In this study, a cable-driven exoskeleton device is developed for stroke patients to enable them to perform passive range of motion exercises and teleoperation rehabilitation of their impaired hands. Each exoskeleton finger is controlled by an actuator via two cables. The motions between the metacarpophalangeal and distal/proximal interphalangeal joints are decoupled, through which the movement pattern is analogous to that observed in the human hand. A dynamic model based on the Lagrange method is derived to estimate how cable tension varies with the angular position of the finger joints. Two discernable phases are observed, each of which reflects the motion of the metacarpophalangeal and distal/proximal interphalangeal joints. The tension profiles of exoskeleton fingers predicted by the Lagrange model are verified through a mechatronic integrated platform. The model can precisely estimate the tensions at different movement velocities, and it shows that the characteristics of two independent phases remain the same even for a variety of movement velocities. The feasibility for measuring resistance when manipulating a patient’s finger is demonstrated in human experiments. Specifically, the net force required to move a subject’s finger joints can be accounted for by the Lagrange model.
Our hands are very important in our daily life. They are used for non-verbal communication and sensory feedback, but are also important to perform both fine (e.g. picking up paperclips) and gross (e.g. lifting heavy boxes) motor tasks. Decline of hand function in older adults as a result of age-related loss of muscle mass (i.e. sarcopenia) and/or age-related diseases such as stroke, rheumatoid arthritis or osteoarthritis, is a common problem worldwide. The decline in hand function, in particular grip strength, often results in increased difficulties in performing activities of daily living (ADL), such as carrying heavy objects, doing housework, (un)dressing, preparing food and eating.
New developments, based on the concept of wearable soft-robotic devices, make it possible to support impaired hand function during the performance of daily activities and intensive task-specific training. The ironHand and HandinMind systems are examples of such novel wearable soft-robotic systems that have been developed in the ironHand and HandinMind projects. Both systems are developed to provide grip support during a wide range of daily activities. The ironHand system consists of a 3-finger wearable soft-robotic glove, tailored to older adults with a variety of physical age-related hand function limitations. The HandinMind system consists of a 5-finger wearable soft-robotic glove, dedicated towards application in stroke. In both cases, the wearable soft-robotic system could be connected to a computer with custom software to train specific aspects of hand function in a motivating game-like environment with multiple levels of difficulty. By adding the game environment, an assistive device is transformed into a dedicated training device.
The aim of the current thesis is to define user requirements, to investigate feasibility and to evaluate the direct and clinical effects of a wearable soft-robotic system that is developed to support impaired hand function of older adults and stroke patients in a wide range of daily activities and in exercise training at home.
via The wearable hand robot: supporting impaired hand function in activities of daily living and rehabilitation — University of Twente Research Information
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
Statistics shows that, at European Union level, the upper limb is second common body part injured, as a result of unintentional physical injury . 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 , 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
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
Recent technological developments regarding wearable soft-robotic devices extend beyond the current application of rehabilitation robotics and enable unobtrusive support of the arms and hands during daily activities. In this light, the HandinMind (HiM) system was developed, comprising a soft-robotic, grip supporting glove with an added computer gaming environment. The present study aims to gain first insight into the feasibility of clinical application of the HiM system and its potential impact. In order to do so, both the direct influence of the HiM system on hand function as assistive device and its therapeutic potential, of either assistive or therapeutic use, were explored. A pilot randomized clinical trial was combined with a cross-sectional measurement (comparing performance with and without glove) at baseline in 5 chronic stroke patients, to investigate both the direct assistive and potential therapeutic effects of the HiM system. Extended use of the soft-robotic glove as assistive device at home or with dedicated gaming exercises in a clinical setting was applicable and feasible. A positive assistive effect of the soft-robotic glove was proposed for pinch strength and functional task performance `lifting full cans’ in most of the five participants. A potential therapeutic impact was suggested with predominantly improved hand strength in both participants with assistive use, and faster functional task performance in both participants with therapeutic application.
Neurorehabilitation research has shown that training programs for patients after stroke should ideally consist of high intensity, task-specific and functional exercises with active contribution of the patient, to have the best chance for improving arm/hand function , . Conventional rehabilitation involves predominantly one-to-one attention of a therapist for each patient, which is a challenge when aiming to provide high intensity training and involves high costs , . This is impeded further by an increased ageing of the population, associated with a higher prevalence of stroke patients and less healthcare professionals available to provide such intensive training.
via Applying a soft-robotic glove as assistive device and training tool with games to support hand function after stroke: Preliminary results on feasibility and potential clinical impact – IEEE Conference Publication
The applications of robotics to the rehabilitation training of neuromuscular impairments have received increasing attention due to their promising prospects. The effectiveness of robot-assisted training directly depends on the control strategy applied in the therapy program. This paper presents an upper extremity exoskeleton for the functional recovery training of disabled patients. A minimal-intervention-based admittance control strategy is developed to induce the active participation of patients and maximize the use of recovered motor functions during training. The proposed control strategy can transit among three control modes, including human-conduct mode, robot-assist mode, and motion-restricted mode, based on the real-time position tracking errors of the end-effector. The human-robot interaction in different working areas can be modulated according to the motion intention of patient. Graphical guidance developed in Unity-3-D environment is introduced to provide visual training instructions. Furthermore, to improve training performance, the controller parameters should be adjusted in accordance with the hemiplegia degree of patients. For the patients with severe paralysis, robotic assistance should be increased to guarantee the accomplishment of training. For the patients recovering parts of motor functions, robotic assistance should be reduced to enhance the training intensity of effected limb and improve therapeutic effectiveness. The feasibility and effectiveness of the proposed control scheme are validated via training experiments with two healthy subjects and six stroke patients with different degrees of hemiplegia.
via Development of a Minimal-Intervention-Based Admittance Control Strategy for Upper Extremity Rehabilitation Exoskeleton – IEEE Journals & Magazine
Hybrid rehabilitation robotics combine neuro-prosthetic devices (close-loop functional electrical stimulation systems) and traditional robotic structures and actuators to explore better therapies and promote a more efficient motor function recovery or compensation. Although hybrid robotics and ankle neuroprostheses (NPs) have been widely developed over the last years, there are just few studies on the use of NPs to electrically control both ankle flexion and extension to promote ankle recovery and improved gait patterns in paretic limbs. The aim of this work is to develop an ankle NP specifically designed to work in the field of hybrid robotics. This article presents early steps towards this goal and makes a brief review about motor NPs and Functional Electrical Stimulation (FES) principles and most common devices used to aid the ankle functioning during the gait cycle. It also shows a current sources analysis done in this framework, in order to choose the best one for this intended application.
Source: Towards an ankle neuroprosthesis for hybrid robotics: Concepts and current sources for functional electrical stimulation – IEEE Xplore Document
Published in: Rehabilitation Robotics (ICORR), 2017 International Conference on
Recent technological developments regarding wearable soft-robotic devices extend beyond the current application of rehabilitation robotics and enable unobtrusive support of the arms and hands during daily activities. In this light, the HandinMind (HiM) system was developed, comprising a soft-robotic, grip supporting glove with an added computer gaming environment. The present study aims to gain first insight into the feasibility of clinical application of the HiM system and its potential impact. In order to do so, both the direct influence of the HiM system on hand function as assistive device and its therapeutic potential, of either assistive or therapeutic use, were explored. A pilot randomized clinical trial was combined with a cross-sectional measurement (comparing performance with and without glove) at baseline in 5 chronic stroke patients, to investigate both the direct assistive and potential therapeutic effects of the HiM system. Extended use of the soft-robotic glove as assistive device at home or with dedicated gaming exercises in a clinical setting was applicable and feasible. A positive assistive effect of the soft-robotic glove was proposed for pinch strength and functional task performance ‘lifting full cans’ in most of the five participants. A potential therapeutic impact was suggested with predominantly improved hand strength in both participants with assistive use, and faster functional task performance in both participants with therapeutic application.
Source: Applying a soft-robotic glove as assistive device and training tool with games to support hand function after stroke: Preliminary results on feasibility and potential clinical impact – IEEE Xplore Document
Rehabiliation robotics combined with video game technology provides a means of assisting in the rehabilitation of patients with neuromuscular disorders by performing various facilitation movements. The current work presents ReHabGame, a serious game using a fusion of implemented technologies that can be easily used by patients and therapists to assess and enhance sensorimotor performance and also increase the activities in the daily lives of patients. The game allows a player to control avatar movements through a Kinect Xbox, Myo armband and rudder foot pedal, and involves a series of reach-grasp-collect tasks whose difficulty levels are learnt by a fuzzy interface. The orientation, angular velocity, head and spine tilts and other data generated by the player are monitored and saved, whilst the task completion is calculated by solving an inverse kinematics algorithm which orientates the upper limb joints of the avatar. The different values in upper body quantities of movement provide fuzzy input from which crisp output is determined and used to generate an appropriate subsequent rehabilitation game level. The system can thus provide personalised, autonomously-learnt rehabilitation programmes for patients with neuromuscular disorders with superior predictions to guide the development of improved clinical protocols compared to traditional theraputic activities.
Source: An adaptive self-organizing fuzzy logic controller in a serious game for motor impairment rehabilitation – IEEE Xplore Document