How a Diverse Research Ecosystem Has Generated New Rehabilitation Technologies: Review of NIDILRR’s Rehabilitation Engineering Research Centers

Over 50 million United States citizens (1 in 6 people in the US) have a developmental, acquired, or degenerative disability. The average US citizen can expect to live 20% of his or her life with a disability. Rehabilitation technologies play a major role in improving the quality of life for people with a disability, yet widespread and highly challenging needs remain. Within the US, a major effort aimed at the creation and evaluation of rehabilitation technology has been the Rehabilitation Engineering Research Centers (RERCs) sponsored by the National Institute on Disability, Independent Living, and Rehabilitation Research. As envisioned at their conception by a panel of the National Academy of Science in 1970, these centers were intended to take a “total approach to rehabilitation”, combining medicine, engineering, and related science, to improve the quality of life of individuals with a disability. Here, we review the scope, achievements, and ongoing projects of an unbiased sample of 19 currently active or recently terminated RERCs. Specifically, for each center, we briefly explain the needs it targets, summarize key historical advances, identify emerging innovations, and consider future directions. Our assessment from this review is that the RERC program indeed involves a multidisciplinary approach, with 36 professional fields involved, although 70% of research and development staff are in engineering fields, 23% in clinical fields, and only 7% in basic science fields; significantly, 11% of the professional staff have a disability related to their research. We observe that the RERC program has substantially diversified the scope of its work since the 1970’s, addressing more types of disabilities using more technologies, and, in particular, often now focusing on information technologies. RERC work also now often views users as integrated into an interdependent society through technologies that both people with and without disabilities co-use (such as the internet, wireless communication, and architecture). In addition, RERC research has evolved to view users as able at improving outcomes through learning, exercise, and plasticity (rather than being static), which can be optimally timed. We provide examples of rehabilitation technology innovation produced by the RERCs that illustrate this increasingly diversifying scope and evolving perspective. We conclude by discussing growth opportunities and possible future directions of the RERC program

Socially assistive robotics for post-stroke rehabilitation

BACKGROUND: Although there is a great deal of success in rehabilitative robotics applied to patient recovery post stroke, most of the research to date has dealt with providing physical assistance. However, new rehabilitation studies support the theory that not all therapy need be hands-on. We describe a new area, called socially assistive robotics, that focuses on non-contact patient/user assistance. We demonstrate the approach with an implemented and tested post-stroke recovery robot and discuss its potential for effectiveness. RESULTS: We describe a pilot study involving an autonomous assistive mobile robot that aids stroke patient rehabilitation by providing monitoring, encouragement, and reminders. The robot navigates autonomously, monitors the patient's arm activity, and helps the patient remember to follow a rehabilitation program. We also show preliminary results from a follow-up study that focused on the role of robot physical embodiment in a rehabilitation context. CONCLUSION: We outline and discuss future experimental designs and factors toward the development of effective socially assistive post-stroke rehabilitation robots

Design and Development of a Bilateral Therapeutic Hand Device for Stroke Rehabilitation

The major cause of disability is stroke. It is the second highest cause of death after coronary heart disease in Australia. In this paper, a post stroke therapeutic device has been designed and developed for hand motor function rehabilitation that a str

Wearable Robotics for Impaired Upper-Limb Assistance and Rehabilitation: State of the Art and Future Perspectives

Despite more than thirty-five years of research on wearable technologies to assist the upper-limb and a multitude of promising preliminary results, the goal of restoring pre-impairment quality of life of people with physical disabilities has not been fully reached yet. Whether it is for rehabilitation or for assistance, nowadays robotics is still only used in a few high-tech clinics and hospitals, limiting the access to a small amount of people. This work provides a description of the three major 'revolutions' occurred in the field (end-effector robots, rigid exoskeletons, and soft exosuits), reviewing forty-eight systems for the upper-limb (excluding hand-only devices) used in eighty-nine studies enrolling a clinical population before June 2022. The review critically discusses the state of the art, analyzes the different technologies, and compares the clinical outcomes, with the goal of determine new potential directions to follow

Design and Control of Robotic Systems for Lower Limb Stroke Rehabilitation

Lower extremity stroke rehabilitation exhausts considerable health care resources, is labor intensive, and provides mostly qualitative metrics of patient recovery. To overcome these issues, robots can assist patients in physically manipulating their affected limb and measure the output motion. The robots that have been currently designed, however, provide assistance over a limited set of training motions, are not portable for in-home and in-clinic use, have high cost and may not provide sufficient safety or performance. This thesis proposes the idea of incorporating a mobile drive base into lower extremity rehabilitation robots to create a portable, inherently safe system that provides assistance over a wide range of training motions. A set of rehabilitative motion tasks were established and a six-degree-of-freedom (DOF) motion and force-sensing system was designed to meet high-power, large workspace, and affordability requirements. An admittance controller was implemented, and the feasibility of using this portable, low-cost system for movement assistance was shown through tests on a healthy individual. An improved version of the robot was then developed that added torque sensing and known joint elasticity for use in future clinical testing with a flexible-joint impedance controller

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