Development of an equipment to detect and quantify muscular spasticity

Dissertação para obtenção do Grau de Mestre em Engenharia BiomédicaSpasticity consists of a muscular tonus alteration caused by a flawed central nervous system which results in a hypertonic phenomenon. The presence of spasticity is normally noticeable by the appearance of a denoted velocity dependent “rigidity” throughout the passive mobilization of an affected limb which can be a potential source of constraints in subject independency by negatively affecting the accomplishment of daily basic tasks. Spasticity treatment usually comprises high cost methods and materials. There is also a strict relation between the spasticity grade and the dose that has to be applied to attain the desired effective result. These two facts justify the need for a more precise equipment to detect and quantify muscular spasticity. In the present days, three main groups of spasticity quantification methods coexist: the clinical scales, electrophysiological measurements and the biomechanical measurements. The most used ones are the clinical scales, especially the Modified Ashworth Scale. These scales quantify spasticity based on the perception of muscular response sensed by an operator. In a different field of approach, many instruments have been built to quantify biomechanical magnitudes that have shown direct relation with spasticity. Unfortunately, most of these instruments had either inappropriate size for clinical use, weak result correlation both inter and intra-subject, or a noticeable result dependence on the operator. The objective of this project was to create a reliable method for spasticity detection and quantification that could: be of easy and fast application, have no need for a specialized operator, be portable and present good repeatability and independency from the operator in the produced results. The resulting prototype, named SpastiMed, is a motorized and electronically controlled device which through analysis of the produced signal presented irrefutable proof of its capacity to detect and possibly quantify spasticity while gathering the important characteristics mentioned

Electromechanical System Integration for a Powered Upper Extremity Orthosis

Wearable robotics for assistance and rehabilitation are not yet considered commercially mainstream products, and as a result have not yet seen advanced controls systems and interfaces. Consequently, the available technology is mostly adapted from systems used in parallel technologies, rather than custom applications intended for human use. This study concerns itself with the design and development of a custom control system for a 2-degree of freedom powered upper extremity orthosis capable of driving elbow flexion/extension 135º and humeral rotation 95º . The orthosis has been evaluated for use as both a long-term assistive technology device for persons with disabilities, and as a short-term rehabilitative tool for persons recovering injury. The target demographics for such a device vary in age, cognitive ability and physical function, thus requiring several input parameters requiring consideration. This study includes a full evaluation of the potential users of the device, as well as parameter considerations that are required during the design phase. The final control system is capable of driving each DOF independently or simultaneously, for a more realistic and natural coupled-motion, with proportional control by pulse-width modulation. The dual-axis joystick interface wirelessly transmits to the 1.21 pound control pack which houses a custom microcontroller-driven PCB and 1800 milliamp-hour lithium-ion rechargeable battery capable of delivering 4 hours of running time. Upon integration with the 2 DOF orthosis device, a user may complete full range of motion with up to 5 pounds in their hand in less than 7 seconds, providing full functionality to complete acts of daily living, thus improving quality of life

Robot-Aided Systems for Improving the Assessment of Upper Limb Spasticity: A Systematic Review

This article belongs to the Special Issue Sensors Technology for Medical Robotics.Spasticity is a motor disorder that causes stiffness or tightness of the muscles and can interfere with normal movement, speech, and gait. Traditionally, the spasticity assessment is carried out by clinicians using standardized procedures for objective evaluation. However, these procedures are manually performed and, thereby, they could be influenced by the clinician’s subjectivity or expertise. The automation of such traditional methods for spasticity evaluation is an interesting and emerging field in neurorehabilitation. One of the most promising approaches is the use of robot-aided systems. In this paper, a systematic review of systems focused on the assessment of upper limb (UL) spasticity using robotic technology is presented. A systematic search and review of related articles in the literature were conducted. The chosen works were analyzed according to the morphology of devices, the data acquisition systems, the outcome generation method, and the focus of intervention (assessment and/or training). Finally, a series of guidelines and challenges that must be considered when designing and implementing fully-automated robot-aided systems for the assessment of UL spasticity are summarized

Aerospace Medicine and Biology: A continuing bibliography with indexes

This bibliography lists 253 reports, articles, and other documents introduced into the NASA scientific and technical information system in October 1975

Development and application of devices for improving mobility and measuring the amount of movement in post stroke patients

Összefoglalás: A magyar egészségügyben a folyamatosan szűkülő humán erőforrás következtében olyan gazdaságos módszerek fejlesztése és tesztelése szükséges, amelyek segítik a humán erőforrás diagnosztikus és terápiás tevékenységeit. Stroke után a paretikus alsó végtag izomgyengesége, spazmusa és kóros tartásmintája boka-láb deformitást és a járás harmóniájának megbomlását okozhatja. • Munkacsoportunk kifejlesztett egy elektromosan vezérelt, személyre szabott akciórádiuszú, plantár- és dorzálflexiót kivitelező készüléket, amely minden részletében nem, de összességében jobb és alkalmasabb akut stroke betegek kezelésére, mint a magyar piacon és a szakirodalomban eddig elérhetőek. A készülék sorozatgyártásra alkalmas. • Az általunk fejlesztett és klinikai körülmények között tesztelt passzív boka mobilizáló készülék mozgás szervrendszeri hatását elemeztük, és funkcionális mágneses rezonancia (fMRI) készülékkel megvizsgáltuk, hogy a passzív mozgatás mely agyi területeket aktiválja. Eredményeink alapján a stroke akut stádiumában: - egy passzív boka mobilizálóval végzett kezelésnek jelentős additív hatása van a paretikus boka-láb kezelésében, - a mozgás szervrendszeri klinikai paraméterek javulása mellett nem csak helyileg az ízületben vagy az izomtónusban következik be változás, hanem az agy egyes területeire is hatással van a passzív boka mobilizálóval végzett kezelés, - pusztán az fMRI jelből található olyan mozgást jellemző paraméter, amely összefüggésben van a stroke beteg állapotának súlyosságával. • Kifejlesztettünk, validáltunk és klinikai körülmények között teszteltünk egy olyan mozgásérzékelő műszert, amellyel objektív módon felmérthető és követhető a stroke betegek állapota. Műszerünk előnyei: - a beteg mozgásmennyiségének mérésével lehetővé teszi az aktuális állapot felmérését, - érzékenyen jelzi a mozgásmennyiségek közötti különbségeket (domináns vs. nem domináns vagy paretikus vs. egészséges felsővégtag), - alkalmas a betegek tudatállapotának követésére, - egyes neurológiai betegségek esetén segítséget jelenthet a gyógyszeres és nem gyógyszeres terápiák, valamint a rehabilitáció követésében és hatékonyabbá tételében, - szeptikus körülmények között is alkalmazható, mert vízálló, fertőtleníthető és ütésálló burkolattal ellátott. Summary: Due to continuously growing shortage of human resource in Hungarian health care, it is necessary to develop and test economical methods which help both diagnostic and therapeutic activities of the human resource. Post-stroke muscular weakness, spasticity and pathological posture of the paretic lower limb may cause ankle and foot deformity and disharmony of the gait. • Our team have developed an electronically controlled device which performs plantar flexion and dorsiflexion with personalised action radius, and which is in summary better and more suitable (although not in every aspect) for treating acute stroke patients than any other device available on the Hungarian market or in the literature. The device is suitable for serial production. • We analysed the effect of our passive ankle mobilising device (developed by ourselves and tested in clinical setting) on the locomotor system, and examined by functional magnetic resonance (fMRI) device which areas of the cerebral cortex are activated by passive movement. Our results show that in the acute phase of stroke: - treatment by an ankle passive motion device has significant additive effect in the treatment of the paretic ankle and foot; - in addition to the improvement of the clinical parameters of the locomotor system, changes occur not only in the joint or in the muscle tone, but the treatment performed with the ankle mobiliser also has effect on certain areas of the brain; - the fMRI signals include a motion parameter which is in relation to the severity of the state of the stroke patient. • We have developed, validated and clinically tested an accelerometer which enables us to objectively assess and track the state of stroke patients. Advantages of our device: - it makes possible the assessing of the patient’s current state by measuring their quantity of motion, - it sensitively indicates the differences between quantities of motion (dominant vs. non-dominant or paretic vs. healthy upper limb), - it is suitable for tracking the consciousness of the patient, - in cases of certain neurological diseases, it may help make the follow-up and improve the effectiveness of both pharmacological and non-pharmacological therapies as well as rehabilitation, - it may be used in septic circumstances as well because its casing is waterproof, shockproof and sterilisable.d

M-health review: joining up healthcare in a wireless world

In recent years, there has been a huge increase in the use of information and communication technologies (ICT) to deliver health and social care. This trend is bound to continue as providers (whether public or private) strive to deliver better care to more people under conditions of severe budgetary constraint

Rapid Response Command and Control (R2C2): a systems engineering analysis of scaleable communications for Regional Combatant Commanders

Includes supplementary materialDisaster relief operations, such as the 2005 Tsunami and Hurricane Katrina, and wartime operations, such as Operation Enduring Freedom and Operation Iraqi Freedom, have identified the need for a standardized command and control system interoperable among Joint, Coalition, and Interagency entities. The Systems Engineering Analysis Cohort 9 (SEA-9) Rapid Response Command and Control (R2C2) integrated project team completed a systems engineering (SE) process to address the military’s command and control capability gap. During the process, the R2C2 team conducted mission analysis, generated requirements, developed and modeled architectures, and analyzed and compared current operational systems versus the team’s R2C2 system. The R2C2 system provided a reachback capability to the Regional Combatant Commander’s (RCC) headquarters, a local communications network for situational assessments, and Internet access for civilian counterparts participating in Humanitarian Assistance/Disaster Relief operations. Because the team designed the R2C2 system to be modular, analysis concluded that the R2C2 system was the preferred method to provide the RCC with the required flexibility and scalability to deliver a rapidly deployable command and control capability to perform the range of military operations

Aerospace medicine and biology: A continuing bibliography with indexes, supplement 125

This special bibliography lists 323 reports, articles, and other documents introduced into the NASA scientific and technical information system in January 1974