Home-based eccentric exercise program for fall prevention in an older adult - A Case Report

Background and Purpose: Falls in older adults are common. Fear of falling may affect activity levels in older adults and increase the risk for re-injury. Eccentric strengthening exercises are seldom incorporated into a home-based physical therapy program. Eccentric strengthening needs lower energy costs and may benefit the rehabilitation of older adults at home. The purpose of this case report is to outline a home-based eccentric exercise program and assess the feasibility of the program in home health to prevent falls

Reviewing Clinical Effectiveness of Active Training Strategies of Platform-Based Ankle Rehabilitation Robots

Objective; This review aims to provide a systematical investigation of clinical effectiveness of active training strategies applied in platform-based ankle robots. Method. English-language studies published from Jan 1980 to Aug 2017 were searched from four databases using key words of “Ankle” AND “Robot” AND “Effect OR Improv OR Increas.” Following an initial screening, three rounds of discrimination were successively conducted based on the title, the abstract, and the full paper. Result. A total of 21 studies were selected with 311 patients involved; of them, 13 studies applied a single group while another eight studies used different groups for comparison to verify the therapeutic effect. Virtual-reality (VR) game training was applied in 19 studies, while two studies used proprioceptive neuromuscular facilitation (PNF) training. Conclusion. Active training techniques delivered by platform ankle rehabilitation robots have been demonstrated with great potential for clinical applications. Training strategies are mostly combined with one another by considering rehabilitation schemes and motion ability of ankle joints. VR game environment has been commonly used with active ankle training. Bioelectrical signals integrated with VR game training can implement intelligent identification of movement intention and assessment. These further provide the foundation for advanced interactive training strategies that can lead to enhanced training safety and confidence for patients and better treatment efficacy

Development of an Improved Rotational Orthosis for Walking With Arm Swing and Active Ankle Control

Based on interlimb neural coupling, gait robotic systems should produce walking-like movement in both upper and lower limbs for effective walking restoration. Two orthoses were previously designed in our lab to provide passive walking with arm swing. However, an active system for walking with arm swing is desirable to serve as a testbed for investigation of interlimb neural coupling in response to voluntary input. Given the important function of the ankle joint during normal walking, this work aimed to develop an improved rotational orthosis for walking with arm swing, which is called ROWAS II, and especially to develop and evaluate the algorithms for active ankle control. After description of the mechanical structure and control schemes of the overall ROWAS II system, the closed-loop position control and adjustable admittance control algorithms were firstly deduced, then simulated in Matlab/Simulink and finally implemented in the ROWAS II system. Six able-bodied participants were recruited to use the ROWAS II system in passive mode, and then to estimate the active ankle mechanism. It was showed that the closed-loop position control algorithms enabled the ROWAS II system to track the target arm-leg walking movement patterns well in passive mode, with the tracking error of each joint <0.7°. The adjustable admittance control algorithms enabled the participants to voluntarily adjust the ankle movement by exerting various active force. Higher admittance gains enabled the participants to more easily adjust the movement trajectory of the ankle mechanism. The ROWAS II system is technically feasible to produce walking-like movement in the bilateral upper and lower limbs in passive mode, and the ankle mechanism has technical potential to provide various active ankle training during gait rehabilitation. This novel ROWAS II system can serve as a testbed for further investigation of interlimb neural coupling in response to voluntary ankle movement and is technically feasible to provide a new training paradigm of walking with arm swing and active ankle control

serial and parallel robotics: energy saving systems and rehabilitation devices

This thesis focuses on the design and discussion of robotic devices and their applications. Robotics is the branch of technology that deals with the design, construction, operation, and application of robots as well as computer systems for their control, sensory feedback, and information processing [1]. Nowadays, robotics has been an unprecedented increase in applications of industry, military, health, domestic service, exploration, commerce, etc. Different applications require robots with different structures and different functions. Robotics normally includes serial and parallel structures. To have contribution to two kinds of structures, this thesis consisting of two sections is devoted to the design and development of serial and parallel robotic structures, focused on applications in the two different fields: industry and health

Effectiveness of robot-assisted therapy on ankle rehabilitation – a systematic review

Objective The aim of this study was to provide a systematic review of studies that investigated the effectiveness of robot-assisted therapy on ankle motor and function recovery from musculoskeletal or neurologic ankle injuries. Methods Thirteen electronic databases of articles published from January, 1980 to June, 2012 were searched using keywords ‘ankle*’, ‘robot*’, ‘rehabilitat*’ or ‘treat*’ and a free search in Google Scholar based on effects of ankle rehabilitation robots was also conducted. References listed in relevant publications were further screened. Eventually, twenty-nine articles were selected for review and they focused on effects of robot-assisted ankle rehabilitation. Results Twenty-nine studies met the inclusion criteria and a total of 164 patients and 24 healthy subjects participated in these trials. Ankle performance and gait function were the main outcome measures used to assess the therapeutic effects of robot-assisted ankle rehabilitation. The protocols and therapy treatments were varied, which made comparison among different studies difficult or impossible. Few comparative trials were conducted among different devices or control strategies. Moreover, the majority of study designs met levels of evidence that were no higher than American Academy for Cerebral Palsy (CP) and Developmental Medicine (AACPDM) level IV. Only one study used a Randomized Control Trial (RCT) approach with the evidence level being II. Conclusion All the selected studies showed improvements in terms of ankle performance or gait function after a period of robot-assisted ankle rehabilitation training. The most effective robot-assisted intervention cannot be determined due to the lack of universal evaluation criteria for various devices and control strategies. Future research into the effects of robot-assisted ankle rehabilitation should be carried out based on universal evaluation criteria, which could determine the most effective method of intervention. It is also essential to conduct trials to analyse the differences among different devices or control strategies

A Review Study for Robotic Exoskeletons Rehabilitation Devices

Nowadays, robotic exoskeletons demonstrated great abilities to replace traditional rehabilitation processes for activating neural abilities performed by physiotherapists. The main aim of this review study is to determine a state-of-the-art robotic exoskeleton that can be used for the rehabilitation of the lower limb of people who have mobile disabilities as a result of stroke and musculoskeletal conditions. The study presented the anatomy of the lower limb and the biomechanics of human gait to explain the mechanism of the limb, which helps in constructing a robotic exoskeleton. A state-of-the-art review of more than 100 articles related to robotic exoskeletons and their constructions, functionality, and rehabilitation capabilities are accurately implemented. Moreover, the study included a review of upper limb rehabilitation that has been studied locally and successfully applied to patients who exhibited significant improvements. Results of recent studies herald an abundant future for robotic exoskeletons used in the rehabilitation of the lower extremity. Significant improvement in the mechanism and design, as well as the quality, were observed. Also, impressive results were obtained from the performance when used by patients. This study concludes that working and improving the robotic devices continuously in accordance with the cases are necessary to be treated with the best results and the lowest cost

Passive Exercise Adaptation for Ankle Rehabilitation Based on Learning Control Framework

[EN] Ankle injuries are among the most common injuries in sport and daily life. However, for their recovery, it is important for patients to perform rehabilitation exercises. These exercises are usually done with a therapist's guidance to help strengthen the patient's ankle joint and restore its range of motion. However, in order to share the load with therapists so that they can offer assistance to more patients, and to provide an efficient and safe way for patients to perform ankle rehabilitation exercises, we propose a framework that integrates learning techniques with a 3-PRS parallel robot, acting together as an ankle rehabilitation device. In this paper, we propose to use passive rehabilitation exercises for dorsiflexion/plantar flexion and inversion/eversion ankle movements. The therapist is needed in the first stage to design the exercise with the patient by teaching the robot intuitively through learning from demonstration. We then propose a learning control scheme based on dynamic movement primitives and iterative learning control, which takes the designed exercise trajectory as a demonstration (an input) together with the recorded forces in order to reproduce the exercise with the patient for a number of repetitions defined by the therapist. During the execution, our approach monitors the sensed forces and adapts the trajectory by adding the necessary offsets to the original trajectory to reduce its range without modifying the original trajectory and subsequently reducing the measured forces. After a predefined number of repetitions, the algorithm restores the range gradually, until the patient is able to perform the originally designed exercise. We validate the proposed framework with both real experiments and simulation using a Simulink model of the rehabilitation parallel robot that has been developed in our lab.This work has been partially funded by the FEDER-CICYT project with reference DPI2017-84201-R (Integracion de modelos biomecanicos en el desarrollo y operacion de robots rehabilitadores reconfigurables) financed by Ministerio de Economia, Industria e Innovacion (Spain).Abu-Dakka, FJ.; Valera Fernández, Á.; Escalera, JA.; Abderrahim, M.; Page Del Pozo, AF.; Mata Amela, V. (2020). Passive Exercise Adaptation for Ankle Rehabilitation Based on Learning Control Framework. Sensors. 20(21):1-23. https://doi.org/10.3390/s20216215S123202

Passive exercise adaptation for ankle rehabilitation based on learning control framework

This article belongs to the Special Issue Human-Robot Interaction.Ankle injuries are among the most common injuries in sport and daily life. However, for their recovery, it is important for patients to perform rehabilitation exercises. These exercises are usually done with a therapist's guidance to help strengthen the patient's ankle joint and restore its range of motion. However, in order to share the load with therapists so that they can offer assistance to more patients, and to provide an efficient and safe way for patients to perform ankle rehabilitation exercises, we propose a framework that integrates learning techniques with a 3-PRS parallel robot, acting together as an ankle rehabilitation device. In this paper, we propose to use passive rehabilitation exercises for dorsiflexion/plantar flexion and inversion/eversion ankle movements. The therapist is needed in the first stage to design the exercise with the patient by teaching the robot intuitively through learning from demonstration. We then propose a learning control scheme based on dynamic movement primitives and iterative learning control, which takes the designed exercise trajectory as a demonstration (an input) together with the recorded forces in order to reproduce the exercise with the patient for a number of repetitions defined by the therapist. During the execution, our approach monitors the sensed forces and adapts the trajectory by adding the necessary offsets to the original trajectory to reduce its range without modifying the original trajectory and subsequently reducing the measured forces. After a predefined number of repetitions, the algorithm restores the range gradually, until the patient is able to perform the originally designed exercise. We validate the proposed framework with both real experiments and simulation using a Simulink model of the rehabilitation parallel robot that has been developed in our lab