Posts Tagged Patient treatment
[Abstract] A wearable monitoring system for at-home stroke rehabilitation exercises: A preliminary study
Stroke is a leading cause of death and disabilities in adults, and the majority of its survivors suffer from upper extremity paresis . There is scientific evidence that repetitive rehabilitation exercises and training could improve motor abilities as a result of motor learning processes . Among many, a reaching movement is a fundamental component of daily movement that requires the coordination of multiple upper extremity segments . It is shown that repetitive reaching exercises improve the smoothness, precision, and speed of arm movements . To continue to improve and to sustain motor function, it is clinically important that patients continue to engage in rehabilitation exercises even outside the clinical settings , which emphasizes the importance of the home-based therapy.
[Abstract] Use of a Portable Assistive Glove to Facilitate Rehabilitation in Stroke Survivors With Severe Hand Impairment
Treatment options for stroke survivors with severe hand impairment are limited. Active task practice can be restricted by difficulty in voluntarily activating finger muscles and interference from involuntary muscle excitation.
We developed a portable, actuated glove-orthosis, which could be employed to address both issues. We hypothesized that combining passive cyclical stretching (reducing motoneuronal hyperexcitability) imposed by the device with active-assisted, task-oriented training (rehabilitating muscle activation) would improve upper extremity motor control and task performance post-stroke.
Thirteen participants who experienced a stroke 2-6 months prior to enrollment completed 15 treatment sessions over five weeks. Each session involved cyclically stretching the long finger flexors (30 min) followed by active-assisted task-oriented movement practice (60 min). Outcome measures were completed at six intervals: three before and three after treatment initiation.
Overall improvement in post-training scores was observed across all outcome measures, including the Graded Wolf Motor Function Test, Action Research Arm Test, and grip and pinch strength ( p ≤ 0.02), except finger extension force. No significant change in spasticity was observed. Improvement in upper extremity capabilities is achievable for stroke survivors even with severe hand impairment through a novel intervention combining passive cyclical stretching and active-assisted task practice, a paradigm which could be readily incorporated into the clinic.
[Abstract] Design and Analysis of a Cable-Driven Articulated Rehabilitation System for Gait Training – ASME
Assisted motor therapies play a critical role in enhancing functional musculoskeletal recovery and neurological rehabilitation. Our long term goal is to assist and automate the performance of repetitive motor-therapy of the human lower limbs. Hence, in this paper, we examine the viability of a light-weight and reconfigurable hybrid (articulated-multibody and cable) robotic system for assisting lower-extremity rehabilitation and analyze its performance. A hybrid cable-actuated articulated multibody system is formed when multiple cables are attached from a ground-frame to various locations on an articulated-linkage based orthosis. Our efforts initially focus on developing an analysis and simulation framework for the kinematics and dynamics of the cable-driven lower limb orthosis. A Monte Carlo approach is employed to select configuration parameters including cuff sizes, cuff locations, and the position of fixed winches. The desired motions for the rehabilitative exercises are prescribed based upon motion patterns from a normative subject cohort. We examine the viability of using two controllers — a joint-space feedback linearized PD controller and a task-space force-control strategy — to realize trajectory- and path- tracking of the desired motions within a simulation environment. In particular, we examine performance in terms of (i) coordinated control of the redundant system; (ii) reducing internal stresses within the lower-extremity joints; and (iii) continued satisfaction of the unilateral cable-tension constraints throughout the workspace.