lift the seat  225  and the user  102 . In some embodiments, a lifting handle may be coupled to the opening module. The lifting handle may be positioned within the reach of the user  102  throughout the lifting process, so that a user who has hand strength may independently lift themselves from the sitting position to the standing position. In some embodiments, the lifting handle may be long to provide mechanical leverage to facilitate the ease of lifting the seat  225  and user  102 . Various opening modules  102  for lifting the seat  225  from a sitting position to a standing position may be employed. For example, a hydraulic pump may be used as an opening module. The hydraulic pump may provide a smooth operation. In addition, the hydraulic pump may provide shock absorption. 
     In some examples, an electric motor may be used to lift the seat  225  and the user  102 . In an exemplary embodiment, a mechanical screw thread may be used to lift the user to a standing position. Some examples may use an electric hydraulic pump as a lifting module. In various examples, gas springs may be used for lifting the seat  225  and user  102  from a sitting position to a standing position. In some embodiments, the lifting module may include a mechanical lever to drive a telescoping member, for example. Such mechanical levers have been described, for example, in at least FIG. 6 of U.S. Provisional Patent Application Ser. No. 62/374,383 titled “Natural Assist Simulated Gait Therapy Adjustment System,” filed by Alan Tholkes et al., on Aug. 12, 2016, the entire contents of which is hereby incorporated by reference. 
       FIG. 3C  depicts a right side elevation view of the user  102  within an exemplary walking therapy station, in a final preparation (walking) state, the user  102  now being ready for active therapy. The preparation states prepare the user by first making the transition from sitting to standing, then by making the transition between a standing position and a walking position. The transition from standing to walking is described with reference to FIGS. 4, 5, 6 and 7 of U.S. Provisional Application Ser. No. 62/569,378 incorporated herein by reference. Although the depicted embodiment in various figures may be configured with the actuator  330  on the right side of the station  100 , persons of ordinary skill in the art will appreciate upon reading this disclosure that the orientation could be reversed (e.g., the actuator  330  could be on the left side of the station  100 ). Moreover, various features shown on the left side of the station  100  may instead be located on the right side of the station  100  (and vice-versa). 
     A stand-to-walk mechanism (SWM) is shown, including the actuator  330  that is hingedly/pivotably coupled between the right intermediate linkage  325  and the right fifth linkage  320 A. The right intermediate linkage  325  is fixedly coupled at a distal end to the (right end of the) crankshaft  335 . The right intermediate linkage  325  is hingedly coupled at a proximal end to the right fifth linkage  320 A. The right fifth linkage  320 A is hingedly coupled to a right fourth linkage  315 A. The right fourth linkage  315 A is hingedly coupled to a right third linkage  310 A. The right third linkage  310 A is adjustably coupled to a right foot pad  220 A. The right fourth linkage  315 A is hingedly coupled to a right second linkage  305 A. The right second linkage  305 A is hinged at a point on the frame  205 . The frame  205  is hingedly coupled to a right first linkage  300 A. The right first linkage  300 A is hingedly coupled to the right third linkage  310 A. In an operational mode (e.g., while the user  102  is moving through walking/gait motions in the station  100 ), the proximal end of the right fifth linkage  320 A travels in a substantially circular path  340  having a center point aligned with the fixed rotational axis  335  (e.g., crankshaft). 
     The SWM being located in a lower back position of the station  100  allows the user  102  to enter the station  100  from either the left or right side. In operation, as the SWM is retracted, the proximal end of the right fifth linkage  320 A rotates clockwise (from the perspective of the right-side elevational view of  FIG. 3C ). In some examples, the proximal end of the right fifth linkage  320 A may instead rotate counter-clockwise (from the perspective of the right-side elevational view of  FIG. 3C ) to transition from standing to walking modes. As the proximal end of the right fifth linkage  320 A rotates clockwise, the distal end of the right fourth linkage  315 A is driven toward the rear of the station  100  (toward the left with respect to  FIG. 3C ). As the distal end of the right fourth linkage  315 A is driven toward the rear of the station  100 , a pivot point B 1  (associated with the proximal end of the right fifth linkage  320 A and a distal end of the right fourth linkage  315 A) is driven toward the rear. As pivot point B 1  is driven toward the rear, the right foot pan  220 A is brought toward the rear of the station  100 , is lifted, and is angled forward as dictated by the frame  205  and the right linkages  300 A,  305 A,  310 A,  315 A,  320 A, and  325 . This lifted and forward angled position of the right foot pan  220 A prepares the user&#39;s right leg and foot for walking within the station  100 . The SWM is further retracted to complete the transition of the final preparation (walking) state. When the SWM has completed its retraction, pivot point B 1  is moved to the position shown in  FIG. 3C . In addition, by the retraction of the SWM, a right side effective crank is formed by the right linkages  325  and  330 , and the SWM. This right-side effective crank is substantially 180 degrees from the position of the left-side crank, which will be introduced in  FIG. 5 . The full retraction of the SWM transitions pivot point B 1  to the opposite side of the rotational axis defined by the crankshaft  335 . This transition places pivot point B 1  and its counter pivot point on the left side of the station  100  on opposite sides of the crankshaft  335 . Such a configuration may result in, during a walking mode, the left and right cranks being pointed substantially 180° from each other, and when in sit or stand mode, cranks may both be pointed substantially in the same direction. 
       FIG. 4  depicts a back right perspective detail view of an exemplary actuator system of a walk therapy station.  FIG. 4  also depicts a stand-to-walk subsystem of an exemplary station  100 , showing detail of the right crank members and the SWM in a standing state. A stand-to-walk system  400  includes an SWM  405 , including the actuator  330  (shown previously in  FIGS. 3A-3C ). The actuator  330  may couple to a power system of the station  100  via wires and slip ring  420  (discussed further below), for example, to operate/power a motor of the actuator  330 . The SWM  405  is shown in standing mode. In standing mode, pivot point B 1  ( FIG. 4 ) and pivot point B 2  ( FIG. 6A ) are aligned with one another (in phase). 
     The actuator  330  is hingedly coupled to an intermediate linkage  325 . The intermediate linkage  325  is fixedly coupled to the crankshaft  335 . The crankshaft  335  may extend to the left side of the stand-to-walk system  400  as depicted in  FIG. 6A . In  FIG. 6A  the crankshaft  335  is depicted as extending laterally across the station  100 . The intermediate linkage  325  is hingedly coupled to the fifth linkage  320 A at pivot point E. The actuator  330  is hingedly coupled at a proximal end to the fifth linkage  320 A at point C. The actuator  330  is hingedly coupled at a distal end to the intermediate linkage  325  at point D. The right fifth linkage  320 A is hingedly coupled to the right fourth linkage  315 A. 
     In operation, as the stand-to-walk system  400  transitions between standing mode and walking mode, the actuator  330  is retracted upward, as indicated by path  410 . As the actuator  330  is retracted upward, pivot point B 1  is raised (rotated) to the opposite side of the crankshaft  335 , as indicated by path  415 . When the actuator  330  is fully retracted, pivot point B 1  and pivot point B 2  ( FIG. 6A ) are on opposite sides of the crankshaft  335 , similar to the pedals and crank on a bicycle (180° out of phase). 
     The axis of the crankshaft  335  is held at fixed position relative to the frame  205 . The stand-to-walk system includes a slip ring  420 . The slip ring  420  is fixedly coupled to the intermediate linkage  325 . The two outer surfaces of the slip ring  420  are rotatably coupled. The actuator  330  is hingedly coupled to the intermediate linkage  325 . The actuator  330  is electrically powered, and receives power from a power supply  425 . The power supply  425  is fixed relative to the frame  205 . The power from the power supply  425  is supplied to the actuator  330  via the slip ring  420 . The slip ring  420  is configured to transmit power from a stationary member (e.g., an outer housing of the crankshaft  335 ) to a rotating member (e.g., the intermediate linkage  325 ). In this way, the rotating SWM  405  may receive power from the stationary power supply  425 . For example, there may be wires that go between the rotating side of the slip ring  420  and the actuator  330 , and there may be wires from the power supply  425  to the stationary side of the slip ring  420 . 
       FIG. 5  depicts a left side elevational view of an exemplary walk therapy station. A left fifth linkage  320 B is fixedly coupled at a distal end to a (left end of the) crankshaft  335 . The left fifth linkage  320 B is hingedly coupled at a proximal end to a left fourth linkage  315 B. The left fourth linkage  315 B is hingedly coupled to a left third linkage  310 B. The left third linkage  310 B is adjustably coupled to a left foot pad  220 B. The left fourth linkage  315 B is hingedly coupled to a left second linkage  305 B. The left second linkage  305 B is hinged at a point on the frame  205 . The frame  205  is hingedly coupled to a left first linkage  300 B. The left first linkage  300 B is hingedly coupled to the left third linkage  310 B. In an operational mode (e.g., while the user  102  is moving through walking/gait motions in the station  100 ), the proximal end of the left fifth linkage  320 B (signified by point B 2 ) travels in a substantially circular path  340  having a center point aligned with the fixed rotational axis  335  (e.g., crankshaft). In the standing mode  100 B shown in  FIG. 5 , both points B 1  and B 2  are aligned and in phase with one another, while in the walking mode  100 C shown in  FIG. 3C , the points B 1  and B 2  are on opposite sides of the crankshaft  335  and 180° out of phase with one another. 
     Included with the station  100  is a wheel and belt subsystem  500 . The subsystem  500  includes various parts that may smooth a walking motion of the user  102  while utilizing the station  100 . The subsystem  500  may also include various structures that may impose resistance to a walking motion. Various aspects of the subsystem  500  may be adjusted, tuned, or user-selectable (e.g., adjustable resistance). In this sense, the subsystem  500  may advantageously provide a user-customizable resistance setting that can be tuned specifically to the muscle strength and level of control of a given user  102 . The station  100  may be a drive-less or motor-less station, while the station  700  ( FIG. 7 ) may be a driven or motor-powered station. In some examples, the handle bars  270  of the station  100  may be used by a user to drive the gait motion of the support linkage system  210  (e.g., for users having upper body and arm control/strength but without sufficient control/strength of/in their lower extremities). 
       FIG. 6A  depicts a back left side perspective view of an exemplary subsystem of a walk therapy station including a left crank, left-crank resistance-wheel, flywheel, and pretensioner. A wheel and belt subsystem  500  includes a left crank resistance/pulley wheel  505 . The wheel  505  is in a fixed position relative to the crankshaft  335  (e.g., wheel  505  may be fixedly coupled to the crankshaft  335 ). The crankshaft  335  (as explained above) is fixedly coupled to a fifth left linkage  320 B, which is in turn, hingedly coupled to a fourth left linkage  315 B. Coupled to the wheel  505  (via belt  515 ) is a flywheel  510 , which may provide various smoothing aspects to the station  100  while in walking mode  100 C. The belt  515  is engaged with a pretensioner  520 , which may set a level of tension in the belt  515 . In some examples, the pretensioner  520  may be referred to as a pre-tensioning pulley. The belt tensioner  520  may be used to adjust the belt to keep it from slipping. 
     The pulley wheel  505  is rigidly coupled to shaft  335 . In some embodiments, a large diameter pulley wheel  505  (e.g., about 8″ in diameter) may result in a better ratio to drive the flywheel  510  at a faster speed for a smoother walk motion. The speed of the flywheel  510  may be important in creating the ability to control resistance with magnets using an eddy current effect. In various embodiments, at least one of the wheels of the station (e.g., wheel  505  or  510 ) may be an eddy-current brake wheel. For example, a small motor may position magnets closer to the spinning flywheel  510 , thus allowing for a customizable and user-selectable level of resistance for the walk therapy station  100 . The eddy effect resistance may be controlled by an adjustment motor with a switch by the user interface  265 , for example. In at least one embodiment, there are at least two buttons/selection mechanisms on the front end of the station  100 : one button that controls resistance, and another power button for the display  265 . In some examples, all or at least some motors of the station (and possibly the display  265 ) may be powered by the same power supply  425 . 
     For the version of the station with the motor assist (e.g., the station  700  depicted in  FIGS. 7 and 8  and discussed in depth below), a flywheel may be mounted on the motor for a smooth walk when not using/energizing the motor. When a user does not use the walking motor and instead walks manually, the motor may be used to create resistance by applying power to the motor to create resistance rather than assist in walking. A large pulley wheel may also provide more torque for the motor to rotate the shaft  335 , so the station can move the legs of the user at a very slow speed. 
       FIG. 6B  depicts a back left side perspective view of an exemplary position measurement system for a walk therapy station including a position sensor. A left back side perspective view  600  of the station  100  is shown with the linkage  320 B, wheel  505 , and belt  515  removed, for purposes of illustrating a position tracking/measurement system  605 . The measurement system  605  includes the (keyed) crankshaft  335 . Fixedly coupled to the crankshaft  335  is a crankshaft gear  610 . The rotational axis of the crankshaft gear  610  is aligned with the rotational axis of the crankshaft  335  such that when the crankshaft rotates about its rotational axis, it imparts an equal rotational/angular velocity to the crankshaft gear  610 . Gearably coupled/engaged with the crankshaft gear  610  is a position measurement gear  620  configured to rotate about a second rotational axis  615 . In some examples, the rotational axis  335  of the gear  610  is substantially parallel to the rotational axis  620  of the gear  615 . 
     Located adjacent to the gear  620  is a position sensor  625 . The position sensor  625  may sense (e.g., optically, magnetically, mechanically) the angular position of the gear  620  (e.g., 0-360°). For example, the sensor  625  may be a 360 degree absolute hall sensor. The sensor  625  may collect various types of therapy data, which may include, for example, speed, time walking, leg asymmetry, distance, and time stamp data. In some embodiments, the gear  620  may include a detection feature DF (e.g., an optical encoder disk) that can be detected/measured by the sensor  625  to measure the exact or approximate rotational position of the gear  620 . The position measurement gear  620  in conjunction with the sensor  625  facilitates an electrical processor (described later) in determination of the position of the crankshaft  335 . Determination of the position of the shaft  335  can be used as an indication of a position of both legs and feet of the user  102 . The logging of the position(s) of the legs/feet of the user and/or the linkages of the station  100  over time may advantageously be used to determine instantaneous power requirements and malfunctions of the station  100 , or the calories burned or effective distances traveled by a user of the station  100 , for example. 
     The processor controls the SWM  405 , and as such, the processor knows the stand-walk state of the stand-to-walk system  400 . The processor may determine the overall state of the user&#39;s feet with the drive information sent to the SWM  405 , and the position information gathered from the sensor  625 . This overall state may be advantageously utilized for various purposes as will be shown in further figures and description. The encoder disk DF, the crankshaft  335 , the gears  610  and  620 , and the sensor  625  may make up an optical encoder module. In an illustrative example, the sensor  625  may facilitate stopping the station  100 , such that when the user makes a selection during walking (e.g., using the interface  265 ), the left leg may continue to move until the station  100  gets into the standing position. Once the station  100  reaches the standing position, it may stop. The right leg may then transition (via the SWM  405 ) from the walk position to the standing position. This motion may be the reverse of how the station  100  was deployed into the walking position from the standing position. 
       FIG. 6C  depicts a back left side perspective view of an exemplary height adjustment system of a walk therapy station. A height adjustment system  650  is shown with the left third linkage  310 B being transparent to illustrate the various features of the system  650 . The system  650  includes a left foot pedal  220 B. Mechanically and fixedly coupled with the left foot pedal  220 B is a telescoping rod  655 . The telescoping rod  655  is adjustably coupled to the left third linkage  310 B via a plurality of holes  660  of the rod  655 , a hole  665  of the left third linkage  310 B, and a plunger  670 . For example, the plunger  670  may be pulled out of a hole in the plurality of holes  660  by a user to uncouple the rod  655  from the linkage  310 B. When the user adjusts the rod  655  to an optimal height (which may be customized to the height of the actual user  102 ), the plunger may then be inserted into the proper hole of the plurality of holes  660  to set the height of the left foot pedal  220 B at a user-selected height. In this sense, the user may adjust the height of the foot pedals of the station  100  for a person of short height (e.g., 4′ 10″), medium height (e.g., 5′ 8″), or tall height (6′ 5″), for example. 
     It may be understood that the same height adjustment system  650  may be employed on the right side of the station  100  (e.g., as applied to right foot pad  220 A). In some examples, the holes  660  may be referred to as apertures, which may be employed to adjust the height of the foot rest to accommodate users of various heights. In some embodiments, the number of apertures may be modified to accommodate smaller ranges, by placing the apertures closer together. 
       FIG. 7  depicts a left side elevational view of an exemplary walk therapy station implementing a motor to drive movement of the knee and foot support linkage system. A motor-powered station  700  includes many, if not most of the same parts of the non-driven station  100  (e.g., linkages, knee/foot pads, frame, seat). The station  700  includes a motor system  705  configured to drive the linkages of the station  700  to impart a walking motion on a user  102  using the station  700 . The motor system  705  may be advantageous for users with minimal mobility in their lower extremities, and may help in providing physical therapy to an individual to build muscle strength and nerve connections for rehabilitation. 
       FIG. 8  depicts a back left side perspective view of an exemplary drive subsystem of a walk therapy station, showing detail of the left crank, motor, left-crank drive-wheel, and pretensioner. Although not shown in  FIGS. 7 and 8 , the right side of the station  700  includes an SWM  405 / actuator    330 , and right linkages depicted in  FIGS. 3A-3C, and 4 . For example, the right side of station  700  may substantially resemble the right side of station  100 . A motor drive system  705  includes the crankshaft  335 . The crankshaft  335  is fixedly coupled to a left crank drive wheel  710 . The crankshaft  335  is fixedly coupled to a left fifth linkage  320 B. The left fifth linkage  320 B is hingedly coupled to a left fourth linkage  315 . The left crank drive wheel  710  is coupled to a motor shaft  720  of a (walk) motor  715  via a belt  725 . The belt is tensioned by an adjustable pre-tensioning pulley  730 . 
     The motor  715  drives the left fourth linkage  315 B via the belt  725 , the left crank drive wheel  710  and the left fifth linkage  320 B. The left fourth linkage  315  in turn, moves the user&#39;s left foot in a walking pattern. This drive force from the motor  715  also drives the right side of the station  700 , translating the drive force via the crankshaft  335 . The crankshaft  335  exits the right side of the station  700 , and drives intermediate linkage (not shown, but similar to intermediate linkage  325  shown in  FIGS. 3A and 4 ) and associated right side linkages. Accordingly, the motor  715  drives both the left and right foot of the user in a walking pattern. 
     The motor  715  is powered by a power supply (e.g.,  FIG. 4 , power supply  425 ). The motor  715  is controlled by a controller  740 , which may also control other aspects of the station  700  (e.g., the actuators). Other items shown on the rear end of the station  700  may also make up parts of a walk motor controller that controls the motor  715 . In various example, a walk therapy station may include at least one motor (e.g., one sit-to-stand motor that powers the actuator under the seat of the user, one stand-to-walk motor that powers the actuator coupled to the linkages at the rear end of the station, one gait resistance motor to create resistance against walking/gait motions (for the manual version of the station  100 ), and one gait assist motor to assist the user in performing walking/gait motions (walk motor for powered version  700 ). In some examples, a walk therapy station may include at least one sensor (e.g., a gait movement sensor ( 625 ) that collect different therapy data (speed, time walking, leg asymmetry, distance, time stamp), a sit-to-stand sensor in the sit-to-stand stand actuator/motor that indicates a sit-stand position, a stand-to-walk sensor in the stand-to-walk actuator/motor that indicates leg position, and a heart rate sensor (included with the handle bar  225 )). Various sensors may be Hall effect sensors, for example. The motor controller  740  may collect therapy data such as motor speed and time of motor assist, for example, that may be communicated to the display  265 . The display device  265  (e.g., tablet computer) may collect and saves data for the user. The display may have Bluetooth capabilities and may connect with other software applications or electronic hardware, such as blood pressure monitors and oxygen level monitors, for example. The display may connect to a person&#39;s computing device, such as an Android® or Apple® device, for example. The therapy data collected may be sent to the cloud and accessed by doctors and rehab professionals, as well as the user. The station may be used in conjunction with telehealth/telerehab using, for example, an add on camera and speakers. The controller  740  may interface with a user interface (e.g.,  265 ) such that the user can control a walking speed of the station  700 , make an emergency stop, and/or raise/lower the seat  225 , for example. 
       FIG. 9  depicts a block diagram view of a walk therapy station computing and control system. A system includes a walk therapy station control and computing system  900 A and at least one controller  900 B. The system  900 A includes processor(s) operably coupled to volatile memory (RAM), non-volatile memory (NVM), and input/output (I/O). In various examples, the system  900 A may be implemented using a server. In some examples, the system  900 A may be implemented using the user interface device  265  (e.g., a tablet/touch screen computer or other composing device) shown in  FIGS. 2A and 2B . The NVM of the system  900 A includes at least one set of program instructions (P 1 -P 3 ), and at least one data block (D 1 -D 3 ). The I/O of the system  900 A is configured to exchange data with the at least one controller  900 B. At least one of the programs P 1 -P 3  of the system  900 A may include instructions, that when executed by the processor(s), cause the system  900 A to, for example, read/write data from/to the data blocks D 1 -D 3  and/or transmit/receive data to/from the at least one controller  900 B. The system  900 A may interface with the at least one controller  900 B to perform various actions, functions, or operations of the stations  100 ,  700 , including, but not limited to, controlling the motor  715 , controlling the actuators (seat extension system  110  actuator and stand to walk actuator  330 /SWM  405 ), and/or measuring the position of the crank linkages  320 A,  320 B. 
     The system  900 A may include various engines that power the various functions, operations, and aspects of the stations  100 ,  700 . These engines may be program/software instructions (P 1 -P 3 ) stored in the NVM of the system  900 A, and may use the data stored in NVM. In various examples, the engines may be implemented using hardware or software of the system  900 A. The system  900 A may include the following engines: 
     User interface engine: perform various functions associated with the user interface, including reading user input, displaying visual indications on a display screen, and translating input into command or data to send to the at least one controller  900 B. 
     Heart rate monitor engine: perform various functions associated with heart rate monitoring, including reading heart rate of a user via the heart rate monitors  255  and recording heart rate over time. 
     Seat extension control engine: perform various functions associated with the state of the seat  225  (sit to stand operations), including extending/retracting the seat  225  using the seat extension system  110 . 
     Stand to walk engine: perform various functions associated with stand to walk operations, including measuring the state of the actuator  330 , sending commands to the actuator  330  (or the actuator&#39;s controller) to transition the SWM  405  from standing to walking positions (or vice-versa), and measuring the power delivered to the actuator via the slip ring  420 . 
     Motor control engine: perform various functions associated with the motor  715 , including setting/measuring the speed of the motor, turning the motor on or off, setting a level of assistance (handicap) of the motor, and sending an emergency shutdown signal to the motor upon an emergency alert signal. The motor control engine may cooperate with the position measurement engine to determine the amount of power required to be delivered to the motor, for example. 
     Position measurement engine: perform various functions associated with measuring the position of the linkages, including receiving measurement data from the sensor  625 , and determining the (angular) position of the crank linkages  320 A,  320 B based on the received measurement data from the sensor  625 . 
     I/O engine: perform various functions associated with the I/O operations, including interfacing with the at least one controller  900 B. 
     Cloud interface engine: perform various functions associated with interfacing with components in the “cloud,” including sending/receiving data from cloud servers, and interfacing with remote physical therapy assistants or doctors. Examples of cloud storage interfaces are described with reference to FIG. 20 of U.S. Provisional Application Ser. No. 62/569,378, titled “Natural Assist Simulated Gait Therapy Adjustment System,” filed by Alan Tholkes, et al., on Oct. 6, 2017. 
     Resistance engine: perform various functions associated with applying resistance to the gait motion of a user while using the station. For example, the resistance engine may receive (user) input for a resistance level, may track/log a level of resistance, and may control the level of resistance (e.g., via magnets on an eddy current brake). 
     The at least one controller  900 B includes processor(s) operably coupled to volatile memory (RAM), non-volatile memory (NVM), and input/output (I/O). In some examples, each controller  900 B may have only a single memory (either RAM or NVM). The NVM of the controller  900 B includes at least one set of program instructions (P 4 -P 6 ), and at least one data block (D 4 -D 6 ). At least one of the programs P 4 -P 6  of the controller  900 B may include instructions, that when executed by the processor(s), cause the controller  900 B to, among other things, read/write data from/to the data blocks D 4 -D 6  and/or transmit/receive data to/from the system  900 A. 
     Each controller  900 B may be configured to perform specialized operations to control various components of the stations  100 ,  700 . For example, the motor  715  may have its own controller  900 B configured to control various aspect (speed, power, on/off) of the motor  715 . In some embodiments, the actuator  330 /SWM  405  may have its own controller  900 B configured to control various aspect (mode, position, power, actuation speed) or the actuator  330 . In various implementations, the actuator of the seat extension system  110  may have its own controller  900 B configured to control various aspects (mode, position, power, actuation speed) of the seat extension system  110 . The stations  100 ,  700  may include various interconnections (e.g., wiring, antennas) that may interconnect the various parts of the stations to provide for data communication and/or electrical power, for example. In some embodiments, each motor controller may be combined into a motors controller. The motors controller may have sensors connected to the it and may be electronically designed to interface with a display device. 
     Although various embodiments have been described with reference to the Figures, other embodiments are possible. For example, various parts, components, features, or aspects disclosed in other patents and patent applications may be combined with, included with, or substituted for, various parts, components, features, or aspects of the devices, systems, or processed disclosed herein. The following is a list of other patents and patent applications which may be used in conjunction with the devices, systems, or processed disclosed herein, all of which are herein incorporated by reference: U.S. Provisional Application Ser. No. 61/915,834, titled “Natural-Gait Therapy Device,” filed by Alan Tholkes, et al., on Dec. 13, 2013; U.S. Nonprovisional application Ser. No. 14/529,568, titled “Multi-Modal Gait-Based Non-Invasive Therapy Platform,” filed by Alan Tholkes, et al., on Oct. 31, 2014; U.S. Provisional Application Ser. No. 62/374,383, titled “Natural Assist Simulated Gait Therapy Adjustment System,” filed by Alan Tholkes, et al., on Aug. 12, 2016; U.S. PCT Application Serial No. PCT/US17/46788, titled “Natural Assist Simulated Gait Therapy Adjustment System,” filed by Alan Tholkes, et al., on Aug. 14, 2017; U.S. Provisional Application Ser. No. 62/569,378, titled “Natural Assist Simulated Gait Therapy Adjustment System,” filed by Alan Tholkes, et al., on Oct. 6, 2017. 
     In various examples, the words “pivot” or “pivotably” may be used interchangeably with the words “hinge” or “hingedly.” In various implementations, the phrase “substantially circular” may mean an ellipse with an eccentricity value of about 0, 0.1, 0.2, 0.3, 0.4, or about 0.5. In some implementations, the phrase “lateral” may refer to a lateral axis passing between the right and left sides of the station, while the phrase “longitudinal” may refer to a longitudinal axis passing between the front and back ends of the station. 
     Exemplary dimensions for the various linkages of the station  100  may be as follows: the first linkage  300  may have a length of about 16″, the second linkage  305  may have a length of about 30″, the third linkage  310  may have a length of about 17″, the fourth linkage  315  may have a length of about 32″, the fifth linkage  320  may have a length of about 7″, and the intermediate linkage  325  may have a length of about 6″. These lengths may be critical to the achieve the natural gait function of the stations  100 ,  700 , such that a user performs an assisted walking motion that advantageously mimics the natural gait of the user. Put another way, the lengths listed above of each linkage may be optimized values that provide for a very natural and accurate gait motion of a user  102 , thus providing the user with a very therapeutic and productive physical training session. It may be understood that these lengths may be adjusted by about 0.1″, 0.5″, 1″, 2″, or about 5″ or more and still retain the benefits of an optimized, natural gait/walking motion. 
     Some aspects of embodiments may be implemented as a computer system. For example, various implementations may include digital and/or analog circuitry, computer hardware, firmware, software, or combinations thereof. Apparatus elements can be implemented in a computer program product tangibly embodied in an information carrier, e.g., in a machine-readable storage device, for execution by a programmable processor; and methods can be performed by a programmable processor executing a program of instructions to perform functions of various embodiments by operating on input data and generating an output. Some embodiments may be implemented advantageously in one or more computer programs that are executable on a programmable system including at least one programmable processor coupled to receive data and instructions from, and to transmit data and instructions to, a data storage system, at least one input device, and/or at least one output device. A computer program is a set of instructions that can be used, directly or indirectly, in a computer to perform a certain activity or bring about a certain result. A computer program can be written in any form of programming language, including compiled or interpreted languages, and it can be deployed in any form, including as a stand-alone program or as a module, component, subroutine, or other unit suitable for use in a computing environment. 
     Suitable processors for the execution of a program of instructions include, by way of example and not limitation, both general and special purpose microprocessors, which may include a single processor or one of multiple processors of any kind of computer. Generally, a processor will receive instructions and data from a read-only memory or a random-access memory or both. The essential elements of a computer are a processor for executing instructions and one or more memories for storing instructions and data. Storage devices suitable for tangibly embodying computer program instructions and data include all forms of non-volatile memory, including, by way of example, semiconductor memory devices, such as EPROM, EEPROM, and flash memory devices; magnetic disks, such as internal hard disks and removable disks; magneto-optical disks; and, CD-ROM and DVD-ROM disks. The processor and the memory can be supplemented by, or incorporated in, ASICs (application-specific integrated circuits). In some embodiments, the processor and the member can be supplemented by, or incorporated in hardware programmable devices, such as FPGAs, for example. 
     In some implementations, each system may be programmed with the same or similar information and/or initialized with substantially identical information stored in volatile and/or non-volatile memory. For example, one data interface may be configured to perform auto configuration, auto download, and/or auto update functions when coupled to an appropriate host device, such as a desktop computer or a server. 
     In some implementations, one or more user-interface features may be custom configured to perform specific functions. An exemplary embodiment may be implemented in a computer system that includes a graphical user interface and/or an Internet browser. To provide for interaction with a user, some implementations may be implemented on a computer having a display device, such as an LCD (liquid crystal display) monitor for displaying information to the user, a keyboard, and a pointing device, such as a mouse or a trackball by which the user can provide input to the computer. 
     In various implementations, the system may communicate using suitable communication methods, equipment, and techniques. For example, the system may communicate with compatible devices (e.g., devices capable of transferring data to and/or from the system) using point-to-point communication in which a message is transported directly from a source to a receiver over a dedicated physical link (e.g., fiber optic link, infrared link, ultrasonic link, point-to-point wiring, daisy-chain). The components of the system may exchange information by any form or medium of analog or digital data communication, including packet-based messages on a communication network. Examples of communication networks include, e.g., a LAN (local area network), a WAN (wide area network), MAN (metropolitan area network), wireless and/or optical networks, and the computers and networks forming the Internet. Other implementations may transport messages by broadcasting to all or substantially all devices that are coupled together by a communication network, for example, by using omni-directional radio frequency (RF) signals. Still other implementations may transport messages characterized by high directivity, such as RF signals transmitted using directional (i.e., narrow beam) antennas or infrared signals that may optionally be used with focusing optics. Still other implementations are possible using appropriate interfaces and protocols such as, by way of example and not intended to be limiting, USB 2.0, FireWire, ATA/IDE, RS-232, RS-422, RS-485, 802.11 a/b/g/n, Wi-Fi, WiFi-Direct, Li-Fi, BlueTooth, Ethernet, IrDA, FDDI (fiber distributed data interface), token-ring networks, or multiplexing techniques based on frequency, time, or code division. Some implementations may optionally incorporate features such as error checking and correction (ECC) for data integrity, or security measures, such as encryption (e.g., WEP) and password protection. 
     In various embodiments, a computer system may include non-transitory memory. The memory may be connected to the one or more processors may be configured for encoding data and computer readable instructions, including processor executable program instructions. The data and computer readable instructions may be accessible to the one or more processors. The processor executable program instructions, when executed by the one or more processors, may cause the one or more processors to perform various operations. 
     In various embodiments, the computer system may include Internet of Things (IoT) devices. IoT devices may include objects embedded with electronics, software, sensors, actuators, and network connectivity which enable these objects to collect and exchange data. IoT devices may be in-use with wired or wireless devices by sending data through an interface to another device. IoT devices may collect useful data and then autonomously flow the data between other devices. 
     A number of implementations have been described. Nevertheless, it will be understood that various modification may be made. For example, advantageous results may be achieved if the steps of the disclosed techniques were performed in a different sequence, or if components of the disclosed systems were combined in a different manner, or if the components were supplemented with other components. Accordingly, other implementations are within the scope of the following claims.