Posts Tagged wearable
[Thesis] Ubiquitous and Wearable Computing Solutions for Enhancing Motor Rehabilitation of the Upper Extremity Post-Stroke
Coffey, Aodhan L. (2016) Ubiquitous and Wearable Computing Solutions for Enhancing Motor Rehabilitation of the Upper Extremity Post-Stroke. PhD thesis, National University of Ireland Maynooth.
A stroke is the loss of brain function caused by a sudden interruption in the blood supply of the brain. The extent of damage caused by a stroke is dependent on many factors such as the type of stroke, its location in the brain, the extent of oxygen deprivation and the criticality of the neural systems affected. While stroke is a non-cumulative disease, it is nevertheless a deadly pervasive disease and one of the leading causes of death and disability worldwide. Those fortunate enough to survive stroke are often left with some form of serious long-term disability. Weakness or paralysis on one side of the body, or in an individual limb is common after stroke. This affects independence and can greatly limit quality of life.
Stroke rehabilitation represents the collective effort to heal the body following stroke and to return the survivor to as normal a life as possible. It is well established that rehabilitation therapy comprising task-specific, repetitive, prolonged movement training with learning is an effective method of provoking the necessary neuroplastic changes required which ultimately lead to the recovery of function after stroke. However, traditional means of delivering such treatments are labour intensive and constitute a significant burden for the therapist limiting their ability to treat multiple patients. This makes rehabilitation medicine a costly endeavour that may benefit from technological contributions. As such, stroke has severe social and economic implications, problems exasperated by its age related dependencies and the rapid ageing of our world. Consequently these factors are leading to a rise in the number living with stroke related complications. This is increasing the demand for post stroke rehabilitation services and places an overwhelming amount of additional stress on our already stretched healthcare systems.
Therefore, new innovative solutions are urgently required to support the efforts of healthcare professionals in an attempt to alleviate this stress and to ultimately improve the quality of care for stroke survivors. Recent innovations in computer and communication technology have lead to a torrent of research into ubiquitous, pervasive and distributed technologies, which might be put to great use for rehabilitative purpose. Such technology has great potential utility to support the rehabilitation process through the delivery of complementary, relatively autonomous rehabilitation therapy, potentially in the comfort of the patient’s own home.
This thesis describes concerted work to improve the current state and future prospects of stroke rehabilitation, through investigations which explore the utility of wearable, ambient and ubiquitous computing solutions for the development of potentially transformative healthcare technology. Towards this goal, multiple different avenues of the rehabilitation process are explored, tackling the full chain of processes involved in motor recovery, from brain to extremities. Subsequently, a number of cost effective prototype devices for use in supporting the ongoing rehabilitation process were developed and tested with healthy subjects, a number of open problems were identified and highlighted, and tentative solutions for home-based rehabilitation were put forward. It is envisaged that the use of such technology will play a critical role in abating the current healthcare crisis and it is hoped that the ideas presented in this thesis will aid in the progression and development of cost effective, efficacious rehabilitation services, accessible and affordable to all in need.
[ARTICLE] Efficacy of Short-Term Robot-Assisted Rehabilitation in Patients With Hand Paralysis After Stroke – Full Text
Background: We evaluated the effectiveness of robot-assisted motion and activity in additional to physiotherapy (PT) and occupational therapy (OT) on stroke patients with hand paralysis. Methods: A randomized controlled trial was conducted. Thirty-two patients, 34.4% female (mean ± SD age: 68.9 ± 11.6 years), with hand paralysis after stroke participated. The experimental group received 30 minutes of passive mobilization of the hand through the robotic device Gloreha (Brescia, Italy), and the control group received an additional 30 minutes of PT and OT for 3 consecutive weeks (3 d/wk) in addition to traditional rehabilitation. Outcomes included the National Institutes of Health Stroke Scale (NIHSS), Modified Ashworth Scale (MAS), Barthel Index (BI), Motricity Index (MI), short version of the Disabilities of the Arm, Shoulder and Hand (QuickDASH), and the visual analog scale (VAS) measurements. All measures were collected at baseline and end of the intervention (3 weeks). Results: A significant effect of time interaction existed for NIHSS, BI, MI, and QuickDASH, after stroke immediately after the interventions (all, P < .001). The experimental group had a greater reduction in pain compared with the control group at the end of the intervention, a reduction of 11.3 mm compared with 3.7 mm, using the 100-mm VAS scale. Conclusions: In the treatment of pain and spasticity in hand paralysis after stroke, robot-assisted mobilization performed in conjunction with traditional PT and OT is as effective as traditional rehabilitation.
Stroke (or cerebrovascular accident) is a sudden ischemic or hemorrhagic episode which causes a disturbed generation and integration of neural commands from the sensorimotor31 areas of the cortex. As a consequence, the ability to selectively activate muscle tissues for performing movement is reduced.26 Sixty percent of those individuals who survive a stroke exhibit a sensorimotor deficit of one or both hands and may benefit from rehabilitation to maximize recovery of the upper extremity.23,25 Restoration of arm and hand motility is essential for the independent performance of daily activities.23,26 A prompt and effective rehabilitation approach is essential28 to obtain recovery of an impaired limb to prevent tendon shortening, spasticity, and pain.2
Recent technologies have facilitated the use of robots as tools to assist patients in the rehabilitation process, thus maximizing patient outcomes.4 Several groups have developed robotic tools for upper limb rehabilitation of the shoulder and elbow.27 These robotic tools assist the patient with carrying out exercise protocols and may help restore upper limb mobility.22,26 The complexity of wrist and finger articulations had delayed the development of dedicated rehabilitation robots until 2003 when the first tool based on continuous passive motion (CPM) was presented followed by several other solutions, with various levels of complexity and functionality.3
A recent review on the mechanisms for motor relearning reported factors such as attention and stimuli (reinforcement) are crucial during learning which indicates that motor relearning can take place with patients with neurological disorders even when only the sensorial passive stimulation is applied.30 In addition, another review reported the benefits of CPM for stretching and upper limb passive mobilization for patients with stroke but that CPM treatment requires further research.40
Among robotic devices, Gloreha (Figure 1),5,10 with its compliant mechanical transmission, may represent an easily applied innovative solution to rehabilitation, because the hand can perform grasp and release activities wearing the device by mean of a flexible and light orthosis. Our objective of this study was to determine the efficacy of robot-assisted motion in addition to traditional physiotherapy (PT) and occupational therapy (OT) compared with additional time spent in PT and OT on stroke patients with hand paralysis on function, motor strength, spasticity, and pain.
Neuroscientist Professor Stuart Baker describes a new electronic device which could help stroke patients recover movement and control of their hand.
They believe this could revolutionise treatment for patients, providing a wearable solution to the effects of stroke.
The device which is the size of a mobile phone, delivers a series of small electrical shocks followed by an audible click to strengthen brain and spinal connections.
To read more about this ground breaking research and the device visit our website http://www.ncl.ac.uk/press/news/2016/…
FEBRUARY 6, 2017
One third of adults over 65 report difficulty walking three blocks. Mobility is a serious concern for the aging population which stems from the fact that other physical ailments and issues force them to stay at home, leading to loss of freedom, increased depression, and risks of getting other diseases like diabetes.
To cater to that population, SRI International is designing an exoskeleton that can be worn like an undergarment. This soft exoskeleton, weighing four pounds, wraps around the user’s core, and provides another set of mechanical muscles that can help elderly sit, stand, and even walk. An in built computer makes sure that the flexing happens along with the real muscles to supplement the energy generated by them. The first version of this suit may require it to be charged once a day.
The “powered suit” (called Superflex) is designed not just to provide convenience but comfort as well. Rich Mahoney, the CEO, has hired a team of textile and fashion designers to ensure that this suit is worn easily, looks attractive & feels comfortable, and also lets the person use bathroom with ease.
This suit can be used not just by elderly people who complain of a sedentary lifestyle but also by people who have injuries and are in rehabilitation. Superflex is targeting to launch sometime in Mid 2018. Although there is no information on price, the company says that it will be affordable, and people interested in it wouldn’t have to depend on insurance subsidies.
Source: Fast Co Design
In today’s world, wearable devices are progressively being used for the enhancement of the nature of the life of individuals. Human Machine Interface (HMI) has been studied for dominant the mechanical device rehabilitation aids through biosignals like EOG and EMG etc., and so on. EMG signals have been studied in detail due to the occurrence of a definite signal pattern. The current proposal focuses on the advancement of a Wearable Device control by using EMG signals of hand movements for controlling the electronic devices. EMG signals are utilized for the production of the control indicators to develop the device control. Also, an EMG sign procurement framework was produced. To create different control signals relying on the sufficiency and length of time of signal segments, the obtained EMG signals were then prepared for device control.
1.1 Need for Rehabilitation Techniques
A major a part of our society is littered with one or the opposite reasonably disabilities owing to accidents and neuro-logic disorders. These patients rely upon the members of the family or care takers for his or her day to day activities like quality, communication with atmosphere, mistreatment the home instrumentation, etc1,2.
Rehabilitation devices facilitate the patients with disabilities to measure, work, play or study severally. Moreover, they improve the standard of life led by these individuals and maintain their shallowness.
1.2 EMG based Methods
Electrical potentials generated during muscle contraction are measured by EMG. The contraction of somatic cell takes place once it receives associate degree impulse. The myogram ascertained is that the add of all the action potentials that occur round the conductor site. In most of the cases, the amplitude of the myogram will increase as a result of contraction. Myogram signals is used for a range of applications together with clinical applications, HCI and interactive gaming. They’re non-heritable simply and are comparatively high in magnitude than alternative bio-signals. On the opposite hand, myogram signals area unit simply liable to noise. myogram signals contain difficult styles of noise as a result of inherent instrumentation noise, non-particulate
radiation, motion artifacts, and therefore the interaction of various tissues. Hence, to filter the unwanted noise in myogram, preprocessing is critical3. The myogram signals even have completely different signatures counting on age, muscle development, motor unit ways, skin fat layer, and gesture designs. The external appearances of 2 individuals’ gestures would possibly look identical, however the characteristic myogram signals area unit completely different4.
WASHINGTON, D.C., Oct. 25, 2016 — Stroke and spinal cord injury patients often require gait rehabilitation to regain the ability to walk or to help strengthen their muscles. Wearable “robot-assisted training” is quickly emerging as a method that helps improve this rehab process.
In a major advance, researchers from Beihang University in China and Aalborg University in Denmark have designed a lower-limb robot exoskeleton — a wearable robot — that features natural knee movement to greatly improve patients’ comfort and willingness to wear it for gait rehab.
As the team reports this week in Review of Scientific Instruments, from AIP Publishing, their robotic exoskeleton is intended to help stroke patients strengthen their physical fitness, aid the rehabilitation training of paralyzed patients, or to assist those who need help performing daily activities.
Exoskeleton robots aren’t new — they’ve been studied extensively and many designs have focused on lower limbs. This team’s approach focused instead on the knee joint, one of the most complex mechanical systems within the human body and a critical player during gait.
The knee joint’s motion is actuated by several skeletal muscles along its articular surfaces, and its center of rotation moves. The researchers wondered if a parallel mechanism similar to skeletal muscles would be useful for designing a bionic knee joint.
“Our new design features a parallel knee joint to improve the bio-imitability and adaptability of the exoskeleton,” explained Weihai Chen, a professor at Beihang University’s School of Automation Science and Electrical Engineering, in Beijing, China.
Specifically, the team’s exoskeleton taps a hybrid serial-parallel kinematic structure consisting of a 1-degree of freedom (DOF) hip joint module and a 2-DOF knee joint module in the sagittal plane. And a planar 2-DOF parallel mechanism helps to fully accommodate the motion of the human knee — enabling rotation and relative sliding.
[ARTICLE] Development of a wearable exoskeleton rehabilitation system based on hybrid control mode – Full Text
Lower limb rehabilitation exoskeletons usually help patients walk based on fixed gait trajectories. However, it is not suitable for unilateral lower limb disorders. In this article, a hybrid training mode is proposed to be applied in rehabilitation for unilateral lower limb movement disorders. The hybrid training includes two modes, that is, the passive training mode and the active assist mode. At an early stage of the rehabilitation therapy, the passive training mode is utilized, in which microelectromechanical systems-based attitude and heading reference system is used to collect the gait trajectory of the healthy limb. The exoskeleton on the unhealthy limb will be driven to track the joint trajectory of the healthy limb. If the patient’s abilities recovered, the rehabilitation system can be switched to the active assist mode. Two force sensors are imbedded into the interface on the thigh to measure the interaction information in order to detect the patient’s initiative walking intention. In the active mode, the walking gait trajectory is modified and generated based on the gait trajectory of the healthy side via the attitude and heading reference system. In this article, a position close control loop is designed to drive the mechanical leg to help the unhealthy limb walk. Laboratory experiments are performed on a healthy human subject to illustrate the proposed approach. Experimental results show that the proposed method can be applied and extended in the passive and active rehabilitation mode for the unilateral lower limb disorders.
[WEB SITE] New Electrical Stimulation Therapy Shows Promise Improving Hand Function In Stroke Patients : HEALTH : Tech Times
Stroke survivors showed improved hand dexterity more when using a new electrical stimulation therapy compared to an existing stimulation technique, said researchers from the MetroHealth System, Cleveland Functional Electrical Stimulation Center and the Case Western Reserve University.
Every year, some 800,000 individuals experience strokes in the U.S. The medical condition is characterized by reduced blood flow to the brain and usually results in paralysis or partial paralysis on one side of the body, making it difficult for survivors to open a hand. To address this, low-level electric currents are applied to the affected hand to stimulate paralyzed muscles, with intensity, repetitions and timing set by therapists.
For a study published in the journal Stroke, the researchers developed a new electrical stimulation therapy that involved stroke survivors wearing a glove with sensors on their unaffected hand to control stimulation applied to their weak hand. As the unaffected hand is opened, a corresponding level of stimulation is applied to the weak hand, opening it.
Positive results from earlier studies carried out by the researchers encouraged them to compare the electrical stimulation therapy they developed with what’s commonly used to rehabilitate stroke survivors. Specifically, they wanted to determine which one is more effective for patients who are over six months past their stroke.
For the study, the researchers worked with 80 stroke survivors, half of which were administered the new electrical stimulation therapy and the other half provided with the common therapy. Hand function in all the subjects were also assessed before and after the therapy with a standard dexterity test involving moving blocks across a barrier within 60 seconds.
Based on their findings, the researchers saw that those who were on the receiving end of the new electrical stimulation therapy had better dexterity test scores (4.6 blocks) compared to the group that was given the common therapy (1.8 blocks). Additionally, those with no finger movement in the new therapy group prior to the study showed arm movement improvements.
At the end of the study, 97 percent of subjects from the new therapy group said that they have better usage in their affected hand than before the experiment began.
Aside from registering better treatment results, the study was also able to demonstrate that self-administered home therapy can be effective for stroke survivors.
“The more therapy a patient can get the better potential outcome they will get,” said Jayme Knutson, Ph.D., the study’s senior author.
Knutson is joined by John Chae, M.D., Richard Wilson, M.D. and Douglas Gunzler, Ph.D. in the study.
For their next step, the researchers are looking at carrying out a multi-site study not only to confirm results from the study but also to measure improvements in quality of life experienced by stroke survivors using the new electrical stimulation method.