Assessment of joint parameters in a Kinect sensor based rehabilitation game

Copyright © 2019 ASME. A Kinect sensor based basketball game is developed for delivering post-stroke exercises in association with a newly developed elbow exoskeleton. Few interesting features such as audio-visual feedback and scoring have been added to the game platform to enhance patient’s engagement during exercises. After playing the game, the performance score has been calculated based on their reachable points and reaching time to measure their current health conditions. During exercises, joint parameters are measured using the motion capture technique of Kinect sensor. The measurement accuracy of Kinect sensor is validated by two comparative studies where two healthy subjects were asked to move elbow joint in front of Kinect sensor wearing the developed elbow exoskeleton. In the first study, the joint information collected from Kinect sensor was compared with the exoskeleton based sensor. In the next study, the length of upperarm and forearm measured by Kinect were compared with the standard anthropometric data. The measurement errors between Kinect and exoskeleton are turned out to be in the acceptable range; 1% for subject 1 and 0.44% for subject 2 in case of joint angle; 5.55% and 3.58% for subject 1 and subject 2 respectively in case of joint torque. The average errors of Kinect measurement as compared to the anthropometric data of the two subjects are 16.52% for upperarm length and 9.87% for forearm length. It shows that Kinect sensor can measure the activity of joint movement with a minimum margin of error

The use of the Nintendo Wii in motor rehabilitation for virtual reality interventions:a literature review

Several review articles have been published on the use of Virtual Reality (VR) in motor rehabilitation. The majority of these focus on the effectiveness of VR on improving motor function using relatively expensive commercial tools and technologies including robotics, cybergloves, cybergrasps, joysticks, force sensors and motion capture systems. However, we present the case in this chapter that game sensors and VR technologies which can be customized and reconfigured, such as the Nintendo Wii, provide an alternative and affordable VR intervention for rehabilitation. While the performance of many of the Wii based interventions in motor rehabilitation are currently the focus of investigation by researchers, an extensive and holistic discussion on this subject does not yet exist. As such, the purpose of this chapter is to provide readers with an understanding of the advantages and limitations of the Nintendo Wii game sensor device (and its associated accessories) for motor rehabilitation and in addition, to outline the potential for incorporating these into clinical interventions for the benefit of patients and therapists

A Comparison of Recreation Therapy Intervention using Nintendo WiiTM Bowling with Participation in a Tai Chi Program on Balance, Enjoyment, and Leisure Competence of Older Adults in a Community Based Setting

Many older adults experience a decrease in physical activity, which often leads to decreases in functioning. Older adults have been shown to have the lowest levels of physical activity for all age groups. This lack of physical activity has been shown to lead to decreases in performance of activities of daily living (ADLs), independence, quality of life, and increases in number of falls, chance of institutionalization, morbidity, and mortality. Physical activity programs in community settings help to restore or maintain physical function and lessen the level of dependence so that individuals will be able to reach the highest level of functioning possible. In recent years, virtual reality (VR) has been incorporated into both programming for older adults and functional improvement through rehabilitation. VR provides three key elements for functional improvement and rehabilitation: repetition, feedback, and motivation. Research has shown that interventions incorporating VR result in improvements in upper extremity and hand function, lower extremity function, balance, fall reduction, and improved ability to perform ADLs. Following the development of the Nintendo WiiTM, many community- based, long term care, and rehabilitation facilities have begun incorporating its use in their programs. Currently there is very limited existing research on the use of the Nintendo WiiTM in rehabilitation, community-based, or other long term care settings. This study examined the effects of an intervention using the Nintendo WiiTM on physical functioning in older adults in a community-based setting. Results indicate that the Nintendo WiiTM would be beneficial in increasing balance, leisure skills competence, and potentially provide an optimal flow experience for older adults in a community setting. Visual analysis of the data indicated that participants in both groups experienced a mean decrease in Timed Up an Go (TUG) times, mean decrease in balance confidence, and a mean increase in leisure skills competence. While both groups demonstrated a decrease in mean TUG times and Leisure Skills Subscale of the Leisure Competence Measure (LSS LCM) scores, the intervention group experienced a larger decrease than the control group. Although both groups demonstrated a mean decrease in balance confidence, 5 of the intervention group participants and 2 of the control group participants experienced an increase in Activities- Based Balance Confidence (ABC) scores. Split-middle calculation estimates indicated that both groups demonstrated a decelerating trend in mean balance confidence and a mean accelerating trend in leisure skills competence. The intervention group experienced a decelerating trend in TUG times, while the control group experienced an accelerating trend

Telemedicine and Virtual Reality for Cognitive Rehabilitation: A Roadmap for the COVID-19 Pandemic

The current COVID-19 pandemic presents unprecedented new challenges to public health and medical care delivery. To control viral transmission, social distancing measures have been implemented all over the world, interrupting the access to routine medical care for many individuals with neurological diseases. Cognitive disorders are common in many neurological conditions, e.g., stroke, traumatic brain injury, Alzheimer's disease, and other types of dementia, Parkinson's disease and parkinsonian syndromes, and multiple sclerosis, and should be addressed by cognitive rehabilitation interventions. To be effective, cognitive rehabilitation programs must be intensive and prolonged over time; however, the current virus containment measures are hampering their implementation. Moreover, the reduced access to cognitive rehabilitation might worsen the relationship between the patient and the healthcare professional. Urgent measures to address issues connected to COVID-19 pandemic are, therefore, needed. Remote communication technologies are increasingly regarded as potential effective options to support health care interventions, including neurorehabilitation and cognitive rehabilitation. Among them, telemedicine, virtual reality, augmented reality, and serious games could be in the forefront of these efforts. We will briefly review current evidence-based recommendations on the efficacy of cognitive rehabilitation and offer a perspective on the role of tele- and virtual rehabilitation to achieve adequate cognitive stimulation in the era of social distancing related to COVID-19 pandemic. In particular, we will discuss issues related to their diffusion and propose a roadmap to address them. Methodological and technological improvements might lead to a paradigm shift to promote the delivery of cognitive rehabilitation to people with reduced mobility and in remote regions

A Study on Active/Passive Pneumatic Actuators for Assistive Systems

The need for intelligent assistive devices is growing. Due to advances in medicine, people are living longer and able to recover from severe neurological incidents, resulting in an increased population with neuromuscular weakness. In workplaces such as assembly lines, there is a high possibility of work-related fatigue or injury, such as when workers squat down or lift their arms during their work tasks. Assistive devices could help remedy loss of strength on their extremities as well as keep the work environment safe and productive, allowing these growing segments of the population in need of the devices to live more self-sufficient, productive, and higher-quality lives.In the design of assistive systems, an important design goal is prolonged operational time, which requires the minimum usage of energy. Energy consumption can be reduced by modifying the mechanical characteristics of assistive systems according to the dynamic characteristics of the human body, which vary considerably between tasks. This dissertation investigates 1) the design of actuators with adjustable mechanical impedance, 2) control strategies to search for, and adjust to, a suitable mechanical impedance for assistance and 3) sensing technologies for classifying the tasks in which the human engages.The first part of this dissertation characterizes a pneumatic variable stiffness actuator named an Active/Passive Pneumatic Actuator (AP2A). The actuator consists of an air cylinder and an array of solenoid valves. These valves and the corresponding switching algorithms tune the chamber pressures and make the AP2A function as a mechanical spring with desired stiffness. The actuator has a low mechanical impedance compared to geared motors, which enables it to achieve efficient interaction. Control strategies of an assistive system with the AP2A are discussed in the second part. This control framework utilizes the characteristics of the AP2A to provide assistance when necessary and to operate transparently (i.e., neither to assist nor to disturb the users) otherwise. Energy consumed by the AP2A and the assisted system is minimized by solving an optimal control problem. Finally, an estimator is introduced to detect assistive timing for the assistive system with the AP2A. This estimator utilizes physiological signals such as surface electromyogram and prior knowledge of a muscular model, classifying if the user is under the specified condition to be assisted by the AP2A. It demonstrates that the user's effort can be saved, also reducing the number of procedures to collect training data for the estimator before using assistive systems. The performance of the actuator, the controller, and the estimator proposed in this dissertation are verified through experiments.From the above, this dissertation contributes to developing the AP2A that provides assistance and saves energy usage of assistive systems by working as a mechanical spring with stiffness optimized for achieving effective interaction under specific conditions. This actuator supports assistive devices that can be deployed in the real world, properly assisting the users when needed

Towards Enhanced Biofeedback Mechanisms for Upper Limb Rehabilitation in Stroke

This paper highlights a progressive rehabilitation strategy which details the development of a suite of biomedical feedback sensors to promote enhanced rehabilitation after stroke. The strategy involves promoting total upper limb recovery by focusing on aspects of each stage of post-stroke rehabilitation. For a patient with a complete absence of movement in the affected upper limb, brain signals will be acquired using ear-Infrared Spectroscopy (IRS) combined with motor imagery to move a robotic splint. Once residual movement has returned, EMG signals from the muscles will be detected and used to power a robotic splint. For later stages and continuous enhanced rehabilitation of the upper limb, a Sensor Glove will be used for intense rehabilitation exercises of the hand. These combined techniques cover all levels of ability for total upper limb rehabilitation and will be used to provide positive feedback and motivation for patients