Telerobotic 3D Articulated Arm-Assisted Surgery Tools with Augmented Reality for Surgery Training

In this research, human body will be marked and tracked using depth camera. The arm motion from the trainer will be sent through network and then mapped into 3D robotic arm in the destination server. The robotic arm will move according to the trainer. In the meantime, trainee will follow the movement and they can learn how to do particular tasks according to the trainer. The telerobotic-assisted surgery tools will give guidance how to slice or do simple surgery in several steps through the 3D medical images which are displayed in the human body. User will do training and selects some of the body parts and then analyzes it. The system provide specific task to be completed during training and measure how many tasks the user can accomplish during the surgical time. The telerobotic-assisted virtual surgery tools using augmented reality (AR) is expected to be used widely in medical education as an alternative system with low-cost solution

A robotic wheelchair trainer: design overview and a feasibility study

<p>Abstract</p> <p>Background</p> <p>Experiencing independent mobility is important for children with a severe movement disability, but learning to drive a powered wheelchair can be labor intensive, requiring hand-over-hand assistance from a skilled therapist.</p> <p>Methods</p> <p>To improve accessibility to training, we developed a robotic wheelchair trainer that steers itself along a course marked by a line on the floor using computer vision, haptically guiding the driver's hand in appropriate steering motions using a force feedback joystick, as the driver tries to catch a mobile robot in a game of "robot tag". This paper provides a detailed design description of the computer vision and control system. In addition, we present data from a pilot study in which we used the chair to teach children without motor impairment aged 4-9 (n = 22) to drive the wheelchair in a single training session, in order to verify that the wheelchair could enable learning by the non-impaired motor system, and to establish normative values of learning rates.</p> <p>Results and Discussion</p> <p>Training with haptic guidance from the robotic wheelchair trainer improved the steering ability of children without motor impairment significantly more than training without guidance. We also report the results of a case study with one 8-year-old child with a severe motor impairment due to cerebral palsy, who replicated the single-session training protocol that the non-disabled children participated in. This child also improved steering ability after training with guidance from the joystick by an amount even greater than the children without motor impairment.</p> <p>Conclusions</p> <p>The system not only provided a safe, fun context for automating driver's training, but also enhanced motor learning by the non-impaired motor system, presumably by demonstrating through intuitive movement and force of the joystick itself exemplary control to follow the course. The case study indicates that a child with a motor system impaired by CP can also gain a short-term benefit from driver's training with haptic guidance.</p

Exoskeletons with virtual reality, augmented reality and gamification for stroke patients' rehabilitation : systematic review

Background: Robot-assisted therapy has become a promising technology in the field of rehabilitation of post-stroke patients with motor disorders. Motivation during the rehabilitation process is a top priority for a majority of stroke survivors. With the advancement in technology, there has been the introduction of Virtual Reality, Augmented Reality, customizable games or a combination thereof that aid robotic therapy in retaining or increasing the interests of patients to keep performing the exercises. However, there are gaps in evidence regarding the transition from clinical rehabilitation to home-based therapy and it calls for an updated synthesis of literature showcasing this trend. The present review proposes a categorization of these studies according to technologies used by them and also details research in upper limb and lower limb applications. Objective: The goal of this work was to review the practices and technologies implemented for the rehabilitation of post-stroke patients. It aims to assess the effectiveness of exoskeleton robotics in conjunction with any of the three technologies, Virtual Reality, Augmented Reality or Gamification for improving activity and participation in post-stroke survivors. Methods: A systematic search of the literature on exoskeleton robotics applied with any of the three technologies, Virtual Reality, Augmented Reality or Gamification, was performed in the databases namely; MEDLINE (Medical Literature Analysis and Retrieval System Online, or MEDLARS Online), EMBASE (Excerpta Medica database), Science Direct & The Cochrane Library. Exoskeleton based studies that did not include any VR, AR or gamification elements were excluded and publications from the year 2010 to 2017 were included. Results in the form of improvements in patients were also recorded and taken into consideration in finding the effectiveness of therapy on patients. Results: Thirty studies were identified based on the inclusion criteria that included randomised controlled trials as well as explorative research pieces. There was a total of around 385 participants across the studies. Use of technologies such as Virtual Reality/Augmented Reality/Gamification based Exoskeletons are capable of filling the transition from clinical to home-based settings. Our analysis showed that there were in general improvements in the motor deficiency for patients using the novel interfacing techniques with exoskeletons. This categorization of studies helps in understanding the scope of rehabilitation therapies that can be successfully arranged for home-based rehabilitation. Conclusions: Future studies are necessary to explore various types of customizable games required to retain or increase the motivation of patients going through the therapy individually

ReachMAN to help sub-acute patients training reaching and manipulation

Conventional rehabilitation after stroke, consisting in one-to-one practice with the therapist, is labor-intensive and subjective. Furthermore, there is evidence that increasing training would benefit the motor function of stroke survivors, though the available resources do not allow it. Training with dedicated robotic devices promises to address these problems and to promote motivation through therapeutic games. The goal of this project is to develop a simple robotic system to assist rehabilitation that could easily be integrated in existing hospital environments and rehabilitation centers. A study was first carried out to analyze the kinematics of hand movements while performing representative activities of daily living. Results showed that movements were confined to one plane so can be trained using a robot with less degrees-of-freedom (DOF). Hence ReachMAN, a compact 3 DOF robot based on an endpoint based approach, was developed to train reaching, forearm pronosupination and grasping, independently or simultaneously. ReachMAN's exercises were developed using games based on software thereby facilitating active participation from patients. Visual, haptic and performance feedback were provided to increase motivation. Tuneable levels of difficulty were provided to suit patient's ability. A pilot study with three subjects was first conducted to evaluate the potential use of ReachMAN as a rehabilitation tool and to determine suitable settings for training. Following positive results from a pilot study, a clinical study was initiated to investigate the effect of rehabilitation using ReachMAN. Preliminary results of 6 subjects show an increase in patients upper limb motor activity, range of movements, smoothness and reduction in movement duration. Subjects reported to be motivated with the robot training and felt that the robot helped in their recovery. The results of this thesis suggest that a compact and simple robot such as ReachMAN can be used to enhance recovery in sub-acute stroke patients

Design strategies to improve patient motivation during robot-aided rehabilitation

BACKGROUND: Motivation is an important factor in rehabilitation and frequently used as a determinant of rehabilitation outcome. Several factors can influence patient motivation and so improve exercise adherence. This paper presents the design of two robot devices for use in the rehabilitation of upper limb movements, that can motivate patients during the execution of the assigned motor tasks by enhancing the gaming aspects of rehabilitation. In addition, a regular review of the obtained performance can reinforce in patients' minds the importance of exercising and encourage them to continue, so improving their motivation and consequently adherence to the program. In view of this, we also developed an evaluation metric that could characterize the rate of improvement and quantify the changes in the obtained performance. METHODS: Two groups (G1, n = 8 and G2, n = 12) of patients with chronic stroke were enrolled in a 3-week rehabilitation program including standard physical therapy (45 min. daily) plus treatment by means of robot devices (40 min., twice daily) respectively for wrist (G1) and elbow-shoulder movements (G2). Both groups were evaluated by means of standard clinical assessment scales and the new robot measured evaluation metric. Patients' motivation was assessed in 9/12 G2 patients by means of the Intrinsic Motivation Inventory (IMI) questionnaire. RESULTS: Both groups reduced their motor deficit and showed a significant improvement in clinical scales and the robot measured parameters. The IMI assessed in G2 patients showed high scores for interest, usefulness and importance subscales and low values for tension and pain subscales. CONCLUSION: Thanks to the design features of the two robot devices the therapist could easily adapt training to the individual by selecting different difficulty levels of the motor task tailored to each patient's disability. The gaming aspects incorporated in the two rehabilitation robots helped maintain patients' interest high during execution of the assigned tasks by providing feedback on performance. The evaluation metric gave a precise measure of patients' performance and thus provides a tool to help therapists promote patient motivation and hence adherence to the training program

Assessing walking ability using a robotic gait trainer: opportunities and limitations of assist-as-needed control in spinal cord injury

Background: Walking impairments are a common consequence of neurological disorders and are assessed with clinical scores that suffer from several limitations. Robot-assisted locomotor training is becoming an established clinical practice. Besides training, these devices could be used for assessing walking ability in a controlled environment. Here, we propose an adaptive assist-as-needed (AAN) control for a treadmill-based robotic exoskeleton, the Lokomat, that reduces the support of the device (body weight support and impedance of the robotic joints) based on the ability of the patient to follow a gait pattern displayed on screen. We hypothesize that the converged values of robotic support provide valid and reliable information about individuals' walking ability.Methods: Fifteen participants with spinal cord injury and twelve controls used the AAN software in the Lokomat twice within a week and were assessed using clinical scores (10MWT, TUG). We used a regression method to identify the robotic measure that could provide the most relevant information about walking ability and determined the test–retest reliability. We also checked whether this result could be extrapolated to non-ambulatory and to unimpaired subjects.Results: The AAN controller could be used in patients with different injury severity levels. A linear model based on one variable (robotic knee stiffness at terminal swing) could explain 74% of the variance in the 10MWT and 61% in the TUG in ambulatory patients and showed good relative reliability but poor absolute reliability. Adding the variable 'maximum hip flexor torque' to the model increased the explained variance above 85%. This did not extend to non-ambulatory nor to able-bodied individuals, where variables related to stance phase and to push-off phase seem more relevant.Conclusions: The novel AAN software for the Lokomat can be used to quantify the support required by a patient while performing robotic gait training. The adaptive software might enable more challenging training conditions tuned to the ability of the individuals. While the current implementation is not ready for assessment in clinical practice, we could demonstrate that this approach is safe, and it could be integrated as assist-as-needed training, rather than as assessment.Trial registration: ClinicalTrials.gov Identifier: NCT02425332

Detecting emotions during a memory training assisted by a social robot for individuals with Mild Cognitive Impairment (MCI)

The attention towards robot-assisted therapies (RAT) had grown steadily in recent years particularly for patients with dementia. However, rehabilitation practice using humanoid robots for individuals with Mild Cognitive Impairment (MCI) is still a novel method for which the adherence mechanisms, indications and outcomes remain unclear. An effective computing represents a wide range of technological opportunities towards the employment of emotions to improve human-computer interaction. Therefore, the present study addresses the effectiveness of a system in automatically decode facial expression from video-recorded sessions of a robot-assisted memory training lasted two months involving twenty-one participants. We explored the robot’s potential to engage participants in the intervention and its effects on their emotional state. Our analysis revealed that the system is able to recognize facial expressions from robot-assisted group therapy sessions handling partially occluded faces. Results indicated reliable facial expressiveness recognition for the proposed software adding new evidence base to factors involved in Human-Robot Interaction (HRI). The use of a humanoid robot as a mediating tool appeared to promote the engagement of participants in the training program. Our findings showed positive emotional responses for females. Tasks affects differentially affective involvement. Further studies should investigate the training components and robot responsiveness

Human-robot sensor interface for cardiac rehabilitation.

Cardiovascular disease is the leading cause of death in the world. A program of cardiac rehabilitation (CR) is related to physical activities or exercises to regain the optimal quality of life. CR relies on the necessity to evaluate, control and supervise a patient's status and progress. This work has two objectives: on the one hand, provide a tool for clinicians to assess the patient's status during CR. On the other hand, there is evidence that robots can motivate patients during therapeutic procedures. Our sensor interface explores the possibility to integrate a robotic agent into cardiac therapy. This work presents an exploratory experiment for on-line assessment of typical CR routines

Robotic Rehabilitation System In Malaysia

The goal of this project entitled Robotic Rehabititation System in Malaysia is to examine the purpose of robotics to therapeutic procedures for achieving the finest possible motor and functional recovery for persons with impairments following various diseases such as amputations, life-threatening wounds, brain injury, pain management issues, orthopaedics, pulmonary, spinal cord injuries and strokes. Feasibility study and research concerning robotic rehabilitation system iue prepared for the development of robotic based rehabilitation system in Malaysia to be fulfilled. However, there are significant research challenges in developing and testing rehabilitation robots so that they meet the requirements of the patients. The technology must be capable of improving person's impaired limbs or part of the body. In addition, robots must be able to understand the complexity of human type of movements. Thus, non-robotic rehabilitation centre can be transformed to a robotic based rehabilitation centre by analysing the possibility of transforming the current practice of rehabilitation programs conducted via physiotherapist to an automated rehabilitation activity by means of robot follows with good evidence on how robots might enhance the delivery of robotic rehabilitation to people of all ages

Simultaneous bilaternal training for improving arm function after stroke

Background Simultaneous bilateral training, the completion of identical activities with both arms simultaneously, is one intervention to improve arm function and reduce impairment. Objectives To determine the effects of simultaneous bilateral training for improving arm function after stroke. Search strategy We searched the Cochrane Stroke Trials Register (last searched August 2009) and 10 electronic bibliographic databases including the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 3, 2009), MEDLINE, EMBASE, CINAHL and AMED (August 2009). We also searched reference lists and trials registers. Selection criteria Randomised trials in adults after stroke, where the intervention was simultaneous bilateral training compared to placebo or no intervention, usual care or other upper limb (arm) interventions. Primary outcomes were performance in activities of daily living (ADL) and functional movement of the upper limb. Secondary outcomes were performance in extended activities of daily living and motor impairment of the arm. Data collection and analysis Two authors independently screened abstracts, extracted data and appraised trials. Assessment of methodological quality was undertaken for allocation concealment, blinding of outcome assessor, intention-to-treat, baseline similarity and loss to follow up. Main results We included 18 studies involving 549 relevant participants, of which 14 (421 participants) were included in the analysis (one within both comparisons). Four of the 14 studies compared the effects of bilateral training with usual care. Primary outcomes: results were not statistically significant for performance in ADL (standardised mean difference (SMD) 0.25, 95% confidence interval (CI) -0.14 to 0.63); functional movement of the arm (SMD -0.07, 95% CI -0.42 to 0.28) or hand (SMD -0.04, 95% CI -0.50 to 0.42). Secondary outcomes: no statistically significant results. Eleven of the 14 studies compared the effects of bilateral training with other specific upper limb (arm) interventions. Primary outcomes: no statistically significant results for performance of ADL (SMD -0.25, 95% CI -0.57 to 0.08); functional movement of the arm (SMD -0.20, 95% CI -0.49 to 0.09) or hand (SMD -0.21, 95% CI -0.51 to 0.09). Secondary outcomes: one study reported a statistically significant result in favour of another upper limb intervention for performance in extended ADL. No statistically significant differences were found for motor impairment outcomes. Authors' conclusions There is insufficient good quality evidence to make recommendations about the relative effect of simultaneous bilateral training compared to placebo, no intervention or usual care. We identified evidence that suggests that bilateral training may be no more (or less) effective than usual care or other upper limb interventions for performance in ADL, functional movement of the upper limb or motor impairment outcome