Posts Tagged robotics

[ARTICLE] How a diverse research ecosystem has generated new rehabilitation technologies: Review of NIDILRR’s Rehabilitation Engineering Research Centers – Full Text

Abstract

Over 50 million United States citizens (1 in 6 people in the US) have a developmental, acquired, or degenerative disability. The average US citizen can expect to live 20% of his or her life with a disability. Rehabilitation technologies play a major role in improving the quality of life for people with a disability, yet widespread and highly challenging needs remain. Within the US, a major effort aimed at the creation and evaluation of rehabilitation technology has been the Rehabilitation Engineering Research Centers (RERCs) sponsored by the National Institute on Disability, Independent Living, and Rehabilitation Research. As envisioned at their conception by a panel of the National Academy of Science in 1970, these centers were intended to take a “total approach to rehabilitation”, combining medicine, engineering, and related science, to improve the quality of life of individuals with a disability. Here, we review the scope, achievements, and ongoing projects of an unbiased sample of 19 currently active or recently terminated RERCs. Specifically, for each center, we briefly explain the needs it targets, summarize key historical advances, identify emerging innovations, and consider future directions. Our assessment from this review is that the RERC program indeed involves a multidisciplinary approach, with 36 professional fields involved, although 70% of research and development staff are in engineering fields, 23% in clinical fields, and only 7% in basic science fields; significantly, 11% of the professional staff have a disability related to their research. We observe that the RERC program has substantially diversified the scope of its work since the 1970’s, addressing more types of disabilities using more technologies, and, in particular, often now focusing on information technologies. RERC work also now often views users as integrated into an interdependent society through technologies that both people with and without disabilities co-use (such as the internet, wireless communication, and architecture). In addition, RERC research has evolved to view users as able at improving outcomes through learning, exercise, and plasticity (rather than being static), which can be optimally timed. We provide examples of rehabilitation technology innovation produced by the RERCs that illustrate this increasingly diversifying scope and evolving perspective. We conclude by discussing growth opportunities and possible future directions of the RERC program.

Background

Disabilities cause complex problems in society often unique to each person. A physical disability can limit a person’s ability to access buildings and other facilities, drive, use public transportation, or obtain the health benefits of regular exercise. Blindness can limit a person’s ability to interpret images or navigate the environment. Disabilities in speaking or writing ability may limit the effectiveness of communication. Cognitive disabilities can alter a person’s employment opportunities. In total, a substantial fraction of the world’s population – at least 1 in 6 people – face these individualized problems that combine to create major societal impacts, including limited participation. Further, the average person in the United States can expect to live 20% of his or her life with disability, with the rate of disability increasing seven-fold by age 65 [1].

In light of these complex, pervasive issues, the field of rehabilitation engineering asks, “How can technology help?” Answering this question is also complex, as it often requires the convergence of multiple engineering and design fields (mechanical, electrical, materials, and civil engineering, architecture and industrial design, information and computer science) with clinical fields (rehabilitation medicine, orthopedic surgery, neurology, prosthetics and orthotics, physical, occupational, and speech therapy, rehabilitation psychology) and scientific fields (neuroscience, neuropsychology, biomechanics, motor control, physiology, biology). Shaping of policy, generation of new standards, and education of consumers play important roles as well.

In the US, a unique research center structure was developed to try to facilitate this convergence of fields. In the 1970’s the conceptual model of a Rehabilitation Engineering Center (REC), focusing engineering and clinical expertise on particular problems associated with disability, was first tested. The first objective of the nascent REC’s, defined at a meeting held by the Committee on Prosthetic Research and Development of the National Academy of Sciences, was “to improve the quality of life of the physically handicapped through a total approach to rehabilitation, combining medicine, engineering, and related science” [2]. This objective became a working definition of Rehabilitation Engineering [2].

The first five centers focused on topics including functional electrical stimulation, powered orthoses, neuromuscular control, the effects of pressure on tissue, prosthetics, sensory feedback, quantification of human performance, total joint replacement, and control systems for powered wheelchairs and the environment [2]. The first two RECs were funded by the Department of Health, Education, and Welfare in 1971 at Rancho Los Amigos Medical Center in Downey, CA, and Moss Rehabilitation Hospital in Philadelphia. Three more were added the following year at the Texas Institute for Rehabilitation and Research in Houston, Northwestern University/the Rehabilitation Institute of Chicago, and the Children’s Hospital Center in Boston, involving researchers from Harvard and the Massachusetts Institute of Technology [3]. The Rehabilitation Act of 1973 formally defined REC’s and mandated that 25 percent of research funding under the Act go to them [2]. The establishment of these centers was stimulated by “the polio epidemic, thalidomide tragedy and the Vietnam War, as well as the disability movement of the early 70s with its demands for independence, integration and employment opportunities” [3].

After the initial establishment of these RECs, the governmental funding agency evolved into the National Institute on Disability and Rehabilitation Research (NIDRR, a part of the U.S. Department of Education), and now is the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR, a part of the U.S. Department of Health and Human Services. Today, as we describe below, the RERC’s study a diverse set of technologies and their use by people with a disability, including human-computer interaction, mobile computing, wearable sensors and actuators, robotics, computer gaming, motion capture, wheeled mobility, exoskeletons, lightweight materials, building and transportation technology, biomechanical modeling, and implantable technologies. For this review, we invited all RERCs that were actively reporting to NIDILRR at the onset of this review project in 2015, and had not begun in the last two years, to participate. These were centers that were funded (new or renewal) in the period 2008-2013, except the RERC Wheelchair Transportation Safety, which was funded from 2001-2011. Two of the RERCs did not respond (see Table 1). For each center, we asked it to describe the user needs it targets, summarize key advances that it had made, and identify emerging innovations and opportunities. By reviewing the scope of rehabilitation engineering research through the lens of the RERCs, our goal was to better understand the evolving nature and demands of rehabilitation technology development, as well as the influence of a multidisciplinary structure, like the RERCs, in shaping the producing of such technology. We also performed an analysis of how multidisciplinary the current RERCs actually are (see Table 3), and asked the directors to critique and suggest future directions for the RERC program.[…]

Continue —>  How a diverse research ecosystem has generated new rehabilitation technologies: Review of NIDILRR’s Rehabilitation Engineering Research Centers | Journal of NeuroEngineering and Rehabilitation | Full Text

Fig. 14 Some MARS RERC projects. a) The KineAssist MX® Gait and Balance Device b) The Armeo Spring® reaching assistance device c) The March Hare virtual reality therapy game d) The Lokomat® gait assistance robot e) Robotic Error Augmentation between the therapist and patient f) lever drive wheelchair g) Ekso® exoskeleton h) Body-machine interface for device control

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[ARTICLE] Effect of Robot-Assisted Game Training on Upper Extremity Function in Stroke Patients – Full Text

ObjectiveTo determine the effects of combining robot-assisted game training with conventional upper extremity rehabilitation training (RCT) on motor and daily functions in comparison with conventional upper extremity rehabilitation training (OCT) in stroke patients.

MethodsSubjects were eligible if they were able to perform the robot-assisted game training and were divided randomly into a RCT and an OCT group. The RCT group performed one daily session of 30 minutes of robot-assisted game training with a rehabilitation robot, plus one daily session of 30 minutes of conventional rehabilitation training, 5 days a week for 2 weeks. The OCT group performed two daily sessions of 30 minutes of conventional rehabilitation training. The effects of training were measured by a Manual Function Test (MFT), Manual Muscle Test (MMT), Korean version of the Modified Barthel Index (K-MBI) and a questionnaire about satisfaction with training. These measurements were taken before and after the 2-week training.

ResultsBoth groups contained 25 subjects. After training, both groups showed significant improvements in motor and daily functions measured by MFT, MMT, and K-MBI compared to the baseline. Both groups demonstrated similar training effects, except motor power of wrist flexion. Patients in the RCT group were more satisfied than those in the OCT group.

ConclusionThere were no significant differences in changes in most of the motor and daily functions between the two types of training. However, patients in the RCT group were more satisfied than those in the OCT group. Therefore, RCT could be a useful upper extremity rehabilitation training method.

INTRODUCTION

stroke is a central nervous system disease caused by cerebrovascular problems such as infarction or hemorrhage. Stroke may lead to impairment of various physical functions, including hemiplegia, language disorder, swallowing disorder or cognitive disorder, according to the location and degree of morbidity [1]. Among these, hemiplegia is a common symptom occurring in 85% of stroke patients. In particular, upper extremity paralysis is more frequent and requires longer recovery time than lower extremity paralysis [23]. To maintain the basic functions of ordinary life, the use of the upper extremities is essential; therefore, upper extremity paralysis commonly causes problems in performing the activities of daily living [2].

Robot-assisted rehabilitation treatment has recently been widely investigated as an effective neurorehabilitation approach that may augment the effects of physical therapy and facilitate motor recovery [4]. Robot-assisted rehabilitation treatments have been developed in recent decades to reduce the expenditure of therapists’ effort and time, to reproduce accurate repetitive motions and to interact with force feedback [56]. The most important advantage of using robot-assisted rehabilitation treatment is the ability to deliver high-dosage and high-intensity training [7].

In rehabilitation patients may find such exercises monotonous and boring, and may lose motivation over time [8]. Upper extremity rehabilitation training using video games, such as Nintendo Wii games and the PlayStation EyeToy games, enhanced upper extremity functions and resulted in greater patient satisfaction than conventional rehabilitation treatment [910111213].

The objective of this study was to determine the effects of combining robot-assisted game training with conventional upper extremity rehabilitation training (RCT) on motor and daily functions in comparison to conventional upper extremity rehabilitation training (OCT) in stroke patients. This study was a randomized controlled trial and we evaluated motor power, upper extremity motor function, daily function and satisfaction. […]

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Fig. 1. (A) Neuro-X, an upper extremity rehabilitation robot, consisting of a video monitor, a robot arm and a computer. (B) The patient performing robot-assisted game training with the upper extremity rehabilitation robot.

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[REVIEW] Technical Developments for Rehabilitation of Mobility – Full Text

Abstract

Technically assisted rehabilitation of mobility after stroke has been well established for several years. There is good evidence for the use of end-effector devices, exoskeletons and treadmill training with and without body weight support. New developments provide the possibility for functional training during mobilization, even in intensive care units. Mobile exoskeleton devices have been developed, but their clinical effects need still to be evaluated. All devices should not only focus on increasing the number of repetitions, but also include motivational aspects such as virtual reality environments. Hygienic aspects impose a special challenge. All devices should be integrated into a rational and clearly-defined therapy concept.

Introduction

Technicallyassisted rehabilitation of mobility after stroke has been well established for several years [1]. The premise “if you want to learn to walk, you have to walk” is of primary importance. In 1995, the working group led by Stefan Hesse showed that repetitive training of walking movements using a treadmill leads to greater improvement of walking ability in stroke patients compared to conventional physiotherapy [2].

Since using a treadmill for severely affected patients is not an optimal approach, alternative solutions have been sought [3]. Almost simultaneously two technical solutions were developed. By developing the electromechanical Gangtrainer GT1®, the Berlin group created a so-called end-effector device in which the trajectory of the gait cycle is predefined and the body’s center of gravity is controlled by a belt system in the vertical and horizontal direction. An alternative technical solution, the Lokomat®, was developed by a Zürich working group as an exoskeleton which uses motors to control the knee and hip joints, so that the patient can perform gait exercises even in the case of complete paraplegia.

These approaches can now be classified as clearly evidence-based. Within the framework of the guideline initiative of the German Society for Neurorehabilitation, the guideline “Rehabilitation of Motor Function after Stroke” (ReMos) was published in 2015. Based on a systematic literature search, a total of 188 randomized clinical trials and 11 systematic reviews were identified that met stipulated quality criteria [4]. This literature was grouped not only according to interventions, but also according to the target criteria and thus the severity of the patients’ disability. Based on available evidence, different recommendations were made for gaining and improving mobility, improving walking speed, walking distance and balance [5].

However, during the last few years the rehabilitation landscape in Germany has been particularly characterized by earlier admissions of patients who are still quite disabled when leaving the primary care hospitals. This is demonstrated by massive increases in early rehabilitation treatment capacity, including those with possibilities of mechanical ventilation [6]. For patients, this development offers the advantage of being transferred early in structured rehabilitative environments where new solutions are being developed. The current state of the art as well as new developments will be discussed below. […]

Continue —>  Thieme E-Journals – Neurology International Open / Full Text

Fig. 1 Verticalization in conjunction with initiation of walking movements (Erigo®, image rights: Hocoma, Zürich, Switzerland).

 

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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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[ARTICLE] COMBINING UPPER LIMB ROBOTIC REHABILITATION WITH OTHER THERAPEUTIC APPROACHES AFTER STROKE: CURRENT STATUS, RATIONALE AND CHALLENGES – Full Text PDF

Abstract:

A better understanding of the neural substrates that underlie motor recovery after stroke has led to the development of innovative rehabilitation strategies and tools that incorporate key elements of motor skill re-learning, i.e. intensive motor training involving goal-oriented repeated movements. Robotic devices for the upper limb are increasingly used in rehabilitation. Studies have demonstrated the effectiveness of these devices in reducing motor impairments, but less so for the improvement of upper limb function. Other studies have begun to investigate the benefits of combined approaches that target muscle function (functional electrical stimulation and Botulinum Toxin injections), modulate neural activity (Noninvasive Brain stimulation) and enhance motivation (Virtual Reality) in an attempt to potentialize the benefits of robot-mediated training. The aim of this paper is to overview the current status of such combined-treatments and to analyze the rationale behind them.

1. Introduction
Significant advances have been made in the management of stroke (including prevention, acute management and rehabilitation), however cerebrovascular diseases remain the third most common cause of death and the first cause of disability worldwide[1–6]. Stroke causes brain damage, leading to loss of motor function. Upper limb (UL) function is particularly reduced, resulting in disability. Many rehabilitation techniques have been developed over the last decades to facilitate motor recovery of the UL in order to improve functional ability and quality of life [7–10]. They are commonly based on principles of motor skill learning to promote plasticity of motor neural networks. These principles include intensive, repetitive, task-oriented movement-based training [11–19]. A better understanding of the neural substrates of motor re-learning has led to the development of innovative strategies and tools to deliver exercise that meets these requirements. Treatments mostly target the neurological impairment (paresis, spasticity etc.) through the activation of neural circuits or by acting on peripheral effectors. Robotic devices provide exercises that incorporate key elements of motor learning. Advanced robotic systems can offer highly repetitive, reproducible, interactive forms of training for the paretic limb, which are quantifiable. Robotic devices also enable easy and objective assessment of motor performance in standardized conditions by the recording of biomechanical data (i.e., speed, forces, etc.) [20–22]. This data can be used to analyze and assess motor recovery in stroke patients [23–26]. Since the 1990’s, many other technology-based approaches and innovative pharmaceutical treatments have also been developed for rehabilitation, including virtual reality (VR)-based systems, Botulinum neurotoxin (BoNT) injections and Non Invasive Brain stimulation (NIBS) (Direct Current Stimulation (tDCS) and repetitive Transcranial Magnetic Stimulation (rTMS)). There is currently no high-quality evidence to support any of these innovative interventions, despite the fact that some are used in routine practice [27]. By their respective mechanisms of action, each of these treatments could potentiate the effects of robotic therapy, leading to greater improvements in motor capacity. The aim of this paper is to review studies of combined treatments based on robotic rehabilitation, and to analyze the rationale behind such approaches. […]

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[ARTICLE] Robot Assisted Training for the Upper Limb after Stroke (RATULS): study protocol for a randomised controlled trial – Full Text

Abstract

Background

Loss of arm function is a common and distressing consequence of stroke. We describe the protocol for a pragmatic, multicentre randomised controlled trial to determine whether robot-assisted training improves upper limb function following stroke.

Methods/design

Study design: a pragmatic, three-arm, multicentre randomised controlled trial, economic analysis and process evaluation.

Setting: NHS stroke services.

Participants: adults with acute or chronic first-ever stroke (1 week to 5 years post stroke) causing moderate to severe upper limb functional limitation.

Randomisation groups:

1. Robot-assisted training using the InMotion robotic gym system for 45 min, three times/week for 12 weeks

2. Enhanced upper limb therapy for 45 min, three times/week for 12 weeks

3. Usual NHS care in accordance with local clinical practice

Randomisation: individual participant randomisation stratified by centre, time since stroke, and severity of upper limb impairment.

Primary outcome: upper limb function measured by the Action Research Arm Test (ARAT) at 3 months post randomisation.

Secondary outcomes: upper limb impairment (Fugl-Meyer Test), activities of daily living (Barthel ADL Index), quality of life (Stroke Impact Scale, EQ-5D-5L), resource use, cost per quality-adjusted life year and adverse events, at 3 and 6 months.

Blinding: outcomes are undertaken by blinded assessors.

Economic analysis: micro-costing and economic evaluation of interventions compared to usual NHS care. A within-trial analysis, with an economic model will be used to extrapolate longer-term costs and outcomes.

Process evaluation: semi-structured interviews with participants and professionals to seek their views and experiences of the rehabilitation that they have received or provided, and factors affecting the implementation of the trial.

Sample size: allowing for 10% attrition, 720 participants provide 80% power to detect a 15% difference in successful outcome between each of the treatment pairs. Successful outcome definition: baseline ARAT 0–7 must improve by 3 or more points; baseline ARAT 8–13 improve by 4 or more points; baseline ARAT 14–19 improve by 5 or more points; baseline ARAT 20–39 improve by 6 or more points.

Discussion

The results from this trial will determine whether robot-assisted training improves upper limb function post stroke.

Background

Stroke is the commonest cause of complex adult disability in high-income countries [1]. Loss of arm function affects 69% of people who have a stroke [2]. Only 12% of people with arm weakness at the onset of stroke make a full recovery [3]. Improving arm function has been identified as a research priority by stroke survivors, carers and health professionals who report that current rehabilitation pays insufficient attention to arm recovery [4].

Robot-assisted training enables a greater number of repetitive tasks to be practised in a consistent and controllable manner. Repetitive task training is known to drive Hebbian plasticity, where wiring of pathways that are coincidently active is strengthened [5, 6]. A dose of greater than 20 h of repetitive task training improves upper limb motor recovery following a stroke [7] and, therefore, robot-assisted training has the potential to improve arm motor recovery after stroke. We anticipate that Hebbian neuroplasticity, which is learning dependent, will operate regardless of the post-stroke phase.

A Cochrane systematic review of electromechanical and robot-assisted arm training after stroke reported outcomes from a total of 1160 patients who participated in 34 randomised controlled trials (RCTs). Improvements in arm function (standardised mean difference (SMD) 0.35, 95% confidence interval (CI), 0.18–0.51) and activities of daily living (SMD 0.37, 95% CI, 0.11–0.64) were found in patients who received this treatment, but studies were often of low quality [8]. In the UK there is currently insufficient evidence to justify the use of this technology in routine clinical practice.

In addition, studies which suggest that robot-assisted training may improve upper limb function after stroke should be treated with caution as participants who were randomised to receive robot-assisted training may have also received an increased intensity of rehabilitation sessions (e.g. frequency or duration) compared to participants in the control groups. Greater intensity of upper limb rehabilitation sessions has been shown to improve upper limb functional outcomes [7], and a meta-analysis of robot-assisted training RCTs reported that if control group therapy sessions were delivered at the same frequency and duration, there was no additional functional improvement [9]. Studies are required which provide further direct evidence of the effectiveness of robot-assisted training without the confounding effect of therapy dose.

The aim of the Robot Assisted Training for the Upper Limb after Stroke (RATULS) trial is to evaluate the clinical and cost-effectiveness of robot-assisted training compared to an upper limb therapy programme of the same frequency and duration, and usual post-stroke care.

The null hypothesis is that there is no difference in upper limb function at 3 months between study participants who receive robot-assisted training and those who receive an enhanced upper limb therapy programme and those who receive usual post-stroke care. The RATULS trial will be making comparisons of the effectiveness of rehabilitation on upper limb function between all three pairs of trial arms.

Source: Robot Assisted Training for the Upper Limb after Stroke (RATULS): study protocol for a randomised controlled trial | Trials | Full Text

 

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Smart walk assist improves rehabilitation – YouTube

Using smart algorithms to help the brain develop a new way of walking after a stroke. Incredible advances in rehab technologies!

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[Abstract] Use of Lower-Limb Robotics to Enhance Practice and Participation in Individuals With Neurological Conditions

Purpose: To review lower-limb technology currently available for people with neurological disorders, such as spinal cord injury, stroke, or other conditions. We focus on 3 emerging technologies: treadmill-based training devices, exoskeletons, and other wearable robots.

Summary of Key Points: Efficacy for these devices remains unclear, although preliminary data indicate that specific patient populations may benefit from robotic training used with more traditional physical therapy. Potential benefits include improved lower-limb function and a more typical gait trajectory.

Statement of Conclusions: Use of these devices is limited by insufficient data, cost, and in some cases size of the machine. However, robotic technology is likely to become more prevalent as these machines are enhanced and able to produce targeted physical rehabilitation.

Recommendations for Clinical Practice: Therapists should be aware of these technologies as they continue to advance but understand the limitations and challenges posed with therapeutic/mobility robots.

Source: Use of Lower-Limb Robotics to Enhance Practice and Participa… : Pediatric Physical Therapy

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[Abstract] A Randomized Trial on the Effects of Attentional Focus on Motor Training of the Upper Extremity Using Robotics with Individuals after Chronic Stroke 

 

Highlights

  • Individuals with moderate-to-severe arm impairment after stroke improved motor control after engaging in high-repetition training
  • There were no differences between external focus or internal focus of attention on retention of motor skills after four weeks of arm training for individuals with stroke
  • Individuals with moderate-to-severe arm impairment may not experience the advantages of an external focus during motor training found in healthy individuals
  • Attentional focus is most likely not an active ingredient for retention of trained motor skills for individuals with moderate-to-severe arm impairment

Abstract

Objective

To compare the long-term effects of external focus (EF) versus internal focus (IF) of attention after 4-weeks of arm training. Design: Randomized, repeated measure, mixed ANOVA.

Setting

Outpatient clinic.

Participants

33 individuals with stroke and moderate-to-severe arm impairment living in the community (3 withdrawals).

Interventions

4-week arm training protocol on the InMotion ARM robot (12 sessions).

Main Outcome Measures

Joint independence, Fugl-Meyer Assessment, and Wolf Motor Function Test measured at baseline, discharge, and 4-week follow-up.

Results

There were no between-group effects for attentional focus. Participants in both groups improved significantly on all outcome measures from baseline to discharge and maintained those changes at 4-week follow-up regardless of group assignment [Jt indep-EF, F(1.6, 45.4) = 17.74, p<.0005, partial η2=.39; Jt indep-IF, F(2, 56)= 18.66, p<.0005, partial η2=.40; FMA, F(2, 56) = 27.83, p<.0005, partial η2=.50 ; WMFT, F(2, 56) =14.05, p<.0005, partial η2=.35].

Conclusion

There were no differences in retention of motor skills between EF and IF participants four weeks after arm training, suggesting that individuals with moderate-to-severe arm impairment may not experience the advantages of an EF found in healthy individuals. Attentional focus is most likely not an active ingredient for retention of trained motor skills for individuals with moderate-to-severe arm impairment, whereas dosage and intensity of practice appear to be pivotal. Future studies should investigate the long-term effects of attentional focus for individuals with mild arm impairment.

Source: A Randomized Trial on the Effects of Attentional Focus on Motor Training of the Upper Extremity Using Robotics with Individuals after Chronic Stroke – Archives of Physical Medicine and Rehabilitation

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[WEB SITE] Robotic-Assisted Rehabilitation Therapy Designed to Aid Stroke Recovery

Pictured here is the experimental setup for the estimation of the 3 DOF human forearm and wrist impedance. (Photo courtesy of UNIST)

Pictured here is the experimental setup for the estimation of the 3 DOF human forearm and wrist impedance. (Photo courtesy of UNIST)

Scientists from Ulsan National Institute of Science and Technology (UNIST) have developed a new robotic tool to assess muscle overactivity and movement dysfunction in stroke survivors.

They suggest, in a study published recently in IEEE Transactions on Neural Systems and Rehabilitation Engineering, that their robotic-assisted rehabilitation therapy may help improve the stroke patients’ mobility.

The study was led by Professor Sang Hoon Kang of Mechanical, Aerospace and Nuclear Engineering at UNIST in collaboration with Professor Pyung-Hun Chang of DGIST and Dr Kyungbin Park of Samsung Electronics Co Ltd, according to a media release from UNIST.

In their study, Kang and the others on the team developed a rehabilitation robotic system that quantitatively measures the 3 degrees-of-freedom (DOF) impedance of human forearm and wrist in minutes.

Using their impedance estimation device, which they call the distal internal model based impedance control (dIMBIC)-based method, the team was able to accurately characterize the 3 DOF forearm and wrist impedance, including inertia, damping, and stiffness, for the first time, the release continues.

“The dIMBIC-based method can be used to assist in the quantitative and objective evaluation of neurological disorders, like stroke,” Kang says, in the release. “Findings from this study will open a new chapter in robot-assisted rehabilitation in the workplace accident rehabilitation hospitals, as well as in nursing homes and assisted living facilities.”

The research team expects that, in the long run, the proposed 3 DOF impedance estimation may promote wrist and forearm motor control studies and complement the diagnosis of the alteration in wrist and forearm resistance post-stroke by providing objective impedance values including cross-coupled terms, the release concludes.

[Source(s): Ulsan National Institute of Science and Technology (UNIST), Science Daily]

Source: Robotic-Assisted Rehabilitation Therapy Designed to Aid Stroke Recovery – Rehab Managment

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