Tele-Rehabilitation Versus Local Rehabilitation Therapies Assisted by Robotic Devices: A Pilot Study with Patients

The present study aims to evaluate the advantages of a master-slave robotic rehabilitation therapy in which the patient is assisted in real-time by a therapist. We have also explored if this type of strategy is applicable in a tele-rehabilitation environment. A pilot study has been carried out involving 10 patients who have performed a point-to-point rehabilitation exercise supported by three assistance modalities: fixed assistance (without therapist interaction), local therapist assistance, and remote therapist assistance in a simulated tele-rehabiliation scenario. The rehabilitation exercise will be performed using an upper-limb rehabilitation robotic device that assists the patients through force fields. The results suggest that the assistance provided by the therapist is better adapted to patient needs than fixed assistance mode. Therefore, it maximizes the patient’s level of effort, which is an important aspect to improve the rehabilitation outcomes. We have also seen that in a tele-rehabilitation environment it is more difficult to assess when to assist the patient than locally. However, the assistance suits patients better than the fixed assistance mode.This work was funded by the Conselleria d’Educacio, Cultura i Esport of Generalitat Valenciana by the European Social Fund—Investing in your Future, through the grant ACIF 2018/214, PEJ2018-002684-A and PEJ2018-002670-A, and by the Spanish Ministry of Science and Innovation through the project PID2019-108310RB-I00

Tele-rehabilitation versus local rehabilitation therapies assisted by robotic devices: a pilot study with patients

The present study aims to evaluate the advantages of a master-slave robotic rehabilitation therapy in which the patient is assisted in real-time by a therapist. We have also explored if this type of strategy is applicable in a tele-rehabilitation environment. A pilot study has been carried out involving 10 patients who have performed a point-to-point rehabilitation exercise supported by three assistance modalities: fixed assistance (without therapist interaction), local therapist assistance, and remote therapist assistance in a simulated tele-rehabiliation scenario. The rehabilitation exercise will be performed using an upper-limb rehabilitation robotic device that assists the patients through force fields. The results suggest that the assistance provided by the therapist is better adapted to patient needs than fixed assistance mode. Therefore, it maximizes the patient's level of effort, which is an important aspect to improve the rehabilitation outcomes. We have also seen that in a tele-rehabilitation environment it is more difficult to assess when to assist the patient than locally. However, the assistance suits patients better than the fixed assistance mode

Desarrollo y análisis de estrategias avanzadas de interacción en sistemas robóticos complejos de rehabilitación y asistencia

Los últimos informes indican que la incidencia de los accidentes cerebro vasculares van en aumento. Los supervivientes de un accidente cerebro vascular generalmente experimentan hemiparesia, lo que provoca un deterioro de las extremidades que implica un notable deterioro de la calidad de vida. La escasez de recursos junto con la necesidad de rehabilitación y asistencia que presentan estas personas, hacen que el cuidado y los ejercicios de rehabilitación que proporcionan las plataformas robóticas de rehabilitación cobren aún más importancia en la actualidad y en los próximos años. La presente Tesis Doctoral se centra en el desarrollo de una arquitectura multimodal capaz de implementar sistemas robóticos complejos de rehabilitación y asistencia. Con esta arquitectura, se plantea implementar y evaluar los siguientes sistemas. Primero, llevar a cabo la implementación de un sistema complejo de robótica asistencial. Después, desarrollar un sistema para la realización de terapias competitivas. Seguidamente, implementar un sistema para realizar terapias cooperativas. Y finalmente, desarrollar un sistema capaz de implementar terapias de tele-rehabilitación mediante una estrategia de teleoperación maestro-esclavo. Los principales resultados de esta tesis se han publicado en dos artículos en revistas incluidas en el Journal Citation Reports (JCR). La publicación “Feasibility and safety of shared EEG/EOG and vision-guided autonomous whole-arm exoskeleton control to perform activities of daily living” se ha evaluado la implementación de un sistema complejo de robótica asistencial basado en la arquitectura multimodal desarrollada en esta tesis, en el que se ha integrado con éxito multitud de sensores junto con diferentes interfaces de control y dispositivos robóticos para la creación de un sistema autónomo capaz de ayudar a un usuario a realizar actividades de la vida diaria. Por otro lado, en la publicación “Differences in Physiological Reactions Due to a Competitive Rehabilitation Game Modality”, se han analizado los cambios que se producen en el estado afectivo del paciente en una terapia de neurorrehabilitación asistida por robots debidos a una modalidad de juego multijugador de tipo competitivo. Finalmente, cabe destacar que uno de los resultados de la presente tesis ha dado lugar a la patente ES1234596U: Dispositivo robótico interconectable para rehabilitación de extremidades