Posts Tagged Kinematics.

[Abstract] Kinematic analysis and control for upper limb robotic rehabilitation system – IEEE Conference Publication

Abstract

Present physical rehabilitation practice implies one-to-one therapist — patient interactions. This leads to shortage of therapists and high costs for patient or healthcare insurance systems. Along with Prokinetic Rehabilitation Clinic, we proposed a new intelligent, adaptive robotic system (RAPMES), which can provide the rehabilitation protocols, defined by a therapist, for the wrist and elbow of upper limb, considering the patient reactions and based on real-time feedback. RAPMES is a passive rehabilitation robotic system (RRS) with 3 degrees of freedom, and assists the rehabilitation process for elbow, forearm and wrist movements. Computation of the kinematic model for the RAPMES robotic device is required in order to determine the parameters associated with the mechanical joints, so that the experimental model executes certain trajectories in space. In this paper, we will present both forward and inverse kinematics determined for the experimental model. The kinematic model was implemented in Matlab environment, and we present a series of simulations, conducted in order to validate the proposed kinematic model. Then, we impose the functional movements (determined using the real-time video motion analysis system, as polynomial movement functions) as input to the kinematic model, and we present a series of simulations and results. The RAPMES control algorithm includes the kinematic model, and uses the polynomial movement functions as control input.
Date of Conference: 28-31 May 2018

 

I. Introduction

Statistics shows that, at European Union level, the upper limb is second common body part injured, as a result of unintentional physical injury [1]. Also, one can note the shortage of therapists and high costs for patient or healthcare insurance systems. Current development in robotics may offer a solution for this problem [2], allowing the creation of robotic devices to support the rehabilitation process, in a supervised or unsupervised way, in physiotherapy clinics or at home. In this context, we proposed RAPMES, a new intelligent, adaptive robotic system, which can provide the rehabilitation protocols, defined by a therapist, for the wrist and elbow of upper limb, considering the patient reactions and based on real-time feedback. RAPMES robotic system is designed on an ongoing research project, which implies several stages of development. In a first stage, we conducted a study involving therapists, the personnel and devices existent in a physiotherapy clinic. The role of this study was to determine the requirements for the robotic device, and to reveal the specific therapeutic needs of patients with rehabilitation indications at wrist and elbow level. On a second stage, we used a real-time video motion analysis system, to determine and understand specific functional movements frequently made with the dominant upper limb, by healthy persons. One of our research objectives is to include these movements as a part of RAPMES control algorithm, as they may offer a better rehabilitation of the upper limb, for specific moves. Next, we designed the robotic device, based on findings described above, and realized an experimental model of the robotic device.

via Kinematic analysis and control for upper limb robotic rehabilitation system – IEEE Conference Publication

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[Abstract] A Portable Passive Rehabilitation Robot for Upper-Extremity Functional Resistance Training

Abstract:

Objective: Loss of arm function is common in individuals with neurological damage, such as stroke or cerebral palsy. Robotic devices that address muscle strength deficits in a task-specific manner can assist in the recovery of arm function; however, current devices are typically large, bulky, and expensive to be routinely used in the clinic or at home. This study sought to address this issue by developing a portable planar passive rehabilitation robot, PaRRo. Methods: We designed PaRRo with a mechanical layout that incorporated kinematic redundancies to generate forces that directly oppose the user’s movement. Cost-efficient eddy current brakes were used to provide scalable resistances. The lengths of the robot’s linkages were optimized to have a reasonably large workspace for human planar reaching. We then performed theoretical analysis of the robot’s resistive force generating capacity and steerable workspace using MATLAB simulations. We also validated the device by having a subject move the end-effector along different paths at a set velocity using a metronome while simultaneously collecting surface electromyography (EMG) and end-effector forces felt by the user. Results: Results from simulation experiments indicated that the robot was capable of producing sufficient end-effector forces for functional resistance training. We also found the endpoint forces from the user were similar to the theoretical forces expected at any direction of motion. EMG results indicated that the device was capable of providing adjustable resistances based on subjects’ ability levels, as the muscle activation levels scaled with increasing magnet exposures. Conclusion: These results indicate that PaRRo is a feasible approach to provide functional resistance training to the muscles along the upper extremity. Significance: The proposed robotic device could provide a technological breakthrough that will make rehabilitation robots accessible for small outpatient rehabilitation centers and in-home therapy.

via A Portable Passive Rehabilitation Robot for Upper-Extremity Functional Resistance Training – IEEE Journals & Magazine

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[Conference paper] Kinematic Design of a Parallel Robot for Elbow and Wrist Rehabilitation|Abstract+References

Abstract

This paper presents the kinematics of modular a parallel robot for post-stroke rehabilitation of elbow and wrist. The targeted motions for rehabilitation are: elbow flexion, pronation/supination, flexion/extension and adduction/abduction (radial/ulnar deviation) of the wrist. The kinematic structure of the robotic system is presented starting from general considerations concerning the rehabilitation protocol of the upper limb. Its kinematics is developed and simulation results are presented for a proposed training exercise.

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via Kinematic Design of a Parallel Robot for Elbow and Wrist Rehabilitation | SpringerLink

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[ARTICLE] Upper Limb Kinematics in Stroke and Healthy Controls Using Target-to-Target Task in Virtual Reality – Full Text

Background: Kinematic analysis using virtual reality (VR) environment provides quantitative assessment of upper limb movements. This technique has rarely been used in evaluating motor function in stroke despite its availability in stroke rehabilitation.

Objective: To determine the discriminative validity of VR-based kinematics during target-to-target pointing task in individuals with mild or moderate arm impairment following stroke and in healthy controls.

Methods: Sixty-seven participants with moderate (32–57 points) or mild (58–65 points) stroke impairment as assessed with Fugl-Meyer Assessment for Upper Extremity were included from the Stroke Arm Longitudinal study at the University of Gothenburg—SALGOT cohort of non-selected individuals within the first year of stroke. The stroke groups and 43 healthy controls performed the target-to-target pointing task, where 32 circular targets appear one after the other and disappear when pointed at by the haptic handheld stylus in a three-dimensional VR environment. The kinematic parameters captured by the stylus included movement time, velocities, and smoothness of movement.

Results: The movement time, mean velocity, and peak velocity were discriminative between groups with moderate and mild stroke impairment and healthy controls. The movement time was longer and mean and peak velocity were lower for individuals with stroke. The number of velocity peaks, representing smoothness, was also discriminative and significantly higher in both stroke groups (mild, moderate) compared to controls. Movement trajectories in stroke more frequently showed clustering (spider’s web) close to the target indicating deficits in movement precision.

Conclusion: The target-to-target pointing task can provide valuable and specific information about sensorimotor impairment of the upper limb following stroke that might not be captured using traditional clinical scale.

Introduction

In stroke, the prevalence of upper limb impairment is approximately 50–80% in the acute phase (13) and 40–50% in the chronic phase (24). The frequently observed upper limb impairments after stroke are paresis, abnormal muscle tone, decreased somatosensation, and coordination. As a consequence of these impairments, individuals with stroke may experience reduced ability to perform everyday activities such as opening a door, handling a key, or working with a computer. Therefore, assessment of upper limb motor function is critical for determining the prognosis and evaluating the treatment effects following stroke (56).

The assessment of motor functions in stroke is usually performed using standardized clinical scales. Some of the most frequently used clinical instruments for assessing upper extremity impairment and activity capacity in stroke are Fugl-Meyer Assessment of Upper Extremity (FMA-UE) and Action Research Arm Test (ARAT) (79). These scales are reliable (1012) and responsive to change (1314) for measuring gross changes in motor function. They have also been recommended as core measures to be included in every stroke recovery trial (6). However, observer-based ordinal instruments like FMA-UE and ARAT lack the sensitivity to assess subtle, yet, potentially important changes in movement performance (15). These clinical scales tend to have ceiling effect since they rely on scoring criteria rather than a continuous measurement construct (16).

Kinematic assessment is one solution for the need for a more objective, accurate, and sensitive measurement method (6). Kinematic assessment is being increasingly used in upper limb evaluation after stroke, out of which motion capture systems (17), robotic devices, and virtual reality (VR) systems with haptic devices (18) have become popular in the last decade. Kinematic assessment has revealed that the arm movements in subjects with stroke are slower, less accurate, less smooth, and more segmented than healthy subjects (1926).

Kinematic assessment involving the use of VR with haptic device has shown to be a promising tool for upper limb stroke rehabilitation (2728). Despite the availability of the VR system for stroke rehabilitation, it has been rarely used in assessment of upper limb movements after stroke. Individuals with stroke use similar strategies for reaching objects in both real and virtual environments (29). Previous studies using the target-to-target pointing task have shown that the movement time, velocity, and trajectory straightness were improved after a 5-week computer gaming practice in individuals with stroke (30). Movement time, mean velocity, and trajectory straightness were also stable in a test–retest study in healthy subjects (31). A clear advantage with VR systems as a measurement tool is its standardized instructions, adaptation of tasks according to patients’ functioning level, and availability of quick feedback (32). The VR assessment and training are often described as enjoyable and challenging by the users (3334).

The target-to-target pointing task is similar to routinely used tasks in everyday life, such as interacting with touch screens, using electrical switches, and pushing buttons on various devices. The choice of a regularly performed, purposeful task for this study increases its ecological validity. With VR technologies becoming more available, it opens up an opportunity to use the VR interface to acquire accurate and detailed kinematic data of upper limb movements after stroke (35). The novelty of this study is in evaluating a compact and easy-to-use haptic device coupled with VR in 3D space in order to measure movement performance during a common upper limb task.

The aim of this study was to identify the end-point kinematic variables obtained during the VR-based target-to-target pointing task that discriminate among individuals with mild and moderate upper limb impairment after stroke and healthy controls.[…]

 

Continue —>  Frontiers | Upper Limb Kinematics in Stroke and Healthy Controls Using Target-to-Target Task in Virtual Reality | Neurology

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[Abstract] Evolution of upper limb kinematics four years after subacute robot-assisted rehabilitation in stroke patients

Purpose: To assess functional status and robot-based kinematic measures four years after subacute robot-assisted rehabilitation in hemiparesis.

Material and methods: Twenty-two patients with stroke-induced hemiparesis participated in a ≥3-month upper limb combined program of robot-assisted and occupational therapy from two months post-stroke, and received community-based therapy after discharge. Four years later, nineteen (86%) participated in this long-term follow-up study. Assessments two, five and 54 months post-stroke included Fugl-Meyer (FM), Modified Frenchay Scale (MFS, at Month 54) and robot-based kinematic measures of targeting tasks in three directions, north, paretic and non-paretic: distance covered, velocity, accuracy (RMS error from straight line) and smoothness (number of velocity peaks; upward changes in accuracy and smoothness measures represent worsening). Analysis was stratified by FM score at two months: ≥17 (Group 1) or < 17 (Group 2). Correlation between impairment (FM) and function (MFS) was explored at 54 months.

Results: Fugl-Meyer scores were stable from five to 54 months (+1[-2;4], median[1st;3rd quartiles], ns). Kinematic changes in the three directions pooled were: distance covered, -1[-17;2]% (ns); velocity, -8[-32;28]% (ns); accuracy, +6[-13;98]% (ns); smoothness, +44[-6;126]% (p<0.05). Group 2 showed decline vs Group 1 (p<0.001) in FM (Group 1, +3[1;5], p<0.01; Group 2, -7[-11;-1], ns) and accuracy (Group 1, -3[-27;38]%, ns; Group 2, +29[17;140]%, p<0.001). At 54 months, FM and MFS were highly correlated (Pearson’s rho = 0.89; p<0.001).

Conclusions: While impairment appeared stable four years after robot-assisted upper limb training during subacute post-stroke phase, kinematic performance deteriorated in spite of community-based therapy, especially in patients with more severe impairment.

 

via Evolution of upper limb kinematics four years after subacute robot-assisted rehabilitation in stroke patients: International Journal of Neuroscience: Vol 0, No ja

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[Abstract] Modelling and control of a novel walker robot for post-stroke gait rehabilitation

Abstract:

In this paper, a novel walker robot is proposed for post-stroke gait rehabilitation. It consists of an omni-directional mobile platform which provides high mobility in horizontal motion, a linear motor that moves in vertical direction to support the body weight of a patient and a 6-axis force/torque sensor to measure interaction force/torque between the robot and patient. The proposed novel walker robot improves the mobility of pelvis so it can provide more natural gait patterns in rehabilitation. This paper analytically derives the kinematic and dynamic models of the novel walker robot. Simulation results are given to validate the proposed kinematic and dynamic models.

I. Introduction

Stroke is one of the leading causes of death overall the world [1]. According to a report from the American Heart Association, around 8 million population experience stroke onset every year worldwide [2]. It remains many sequalae including a pathological walking pattern. Impaired walking function refrains stroke survivors from not only activities of daily living but also social participation, which causes poststroke depression in stroke survivors [3]. Unfortunately, the depressed mood also negatively influences on the recovery of daily functions [4]–[6]. Moreover, decreased mobility is associated with other diseases such as obesity which leads to comorbidity then raise the possibility to get recurrent strokes [7], [8]. This might become a vicious circle and form a huge economic burden for governments [9].

via Modelling and control of a novel walker robot for post-stroke gait rehabilitation – IEEE Conference Publication

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[Abstract] Effects of constraint-induced movement therapy for lower limbs on measurements of functional mobility and postural balance in subjects with stroke: a randomized controlled trial

Background: Constraint-induced movement therapy (CIMT) is suggested to reduce functional asymmetry between the upper limbs after stroke. However, there are few studies about CIMT for lower limbs.

Objective: To examine the effects of CIMT for lower limbs on functional mobility and postural balance in subjects with stroke.

Methods: A 40-day follow-up, single-blind randomized controlled trial was performed with 38 subacute stroke patients (mean of 4.5 months post-stroke). Participants were randomized into: treadmill training with load to restraint the non-paretic ankle (experimental group) or treadmill training without load (control group). Both groups performing daily training for two consecutive weeks (nine sessions) and performed home-based exercises during this period. As outcome measures, postural balance (Berg Balance Scale – BBS) and functional mobility (Timed Up and Go test – TUG and kinematic parameters of turning – Qualisys System of movement analysis) were obtained at baseline, mid-training, post-training and follow-up.

Results: Repeated-measures ANOVA showed improvements after training in postural balance (BBS: F = 39.39, P < .001) and functional mobility, showed by TUG (F = 18.33, P < .001) and by kinematic turning parameters (turn speed: F = 35.13, P < .001; stride length: F = 29.71, P < .001; stride time: F = 13.42, P < .001). All these improvements were observed in both groups and maintained in follow-up.

Conclusions: These results suggest that two weeks of treadmill gait training associated to home-based exercises can be effective to improve postural balance and functional mobility in subacute stroke patients. However, the load addition was not a differential factor in intervention.

 

via Effects of constraint-induced movement therapy for lower limbs on measurements of functional mobility and postural balance in subjects with stroke: a randomized controlled trial: Topics in Stroke Rehabilitation: Vol 24, No 8

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[Abstract] Effect of postural insoles on gait pattern in individuals with hemiparesis: A randomized controlled clinical trial.

Abstract

Introduction

Recovering the ability to walk is an important goal of physical therapy for patients who have survived cerebrovascular accident (stroke). Orthotics can provide a reduction in plantar flexion of the ankle, leading to greater stability in the stance phase of the gait cycle. Postural insoles can be used to reorganize the tone of muscle chains, which exerts an influence on postural control through correction reflexes. The aim of the present study was to perform kinematic and spatiotemporal analyses of gait in stroke survivors with hemiparesis during postural insole usage.

Material and Methods

Twenty stroke victims were randomly divided into two groups: 12 in the experimental group, who used insoles with corrective elements specifically designed for equinovarus foot, and eight in the control group, who used placebo insoles with no corrective elements. Both groups were also submitted to conventional physical therapy. The subjects were analyzed immediately following insole placement and after three months of insole usage. The SMART-D 140® system (BTS Engineering) with eight cameras sensitive to infrared light and the 32-channel SMART-D INTEGRATED WORKSTATION® were used for the three-dimensional gait evaluation.

Results

Significant improvements were found in kinematic range of movement in the ankle and knee as well as gains in ankle dorsiflexion and knee flexion in the experimental group in comparison to the control group after three months of using the insoles.

Conclusion

Postural insoles offer significant benefits to stroke survivors regarding the kinematics of gait, as evidenced by gains in ankle dorsiflexion and knee flexion after three months of usage in combination with conventional physical therapy.

Keywords:

via Effect of postural insoles on gait pattern in individuals with hemiparesis: A randomized controlled clinical trial – Journal of Bodywork and Movement Therapies

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[Abstract+References] Upper Limb Coordination in Individuals With Stroke: Poorly Defined and Poorly Quantified.

Background. The identification of deficits in interjoint coordination is important in order to better focus upper limb rehabilitative treatment after stroke. The majority of standardized clinical measures characterize endpoint performance, such as accuracy, speed, and smoothness, based on the assumption that endpoint performance reflects interjoint coordination, without measuring the underlying temporal and spatial sequences of joint recruitment directly. However, this assumption is questioned since improvements of endpoint performance can be achieved through different degrees of restitution or compensation of upper limb motor impairments based on the available kinematic redundancy of the system. Confusion about adequate measurement may stem from a lack a definition of interjoint coordination during reaching. Methods and Results. We suggest an operational definition of interjoint coordination during reaching as a goal-oriented process in which joint degrees of freedom are organized in both spatial and temporal domains such that the endpoint reaches a desired location in a context-dependent manner. Conclusions. In this point-of-view article, we consider how current approaches to laboratory and clinical measures of coordination comply with our definition. We propose future study directions and specific research strategies to develop clinical measures of interjoint coordination with better construct and content validity than those currently in use.

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via Upper Limb Coordination in Individuals With Stroke: Poorly Defined and Poorly QuantifiedNeurorehabilitation and Neural Repair – Yosuke Tomita, Marcos R. M. Rodrigues, Mindy F. Levin, 2017

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[Abstract] Robot-assisted arm training in physical and virtual environments: A case study of long-term chronic stroke

Abstract:

Robot-assisted training (RT) is a novel technique with promising results for stroke rehabilitation. However, benefits of RT on individuals with long-term chronic stroke have not been well studied. For this case study, we developed an arm-based RT protocol for reaching practice in physical and virtual environments and tracked the outcomes in an individual with a long-term chronic stroke (20+ years) over 10 half-hour sessions. We analyzed the performance of the reaching movement with kinematic measures and the arm motor function using the Fugl-Meyer Assessment-Upper Extremity scale (FMA-UE). The results showed significant improvements in the subject’s reaching performance accompanied by a small increase in FMA-UE score from 18 to 21. The improvements were also transferred into real life activities, as reported by the subject. This case study shows that even in long-term chronic stroke, improvements in motor function are still possible with RT, while the underlying mechanisms of motor learning capacity or neuroplastic changes need to be further investigated.

Source: Robot-assisted arm training in physical and virtual environments: A case study of long-term chronic stroke – IEEE Xplore Document

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