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

sCAM: An Untethered Insertable Laparoscopic Surgical Camera Robot

Fully insertable robotic imaging devices represent a promising future of minimally invasive laparoscopic vision. Emerging research efforts in this field have resulted in several proof-of-concept prototypes. One common drawback of these designs derives from their clumsy tethering wires which not only cause operational interference but also reduce camera mobility. Meanwhile, these insertable laparoscopic cameras are manipulated without any pose information or haptic feedback, which results in open loop motion control and raises concerns about surgical safety caused by inappropriate use of force.This dissertation proposes, implements, and validates an untethered insertable laparoscopic surgical camera (sCAM) robot. Contributions presented in this work include: (1) feasibility of an untethered fully insertable laparoscopic surgical camera, (2) camera-tissue interaction characterization and force sensing, (3) pose estimation, visualization, and feedback with sCAM, and (4) robotic-assisted closed-loop laparoscopic camera control. Borrowing the principle of spherical motors, camera anchoring and actuation are achieved through transabdominal magnetic coupling in a stator-rotor manner. To avoid the tethering wires, laparoscopic vision and control communication are realized with dedicated wireless links based on onboard power. A non-invasive indirect approach is proposed to provide real-time camera-tissue interaction force measurement, which, assisted by camera-tissue interaction modeling, predicts stress distribution over the tissue surface. Meanwhile, the camera pose is remotely estimated and visualized using complementary filtering based on onboard motion sensing. Facilitated by the force measurement and pose estimation, robotic-assisted closed-loop control has been realized in a double-loop control scheme with shared autonomy between surgeons and the robotic controller.The sCAM has brought robotic laparoscopic imaging one step further toward less invasiveness and more dexterity. Initial ex vivo test results have verified functions of the implemented sCAM design and the proposed force measurement and pose estimation approaches, demonstrating the technical feasibility of a tetherless insertable laparoscopic camera. Robotic-assisted control has shown its potential to free surgeons from low-level intricate camera manipulation workload and improve precision and intuitiveness in laparoscopic imaging

Predictive Modeling of Tissue Mechanical Response for Rolling Motion

The application of miniature, in vivo wheeled surgical robots placed inside the abdominal cavities may improve and expand the application of minimally invasive surgery (MIS). Study of robotic mobility is necessary to advance this work by providing good criteria for performance evaluation of wheel pattern design strategies. The research reported aims at the development of an analytical base model of rolling motion on tissue and verification of model effectiveness through experimental and computational methods. The results derived in this work are anticipated to be used as the foundation of a more detailed and specific analytical model, and provide guidance for future wheel pattern design of in vivo surgical robots

METHODS, SYSTEMS, AND DEVICES RELATING TO FORCE CONTROL SURGICAL SYSTEMS

The various embodiments herein relate to robotic surgical systems and devices that use force and/or torque sensors to measure forces applied at various components of the system or device. Certain implementations include robotic surgical devices having one or more force/torque sensors that detect or measure one or more forces applied at or on one or more arms. Other embodiments relate to systems having a robotic surgical device that has one or more sensors and an external controller that has one or more motors such that the sensors transmit information that is used at the controller to actuate the motors to provide haptic feedback to a user

The Design and Development of a Mobile Colonoscopy Robot

The conventional colonoscopy is a common procedure used to access the colon. Despite it being considered the Gold Standard procedure for colorectal cancer diagnosis and treatment, it has a number of major drawbacks, including high patient discomfort, infrequent but serious complications and high skill required to perform the procedure. There are a number of potential alternatives to the conventional colonoscopy, from augmenting the colonoscope to using Computed Tomography Colonography (CTC) - a completely non-invasive method. However, a truly effective, all-round alternative has yet to be found. This thesis explores the design and development of a novel solution: a fully mobile colonoscopy robot called “RollerBall”. Unlike current passive diagnostic capsules, such as PillCam, this device uses wheels at the end of adjustable arms to provide locomotion through the colon, while providing a stable platform for the use of diagnostic and therapeutic tools. The work begins by reviewing relevant literature to better understand the problem and potential solutions. RollerBall is then introduced and its design described in detail. A robust prototype was then successfully fabricated using a 3D printing technique and its performance assessed in a series of benchtop experiments. These showed that the mechanisms functioned as intended and encouraged the further development of the concept. Next, the fundamental requirement of gaining traction on the colon was shown to be possible using hexagonal shaped, macro-scale tread patterns. A friction coefficient ranging between 0.29 and 0.55 was achieved with little trauma to the tissue substrate. The electronics hardware and control were then developed and evaluated in a series of tests in silicone tubes. An open-loop strategy was first used to establish the control algorithm to map the user inputs to motor outputs (wheel speeds). These tests showed the efficacy of the locomotion technique and the control algorithm used, but they highlighted the need for autonomy. To address this, feedback was included to automate the adjusting of the arm angle and amount of force applied by the device; a forward facing camera was also used to automate the orientation control by tracking a user-defined target. Force and orientation control were then combined to show that semi-autonomous control was possible and as a result, it was concluded that clinical use may be feasible in future developments

Exotendons for assistance of human locomotion

BACKGROUND: Powered robotic exoskeletons for assistance of human locomotion are currently under development for military and medical applications. The energy requirements for such devices are excessive, and this has become a major obstacle for practical applications. Legged locomotion in many animals, however, is very energy efficient. We propose that poly-articular elastic mechanisms are a major contributor to the economy of locomotion in such specialized animals. Consequently, it should be possible to design unpowered assistive devices that make effective use of similar mechanisms. METHODS: A passive assistive technology is presented, based on long elastic cords attached to an exoskeleton and guided by pulleys placed at the joints. A general optimization procedure is described for finding the best geometrical arrangement of such "exotendons" for assisting a specific movement. Optimality is defined either as minimal residual joint moment or as minimal residual joint power. Four specific exotendon systems with increasing complexity are considered. Representative human gait data were used to optimize each of these four systems to achieve maximal assistance for normal walking. RESULTS: The most complex exotendon system, with twelve pulleys per limb, was able to reduce the joint moments required for normal walking by 71% and joint power by 74%. A simpler system, with only three pulleys per limb, could reduce joint moments by 46% and joint power by 47%. CONCLUSION: It is concluded that unpowered passive elastic devices can substantially reduce the muscle forces and the metabolic energy needed for walking, without requiring a change in movement. When optimally designed, such devices may allow independent locomotion in patients with large deficits in muscle function

Advanced Strategies for Robot Manipulators

Amongst the robotic systems, robot manipulators have proven themselves to be of increasing importance and are widely adopted to substitute for human in repetitive and/or hazardous tasks. Modern manipulators are designed complicatedly and need to do more precise, crucial and critical tasks. So, the simple traditional control methods cannot be efficient, and advanced control strategies with considering special constraints are needed to establish. In spite of the fact that groundbreaking researches have been carried out in this realm until now, there are still many novel aspects which have to be explored