Robotics rehabilitation of the elbow based on surface electromyography signals

Physical rehabilitation based on robotic systems has the potential to cover the patient’s need of improvement of upper extremity functionalities. In this article, the state of the art of resistant and assistive upper limb exoskeleton robots and their control are thoroughly investigated. Afterward, a single-degree-of-freedom exoskeleton matching the elbow–forearm has been advanced to grant a valid rehabilitation therapy for persons with physical disability of upper limb motion. The authors have focused on the control system based on the use of electromyography signals as an input to drive the joint movement and manage the robotics arm. The correlation analysis between surface electromyography signal and the force exerted by the subject was studied in objects’ grasping tests with the purpose of validating the methodology. The authors developed an innovative surface electromyography force–based active control that adjusts the force exerted by the device during rehabilitation. The control was validated by an experimental campaign on healthy subjects simulating disease on an arm, with positive results that confirm the proposed solution and that open the way to future researches

Role of Sensation in Altered Phalanx Grip Force in Persons with Stroke

Many individuals experience hand impairment after stroke leading to decreased ability to perform daily living activities. Previous research studies have investigated how stroke survivors\u27 pinch grip control differs from healthy individuals, even though many individuals can only grasp with power grip after stroke. Furthermore, many stroke survivors experience tactile sensory deficit in their paretic limb in addition to motor deficit. It is currently unknown how stroke induced tactile sensory deficit affects power grip force directional control, which is important in terms of preventing object slippage and power grip normal force generation. Additionally it is unknown if power grip could be improved through tactile sensory enhancement. This dissertation investigated how stroke survivors\u27 power grip force control is different from healthy individuals. Also, the effect of stroke induced tactile sensory deficit on power grip force control and the benefits of a sensory enhancement method using remote subsensory vibrotactile noise on power grip phalanx force deviation was assessed. In addition, the effect of noise on the tactile sensation for stroke survivors with tactile sensory deficit and their performance on two dynamic gripping tasks, the Box and Block Test (`BBT\u27, number of blocks moved in 60 seconds) and the Nine Hole Peg Test (`NHPT\u27, time to pick up, place, and remove 9 pegs from 9 holes), were investigated. The theoretical framework of this dissertation is that tactile sensation is critical for grip control and impairment or enhancement of tactile sensation impacts power grip force control post stroke. Results showed that stroke survivors, especially those with tactile sensory deficit, gripped with increased phalanx force deviation compared to healthy individuals, showing reduced directional force control and increasing their chances of dropping objects. Remote subsensory vibrotactile noise improved fingertip and upper palm tactile sensation for stroke survivors with tactile sensory deficit. The noise also improved phalanx force directional control during power grip (reducing phalanx force deviation) for stroke survivors with and without tactile sensory deficit and age-matched healthy controls and improved the BBT score and time to complete the NHPT for stroke survivors with tactile sensory deficit. Overall, stroke survivors, particularly those with tactile sensory deficit, appear to have reduced phalanx force control during power grip, which may biomechanically result from a muscle activation pattern. Remote subsensory vibrotactile noise may have enhanced tactile sensation and hand motor control via stochastic resonance and interneuronal connections and could have potential as a wearable rehabilitation device for stroke survivors. This dissertation contributes to the long term goal of increasing stroke survivors\u27 independence in completing daily living activities

Grip type and task goal modify reach-to-grasp performance in post-stroke hemiparesis

This study investigated whether grip type and/or task goal influenced reaching and grasping performance in post-stroke hemiparesis. Sixteen adults with post-stroke hemiparesis and twelve healthy adults reached to and grasped a cylindrical object using one of two grip types (3-finger or palmar) to achieve one of two task goals (hold or lift). Performance of the stroke group was characteristic of hemiparetic limb movement during reach-to-grasp, with more curved handpaths and slower velocities compared to the control group. These effects were present regardless of grip type or task goal. Other measures of reaching (reach time and reach velocity at object contact) and grasping (peak thumb-index finger aperture during the reach and peak grip force during the grasp) were differentially affected by grip type, task goal, or both, despite the presence of hemiparesis, providing new evidence that changes in motor patterns after stroke may occur to compensate for stroke-related motor impairment

Impact of Ear Occlusion on In-Ear Sounds Generated by Intra-oral Behaviors

We conducted a case study with one volunteer and a recording setup to detect sounds induced by the actions: jaw clenching, tooth grinding, reading, eating, and drinking. The setup consisted of two in-ear microphones, where the left ear was semi-occluded with a commercially available earpiece and the right ear was occluded with a mouldable silicon ear piece. Investigations in the time and frequency domains demonstrated that for behaviors such as eating, tooth grinding, and reading, sounds could be recorded with both sensors. For jaw clenching, however, occluding the ear with a mouldable piece was necessary to enable its detection. This can be attributed to the fact that the mouldable ear piece sealed the ear canal and isolated it from the environment, resulting in a detectable change in pressure. In conclusion, our work suggests that detecting behaviors such as eating, grinding, reading with a semi-occluded ear is possible, whereas, behaviors such as clenching require the complete occlusion of the ear if the activity should be easily detectable. Nevertheless, the latter approach may limit real-world applicability because it hinders the hearing capabilities.</p

Latent disconnectome prediction of long-term cognitive-behavioural symptoms in stroke

Stroke significantly impacts the quality of life. However, the long-term cognitive evolution in stroke is poorly predictable at the individual level. There is an urgent need to better predict long-term symptoms based on acute clinical neuroimaging data. Previous works have demonstrated a strong relationship between the location of white matter disconnections and clinical symptoms. However, rendering the entire space of possible disconnection-deficit associations optimally surveyable will allow for a systematic association between brain disconnections and cognitive-behavioural measures at the individual level. Here we present the most comprehensive framework, a composite morphospace of white matter disconnections (disconnectome) to predict neuropsychological scores 1 year after stroke. Linking the latent disconnectome morphospace to neuropsychological outcomes yields biological insights that are available as the first comprehensive atlas of disconnectome-deficit relations across 86 scores-a Neuropsychological White Matter Atlas. Our novel predictive framework, the Disconnectome Symptoms Discoverer, achieved better predictivity performances than six other models, including functional disconnection, lesion topology and volume modelling. Out-of-sample prediction derived from this atlas presented a mean absolute error below 20% and allowed personalize neuropsychological predictions. Prediction on an external cohort achieved an R2 = 0.201 for semantic fluency. In addition, training and testing were replicated on two external cohorts achieving an R2 = 0.18 for visuospatial performance. This framework is available as an interactive web application (http://disconnectomestudio.bcblab.com) to provide the foundations for a new and practical approach to modelling cognition in stroke. We hope our atlas and web application will help to reduce the burden of cognitive deficits on patients, their families and wider society while also helping to tailor future personalized treatment programmes and discover new targets for treatments. We expect our framework's range of assessments and predictive power to increase even further through future crowdsourcing

Rehabilitation Engineering

Population ageing has major consequences and implications in all areas of our daily life as well as other important aspects, such as economic growth, savings, investment and consumption, labour markets, pensions, property and care from one generation to another. Additionally, health and related care, family composition and life-style, housing and migration are also affected. Given the rapid increase in the aging of the population and the further increase that is expected in the coming years, an important problem that has to be faced is the corresponding increase in chronic illness, disabilities, and loss of functional independence endemic to the elderly (WHO 2008). For this reason, novel methods of rehabilitation and care management are urgently needed. This book covers many rehabilitation support systems and robots developed for upper limbs, lower limbs as well as visually impaired condition. Other than upper limbs, the lower limb research works are also discussed like motorized foot rest for electric powered wheelchair and standing assistance device

Soft pneumatic muscles for post-stroke lower limb ankle rehabilitation: leveraging the potential of soft robotics to optimize functional outcomes

Introduction: A soft pneumatic muscle was developed to replicate intricate ankle motions essential for rehabilitation, with a specific focus on rotational movement along the x-axis, crucial for walking. The design incorporated precise geometrical parameters and air pressure regulation to enable controlled expansion and motion.Methods: The muscle’s response was evaluated under pressure conditions ranging from 100-145 kPa. To optimize the muscle design, finite element simulation was employed to analyze its performance in terms of motion range, force generation, and energy efficiency. An experimental platform was created to assess the muscle’s deformation, utilizing advanced techniques such as high-resolution imaging and deep-learning position estimation models for accurate measurements. The fabrication process involved silicone-based materials and 3D-printed molds, enabling precise control and customization of muscle expansion and contraction.Results: The experimental results demonstrated that, under a pressure of 145 kPa, the y-axis deformation (y-def) reached 165 mm, while the x-axis and z-axis deformations were significantly smaller at 0.056 mm and 0.0376 mm, respectively, highlighting the predominant elongation in the y-axis resulting from pressure actuation. The soft muscle model featured a single chamber constructed from silicone rubber, and the visually illustrated and detailed geometrical parameters played a critical role in its functionality, allowing systematic manipulation to meet specific application requirements.Discussion: The simulation and experimental results provided compelling evidence of the soft muscle design’s adaptability, controllability, and effectiveness, thus establishing a solid foundation for further advancements in ankle rehabilitation and soft robotics. Incorporating this soft muscle into rehabilitation protocols holds significant promise for enhancing ankle mobility and overall ambulatory function, offering new opportunities to tailor rehabilitation interventions and improve motor function restoration