Computational neurorehabilitation: modeling plasticity and learning to predict recovery

Despite progress in using computational approaches to inform medicine and neuroscience in the last 30 years, there have been few attempts to model the mechanisms underlying sensorimotor rehabilitation. We argue that a fundamental understanding of neurologic recovery, and as a result accurate predictions at the individual level, will be facilitated by developing computational models of the salient neural processes, including plasticity and learning systems of the brain, and integrating them into a context specific to rehabilitation. Here, we therefore discuss Computational Neurorehabilitation, a newly emerging field aimed at modeling plasticity and motor learning to understand and improve movement recovery of individuals with neurologic impairment. We first explain how the emergence of robotics and wearable sensors for rehabilitation is providing data that make development and testing of such models increasingly feasible. We then review key aspects of plasticity and motor learning that such models will incorporate. We proceed by discussing how computational neurorehabilitation models relate to the current benchmark in rehabilitation modeling – regression-based, prognostic modeling. We then critically discuss the first computational neurorehabilitation models, which have primarily focused on modeling rehabilitation of the upper extremity after stroke, and show how even simple models have produced novel ideas for future investigation. Finally, we conclude with key directions for future research, anticipating that soon we will see the emergence of mechanistic models of motor recovery that are informed by clinical imaging results and driven by the actual movement content of rehabilitation therapy as well as wearable sensor-based records of daily activity

Functional Electrical Stimulation mediated by Iterative Learning Control and 3D robotics reduces motor impairment in chronic stroke

Background: Novel stroke rehabilitation techniques that employ electrical stimulation (ES) and robotic technologies are effective in reducing upper limb impairments. ES is most effective when it is applied to support the patients’ voluntary effort; however, current systems fail to fully exploit this connection. This study builds on previous work using advanced ES controllers, and aims to investigate the feasibility of Stimulation Assistance through Iterative Learning (SAIL), a novel upper limb stroke rehabilitation system which utilises robotic support, ES, and voluntary effort. Methods: Five hemiparetic, chronic stroke participants with impaired upper limb function attended 18, 1 hour intervention sessions. Participants completed virtual reality tracking tasks whereby they moved their impaired arm to follow a slowly moving sphere along a specified trajectory. To do this, the participants’ arm was supported by a robot. ES, mediated by advanced iterative learning control (ILC) algorithms, was applied to the triceps and anterior deltoid muscles. Each movement was repeated 6 times and ILC adjusted the amount of stimulation applied on each trial to improve accuracy and maximise voluntary effort. Participants completed clinical assessments (Fugl-Meyer, Action Research Arm Test) at baseline and post-intervention, as well as unassisted tracking tasks at the beginning and end of each intervention session. Data were analysed using t-tests and linear regression. Results: From baseline to post-intervention, Fugl-Meyer scores improved, assisted and unassisted tracking performance improved, and the amount of ES required to assist tracking reduced. Conclusions: The concept of minimising support from ES using ILC algorithms was demonstrated. The positive results are promising with respect to reducing upper limb impairments following stroke, however, a larger study is required to confirm this

Human-centred design methods : developing scenarios for robot assisted play informed by user panels and field trials

Original article can be found at: http://www.sciencedirect.com/ Copyright ElsevierThis article describes the user-centred development of play scenarios for robot assisted play, as part of the multidisciplinary IROMEC1 project that develops a novel robotic toy for children with special needs. The project investigates how robotic toys can become social mediators, encouraging children with special needs to discover a range of play styles, from solitary to collaborative play (with peers, carers/teachers, parents, etc.). This article explains the developmental process of constructing relevant play scenarios for children with different special needs. Results are presented from consultation with panel of experts (therapists, teachers, parents) who advised on the play needs for the various target user groups and who helped investigate how robotic toys could be used as a play tool to assist in the children’s development. Examples from experimental investigations are provided which have informed the development of scenarios throughout the design process. We conclude by pointing out the potential benefit of this work to a variety of research projects and applications involving human–robot interactions.Peer reviewe

In-home and remote use of robotic body surrogates by people with profound motor deficits

By controlling robots comparable to the human body, people with profound motor deficits could potentially perform a variety of physical tasks for themselves, improving their quality of life. The extent to which this is achievable has been unclear due to the lack of suitable interfaces by which to control robotic body surrogates and a dearth of studies involving substantial numbers of people with profound motor deficits. We developed a novel, web-based augmented reality interface that enables people with profound motor deficits to remotely control a PR2 mobile manipulator from Willow Garage, which is a human-scale, wheeled robot with two arms. We then conducted two studies to investigate the use of robotic body surrogates. In the first study, 15 novice users with profound motor deficits from across the United States controlled a PR2 in Atlanta, GA to perform a modified Action Research Arm Test (ARAT) and a simulated self-care task. Participants achieved clinically meaningful improvements on the ARAT and 12 of 15 participants (80%) successfully completed the simulated self-care task. Participants agreed that the robotic system was easy to use, was useful, and would provide a meaningful improvement in their lives. In the second study, one expert user with profound motor deficits had free use of a PR2 in his home for seven days. He performed a variety of self-care and household tasks, and also used the robot in novel ways. Taking both studies together, our results suggest that people with profound motor deficits can improve their quality of life using robotic body surrogates, and that they can gain benefit with only low-level robot autonomy and without invasive interfaces. However, methods to reduce the rate of errors and increase operational speed merit further investigation.Comment: 43 Pages, 13 Figure

Overcoming barriers and increasing independence: service robots for elderly and disabled people

This paper discusses the potential for service robots to overcome barriers and increase independence of elderly and disabled people. It includes a brief overview of the existing uses of service robots by disabled and elderly people and advances in technology which will make new uses possible and provides suggestions for some of these new applications. The paper also considers the design and other conditions to be met for user acceptance. It also discusses the complementarity of assistive service robots and personal assistance and considers the types of applications and users for which service robots are and are not suitable

Neuroplastic Changes Following Brain Ischemia and their Contribution to Stroke Recovery: Novel Approaches in Neurorehabilitation

Ischemic damage to the brain triggers substantial reorganization of spared areas and pathways, which is associated with limited, spontaneous restoration of function. A better understanding of this plastic remodeling is crucial to develop more effective strategies for stroke rehabilitation. In this review article, we discuss advances in the comprehension of post-stroke network reorganization in patients and animal models. We first focus on rodent studies that have shed light on the mechanisms underlying neuronal remodeling in the perilesional area and contralesional hemisphere after motor cortex infarcts. Analysis of electrophysiological data has demonstrated brain-wide alterations in functional connectivity in both hemispheres, well beyond the infarcted area. We then illustrate the potential use of non-invasive brain stimulation (NIBS) techniques to boost recovery. We finally discuss rehabilitative protocols based on robotic devices as a tool to promote endogenous plasticity and functional restoration

Vision-based interface applied to assistive robots

This paper presents two vision-based interfaces for disabled people to command a mobile robot for personal assistance. The developed interfaces can be subdivided according to the algorithm of image processing implemented for the detection and tracking of two different body regions. The first interface detects and tracks movements of the user's head, and these movements are transformed into linear and angular velocities in order to command a mobile robot. The second interface detects and tracks movements of the user's hand, and these movements are similarly transformed. In addition, this paper also presents the control laws for the robot. The experimental results demonstrate good performance and balance between complexity and feasibility for real-time applications.Fil: Pérez Berenguer, María Elisa. Universidad Nacional de San Juan. Facultad de Ingeniería. Departamento de Electrónica y Automática. Gabinete de Tecnología Médica; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Soria, Carlos Miguel. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Juan. Instituto de Automática. Universidad Nacional de San Juan. Facultad de Ingeniería. Instituto de Automática; ArgentinaFil: López Celani, Natalia Martina. Universidad Nacional de San Juan. Facultad de Ingeniería. Departamento de Electrónica y Automática. Gabinete de Tecnología Médica; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Nasisi, Oscar Herminio. Universidad Nacional de San Juan. Facultad de Ingeniería. Instituto de Automática; ArgentinaFil: Mut, Vicente Antonio. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Juan. Instituto de Automática. Universidad Nacional de San Juan. Facultad de Ingeniería. Instituto de Automática; Argentin

Feedback Control of an Exoskeleton for Paraplegics: Toward Robustly Stable Hands-free Dynamic Walking

This manuscript presents control of a high-DOF fully actuated lower-limb exoskeleton for paraplegic individuals. The key novelty is the ability for the user to walk without the use of crutches or other external means of stabilization. We harness the power of modern optimization techniques and supervised machine learning to develop a smooth feedback control policy that provides robust velocity regulation and perturbation rejection. Preliminary evaluation of the stability and robustness of the proposed approach is demonstrated through the Gazebo simulation environment. In addition, preliminary experimental results with (complete) paraplegic individuals are included for the previous version of the controller.Comment: Submitted to IEEE Control System Magazine. This version addresses reviewers' concerns about the robustness of the algorithm and the motivation for using such exoskeleton