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Posts Tagged Wrist
Objective: The related patents of rehabilitation training equipment for wrist joint will be reviewed, and the structure and working principle of these equipments will be illustrated. The results of the analysis provide some meaningful reference for the optimal design of the wrist joint.
Methods: Based on the comparative analysis of the latest patents related to wrist rehabilitation equipment, the key problems and future development of the rehabilitation equipment are put forward.
Results: The patents of the rehabilitation training equipment for the wrist are classified in the paper. Studies show that remarkable improvements have been achieved in the invention of the wrist rehabilitation equipment.
Conclusion: In the future, the mechanical design, control system and rehabilitation strategy of wrist rehabilitation equipment should be further studied.
[Abstract] Design and development of an upper limb rehabilitation robotic system – IEEE Conference Publication
[Abstract] Kinematic analysis and control for upper limb robotic rehabilitation system – IEEE Conference Publication
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.
Scientists in Switzerland have demonstrated that combining a brain-computer interface (BCI) with functional electrical stimulation (FES) can help stroke victims recover greater use of their paralysed limbs – even years after the stroke.
Paralysis of an arm and/or leg is one of the most common results of a stroke. However, a team of scientists at the Defitech Foundation Chair in Brain-Machine Interface, in association with other members of EPFL’s Center for Neuroprosthetics, the Clinique Romande de Réadaptation in Sion, and the Geneva University Hospitals, have developed a technique aimed at enabling stroke victims to recover greater use of their paralysed limbs. The scientists’ pioneering approach utilises two existing therapies – a brain-computer interface (BCI) and functional electrical stimulation (FES).
Explaining the key to their approach, José del R. Millán, who holds the Defitech Chair at EPFL, said: “The key is to stimulate the nerves of the paralysed arm precisely when the stroke-affected part of the brain activates to move the limb, even if the patient can’t actually carry out the movement. That helps re-establish the link between the two nerve pathways where the signal comes in and goes out.”.
Combined therapy tested on stroke patients
Twenty-seven patients aged between 36 and 76 took part in the clinical trial. All had a similar lesion that resulted in moderate to severe arm paralysis following a stroke occurring at least ten months earlier. Half of the patients were treated with the scientists’ dual-therapy approach and reported clinically significant improvements. The other half were treated only with FES and served as a control group.
For the first group, the scientists used a BCI system to link the patients’ brains to computers by means of electrodes. This enabled them to pinpoint exactly where the electrical activity occurred in the brain tissue when the patients tried to reach out their hands. Each time the electrical activity was identified the system immediately stimulated the arm muscle controlling the corresponding wrist and finger movements. The patients in the second group also had their arm muscles stimulated, but at random times. This control group enabled the scientists to determine how much of the additional motor-function improvement could be attributed to the BCI system.
The scientists noted a significant improvement in arm mobility among patients in the first group after just ten one-hour sessions. When the full round of treatment was completed, some of the first-group patients’ scores on the Fugl-Meyer Assessment – a test used to evaluate motor recovery among patients with post-stroke hemiplegia – were over twice as high as those of the second group.
“Patients who received the BCI treatment showed more activity in the neural tissue surrounding the affected area. Due to their plasticity, they could help make up for the functioning of the damaged tissue,” says Millán.
Electroencephalographies (EEGs) of the patients clearly showed an increase in the number of connections among the motor cortex regions of their damaged brain hemisphere, which corresponded with the increased ease in carrying out the associated movements. In addition, the enhanced motor function didn’t seem to diminish with time. Evaluated again 6-12 months later, the patients were found to have lost none of their recovered mobility.
The study results were published in Nature Communications.
[ARTICLE] Automatic Control of Wrist Rehabilitation Therapy (WRist-T) device for Post-Ischemic Stroke Patient – Full Text PDF
Full Text: PDF
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Z.J. Lu, L.C.B. Wang, L.H. Duan, Q.Q. Lui, H.Q. Sun, Z.I. Chen, “Development of a robot MKW-II for hand and Wrist Rehabilitation Training,”The Annual IEEE International Conference on Cyber Technology in Automation, Control and Intelligent Systems, 2016, pp. 302-307.
[BOOK] New Vibratory Device for Wrist Rehabilitation – Innovation, Engineering and Entrepreneurship – Google Books
but also other pathologies such as tendinitis and neurological diseases. When the
wrist is injured, their flexion-extension and radial-ulnar deviation and pronation …
[Conference paper] Kinematic Design of a Parallel Robot for Elbow and Wrist Rehabilitation|Abstract+References
This paper presents the kinematics of modular a parallel robot for post-stroke rehabilitation of elbow and wrist. The targeted motions for rehabilitation are: elbow flexion, pronation/supination, flexion/extension and adduction/abduction (radial/ulnar deviation) of the wrist. The kinematic structure of the robotic system is presented starting from general considerations concerning the rehabilitation protocol of the upper limb. Its kinematics is developed and simulation results are presented for a proposed training exercise.
[Abstract] Motor skill changes and neurophysiologic adaptation to recovery-oriented virtual rehabilitation of hand function in a person with subacute stroke: a case study.
The complexity of upper extremity (UE) behavior requires recovery of near normal neuromuscular function to minimize residual disability following a stroke. This requirement places a premium on spontaneous recovery and neuroplastic adaptation to rehabilitation by the lesioned hemisphere. Motor skill learning is frequently cited as a requirement for neuroplasticity. Studies examining the links between training, motor learning, neuroplasticity, and improvements in hand motor function are indicated.
This case study describes a patient with slow recovering hand and finger movement (Total Upper Extremity Fugl-Meyer examination score = 25/66, Wrist and Hand items = 2/24 on poststroke day 37) following a stroke. The patient received an intensive eight-session intervention utilizing simulated activities that focused on the recovery of finger extension, finger individuation, and pinch-grasp force modulation.
Over the eight sessions, the patient demonstrated improvements on untrained transfer tasks, which suggest that motor learning had occurred, as well a dramatic increase in hand function and corresponding expansion of the cortical motor map area representing several key muscles of the paretic hand. Recovery of hand function and motor map expansion continued after discharge through the three-month retention testing.
This case study describes a neuroplasticity based intervention for UE hemiparesis and a model for examining the relationship between training, motor skill acquisition, neuroplasticity, and motor function changes. Implications for rehabilitation Intensive hand and finger rehabilitation activities can be added to an in-patient rehabilitation program for persons with subacute stroke. Targeted training of the thumb may have an impact on activity level function in persons with upper extremity hemiparesis. Untrained transfer tasks can be utilized to confirm that training tasks have elicited motor learning. Changes in cortical motor maps can be used to document changes in brain function which can be used to evaluate changes in motor behavior persons with subacute stroke.
According to the United Nations (UN), by 2030 the number of people over 60 years will increase by 56 per cent, from 901 million to more than 1.4 billion worldwide . As the number of older persons is expected to grow, it is imperative that government and private health care providers prepare adequate and modern facilities that can provide quality services for the needs of older persons especially in rehabilitation centers. Implementation of robotic technology in rehabilitation process is a modern method and definitely can contribute in this policy and capable in promoting early recovery and motor learning . Furthermore, systematic application of robotic technology can produce significant clinical results in motor recovery of post-traumatic central nervous system injury by assisting in physical exercise based on voluntary movement in rehabilitation .
[Abstract] Effect of task specific training and wrist-fingers extension splint on hand joints range of motion and function after stroke