Adaptive hybrid robotic system for rehabilitation of reaching movement after a brain injury: a usability study

BACKGROUND: Brain injury survivors often present upper-limb motor impairment affecting the execution of functional activities such as reaching. A currently active research line seeking to maximize upper-limb motor recovery after a brain injury, deals with the combined use of functional electrical stimulation (FES) and mechanical supporting devices, in what has been previously termed hybrid robotic systems. This study evaluates from the technical and clinical perspectives the usability of an integrated hybrid robotic system for the rehabilitation of upper-limb reaching movements after a brain lesion affecting the motor function. METHODS: The presented system is comprised of four main components. The hybrid assistance is given by a passive exoskeleton to support the arm weight against gravity and a functional electrical stimulation device to assist the execution of the reaching task. The feedback error learning (FEL) controller was implemented to adjust the intensity of the electrical stimuli delivered on target muscles according to the performance of the users. This control strategy is based on a proportional-integral-derivative feedback controller and an artificial neural network as the feedforward controller. Two experiments were carried out in this evaluation. First, the technical viability and the performance of the implemented FEL controller was evaluated in healthy subjects (N = 12). Second, a small cohort of patients with a brain injury (N = 4) participated in two experimental session to evaluate the system performance. Also, the overall satisfaction and emotional response of the users after they used the system was assessed. RESULTS: In the experiment with healthy subjects, a significant reduction of the tracking error was found during the execution of reaching movements. In the experiment with patients, a decreasing trend of the error trajectory was found together with an increasing trend in the task performance as the movement was repeated. Brain injury patients expressed a great acceptance in using the system as a rehabilitation tool. CONCLUSIONS: The study demonstrates the technical feasibility of using the hybrid robotic system for reaching rehabilitation. Patients’ reports on the received intervention reveal a great satisfaction and acceptance of the hybrid robotic system

Haptic Adaptive Feedback to Promote Motor Learning With a Robotic Ankle Exoskeleton Integrated With a Video Game

Background: Robotic devices have been used to rehabilitate walking function after stroke. Although results suggest that post-stroke patients benefit from this non-conventional therapy, there is no agreement on the optimal robot-assisted approaches to promote neurorecovery. Here we present a new robotic therapy protocol using a grounded exoskeleton perturbing the ankle joint based on tacit learning control. Method: Ten healthy individuals and a post-stroke patient participated in the study and were enrolled in a pilot intervention protocol that involved performance of ankle movements following different trajectories via video game visual feedback. The system autonomously modulated task difficulty according to the performance to increase the challenge. We hypothesized that motor learning throughout training sessions would lead to increased corticospinal excitability of dorsi-plantarflexor muscles. Transcranial Magnetic Stimulation was used to assess the effects on corticospinal excitability. Results: Improvements have been observed on task performance and motor outcomes in both healthy individuals and post-stroke patient case study. Tibialis Anterior corticospinal excitability increased significantly after the training; however no significant changes were observed on Soleus corticospinal excitability. Clinical scales showed functional improvements in the stroke patient. Discussion and Significance: Our findings both in neurophysiological and performance assessment suggest improved motor learning. Some limitations of the study include treatment duration and intensity, as well as the non-significant changes in corticospinal excitability obtained for Soleus. Nonetheless, results suggest that this robotic training framework is a potentially interesting approach that can be explored for gait rehabilitation in post-stroke patients.This research has been funded by the Commission of the European Union under the BioMot project–Smart Wearable Robots with Bioinspired Sensory-Motor Skills (Grant Agreement number IFP7-ICT-2013-10-611695), also under the ASTONISH Project–Advancing Smart Optical Imaging and Sensing for Health (Grant Agreement number H2020-EU.2.1.1.7.-ECSEL-04-2015-692470); with financial support of Spanish Ministry of Economy and Competitiveness (MINECO) under the ASSOCIATE project—A comprehensive and wearable robotics based approach to the rehabilitation and assistance to people with stroke and spinal cord injury (Grant Agreement number 799158449-58449-45-514); and with grant RYC-2014-16613, also by Spanish Ministry of Economy and Competitiveness

Electroweak parameters of the z0 resonance and the standard model

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Electroweak parameters of the Z0^0 resonance and the standard model

Media temporalities of the elderly : evolutions in stability This article shows the context of analysis and the first results of a research on media temporalities of the elderly. Several works have finely analysed the diversity of the media practices and studied meanings of media uses. I wish to continue these analyses by insisting on the evolutionary and dynamic aspect of the practices and temporalities of users having expanded, enhanced, so called "interactive" radio and especially television programming. A priori, the elderly, upon retirement, have a "full-time free time". Their media practices seem strongly influenced by their first experiments ; the appropriation of the various peripheral accessories which gradually came with the media, to the latest digital ones, seems to reinforce their habits of watching television. Their representations and relations with times and media are very far away from the image of television like omnipresent media or "devourer of time". Rather, their media practices are to be understood like a temporality of the occupation, according to the expression of Gerard Derèze, characterized by interest and utility. A particular glance at the users who do not carry out a systematic selection of the programs, accepting the unforeseen, highlights an approach of media and time that allow "useful encounter" which I would qualify in a first stage by : "chance and encounter" and "random and the following". The few points presented here make me assume that the global relation of the autonomous elderly persons to the media can evolve when confronted to their new temporal framework and the new program offer, whereas their representations and use of the media remain quite stable

Electroweak parameters of the Z0^0 resonance and the standard model

Media temporalities of the elderly : evolutions in stability This article shows the context of analysis and the first results of a research on media temporalities of the elderly. Several works have finely analysed the diversity of the media practices and studied meanings of media uses. I wish to continue these analyses by insisting on the evolutionary and dynamic aspect of the practices and temporalities of users having expanded, enhanced, so called "interactive" radio and especially television programming. A priori, the elderly, upon retirement, have a "full-time free time". Their media practices seem strongly influenced by their first experiments ; the appropriation of the various peripheral accessories which gradually came with the media, to the latest digital ones, seems to reinforce their habits of watching television. Their representations and relations with times and media are very far away from the image of television like omnipresent media or "devourer of time". Rather, their media practices are to be understood like a temporality of the occupation, according to the expression of Gerard Derèze, characterized by interest and utility. A particular glance at the users who do not carry out a systematic selection of the programs, accepting the unforeseen, highlights an approach of media and time that allow "useful encounter" which I would qualify in a first stage by : "chance and encounter" and "random and the following". The few points presented here make me assume that the global relation of the autonomous elderly persons to the media can evolve when confronted to their new temporal framework and the new program offer, whereas their representations and use of the media remain quite stable