A system to provide guidance to stroke patients during independent physiotherapy

Stroke is a serious disease that leaves many sufferers physically disabled. Treatment resources are limited, meaning stroke patients, are in many cases, discharged prior to reaching their full potential of physical recovery. The hypothesis of this research is that a system that enables regular guided and monitored therapeutic exercises in the home can provide a means for stroke patients to achieve a higher level of physical rehabilitation. This research is based on the design, build and testing of an experimental prototype system to allow this, with the aim of investigating the feasibility and potential value for such systems. Any system to assist rehabilitation in the home must clearly be low cost, safe and easy to use. The prototype system therefore aimed to achieve these features as well as focusing on the upper limb. Literature is reviewed in the fields of stroke, human anatomy and mechanisms, motor performance, feedback during motor learning, and existing systems and technology. Interviews are also conducted with stroke physiotherapists to gain input and feedback on concepts that were generated. Although systems exist with similar aims to those mentioned in the hypothesis, there are some areas where investigation is lacking. The prototype system measures movement using a novel combination of gyro sensors and flex sensors. The prototype system is designed with a focus on the method of interaction with patients and the provision of guidance and feedback that simulates that provided by a physiotherapist. The prototype system also provides a unique combination of quantitative information to patients of their personal improvements and graphical feedback of their movements and target movements. Finally, a novel categorisation of movement synergism (a form of movement coordination) is established and a novel method for detecting movement synergism is developed and tested. Performance of the prototype hardware is tested, and it is concluded that identified requirements have been met, although variability of recorded data is high. Tests also indicate that the prototype system is capable of detecting movement synergism. Finally, a controlled test involving healthy participants is performed to investigate the efficacy of the prototype as a whole. It was found that use of the prototype system resulted in a statistically significant improvement in conformance to target movements (ρ < 0.05). Findings are discussed in detail and the hypothesis is concluded as being supported overall. Recommendations for future research are made

Optimised Calibration, Registration and Tracking for Image Enhanced Surgical Navigation in ENT Operations

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Control of multifunctional prosthetic hands by processing the electromyographic signal

The human hand is a complex system, with a large number of degrees of freedom (DoFs), sensors embedded in its structure, actuators and tendons, and a complex hierarchical control. Despite this complexity, the efforts required to the user to carry out the different movements is quite small (albeit after an appropriate and lengthy training). On the contrary, prosthetic hands are just a pale replication of the natural hand, with significantly reduced grasping capabilities and no sensory information delivered back to the user. Several attempts have been carried out to develop multifunctional prosthetic devices controlled by electromyographic (EMG) signals (myoelectric hands), harness (kinematic hands), dimensional changes in residual muscles, and so forth, but none of these methods permits the "natural" control of more than two DoFs. This article presents a review of the traditional methods used to control artificial hands by means of EMG signal, in both the clinical and research contexts, and introduces what could be the future developments in the control strategy of these devices

Anthropomorphically Inspired Design of a Tendon-Driven Robotic Prosthesis for Hand Impairments

This thesis presents the design of a robotic prosthesis, which mimics the morphology of a human hand. The primary goal of this work is to develop a systematic methodology that allows a custom-build of the prosthesis to match the specific requirements of a person with hand impairments. Two principal research questions are addressed toward this goal: 1) How do we cater to the large variation in the distribution of overall hand-sizes in the human population? 2) How closely do we mimic the complex morphological aspects of a biological hand in order to maximize the anthropomorphism (human-like appearance) of the robotic hand, while still maintaining a customizable and manageable design? This design approach attempts to replicate the crucial morphological aspects in the artificial hand (the kinematic structure of the hand skeleton, the shape and aspect ratios of various bone-segments, and ranges of motion). The hand design is partitioned into two parts: 1) A stiff skeleton structure, comprising parametrically synthesized segments that are simplified counterparts of nineteen bone-segments—five metacarpals, five proximal phalanges, four middle phalanges, and five distal phalanges—of the natural hand-skeleton and simplified mechanical substitutes of the remaining eight carpal bones. 2) A soft skin-like structure that encompasses the artificial skeleton to match the cosmetics and compliant features of the natural hand. A parameterized CAD model representation of each synthesized segment is developed by using the feature of design-tables in SolidWorks, which allows easy customization with respect to each person. Average hand measurements available in the literature are used to guide the dimensioning of parameters of each synthesized segment. Tendon-driven actuation of the fingers allows the servo actuators to be mounted remotely, thereby enabling a sleek finger design. A prototype of the robotic hand is constructed by 3D-printing all the parts using an Object 30 Prime 3D printer. Results reported from physical validation experiments of the robotic hand demonstrate the feasibility of the proposed design approach

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

Design and Development of an Upper Limb Rehabilitative Robot with Dual Functionality

The design of an upper limb rehabilitation robot for post-stroke patients is considered a benchmark problem regarding improving functionality and ensuring better human–robot interaction (HRI). Existing upper limb robots perform either joint-based exercises (exoskeleton-type functionality) or end-point exercises (end-effector-type functionality). Patients may need both kinds of exercises, depending on the type, level, and degree of impairments. This work focused on designing and developing a seven-degrees-of-freedom (DoFs) upper-limb rehabilitation exoskeleton called ‘u-Rob’ that functions as both exoskeleton and end-effector types device. Furthermore, HRI can be improved by monitoring the interaction forces between the robot and the wearer. Existing upper limb robots lack the ability to monitor interaction forces during passive rehabilitation exercises; measuring upper arm forces is also absent in the existing devices. This research work aimed to develop an innovative sensorized upper arm cuff to measure the wearer’s interaction forces in the upper arm. A PID control technique was implemented for both joint-based and end-point exercises. The experimental results validated both types of functionality of the developed robot