1,977 research outputs found

    Design and Control of Robotic Systems for Lower Limb Stroke Rehabilitation

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    Lower extremity stroke rehabilitation exhausts considerable health care resources, is labor intensive, and provides mostly qualitative metrics of patient recovery. To overcome these issues, robots can assist patients in physically manipulating their affected limb and measure the output motion. The robots that have been currently designed, however, provide assistance over a limited set of training motions, are not portable for in-home and in-clinic use, have high cost and may not provide sufficient safety or performance. This thesis proposes the idea of incorporating a mobile drive base into lower extremity rehabilitation robots to create a portable, inherently safe system that provides assistance over a wide range of training motions. A set of rehabilitative motion tasks were established and a six-degree-of-freedom (DOF) motion and force-sensing system was designed to meet high-power, large workspace, and affordability requirements. An admittance controller was implemented, and the feasibility of using this portable, low-cost system for movement assistance was shown through tests on a healthy individual. An improved version of the robot was then developed that added torque sensing and known joint elasticity for use in future clinical testing with a flexible-joint impedance controller

    THE EFFECT OF THE MYOMO ROBOTIC ORTHOSIS ON REACH PERFORMANCE AFTER STROKE

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    Stroke affects 795,000 people yearly. Close to 85 percent of stroke survivors experience some degree of stroke-related upper extremity impairment due to spastic paresis (Nakayama, Jorgenson, Pedersen, Raaschou, & Olsen, 1994). Residual upper extremity impairments are associated with increased burden of care (Skidmore, Rogers, Chandler, & Holm, 2006) and decreased ability to garner gainful employment (Desrosiers et al., 2006). Current best evidence supports the use of a task-oriented practice regimen for the treatment of upper extremity impairment; however, many people have insufficient motor control to participate. It was the goal of this study to investigate the effect of the Myomo robotic upper extremity orthosis, a device that facilitates participation in a task-oriented practice regimen, on reach kinematic performance. Specifically, we examined two research questions: Question 1. What is the immediate effect of the Myomo orthosis on kinematic performance of reach? We predicted that before training, temporal (movement efficiency) and spatial characteristics (angular displacement, movement error, and acceleration cycles) of kinematic performance would be better with the Myomo orthosis than without the device. Question 2. What is the training effect of the Myomo orthosis plus training kinematic performance? We predicted that temporal (movement efficiency) and spatial characteristics (angular displacement, movement error, and acceleration cycles) of kinematic performance without the Myomo orthosis would be better after 16 training sessions. Findings suggest that the immediate effect of the Myomo orthosis on reaching performance (question 1) appears to be more attenuated than the training effect of the Myomo orthosis (question 2).All 6 participants demonstrated improvements in movement efficiency for one or more of three reaching targets. Five of the 6 participants demonstrated improvements in one or more of the spatial characteristics of kinematic performance. Effect size calculations suggest that the magnitude of the training effect was greatest for movement efficiency and angular displacement (medium effect size) and the least for movement error and acceleration cycles (small effect size)

    On the Efficacy of Isolating Shoulder and Elbow Movements with a Soft, Portable, and Wearable Robotic Device

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    Treatment intensity has a profound effect on motor recovery following neurological injury. The use of robotics has potential to automate these labor-intensive therapy procedures that are typically performed by physical therapists. Further, the use of wearable robotics offers an aspect of portability that may allow for rehabilitation outside the clinic. The authors have developed a soft, portable, lightweight upper extremity wearable robotic device to provide motor rehabilitation of patients with affected upper limbs due to traumatic brain injury (TBI). A key feature of the device demonstrated in this paper is the isolation of shoulder and elbow movements necessary for effective rehabilitation interventions. Herein is presented a feasibility study with one subject and demonstration of the device's ability to provide safe, comfortable, and controlled upper extremity movements. Moreover, it is shown that by decoupling shoulder and elbow motions, desired isolated joint actuation can be achieved

    Robotic Home-Based Rehabilitation Systems Design: From a Literature Review to a Conceptual Framework for Community-Based Remote Therapy During COVID-19 Pandemic

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    During the COVID-19 pandemic, the higher susceptibility of post-stroke patients to infection calls for extra safety precautions. Despite the imposed restrictions, early neurorehabilitation cannot be postponed due to its paramount importance for improving motor and functional recovery chances. Utilizing accessible state-of-the-art technologies, home-based rehabilitation devices are proposed as a sustainable solution in the current crisis. In this paper, a comprehensive review on developed home-based rehabilitation technologies of the last 10 years (2011–2020), categorizing them into upper and lower limb devices and considering both commercialized and state-of-the-art realms. Mechatronic, control, and software aspects of the system are discussed to provide a classified roadmap for home-based systems development. Subsequently, a conceptual framework on the development of smart and intelligent community-based home rehabilitation systems based on novel mechatronic technologies is proposed. In this framework, each rehabilitation device acts as an agent in the network, using the internet of things (IoT) technologies, which facilitates learning from the recorded data of the other agents, as well as the tele-supervision of the treatment by an expert. The presented design paradigm based on the above-mentioned leading technologies could lead to the development of promising home rehabilitation systems, which encourage stroke survivors to engage in under-supervised or unsupervised therapeutic activities

    Development of a Wearable Mechatronic Elbow Brace for Postoperative Motion Rehabilitation

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    This thesis describes the development of a wearable mechatronic brace for upper limb rehabilitation that can be used at any stage of motion training after surgical reconstruction of brachial plexus nerves. The results of the mechanical design and the work completed towards finding the best torque transmission system are presented herein. As part of this mechatronic system, a customized control system was designed, tested and modified. The control strategy was improved by replacing a PID controller with a cascade controller. Although the experiments have shown that the proposed device can be successfully used for muscle training, further assessment of the device, with the help of data from the patients with brachial plexus injury (BPI), is required to improve the control strategy. Unique features of this device include the combination of adjustability and modularity, as well as the passive adjustment required to compensate for the carrying angle

    A review on design of upper limb exoskeletons

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    Bilateral Assessment of Functional Tasks for Robot-assisted Therapy Applications

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    This article presents a novel evaluation system along with methods to evaluate bilateral coordination of arm function on activities of daily living tasks before and after robot-assisted therapy. An affordable bilateral assessment system (BiAS) consisting of two mini-passive measuring units modeled as three degree of freedom robots is described. The process for evaluating functional tasks using the BiAS is presented and we demonstrate its ability to measure wrist kinematic trajectories. Three metrics, phase difference, movement overlap, and task completion time, are used to evaluate the BiAS system on a bilateral symmetric (bi-drink) and a bilateral asymmetric (bi-pour) functional task. Wrist position and velocity trajectories are evaluated using these metrics to provide insight into temporal and spatial bilateral deficits after stroke. The BiAS system quantified movements of the wrists during functional tasks and detected differences in impaired and unimpaired arm movements. Case studies showed that stroke patients compared to healthy subjects move slower and are less likely to use their arm simultaneously even when the functional task requires simultaneous movement. After robot-assisted therapy, interlimb coordination spatial deficits moved toward normal coordination on functional tasks

    Robotics for rehabilitation of hand movement in stroke survivors

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    This article aims to give an overall review of research status in hand rehabilitation robotic technology, evaluating a number of devices. The main scope is to explore the current state of art to help and support designers and clinicians make better choices among varied devices and components. The review also focuses on both mechanical design, usability and training paradigms since these parts are interconnected for an effective hand recovery. In order to study the rehabilitation robotic technology status, the devices have been divided in two categories: end-effector robots and exoskeleton devices. The end-effector robots are more flexible than exoskeleton devices in fitting the different size of hands, reducing the setup time and increasing the usability for new patients. They suffer from the control of distal joints and haptic aspects of object manipulation. In this way, exoskeleton devices may represent a new opportunity. Nevertheless their design is complex and a deep investigation of hand biomechanics and physical human–robot interaction is required. The main hand exoskeletons have been developed in the last decade and the results are promising demonstrated by the growth of the commercialized devices. Finally, a discussion on the complexity to define which design is better and more effective than the other one is summarized for future investigations
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