Activity-promoting gaming systems in exercise and rehabilitation

Commercial activity-promoting gaming systems provide a potentially attractive means to facilitate exercise and rehabilitation. The Nintendo Wii, Sony EyeToy, Dance Dance Revolution, and Xbox Kinect are examples of gaming systems that use the movement of the player to control gameplay. Activity-promoting gaming systems can be used as a tool to increase activity levels in otherwise sedentary gamers and also be an effective tool to aid rehabilitation in clinical settings. Therefore, the aim of this current work is to review the growing area of activity-promoting gaming in the context of exercise, injury, and rehabilitation

Wearable haptic systems for the fingertip and the hand: taxonomy, review and perspectives

In the last decade, we have witnessed a drastic change in the form factor of audio and vision technologies, from heavy and grounded machines to lightweight devices that naturally fit our bodies. However, only recently, haptic systems have started to be designed with wearability in mind. The wearability of haptic systems enables novel forms of communication, cooperation, and integration between humans and machines. Wearable haptic interfaces are capable of communicating with the human wearers during their interaction with the environment they share, in a natural and yet private way. This paper presents a taxonomy and review of wearable haptic systems for the fingertip and the hand, focusing on those systems directly addressing wearability challenges. The paper also discusses the main technological and design challenges for the development of wearable haptic interfaces, and it reports on the future perspectives of the field. Finally, the paper includes two tables summarizing the characteristics and features of the most representative wearable haptic systems for the fingertip and the hand

Developing Peri-Operative Rehabilitation in Degenerative Cervical Myelopathy [AO Spine RECODE-DCM Research Priority Number 6]: An Unexplored Opportunity?

Study Design Narrative review. Objective Degenerative cervical myelopathy is one of the most frequent impairments of the spinal cord encountered internationally in adults. Currently, surgical decompression is the recommended treatment for people with DCM (PwCM) presenting with moderate to severe symptoms or neurological deficits. However, despite surgical intervention, not all patients make a complete recovery due to the irreversible tissue damage within the spinal cord. The objective of this review is to describe the state and gaps in the current literature on rehabilitation for PwCM and possible innovative rehabilitation strategies. Methods Literature search. Results In other neurological disorders such as stroke and acute traumatic spinal cord injury (SCI), timely and strategic rehabilitation has been shown to be indispensable for maximizing functional outcomes, and it is imperative that appropriate perioperative rehabilitative interventions accompany surgical approaches in order to enable the best outcomes. In this review, the current state of knowledge regarding rehabilitation for PwCM is described. Additionally, various therapies that have shown to improve outcomes in comparable neurological conditions such as stroke and SCI which may be translated to DCM will be reviewed. Conclusions We conclude that locomotor training and arm/hand therapy may benefit PwCM. Further, we conclude that body weight support, robotic assistance, and virtual/augmented reality therapies may be beneficial therapeutic analogs to locomotor and hand therapies

A haptic-robotic platform for upper-limb reaching stroke therapy: Preliminary design and evaluation results

<p>Abstract</p> <p>Background</p> <p>It has been shown that intense training can significantly improve post-stroke upper-limb functionality. However, opportunities for stroke survivors to practice rehabilitation exercises can be limited because of the finite availability of therapists and equipment. This paper presents a haptic-enabled exercise platform intended to assist therapists and moderate-level stroke survivors perform upper-limb reaching motion therapy. This work extends on existing knowledge by presenting: 1) an anthropometrically-inspired design that maximizes elbow and shoulder range of motions during exercise; 2) an unobtrusive upper body postural sensing system; and 3) a vibratory elbow stimulation device to encourage muscle movement.</p> <p>Methods</p> <p>A multi-disciplinary team of professionals were involved in identifying the rehabilitation needs of stroke survivors incorporating these into a prototype device. The prototype system consisted of an exercise device, postural sensors, and a elbow stimulation to encourage the reaching movement. Eight experienced physical and occupational therapists participated in a pilot study exploring the usability of the prototype. Each therapist attended two sessions of one hour each to test and evaluate the proposed system. Feedback about the device was obtained through an administered questionnaire and combined with quantitative data.</p> <p>Results</p> <p>Seven of the nine questions regarding the haptic exercise device scored higher than 3.0 (somewhat good) out of 4.0 (good). The postural sensors detected 93 of 96 (97%) therapist-simulated abnormal postures and correctly ignored 90 of 96 (94%) of normal postures. The elbow stimulation device had a score lower than 2.5 (neutral) for all aspects that were surveyed, however the therapists felt the rehabilitation system was sufficient for use without the elbow stimulation device.</p> <p>Conclusion</p> <p>All eight therapists felt the exercise platform could be a good tool to use in upper-limb rehabilitation as the prototype was considered to be generally well designed and capable of delivering reaching task therapy. The next stage of this project is to proceed to clinical trials with stroke patients.</p

Impact of virtual embodiment and exercises on functional ability and range of motion in orthopedic rehabilitation

Recent evidence supports the use of immersive virtual reality (immersive VR) as a means of applying visual feedback techniques in neurorehabilitation. In this study, we investigated the benefits of an embodiment-based immersive VR training program for orthopedic upper limb rehabilitation, with the aim of improving the motor functional ability of the arm and accelerating the rehabilitation process in patients with a conservatively managed distal radius fracture. We designed a rehabilitation program based on developing ownership over a virtual arm and then exercising it in immersive VR. We carried out a between 3-group controlled trial with 54 patients (mean age = 61.80 ± 14.18): 20 patients were assigned to the experimental training group (immersive VR), 20 to the conventional digit mobilization (CDM) training control group, and 14 to a non-immersive (non-immersive VR) training control group. We found that functional recovery of the arm in the immersive VR group was correlated with the ownership and agency scores over the virtual arm. We also found larger range of joint movements and lower disability of the fractured arm compared with patients in the Non-immersive VR and CDM groups. Feeling embodied in a virtual body can be used as a rehabilitation tool to speed up and improve motor functional recovery of a fractured arm after the immobilization period

3D printed pneumatic soft actuators and sensors: their modeling, performance quantification, control and applications in soft robotic systems

Continued technological progress in robotic systems has led to more applications where robots and humans operate in close proximity and even physical contact in some cases. Soft robots, which are primarily made of highly compliant and deformable materials, provide inherently safe features, unlike conventional robots that are made of stiff and rigid components. These robots are ideal for interacting safely with humans and operating in highly dynamic environments. Soft robotics is a rapidly developing field exploiting biomimetic design principles, novel sensor and actuation concepts, and advanced manufacturing techniques. This work presents novel soft pneumatic actuators and sensors that are directly 3D printed in one manufacturing step without requiring postprocessing and support materials using low-cost and open-source fused deposition modeling (FDM) 3D printers that employ an off-the-shelf commercially available soft thermoplastic poly(urethane) (TPU). The performance of the soft actuators and sensors developed is optimized and predicted using finite element modeling (FEM) analytical models in some cases. A hyperelastic material model is developed for the TPU based on its experimental stress-strain data for use in FEM analysis. The novel soft vacuum bending (SOVA) and linear (LSOVA) actuators reported can be used in diverse robotic applications including locomotion robots, adaptive grippers, parallel manipulators, artificial muscles, modular robots, prosthetic hands, and prosthetic fingers. Also, the novel soft pneumatic sensing chambers (SPSC) developed can be used in diverse interactive human-machine interfaces including wearable gloves for virtual reality applications and controllers for soft adaptive grippers, soft push buttons for science, technology, engineering, and mathematics (STEM) education platforms, haptic feedback devices for rehabilitation, game controllers and throttle controllers for gaming and bending sensors for soft prosthetic hands. These SPSCs are directly 3D printed and embedded in a monolithic soft robotic finger as position and touch sensors for real-time position and force control. One of the aims of soft robotics is to design and fabricate robotic systems with a monolithic topology embedded with its actuators and sensors such that they can safely interact with their immediate physical environment. The results and conclusions of this thesis have significantly contributed to the realization of this aim

Design and development of a new approach to wrist rehabilitation

Wrist injuries are a very common type of pathology that can compromise most daily tasks. Conventional therapy is dependent on the availability of physiotherapists as well as devices designed for this purpose. Conventional devices do not accompany the patient throughout their rehabilitation process, requiring their constant replacement. Vibratory therapies emerged in recent years and have demonstrated several benefits in this area. However, there are few vibratory devices designed for wrist rehabilitation. In this paper, we propose two different portable and active models for wrist rehabilitation based on vibratory therapy for wrist rehabilitation. The first model has a cylindrical shape and the second model has a dumbbell shape. The results obtained showed that vibratory therapy can assist the wrist rehabilitation because it promoted improvements in joint amplitude gain in all wrist movements. Furthermore, the second device demonstrated higher joint gains than the first device. In addition, the results obtained from the measurement of accelerations demonstrate that the natural frequencies of both devices are adequate for wrist and forearm rehabilitation as well as the mode of vibration. There are differences between what the simulations predicted and what was obtained in practice in terms of natural frequency values.- (undefined

Focal Vibration for Upper Limb Rehabilitation After Stroke

Stroke is the fifth leading cause of death and a leading cause of disability in the state of Oklahoma and the United States. Although there are several approaches to stroke rehabilitation, most stroke survivors live with upper limb impairments, which causes difficulties for independent living and social participation. One promising method for rehabilitation of the upper limb following stroke is focal muscle vibration, thought to work by activating the Ia afferent muscle spindle fibers for somatosensory and motor cortex stimulation. In this thesis, I describe the development of a novel wearable focal vibration device, called FoVi. Then, I report the findings from a pilot study of the feasibility and efficacy of the FoVi device in a short-term intervention. The FoVi device was developed according to design criteria specified through a focus group, including being comfortable and easy to use, having vibration motor pods controlled by an app on the user’s smartphone, and recording usage logs for real-time communication with therapists. Short-term interventions with FoVi show promise in increasing upper limb mobility and function, evidenced through non-significant increases in Fugl-Meyer Upper Extremity score, Chedoke Arm- Hand Activity Inventory score, and grip strength. In conclusion, the FoVi device could be a helpful treatment method in stroke rehabilitation, and future long-term intervention studies with larger sample sizes and more robust outcome measures may show significant improvements in upper limb function. Combination with other treatment modalities, such as transcranial direct current stimulation, may enable a more effective treatment of the upper limb in stroke patients