The paper suggests a therapeutic device for hemiparesis that combines robot-assisted rehabilitation and mirror therapy. The robot, which consists of a motor, a position sensor, and a torque sensor, is provided not only to the paralyzed wrist, but also to the unaffected wrist to induce a symmetric movement between the joints. As a user rotates his healthy wrist to the direction of either flexion or extension, the motor on the damaged side rotates and reflects the motion of the normal side to the symmetric angular position. To verify performance of the device, five stroke patients joined a clinical experiment to practice a 10-minute mirroring exercise. Subjects on Brunnstrom stage 3 had shown relatively high repulsive torques due to severe spasticity toward their neutral wrist positions with a maximum magnitude of 0.300kgfm, which was reduced to 0.161kgfm after the exercise. Subjects on stage 5 practiced active bilateral exercises using both wrists with a small repulsive torque of 0.052kgfm only at the extreme extensional angle. The range of motion of affected wrist increased as a result of decrease in spasticity. The therapeutic device not only guided a voluntary exercise to loose spasticity and increase ROM of affected wrist, but also helped distinguish patients with different Brunnstrom stages according to the size of repulsive torque and phase difference between the torque and the wrist position.
Source: Robot-assisted mirroring exercise as a physical therapy for hemiparesis rehabilitation – IEEE Conference Publication
Lower extremity function recovery is one of the most important goals in stroke rehabilitation. Many paradigms and technologies have been introduced for the lower limb rehabilitation over the past decades, but their outcomes indicate a need to develop a complementary approach. One attempt to accomplish a better functional recovery is to combine bottom-up and top-down approaches by means of brain-computer interfaces (BCIs). In this study, a BCI-controlled robotic mirror therapy system is proposed for lower limb recovery following stroke. An experimental paradigm including four states is introduced to combine robotic training (bottom-up) and mirror therapy (top-down) approaches. A BCI system is presented to classify the electroencephalography (EEG) evidence. In addition, a probabilistic model is presented to assist patients in transition across the experiment states based on their intent. To demonstrate the feasibility of the system, both offline and online analyses are performed for five healthy subjects. The experiment results show a promising performance for the system, with average accuracy of 94% in offline and 75% in online sessions.
Source: EEG-guided robotic mirror therapy system for lower limb rehabilitation – IEEE Conference Publication
The optimal conditions inducing proper brain activation during performance of rehabilitation robots should be examined to enhance the efficiency of robot rehabilitation based on the concept of brain plasticity. In this study, we attempted to investigate differences in cortical activation according to the speeds of passive wrist movements performed by a rehabilitation robot for stroke patients. 9 stroke patients with right hemiparesis participated in this study. Passive movements of the affected wrist were performed by the rehabilitation robot at three different speeds: 0.25 Hz; slow, 0.5Hz; moderate and 0.75 Hz; fast. We used functional near-infrared spectroscopy to measure the brain activity during the passive movements performed by a robot. Group-average activation map and the relative changes in oxy-hemoglobin (ΔOxyHb) in two regions of interest: the primary sensory-motor cortex (SM1); premotor area (PMA) and region of all channels were measured. In the result of group-averaged activation map, the contralateral SM1, PMA and somatosensory association cortex (SAC) showed the greatest significant activation according to the movements at 0.75 Hz, while there is no significantly activated area at 0.5 Hz. Regarding ΔOxyHb, no significant diiference was observed among three speeds regardless of region. In conclusion, the contralateral SM1, PMA and SAC showed the greatest activation by a fast speed (0.75 Hz) rather than slow (0.25 Hz) and moderate (0. 5 Hz) speed. Our results suggest an optimal speed for execution of the wrist rehabilitation robot. Therefore, we believe that our findings might point to several promising applications for future research regarding useful and empirically-based robot rehabilitation therapy.
Source: A pilot study on the optimal speeds for passive wrist movements by a rehabilitation robot of stroke patients: A functional NIRS study – IEEE Xplore Document
The occurrence of strokes has been progressively increasing. Upper limb recovery after stroke is more difficult than lower limb. One of the rapidly expanding technologies in post-stroke rehabilitation is robot-aided therapy. The advantage of robots is that they are able to deliver highly repetitive therapeutic tasks with minimal supervision of a therapist. However, from the literature, the focus of robotic design in stroke rehabilitation has been technology-driven. Clinical and therapeutic requirements were not seriously considered in the design of rehabilitation robots. The purpose of this study was twofold: (1) demonstrate the missing elements of current robot-aided therapy; (2) identify design factors and opportunities of rehabilitation robots (in upper-limb training after stroke). In this study, we performed a literature review on articles relevant to rehabilitation robots in upper-limb training after stroke. We identified the design foci of current rehabilitation robots for upper limb stroke recovery. Using the therapeutic framework for stroke rehabilitation in occupational therapy, we highlighted design factors and opportunities of rehabilitation robots. The outcomes of this study benefit the robotics design community in the design of rehabilitation robots.
A robot is defined as a machine programmable to perform and modify tasks in response to changes in the environment . The benefits of robots are noticeable in productivity, safety, and in saving time and money. The advancement of robot technologies in the past decade caused the wide adoption of robots in our lives and in the society. For instance, in education, robots were implemented in undergraduate courses to teach core artificial intelligence concepts, e.g., algorithms for searching tree data structures . In agriculture, robotic milking systems (being able to reduce labor/operational costs) were installed to replace conventional milking that gave cows the freedom to be milked throughout the day . In healthcare, service robots were implemented to provide functional assistance for the elderly in home environments, e.g., bringing medication for the emergency and picking up heavy objects low on the ground .
Source: Design factors and opportunities of rehabilitation robots in upper-limb training after stroke – IEEE Xplore Document
Stroke survivors who experience severe hemipare-sis often cannot completely recover the use of their hand and arm. Many of the rehabilitation devices currently available are designed to increase the functional recovery right after the stroke when, in some cases, biological restoring and plastic reorganization of the central nervous system can take place. However, this is not always the case. Even after extensive therapeutic interventions, the probability of regaining functional use of the impaired hand is low. In this respect, we present a novel robotic system composed of a supernumerary robotic finger and a wearable cutaneous finger interface. The supernumerary finger is used to help grasping objects while the wearable interface provides information about the forces exerted by the robotic finger on the object being held. We carried out two experiments, enrolling 16 healthy subjects and 2 chronic stroke patients. Results showed that using the supernumerary finger greatly improved the grasping capabilities of the subjects. Moreover, providing cutaneous feedback significantly improved the performance of the considered task and was preferred by all subjects.
Source: A soft robotic supernumerary finger and a wearable cutaneous finger interface to compensate the missing grasping capabilities in chronic stroke patients – IEEE Xplore Document
Rehabilitation robots have become increasingly popular for stroke rehabilitation. However, the high cost of robots hampers their implementation on a large scale. This study implements the concept of a modular and reconfigurable robot, reducing its cost and size by adopting different therapeutic end effectors for different training movements using a single robot. The challenge is to increase the robot’s portability and identify appropriate kinds of modular tools and configurations. Because literature on the effectiveness of this kind of rehabilitation robot is still scarce, this paper presents the design of a portable and reconfigurable rehabilitation robot and describes its use with a group of post-stroke patients for wrist and forearm training. Seven stroke subjects received training using a reconfigurable robot for 30 sessions, lasting 30 minutes per session. Post-training, statistical analysis showed significant improvement of 3.29 points (16.20%, p = 0.027) on the Fugl-Meyer Assessment Scale for forearm and wrist components (FMA-FW). Significant improvement of active range of motion (AROM) was detected in both pronation-supination (75.59%, p = 0.018) and wrist flexion-extension (56.12%, p = 0.018) after the training. These preliminary results demonstrate that the developed reconfigurable robot could improve subjects’ wrist and forearm movement.
Source: Portable and Reconfigurable Wrist Robot Improves Hand Function for Post-Stroke Subjects – IEEE Xplore Document
Nowadays virtual reality (VR) technology give us the considerable opportunities to develop new methods to supplement traditional physiotherapy with sustain beneficial quantity and quality of rehabilitation. VR tools, like Leap motion have received great attention in the recent few years because of their immeasurable applications, whish include gaming, robotics, education, medicine etc. In this paper we present a game for hand rehabilitation using the Leap Motion controller. The main idea of gamification of hand rehabilitation is to help develop the muscle tonus and increase precision in gestures using the opportunities that VR offer by making the rehabilitation process more effective and motivating for patients.
Source: Gamification of Hand Rehabilitation Process Using Virtual Reality Tools: Using Leap Motion for Hand Rehabilitation – IEEE Xplore Document
Electrophysiological recordings from human muscles can serve as control signals for robotic rehabilitation devices. Given that many diseases affecting the human sensorimotor system are associated with abnormal patterns of muscle activation, such biofeedback can optimize human-robot interaction and ultimately enhance motor recovery. To understand how mechanical constraints and forces imposed by a robot affect muscle synergies, we mapped the muscle activity of 7 major arm muscles in healthy individuals performing goal-directed discrete wrist movements constrained by a wrist robot. We tested 6 movement directions and 4 force conditions typically experienced during robotic rehabilitation. We analyzed electromyographic (EMG) signals using a space-by-time decomposition and we identified a set of spatial and temporal modules that compactly described the EMG activity and were robust across subjects. For each trial, coefficients expressing the strength of each combination of modules and representing the underlying muscle recruitment, allowed for a highly reliable decoding of all experimental conditions. The decomposition provides compact representations of the observable muscle activation constrained by a robotic device. Results indicate that a low-dimensional control scheme incorporating EMG biofeedback could be an effective add-on for robotic rehabilitative protocols seeking to improve impaired motor function in humans.
Source: Biofeedback Signals for Robotic Rehabilitation: Assessment of Wrist Muscle Activation Patterns in Healthy Humans – IEEE Xplore Document
Finger recovery is much harder than other parts on the upper limbs, because finger recovery movement has several key problems need to overcome, including high precision of movement, high control resolution requirements, variable data with different person, as well as the fuzzy signal during the movement. In order to overcome the difficulties, a new scheme of finger recovery is presented in the paper based on symmetric rehabilitation. In the paralyzed hand side, a mechanical exoskeleton hand is designed and simulated to provide skeletal traction, while in the regular hand side, the curve magnitude of every joint during movement is detected. Then the hand motion is analyzed and recognized using Multi-class SVM. Many candidates were chosen to perform the experiment, and the data produced by the candidates were divided the training parts and recognition parts. Experiments shows that the Multi-class SVM is effective and practical for classification and recognition, and could be helpful in the finger recovery process.
Source: A novel scheme of finger recovery based on symmetric rehabilitation: Specially for hemiplegia – IEEE Xplore Document
Long-term rehabilitation opportunities are critical for millions of individuals with chronic upper limb motor deficits striving to improve their motor performance through self-managed rehabilitation programs. However, there is minimal professional support of rehabilitation across the lifespan. In this paper, we introduce an upper extremity rehabilitation system, the Quality of Movement Feedback-Oriented Measurement System (QM-FOrMS), by integrating cost-effective portable sensors and clinically verified motion quality analysis towards individuals with upper limb motor deficits. Specifically, QM-FOrMS is comprised of an eTextile pressure sensitive mat, named Smart Mat, a sensory can, named Smart Can, and a mobile device. A personalizable and adaptive upper limb rehabilitation program is developed, including both unilateral and bilateral functional activities which can be selected from a list or custom designed to further tailor the program to the individual. Quantitative evaluation of the motor performance from the QM-FOrMS is derived from fine-grained kinematic measurements. We ran a pilot study with three groups, including five baseline subjects (i.e., healthy young adults), six older adults and four individuals with movement impairment. The experimental results show that QM-FOrMS can provide the detailed feature during the unattended rehabilitation exercise, and proposed metrics can distinguish the evaluation results across group.
Source: A portable and cost-effective upper extremity rehabilitation system for individuals with upper limb motor deficits – IEEE Xplore Document