Design and Development of an Affordable Haptic Robot with Force-Feedback and Compliant Actuation to Improve Therapy for Patients with Severe Hemiparesis

The study describes the design and development of a single degree-of-freedom haptic robot, Haptic Theradrive, for post-stroke arm rehabilitation for in-home and clinical use. The robot overcomes many of the weaknesses of its predecessor, the TheraDrive system, that used a Logitech steering wheel as the haptic interface for rehabilitation. Although the original TheraDrive system showed success in a pilot study, its wheel was not able to withstand the rigors of use. A new haptic robot was developed that functions as a drop-in replacement for the Logitech wheel. The new robot can apply larger forces in interacting with the patient, thereby extending the functionality of the system to accommodate low-functioning patients. A new software suite offers appreciably more options for tailored and tuned rehabilitation therapies. In addition to describing the design of the hardware and software, the paper presents the results of simulation and experimental case studies examining the system\u27s performance and usability

The Haptic Bracelets: Gait rehabilitation after Stroke

Restoring mobility and rehabilitation of gait are high priorities for rehabilitation of neurological conditions. Cueing using metronomic rhythmic sensory stimulation has been shown to improve gait, but most versions of this approach have used auditory and visual cues. In contrast, we propose the development of a prototype wearable system for rhythmic cueing based on haptics. The main aim of this research is to investigate how real-time gait monitoring and rhythmic haptic cueing can assist with gait rehabilitation for neurological conditions

Haptic Interactions with Virtual Reality

Many possible systems exist that could benefit from Haptic Interactions, the communication of forces between a user and a system. Robotic assisted rehabilitation, interactive Virtual Reality media, and Telerobotics are some examples. However, due to simplified interactions methods, high costs, and lack of application development tools, Haptic Interaction with Virtual Reality has not reached its full potential. As a solution towards these problems, the team created a development platform Haptic Interaction System, capable of supplying Haptic Interactions between a user and hosted simulated environment and objects, along with the tools to enhance the system and develop applications based on Haptic Interactions

Using rhythm for rehabilitation: evaluation of a novel haptic device

This project explored how new and novel approaches to stroke rehabilitation could improve physical function and the confidence of stroke survivors to remain active and engaged in the community. The innovation trialed was a ‘Haptic bracelet/cueing device’, developed at The Open University. An overview of the Haptic device, its development and role in stroke rehabilitation can be viewed at: https://www.youtube.com/watch?v=S4ZxN6H6XGk The Haptic bracelets provide a physical (embodied) beat that someone can walk to as an alternative to existing audio cuing ways of working. The haptic device provides a non-invasive, relatively cheap way of facilitating people after stroke to continue to maintain or even improve their mobility after intensive rehabilitation has finished. This research explored the impact of the haptic device to gains in mobility. The project had two key aims: 1. To develop a usable and practical prototype of a haptic device to restore gait symmetry after stroke. 2. To investigate the feasibility and acceptability of the prototype in stroke patients. Summary of findings and recommendations When introduced to the Haptic Bracelets participants hoped the product would provide them with: • More confidence and make them feel safer when walking. • Greater ability to take bigger strides rather than little steps. • A way to combat the silly mistakes participants reported making due to tiredness. • Reduced pain (knees, hips) The physiotherapists saw potential for the Haptic devices as part of post stroke rehabilitation, but expressed concern about their lack of access to mobile technologies when out in community practice settings. There were also concerns about use with some stroke survivors because of issues of cognition; and the sensation from the Haptic beat. In the Haptic gait testing • All the participants demonstrated good mobility performance prior to the study (high score on the Rivermead mobility scale) • 4/7* (57.1%) participants who were the most asymmetrical at baseline improved their gait symmetry whilst wearing the haptic device • 3/7* (42%) participant’s gait symmetry continued to improve in the post off condition. • All the participants walked quicker in post-op condition. However, gait speed varied between participants when they were wearing the haptic bracelets. • Participants were had had their strokes between 3-10 years ago, but there was still an indication that the Haptic bracelets were having some impact on mobility. • Syncing of the Haptic device and more mobile Inertial Measurement Unit (IMU) to the fixed gait laboratory (gold standard) system has improved the potential for more community based rehabilitation and commercialisation of the Haptic bracelets. • Post Haptic interviews identified that there were mixed participant feelings about the bracelets. However, some did express positive experiences from testing the Haptic bracelets, including a carry over effect after the devices were removed. Recommendations As this was a pilot study more work is now required to explore the: • use of the Haptic bracelets in community rehabilitation settings • feasibility of the using Haptic bracelets in community settings, particularly looking at staff access to new technologies • potential for the Haptic bracelets to be used in the home as part of ongoing rehabilitation • benefits of Haptic bracelets in the context of longer term stroke rehabilitation • future design needs to improve the look, size and ease of application • cost benefits of using Haptic bracelets as part of an overall program of stroke rehabilitation

Therapeutic Potential of Haptic TheraDrive: An Affordable Robot/Computer System for Motivating Stroke Rehabilitation

There is a need for increased opportunities for effective neurorehabilitation services for stroke survivors outside the hospital environment. Efforts to develop low-cost robot/computer therapy solutions able to be deployed in home and community rehabilitation settings have been growing. Our long-term goal is to develop a very low-cost system for stroke rehabilitation that can use commercial gaming technology and support rehabilitation with stroke survivors at all functioning levels. This paper reports the results of experiments comparing the old and new TheraDrive systems in terms of ability to assist/resist subjects and the root-mean-square (RMS) trajectory tracking error. Data demonstrate that the new system, in comparison to the original TheraDrive, produces a larger change in normalized trajectory tracking error when assistance/resistance is added to exercises and has the potential to support stroke survivors at all functioning levels

Wearable Haptic Devices for Gait Re-education by Rhythmic Haptic Cueing

This research explores the development and evaluation of wearable haptic devices for gait sensing and rhythmic haptic cueing in the context of gait re-education for people with neurological and neurodegenerative conditions. Many people with long-term neurological and neurodegenerative conditions such as Stroke, Brain Injury, Multiple Sclerosis or Parkinson’s disease suffer from impaired walking gait pattern. Gait improvement can lead to better fluidity in walking, improved health outcomes, greater independence, and enhanced quality of life. Existing lab-based studies with wearable devices have shown that rhythmic haptic cueing can cause immediate improvements to gait features such as temporal symmetry, stride length, and walking speed. However, current wearable systems are unsuitable for self-managed use for in-the-wild applications with people having such conditions. This work aims to investigate the research question of how wearable haptic devices can help in long-term gait re-education using rhythmic haptic cueing. A longitudinal pilot study has been conducted with a brain trauma survivor, providing rhythmic haptic cueing using a wearable haptic device as a therapeutic intervention for a two-week period. Preliminary results comparing pre and post-intervention gait measurements have shown improvements in walking speed, temporal asymmetry, and stride length. The pilot study has raised an array of issues that require further study. This work aims to develop and evaluate prototype systems through an iterative design process to make possible the self-managed use of such devices in-the-wild. These systems will directly provide therapeutic intervention for gait re-education, offer enhanced information for therapists, remotely monitor dosage adherence and inform treatment and prognoses over the long-term. This research will evaluate the use of technology from the perspective of multiple stakeholders, including clinicians, carers and patients. This work has the potential to impact clinical practice nationwide and worldwide in neuro-physiotherapy

Interactive Haptics for Remote and On-Site Assessment of Arm Function Following a Stroke

There is a great need to improve the rehabilitation and assessment of arm and hand function of stroke survivors in the home due to cost, time and availability of healthcare professionals. Robotics and haptic technologies can be used to improve and facilitate rehabilitation and assessment in the home. The primary goal of this thesis was to explore the feasibility of using lightweight, low-cost haptic devices for remote home-based rehabilitation. The strategy that this thesis followed was to develop tools, perform unit testing, and finally assess feasibility with target users in a series of case studies. The thesis started by developing an assessment tool, specifically the Nine Hole Peg Test (NHPT), and investigated how haptic devices can be used to enhance the data collection for this task to garner more information regarding the level of manual dexterity a stroke survivor has in their impaired limb. The next study investigated collaboration in haptic environments and how the findings from a collaborative haptic experiment could be used to influence task design for future experiments with haptic environments. The final study assessed the feasibility of a home-based assessment and rehabilitation system with elements of telerehabilitation and remote collaboration and interaction providing four complete case studies from stroke survivors. In summary, our findings showed that by combining physical apparatus with a virtual world, less variable results are observed than in purely virtual haptic tasks. We also showed that interaction techniques in collaborative haptic environments change depending on the shape of the objects in the virtual task – this information can be used to influence task design to target specific motor deficits when using the device for exercise. Finally, the home-based study showed the feasibility of using the experimental rig at home and provided improvement measures that matched the perceived benefits to arm function that the participants described on completing the trial

Questioning Classic Patient Classification Techniques in Gait Rehabilitation: Insights from Wearable Haptic Technology

Classifying stroke survivors based on their walking abilities is an important part of the gait rehabilitation process. It can act as powerful indicator of function and prognosis in both the early days after a stroke and long after a survivor receives rehabilitation. This classification often relies solely on walking speed; a quick and easy measure, with only a stopwatch needed. However, walking speed may not be the most accurate way of judging individual’s walking ability. Advances in technology mean we are now in a position where ubiquitous and wearable technologies can be used to elicit much richer measures to characterise gait. In this paper we present a case study from one of our studies, where within a homogenous group of stroke survivors (based on walking speed classification) important differences in individual results and the way they responded to rhythmic haptic cueing were identified during the piloting of a novel gait rehabilitation technique

Wearables for Long Term Gait Rehabilitation of Neurological Conditions

Many people with long-term neurological and neurodegenerative conditions such as stroke, brain injury, multiple sclerosis or Parkinson’s disease suffer from an impaired walking gait pattern. Gait improvement can lead to better fluidity in walking, improved health outcomes, greater independence, and enhanced quality of life. Existing lab-based studies with wearable devices have shown that rhythmic haptic cueing can cause immediate improvements to gait features such as temporal symmetry, stride length and walking speed. However, current wearable systems are unsuitable for self-managed use, and to move this approach from out of the lab into long-term sustained usage, numerous design challenges need to be addressed. We are designing, developing, and testing a closed-loop system to provide adaptive haptic rhythmic cues for sustainable self-managed long-term use outside the lab by survivors of stroke, and other neurological conditions, in their everyday lives