A robotic system to train activities of daily living in a virtual environment

In the past decade, several arm rehabilitation robots have been developed to assist neurological patients during therapy. Early devices were limited in their number of degrees of freedom and range of motion, whereas newer robots such as the ARMin robot can support the entire arm. Often, these devices are combined with virtual environments to integrate motivating game-like scenarios. Several studies have shown a positive effect of game-playing on therapy outcome by increasing motivation. In addition, we assume that practicing highly functional movements can further enhance therapy outcome by facilitating the transfer of motor abilities acquired in therapy to daily life. Therefore, we present a rehabilitation system that enables the training of activities of daily living (ADL) with the support of an assistive robot. Important ADL tasks have been identified and implemented in a virtual environment. A patient-cooperative control strategy with adaptable freedom in timing and space was developed to assist the patient during the task. The technical feasibility and usability of the system was evaluated with seven healthy subjects and three chronic stroke patient

A Systematic Approach For Kinematic Design Of Upper Limb Rehabilitation Exoskeletons

Kinematic structure of an exoskeleton is the most fundamental block of its design and is determinant of many functional capabilities of it. Although numerous upper limb rehabilitation devices have been designed in the recent years, there is not a framework that can systematically guide the kinematic design procedure. Additionally, diversity of currently available devices and the many minute details incorporated to address certain design requirements hinders pinpointing the core kinematics of the available devices to compare them against each other. This makes the review of literature for identifying drawbacks of the state of the art systems a challenging and puzzling task. In fact, lack of a unifying framework makes designing rehabilitation devices an intuitive process and prone to biases from currently available designs. This research work proposes a systematic approach for kinematic design of upper limb rehabilitation exoskeletons based on conceptual design techniques. Having defined a solution neutral problem statement based on the characteristics of an ideal device, the main functionality of the system is divided into smaller functional units via the Functional Decomposition Method. Various directions for concept generation are explored and finally, it has been shown that a vast majority of the current exoskeleton designs fit within the proposed design framework and the defined functionalities

A 3D End-Effector Robot for Upper Limb Functional Rehabilitation of Hemiparesis Patients

Robot-assisted therapy is a new type of rehabilitation that allows for highly repetitive, intensive, adaptable, and quantifiable physical training. It is increasingly being used to restore motor function, particularly in stroke survivors with upper limb paresis. The end-effector type robot allows natural movements without complex structure which is ideal for functional rehabilitation training. A 3D end-effector base on a five-bar linkage has been proposed to improve the common end-effector type that covers mechanical design, dynamic control strategy, and application of rehabilitation training or exercise. The dynamic controllers are deweighting with gravity compensation, passive mobilization or active assistive, and the virtual spring-damper wall concept. These controllers are used for developing functional rehabilitation training or exercise from an engineering point of view based on experiences in developing various types of rehabilitation robots. The experiments, based on the performance of the controllers, have been conducted with healthy subjects. The experimental results have shown very promising results and can be extended to various types of functional rehabilitation

Music meets robotics : a prospective randomized study on motivation during robot aided therapy

Robots have been successfully applied in motor training during neurorehabilitation. As music is known to improve motor function and motivation in neurorehabilitation training, we aimed at integrating music creation into robotic-assisted motor therapy. We developed a virtual game-like environment with music for the arm therapy robot ARMin, containing four different motion training conditions: a condition promoting creativity (C+) and one not promoting creativity (C-), each in a condition with (V+) and without (V-) a visual display (i.e., a monitor). The visual display was presenting the game workspace but not contributing to the creative process itself. In all four conditions the therapy robot haptically displayed the game workspace. Our aim was to asses the effects of creativity and visual display on motivation

The Neurorehabilitation Training Toolkit (NTT): A Novel Worldwide Accessible Motor Training Approach for At-Home Rehabilitation after Stroke

After stroke, enduring rehabilitation is required for maximum recovery, and ideally throughout life to prevent functional deterioration. Hence we developed a new concept for at-home low-cost motor rehabilitation, the NTT, an Internet-based interactive system for upper-limb rehabilitation. In this paper we present the NTT design concepts, its implementation and a proof of concept study with 10 healthy participants. The NTT brings together concepts of optimal learning, engagement, and storytelling to deliver a personalized training to its users. In this study we evaluate the feasibility of NTT as a tool capable of automatically assessing and adapting to its user. This is achieved by means of a psychometric study where we show that the NTT is able to assess movement kinematics—movement smoothness, range of motion, arm displacement and arm coordination—in healthy users. Subsequently, a modeling approach is presented to understand how the measured movement kinematics relate to training parameters, and how these can be modified to adapt the training to meet the needs of patients. Finally, an adaptive algorithm for the personalization of training considering motivational and performance aspects is proposed. In the next phase we will deploy and evaluate the NTT with stroke patients at their homes

Hand-Tool-Tissue Interaction Forces in Neurosurgery for Haptic Rendering

Haptics provides sensory stimuli that represent the interaction with a virtual or telemanipulated object, and it is considered a valuable navigation and manipulation tool during tele-operated surgical procedures. Haptic feedback can be provided to the user via cutaneous information and kinesthetic feedback. Sensory subtraction removes the kinesthetic component of the haptic feedback, having only the cutaneous component provided to the user. Such a technique guarantees a stable haptic feedback loop, while it keeps the transparency of the tele-operation system high, which means that the system faithfully replicates and render back the user's directives. This work focuses on checking whether the interaction forces during a bench model neurosurgery operation can lie in the solely cutaneous perception of the human finger pads. If this assumption is found true, it would be possible to exploit sensory subtraction techniques for providing surgeons with feedback from neurosurgery. We measured the forces exerted to surgical tools by three neurosurgeons performing typical actions on a brain phantom, using contact force sensors, whilst the forces exerted by the tools to the phantom tissue were recorded using a load cell placed under the brain phantom box. The measured surgeon-tool contact forces were 0.01 - 3.49 N for the thumb and 0.01 - 6.6 N for index and middle finger, whereas the measured tool- tissue interaction forces were from six to eleven times smaller than the contact forces, i.e., 0.01 - 0.59 N. The measurements for the contact forces fit the range of the cutaneous sensitivity for the human finger pad, thus, we can say that, in a tele-operated robotic neurosurgery scenario, it would possible to render forces at the fingertip level by conveying haptic cues solely through the cutaneous channel of the surgeon's finger pads. This approach would allow high transparenc

Roboterunterstützte Therapie bei Menschen mit einer Hemiparese : wie wirkt sich diese (moderne) Therapieform auf die Selbständigkeit in den Aktivitäten des täglichen Lebens aus?

Einleitung: Jedes Jahr erleiden in der Schweiz 20’000 Personen eine Hirnverletzung oder -erkrankung. Hemiparesen gehören zu den häufigsten Folgen davon. Um wieder eine grösstmögliche Selbstständigkeit in der Ausführung der täglichen Aktivitäten zu erreichen, ist eine umfassende Rehabilitationstherapie notwendig. Eine Behandlungsart ist die roboterunterstützte Therapie. Ziel: Das Ziel dieser Bachelorarbeit ist es, die Auswirkungen einer roboterunterstützten Therapie bei Klientinnen und Klienten mit einer Hemiparese der oberen Extremitäten in der akuten bis subakuten Krankheitsphase auf die Selbständigkeit in den Aktivitäten des täglichen Lebens (ADLs) darzustellen. Methode: Mittels einer systematischen Literaturrecherche wurden sieben Studien als Hauptstudien inkludiert und anhand des AICA-Rasters zusammengefasst, sowie kritisch gewürdigt. Aus unterschiedlichen Studien wurden verschiedene Resultate der Selbstständigkeits-Assessments miteinander verglichen. Zudem wurden die ADLs aus einer Hauptstudie in der Internationalen Klassifikation der Funktionsfähigkeit, Behinderung und Gesundheit (ICF) klassifiziert. Ergebnisse: In einigen Studien konnten Verbesserungen in der Ausführung von ADLs nach der roboterunterstützten Therapie festgestellt werden. Schlussfolgerung:Die roboterunterstützte Therapie bietet eine zusätzliche Unterstützung zur konventionellen Therapie, ersetzt jedoch die Therapeutin oder den Therapeuten nicht vollständig