The main purpose of the paper is development, implementation, and testing of a low cost portable system to assist partially paralyzed patients in their hand rehabilitation after strokes or some injures. Rehabilitation includes time consuming and repetitive exercises which are costly and demotivating as well as the requirements of clinic attending and direct supervision of physiotherapist. In this work, the system consists of a graphical user interface (GUI) on a smartphone screen to instruct and motivate the patients to do their exercises by themselves. Through the GUI, the patients are instructed to do a sequence of exercises step by step, and the system measures the electrical activities (electromyographic signals EMG) of the user’s forearm muscles by Myo armband. Depending on database, the system can tell whether the patients have done correct movements or not. If a correct movement is detected, the system will inform the user through the GUI and move to the next exercise. For preliminary results, the system was extensively tested on a healthy person.
Posts Tagged wearable
A therapeutic shoe engineered to help improve stroke recovery is proving successful and is expected to hit the market by the end of the year, researchers from University of South Florida suggest.
Results from the recently completed clinical trials on the US patented and licensed iStride Device, formerly the Gait Enhancing Mobile Shoe (GEMS), were published recently in the Journal of NeuroEngineering and Rehabilitation.
Gait asymmetry as the result of a stroke is associated with poor balance, a major cause of degenerative issues that make individuals more susceptible to falls and injuries.
The iStride device is designed to be strapped over the shoe of the stroke patient’s good leg and generate a backwards motion, exaggerating the existing step, making it harder to walk while wearing the shoe. The awkward movement strengthens the stroke-impacted leg, allowing gait to become more symmetrical once the shoe is removed. The impaired foot wears a matching shoe that remains stationary, a media release from University of South Florida (USF Innovation) notes.
“The backward motion of the shoe is generated passively by redirecting the wearer’s downward force during stance phase. Since the motion is generated by the wearer’s force, the person is in control, which allows easier adaptation to the motion,” developer Kyle Reed, PhD, associate professor of mechanical engineering at the University of South Florida, says in the release.
“Unlike many of the existing gait rehabilitation devices, this device is passive, portable, wearable and does not require any external energy.”
The trial included six people between ages 57 and 74 who suffered a cerebral stroke at least 1 year prior to the study. They all had asymmetry large enough to impact their walking ability. Each received 12, 30-minute gait training sessions for 4 weeks. With guidance from a physical therapist, the patients’ gait symmetry and functional walking were measured using the ProtoKinetics Zeno Walkway system.
All participants improved their gait’s symmetry and speed. That includes how long it takes to stand up from a sitting position and walk, as well as how long it takes to walk to a specific location and distance traveled within 6 minutes. Four improved the percentage of time spent in a gait cycle with both feet simultaneously planted on the ground, known as double limb support.
As far as the other two that didn’t improve, one started the study with severe impairment, while the other was highly functional. It’s also important to note that three participants joined the study limited to walking in their homes. Following the trial, two of them could successfully navigate public venues, the release explains.
Reed compared his method to a previous study conducted on split-belt treadmill training (SBT), which is commonly used by physical therapists to help stroke patients improve their gait. The equipment allows the legs to move at different speeds, forcing the patient to compensate in order to remain on the treadmill. While the SBT improves certain aspects of gait, unlike the iStride, it doesn’t strengthen double limb support.
That research concluded only about 60% of patients trained on the SBT corrected their gait when walking in a normal environment. Walking is context dependent where visual cues impact how quickly one tries to move, and in what direction. The iStride allows patients to adjust accordingly. Movement on a treadmill is predictable and provides individuals a static scene.
Since patients are often disappointed in their progress after being discharged from rehabilitation, the iStride’s portability allows patients to relearn to walk in a typical setting more often and for a longer duration.
Reed is now working on a home-based clinical trial with 21 participants and expects to publish results within the next year. He recently received a Fulbright scholarship to conduct research at Hong Kong Polytechnic University. He’s working in the rehabilitation sciences and biomedical engineering departments throughout the 2019-2020 academic year, per the release.
[Source(s): University of South Florida (USF Innovation), EurekAlert]
[ARTICLE] Home rehabilitation supported by a wearable soft-robotic device for improving hand function in older adults: A pilot randomized controlled trial – Full Text
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 wearable soft-robotic ironHand glove is such a system that supports grip strength during the performance of daily activities and hand training exercises at home.
This pilot randomized controlled clinical study explored the effect of prolonged use of the assistive ironHand glove during daily activities at home, in comparison to its use as a trainings tool at home, on functional performance of the hand.
In total, 91 older adults with self-perceived decline of hand function participated in this study. They were randomly assigned to a 4-weeks intervention of either assistive or therapeutic ironHand use, or control group (received no additional exercise or treatment). All participants performed a maximal pinch grip test, Box and Blocks test (BBT), Jebsen-Taylor Hand Function Test (JTHFT) at baseline and after 4-weeks of intervention. Only participants of the assistive and therapeutic group completed the System Usability Scale (SUS) after the intervention period.
Participants of the assistive and therapeutic group reported high scores on the SUS (mean = 73, SEM = 2). The therapeutic group showed improvements in unsupported handgrip strength (mean Δ = 3) and pinch strength (mean Δ = 0.5) after 4 weeks of ironHand use (p≤0.039). Scores on the BBT and JTHFT improved not only after 4 weeks of ironHand use (assistive and therapeutic), but also in the control group. Only handgrip strength improved more in the therapeutic group compared to the assistive and control group. No significant correlations were found between changes in performance and assistive or therapeutic ironHand use (p≥0.062).
This study showed that support of the wearable soft-robotic ironHand system either as assistive device or as training tool may be a promising way to counter functional hand function decline associated with ageing.
Hand function predominantly determines the quality of performance in activities of daily living (ADL) and work-related functioning. Older adults with age-related loss of muscle mass (i.e. sarcopenia)  and/or age-related diseases (e.g. stroke, arthritis) [2, 3] suffer from loss of hand function. As a consequence, they experience functional limitations, which affects independence in performing ADL [3–5].
An effective intervention for improving hand function of (stroke) patients should consist of several key aspects of motor learning, such as high-intensity and task-specificity in repetitive and functional exercises that are actively initiated by the patient him/herself [6, 7]. In a traditional rehabilitation setting, those kinds of interventions are performed with one-on-one attention from the healthcare professional for each patient. This might become problematic in the near future when the population of older adults with age-related diseases (e.g. stroke, rheumatoid arthritis) with hand function decline will rise, resulting in an increased need for healthcare professionals and a rise of healthcare costs . Therefore, new alternatives to provide intensive therapy for all patients are needed in the future.
New technological developments, such as robot-assisted hand training, have the potential to provide such intensive, repetitive and task-specific therapy. Several reviews [9–11] already showed positive results on motor function after robot-assisted training of the upper extremity. However, limiting factors of robot-assisted therapy are the need for supervision of a healthcare professional, the high costs of the devices and the limited availability of wearable devices for training at home . Furthermore, it is often not efficient in transferring the trained movements into daily situations . Therefore, the next generation robotic training approaches should pay substantial attention towards home-based rehabilitation and the functional nature of the exercise involved.
A new way of providing functional, intensive and task-specific hand training would involve using new technological innovations that enable support of the affected hand directly during the performance of ADL, based on the concept of a wearable robotic glove [13–18]. In this way, the affected hand can be used repeatedly and for prolonged periods of time during functional daily activities. These robotic gloves can use different human-robot interfaces to provide assistance for the affected hand, such as an EMG-controlled glove, a tendon driven glove, a glove controlled by force sensors etc. [13, 14, 16, 18, 19]. All these robotic gloves use soft and flexible materials to make such devices more lightweight and easy to use, accommodating wearable applications. This concept of a wearable soft-robotic glove allows persons with reduced hand function to use their hand(s) during a large variety of functional activities and may even turn performing daily activities into extensive training, independent from the availability of healthcare professionals. This is thought to improve hand function and patient’s independence in performing ADL.
Therefore, an easy to use and wearable soft-robotic glove (ironHand system), supporting grip strength and hand training exercises at home, was developed within the ironHand project . Previous studies have examined feasibility  and the orthotic effect of the ironHand system . In a first randomized controlled clinical study, the effect of prolonged use of such an assisting glove during ADL at home on functional performance of the hand was explored, in comparison to its use as a training tool at home.[…]
[ARTICLE] A Wearable Rehabilitation System to Assist Partially Hand Paralyzed Patients in Repetitive Exercises – Full Text PDF
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The BIOMOT project, completed in September 2016, has helped to advance this emerging field by demonstrating that personalised computational models of the human body can effectively be used to control wearable exoskeletons. The project has identified ways of achieving improved flexibility and autonomous performance, which could assist in the use of wearable robots as mobility assistance and rehabilitation tools.
‘An increasing number of researchers in the field of neurorehabilitation are interested in the potential of these robotic technologies for clinical rehabilitation following neurological diseases,’ explains BIOMOT project coordinator Dr. Juan Moreno from the Spanish Council for Scientific Research (CSIC). ‘One reason is that these systems can be optimised to deliver diverse therapeutic interventions at specific points of recuperation or care.’
However, a number of factors have limited the widespread market adoption of wearable robots. Moreno and his team identified a need for wearable equipment to be more compact and lightweight, and better able anticipate and detect the intended movements of the wearer. In addition, robots needed to become more versatile and adaptable in order to aid people in a variety of different situations; walking on uneven ground, for example, or approaching an obstacle.
In order to address these challenges, the project developed robots with real-time adaptability and flexibility by increasing the symbiosis between the robot and the user through dynamic sensorimotor interactions. A hierarchical approach to these interactions was taken, allowing the project team to apply different layers for different purposes. This means in effect that an exoskeleton can be personalised to an individual user.
‘Thanks to this framework, the BIOMOT exoskeleton can rely on mechanical and bioelectric measurements to adapt to a changing user or task condition,’ says Moreno. ‘This leads to improved robotic interventions.’
Following theoretical and practical work, the project team then tested these prototype exoskeletons with volunteers. A key technical challenge was how to combine a robust and open architecture with a novel wearable robotic system that can gather signals from human activity. ‘Nonetheless, we succeeded in investigating for the first time the potential of automatically controlling human-robot interactions in order to enhance user compliance to a motor task,’ says Moreno. ‘Our research with healthy humans showed such positive and promising results that we are keen to continue validation with both stroke and spinal cord injury patients.’
Indeed, Moreno is confident that the success of the project will open up potential new research avenues. For example, the results will help scientists to develop computational models for rehabilitation therapies, and better understand human movement in more detail.
‘In the project we also defined novel techniques to evaluate and benchmark performances of wearable exoskeletons,’ says Moreno. ‘Further innovation projects are planned by consortium members to follow up on this research, and to exploit developments in the field of human motion capture, human-machine interaction and adaptive control.’
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Flint Rehab announces the launch of MiGo, a wearable activity tracker specifically designed for stroke survivors. The device makes its official debut at the 2019 Consumer Electronics Show in Las Vegas.
MiGo is designed to track upper extremity activity — in addition to walking — and is optimized for the movement patterns performed by individuals with stroke. The device is accompanied by a smartphone app that provides motivational support through digital coaching, progressive goal setting, and social networking with other stroke survivors, according to the company in a media release.
“Most wearable fitness trackers are designed to help people get into shape. MiGo is a new type of wearable that helps people regain their independence after a stroke,” says Dr Nizan Friedman, co-founder and CEO of Irvine, Calif-based Flint Rehab, in the release.
“Traditionally, innovation in medical technology has been limited by what insurance companies are willing to cover. As a consumer-level digital health technology, MiGo avoids these constraints, empowering stroke survivors to take their recovery into their own hands.”
A common outcome of stroke is hemiparesis, or impaired movement on one side of the body. One of the leading causes of this lifelong disability is a phenomenon called “learned non-use,” where stroke survivors neglect to use their impaired arm or leg, causing their brain to lose the ability to control those limbs altogether.
MiGo directly addresses the problem of learned non-use by motivating stroke survivors to use their impaired side as much as possible. Using deep-learning algorithms, MiGo accurately tracks how much the wearer is using their impaired side, providing them with an easy-to-understand rep count throughout the day.
MiGo also provides an intelligent activity goal that updates every day based on the wearer’s actual movement ability, ensuring every user stays continuously challenged at the level appropriate for them. Then, the device acts as the wearer’s personal cheerleader, giving them rewards and positive feedback right on their wrist as they work to hit their daily goal, the release explains.
“Suffering a stroke is a traumatic, life-changing event. Many survivors do not have the proper support network to deal with the event, and they may find it difficult to relate with friends and family who don’t understand what they are going through,” states Dan Zondervan, co-founder and vice president of Flint Rehab.
“Using the MiGo app, users can join groups to share their activity data and collaborate with other stroke survivors to achieve group goals. Group members can also share their experiences and offer encouraging support to each other — right in the app,” he adds.
For more information, visit Flint Rehab.
[Source(s0): Flint Rehab, Business Wire]
[Abstract + References] eConHand: A Wearable Brain-Computer Interface System for Stroke Rehabilitation
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This paper presents the design and development of a highly articulated, continuum, wearable, fabric-based Soft Poly-Limb (fSPL). This fabric soft arm acts as an additional limb that provides the wearer with mobile manipulation assistance through the use of soft actuators made with high-strength inflatable fabrics. In this work, a set of systematic design rules is presented for the creation of highly compliant soft robotic limbs through an understanding of the fabric based components behavior as a function of input pressure. These design rules are generated by investigating a range of parameters through computational finite-element method (FEM) models focusing on the fSPL’s articulation capabilities and payload capacity in 3D space. The theoretical motion and payload outputs of the fSPL and its components are experimentally validated as well as additional evaluations verify its capability to safely carry loads 10.1x its body weight, by wrapping around the object. Finally, we demonstrate how the fully collapsible fSPL can comfortably be stored in a soft-waist belt and interact with the wearer through spatial mobility and preliminary pick-and-place control experiments.