AGATHE: A tool for personalized rehabilitation of cognitive functions

Stroke, traumatic brain injury, multiple sclerosis, Parkinson's disease, Alzheimer's... Every year in France, tens of thousands of people fall victim to one of those neurological pathologies. Acquired brain injury leads to cognitive impairment and heavy loss of autonomy. Rehabilitation interventions are needed to enable people to recover capacity and return to Activities of Daily Living (ADL), such as grocery shopping. Unfortunately, the resources made available in cognitive rehabilitation are insufficient for the growing needs of victims of brain damage. The assets of virtual reality to address this big problem of public health are today scientifically recognized [Rizzo and Kim 2005; Klinger, et al. 2010]. In this context, we designed the AGATHE tool (Adaptable, configurable and upgradable tool for the generation of personalized therapeutic applications in cognitive rehabilitation) (AGATHE project, ANR-09-TECS-002).French National Research Agency (ANR) Laval Agglomération et Conseil Général de la Mayenn

AGATHE: A tool for personalized rehabilitation of cognitive functions

Stroke, traumatic brain injury, multiple sclerosis, Parkinson's disease, Alzheimer's... Every year in France, tens of thousands of people fall victim to one of those neurological pathologies. Acquired brain injury leads to cognitive impairment and heavy loss of autonomy. Rehabilitation interventions are needed to enable people to recover capacity and return to Activities of Daily Living (ADL), such as grocery shopping. Unfortunately, the resources made available in cognitive rehabilitation are insufficient for the growing needs of victims of brain damage. The assets of virtual reality to address this big problem of public health are today scientifically recognized [Rizzo and Kim 2005; Klinger, et al. 2010]. In this context, we designed the AGATHE tool (Adaptable, configurable and upgradable tool for the generation of personalized therapeutic applications in cognitive rehabilitation) (AGATHE project, ANR-09-TECS-002).French National Research Agency (ANR) Laval Agglomération et Conseil Général de la Mayenn

Rythmes circadiens et force musculaire (application à la rééducation cardiaque)

DIJON-BU Médecine Pharmacie (212312103) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Evaluation of safety and performance of the self balancing walking system Atalante in patients with complete motor spinal cord injury

Study Design: Prospective, open label, observational. Objectives: To present results of the first clinical study on a newly developed robotic exoskeleton (Atalante®, Wandercraft, Paris, France) that enables individuals with spinal cord injury (SCI) to perform ambulatory functions without technical aids. Setting: Two sites specialized in SCI rehabilitation, France. Methods: Inclusion criteria were presence of chronic complete SCI (AIS A) ranging from T5 to T12. The study protocol included 12 one-hour training sessions during 3 weeks. Patients walked on floor with robotic assistance and wore a harness connected to a mobile suspension system (without weight-bearing) to prevent from falling. Main outcome was the ability to walk 10 meters unassisted, secondary outcomes were assessment of other ambulatory functions, bladder and bowel functions, pain and spasticity. Results: Twelve patients were enrolled, and 11 completed the protocol, mean age 33,9 years. Six patients had T6 levels of lesion or above. Seven patients passed the 10mWT at the 12th session unassisted (mean walking speed 0.13 m/s) while four required some human help. All patients succeeded at the other ambulatory tests (stand-up, sit-down, balance, turn). There were no significant change for bladder (Qualiveen) or bowel (NBD) functions, neuropathic pain (NPSI, NPRS), yet five patients reported a subjective improvement of their bowel function. Impact on spasticity was variable depending on the muscle examined (Ashworth). Ischial skin erosion was seen in one patient that needed local dressing. Conclusion: The Atalante system is safe and enables to perform ambulatory functions in patients with complete SCI

Stakeholder involvement in the innovation process: An example in medical robotics, the ROBO-K project

International audienceIn the field of medical robotics, many studies have called for the integration of end-users in the innovation process. The objective is to identify the factors that facilitate (or not) the use of the designed robots and thus try to guarantee their diffusion in the care services. This recommendation was followed in the ROBO-K project. The ROBO-K project proposes the design and development of a mobile, interactive robot dedicated to gait rehabilitation. This project was initiated by BA Healthcare, a medical robotics company. The design of a robot was accompanied to achieve the targeted therapeutic objectives by taking into account the requirements related to the needs of the patients and the practitioners; the care activity and the institutions involved. A follow-up by the social acceptability of the technology led to focus the innovation process on a co-construction activity involving all stakeholders. This co-construction activity was decisive, as it guided the definition of functional expectations and the technical specifications of the prototype developed. It was completed by a test phase of the prototype (in a care situation for 5 months). The results show the relevance to involve all the stakeholders in all the design and development phases of the robotic device. However, they underline the difficulties or limits linked to this type of approach in terms of innovation

Short-term effect of neck muscle vibration on postural disturbances in stroke patients

International audienceBalance disorders after stroke have a particularly detrimental influence on recovery of autonomy and walking. The present study is aimed at assessing the effect of proprioceptive stimulation by neck muscle vibration (NMV) on the balance of patients with right hemispheric lesion (RHL) and left hemispheric lesion (LHL). Thirty-one (31) patients (15 RHL and 16 LHL), mean age 61.5 years (±10.6), mean delay 3.1 (±1.6) months after one hemispheric stroke were included in this prospective study. The mean position in mediolateral and anteroposterior plane of the CoP (center of pressure) and the surface were evaluated using a force platform at rest and immediately after 10 min of vibration on the contralesional dorsal neck muscle. NMV decreases the lateral deviation balance induced by the stroke. Twenty patients (64.5 %) experienced a visual illusion of light spot moving toward the side opposite stimulus. These patients showed more improvement by vibration than those without visual illusion. There was an interaction between sensitivity and side of stroke on the effect of NMV. Proprioceptive stimulation by NMV reduces postural asymmetry after stroke. This short-term effect of the vibration is more effective in patients susceptible to visual illusion. This result was consistent with a central effect of NMV on the structures involved in the elaboration of perception of body in space. © 2016, Springer-Verlag Berlin Heidelberg

Feasibility study of the use of Fiber Bragg Gratings applied to the prevention of pressure ulcers

International audiencePressure ulcers are sores that occur during prolongedimmobilization in a lying or sitting position. They result frompressure associated with shearing. But other factors are also toconsider, such as temperature and humidity. Initially, there isredness on skin that does not go away, but in later stages it canextend to muscle and bones. Pressure ulcers are most common inthe elderly, people who are bedridden for long periods or inwheelchairs. Areas at risk are the sacrum, pins and heels. The aimof our project is to develop a multi-sensor device to prevent thedevelopment of pressure ulcers. The use of this device in hospitals orfor people in wheelchairs or bedridden persons would allow a fasterand more efficient monitoring. As a first step of our project, we haveconducted a feasibility study on the use of Fiber Bragg Gratings(FBG) for pressure and shear measurements applied to pressureulcer prevention. In this paper, we present a solution integratingFBG sensors for the measurement of pressure and shear forc

ANSO study: Evaluation in an indoor environment of a mobile assistance robotic grasping arm

International audienceObjectiveTo evaluate the reliability and functional acceptability of the “Synthetic Autonomous Majordomo” (SAM) robotic aid system (a mobile Neobotix base equipped with a semi-automatic vision interface and a Manus robotic arm).Materials and methodsAn open, multicentre, controlled study. We included 29 tetraplegic patients (23 patients with spinal cord injuries, 3 with locked-in syndrome and 4 with other disorders; mean ± SD age: 37.83 ± 13.3) and 34 control participants (mean ± SD age: 32.44 ± 11.2). The reliability of the user interface was evaluated in three multi-step scenarios: selection of the room in which the object to be retrieved was located (in the presence or absence of visual control by the user), selection of the object to be retrieved, the grasping of the object itself and the robot's return to the user with the object. A questionnaire was used to assess the robot's user acceptability.ResultsThe SAM system was stable and reliable: both patients and control participants experienced few failures when completing the various stages of the scenarios. The graphic interface was effective for selecting and grasping the object – even in the absence of visual control. Users and carers were generally satisfied with SAM, although only a quarter of patients said that they would consider using the robot in their activities of daily living.ObjectifÉvaluation de la fiabilité et de l’acceptabilité de l’usage d’un robot mobile d’assistance, Synthetic Autonomous Majordomo (SAM) composé d’une base mobile Néobotix avec bras télémanipulateur Manus, doté d’une interface de saisie automatique d’objet.Patients et méthodesÉtude multicentrique ouverte contrôlée sous l’égide de l’association APPROCHE. Vingt-neuf patients tétraplégiques d’âge moyen 37,83 ± 13,3 : 23 blessés médullaires, 2 Locked In Syndrome, 4 autres pathologies. Trente-quatre sujets témoins d’âge moyen 32,44 ± 11,2. La fiabilité de l’interface graphique du système de commande a été évaluée à travers 3 scénarii comportant différentes étapes : désignation de la pièce où se trouve l’objet, déplacement de SAM vers l’objet, désignation de l’objet à saisir avec ou sans contrôle visuel, saisie automatique de l’objet, déclenchement du retour de SAM. L’usage du robot et son acceptabilité ont été évalués par un questionnaire.RésultatsLe système est stable et fiable : il y a peu d’échec dans la réalisation des différentes étapes des scénarii aussi bien pour les patients que pour les témoins. L’interface graphique est efficace pour la désignation et la saisie de l’objet. SAM a été bien accueilli par tous les utilisateurs patients et thérapeutes. Mais seuls les patients envisageraient un transfert de l’utilisation du robot en vie quotidienne

Combined visual and auditory cues do not improve virtual spatial navigation after traumatic brain injury

International audienc

AGATHE : A tool for personalized rehabilitation of cognitive functions based on simulated activities of daily living

Every year, tens of thousands of people fall victim to one of invalidating neurological pathologies. Acquired brain injury leads to cognitive impairment and heavy loss of autonomy. Rehabilitation interventions are needed to enable people to recover capacity and return to Instrumental Activities of Daily Living (iADL), such as grocery shopping. Unfortunately, the resources made available in cognitive rehabilitation are insufficient for the growing needs of victims of brain damage. The goal of the AGATHE project is to develop a tool that will provide therapists with an innovative means of dealing with cognitive rehabilitation and offer patients customized rehabilitation sessions, on the basis of simulated iADL. AGATHE fits into accessibility prospects of the tool (for everyone, everywhere and anywhere) and reduction of the cost of rehabilitation. AGATHE allows the strengthening and diversification of skills and expertise of the project's clinical and research partners as well as the opening of a new application field to the technology of the industrial partners. Initial tests of the AGATHE tool have been performed among therapists and patients after brain injury in order to validate usability issues. Perspective of efficacy trials has been identified and development projects are explored