10 research outputs found

    Sistema rob贸tico ambulatorio de rehabilitaci贸n de marcha. Soluci贸n integrada de inducci贸n de movimientos y descarga parcial de peso del paciente

    Get PDF
    En esta tesis doctoral se presenta el dise帽o, el desarrollo y la validaci贸n de un dispositivo rob贸tico para el entrenamiento y la rehabilitaci贸n de la marcha de personas con deficiencia motora. Se basa en la combinaci贸n de un exoesqueleto bilateral activo de miembros inferiores y de una plataforma de descarga parcial de peso, regulable, que proporciona una alta estabilidad y seguridad durante la marcha. Se ha dise帽ado para proporcionar una marcha natural en un entorno real con una descarga adaptable, con el objeto de potenciar las capacidades motoras residuales del paciente, as铆 como evitar o disminuir importantes problemas que aparecen por per铆odos largos de sedestaci贸n. Inicialmente, se presenta la caracterizaci贸n de la marcha humana a trav茅s de sus par谩metros espacio-temporales y cinem谩ticos, as铆 como los sistemas empleados para su caracterizaci贸n. Se hace igualmente una revisi贸n del estado del arte de los sistemas tecnol贸gicos de ayuda a la movilidad, proponiendo una clasificaci贸n en funci贸n de las capacidades motoras del usuario. Se realiza un especial 茅nfasis en los dispositivos vestibles y en los entrenadores de marcha tanto en fase de investigaci贸n como comerciales. A partir de este estudio, se detectan las carencias que se marcan como objetivos a cumplir para el entrenador HYBRID, desarrollo central del trabajo realizado en esta tesis doctoral, dentro del proyecto nacional DPI 2011-28160-C03. Se detalla el dise帽o mec谩nico realizado, as铆 como la integraci贸n hardware e implementaci贸n software de los subsistemas y su integraci贸n conjunta para su correcto funcionamiento de manera integrada. El sistema se dise帽a como una plataforma abierta que permite el procesamiento y el registro de se帽ales para la caracterizaci贸n de la marcha. El sistema ha sido validado con personas sanas como paso previo a la validaci贸n cl铆nica. Esta se ha centrado en asegurar la estabilidad y seguridad del dispositivo, caracterizar la marcha desarrollada, comprobar la correcta inducci贸n del movimiento sobre las extremidades inferiores del usuario, caracterizar las fuerzas de suspensi贸n y determinar el grado de acoplamiento entre el sistema y el usuario. Finalmente, se ha validado el sistema con pacientes con lesi贸n medular de distinto grado de afecci贸n y capacidades de locomoci贸n. Se ha valorado el impacto metab贸lico en t茅rminos respiratorios, card铆acos y energ茅ticos; adem谩s de los par谩metros de la marcha desarrollada y las fuerzas de suspensi贸n. Los resultados obtenidos tanto de las escalas objetivas empleadas como de las valoraciones subjetivas de los pacientes se han considerado satisfactorios en un buen grado y se presentan en la memoria, constatando el potencial del dispositivo como herramienta fiable para el entrenamiento de la marcha de personas con un alto grado de discapacidad motora.In this PhD thesis, the design, development and validation of a robotic device for the training and rehabilitation of people with motor deficits is presented. This robotic device is based on the combination of a powered bilateral lower limb exoskeleton and an adjustable partial body weight support platform, that gives high stability and safety during walking. It has been designed to provide natural gait in real environments with an adaptive support, focused on enhancing the residual motor abilities of the patient as well as avoiding or diminishing the numerous and important problems that appear after long periods of sitting. Initially, human gait characterization is presented through its spatio-temporal and kinematic parameters as well as the systems used for it. A review of the state-of-theart of the mobility devices is presented, proposing a classification based on the user's residual motor abilities. Special emphasis is placed on wearable devices and gait trainers in both the research field and the market. From this study, the identified shortcomings are proposed as the objectives to be achieved for the HYBRID gait trainer, framework of development of this PhD Thesis, within the national project DPI 2011-28160-C03. In this sense, the mechanical design, hardware integration, software implementation and integration of the subsystems is presented. The system is designed as an open platform that allows the integration of new functionalities, as well as the processing and recording of sensor signals for the gait characterization. The system has been validated with healthy people as a first step to the clinical validation with people with motor disabilities, people with spinal cord injury in this case. This first validation has been focused on ensuring the stability and safety of the device, the analysis of the gait developed with the HYBRID system, the validation of the induced movement of the lower limb in the user, the characterization of the unloading forces and the assessment of the degree of coupling between the system and the user. Finally, the system has been validated with spinal cord injured patients with different levels of motor disability. The metabolic impact in respiratory, cardiac and energetic terms has been evaluated; in addition to the characterization of the gait parameters and the unloading forces. The results obtained from the clinical scales and user experience evaluation, presented in this PhD thesis, have been considered satisfactory, confirming the potential of the device as a reliable tool for gait training of people with a high degree of motor disability.Programa Oficial de Doctorado en Ingenier铆a El茅ctrica, Electr贸nica y Autom谩ticaPresidente: 脕ngel Manuel Gil Agudo.- Secretario: Mar铆a Dolores Blanco Rojas.- Vocal: Cristina S谩nchez L贸pez de Pabl

    A novel human-machine interface for guiding : the NeoASAS Smart Walker

    Get PDF
    In an aging society it is extremely important to develop devices, which can support and aid the elderly in their daily life. This demands tools that extend independent living and promote improved health. In this work it is proposed a new interface approach integrated into a walker. This interface is based on a joystick and it is intended to extract the user鈥檚 movement intentions. The interface is designed to be userfriendly, simple and intuitive, efficient and economic, meeting usability aspects and focused on a commercial implementation, but not being demanding at the user cognitive level. Preliminary sets of experiments were performed which showed the sensibility of the joystick to extract navigation commands from the user. These signals presented a higher frequency component that was attenuated by a Benedict-Bordner g-h filter. The presented methodology offers an effective cancelation of the undesired components from joystick data, allowing the system to extract in real-time voluntary user鈥檚 navigation commands. Based on this real-time identification of voluntary user鈥檚 commands, an approach to the control architecture of the robotic walker is being developed, in order to obtain stable and safe user assisted locomotion.(undefined

    A 3D-printed passive exoskeleton for upper limb assistance in children with motor disorders: proof of concept through an electromyography-based assessment

    No full text
    The rehabilitation of children with motor disorders is mainly focused on physical interventions. Numerous studies have demonstrated the benefits of upper function using robotic exoskeletons. However, there is still a gap between research and clinical practice, owing to the cost and complexity of these devices. This study presents a proof of concept of a 3D-printed exoskeleton for the upper limb, following a design that replicates the main characteristics of other effective exoskeletons described in the literature. 3D printing enables rapid prototyping, low cost, and easy adjustment to the patient anthropometry. The 3D-printed exoskeleton, called POWERUP, assists the user鈥檚 movement by reducing the effect of gravity, thereby allowing them to perform upper limb exercises. To validate the design, this study performed an electromyography-based assessment of the assistive performance of POWERUP, focusing on the muscular response of both the biceps and triceps during elbow flexion鈥揺xtension movements in 11 healthy children. The Muscle Activity Distribution (MAD) is the proposed metric for the assessment. The results show that (1) the exoskeleton correctly assists elbow flexion, and (2) the proposed metric easily identifies the exoskeleton configuration: statistically significant differences (p-value = 2.26 鈰 10鈭7 0.8) in the mean MAD value were identified for both the biceps and triceps when comparing the transparent mode (no assistance provided) with the assistive mode (anti-gravity effect). Therefore, this metric was proposed as a method for assessing the assistive performance of exoskeletons. Further research is required to determine its usefulness for both the evaluation of selective motor control (SMC) and the impact of robot-assisted therapies

    Accuracy study of the Oculus Touch v2 versus inertial sensor for a single-axis rotation simulating the elbow鈥檚 range of motion

    No full text
    Virtual reality (VR) has emerged as a valid addition to conventional therapy in rehabilitation and sports medicine. This has enabled the development of novel and affordable rehabilitation strategies. However, before VR devices can be used in these situations, they must accurately capture the range of motion of the body-segment where they are mounted. This study aims to state the accuracy of the Oculus Touch v2 controller when used to measure the elbow鈥檚 motion in the sagittal plane. The controller is benchmarked against an inertial sensor (ENLAZA), which has already been validated as a reliable measurement device. We have developed a virtual environment that matches both the Oculus Touch v2 and the inertial sensor orientations using a digital goniometer. We have also collected the orientation measurements given by each system for a set of 17 static angles that cover the full range of normal elbow flexion and hyperextension motion, in 10掳 intervals from 鈭捖10掳 (hyperextension) to 150掳 (flexion). We have applied the intra-rater reliability test to assess the level of agreement between the measurements of these devices, obtaining a value of 0.999, with a 95% confidence interval ranged from 0.996 to 1.000. By analyzing the angle measurement outcomes, we have found that the accuracy degrades at flexion values between 70掳 and 110掳, peaking at 90掳. The accuracy of Oculus Touch v2 when used to capture the elbow鈥檚 flexion motion is good enough for the development of VR rehabilitation applications based on it. However, the flaws in the accuracy that have been revealed in this experimental study must be considered when designing such applications.This research was funded by the SPANISH GOVERNMENT (FEDER/Ministry of Science and Innovation/AEI.), Grant Number RTI2018-097122-A-I00

    An Inexpensive and Easy to Use Cervical Range of Motion Measurement Solution Using Inertial Sensors

    No full text
    Neck injuries and the related pain have a high prevalence and represent an important health problem. To properly diagnose and treat them, practitioners need an accurate system for measuring Cervical Range Of Motion (CROM). This article describes the development and validation of an inexpensive, small (4 cm × 4 cm × 8 cm), light (< 200 g) and easy to use solution for measuring CROM using wearable inertial sensors. The proposed solution has been designed with the clinical practice in mind, after consulting with practitioners. It is composed of: (a) two wearable wireless MEMS-based inertial devices, (b) a recording and report generation software application and (c) a measurement protocol for assessing CROM. The solution provides accurate (none of our results is outside the ROM ranges when compared with previously published results based on an optical tracking device) and reliable measurements (ICC = 0.93 for interrater reliability when compared with an optical tracking device and ICC > 0.90 for test-retest reliability), surpassing the popular CROM instrument’s capabilities and precision. It also fulfills the needs for clinical practice attending to effectiveness, efficiency (4 min from setup to final report) and user’s satisfaction (as reported by practitioners). The solution has been certified for mass-production and use in medical environments

    HYBRID: Ambulatory Robotic Gait Trainer with Movement Induction and Partial Weight Support

    No full text
    Robotic exoskeletons that induce leg movement have proven effective for lower body rehabilitation, but current solutions offer limited gait patterns, lack stabilization, and do not properly stimulate the proprioceptive and balance systems (since the patient remains in place). Partial body weight support (PBWS) systems unload part of the patient’s body weight during rehabilitation, improving the locomotive capabilities and minimizing the muscular effort. HYBRID is a complete system that combines a 6DoF lower body exoskeleton (H1) with a PBWS system (REMOVI) to produce a solution apt for clinical practice that offers improves on existing devices, moves with the patient, offers a gait cycle extracted from the kinematic analysis of healthy users, records the session data, and can easily transfer the patient from a wheelchair to standing position. This system was developed with input from therapists, and its response times have been measured to ensure it works swiftly and without a perceptible delay

    Monitorizaci贸nn de la estabilidad de la marcha con exoesqueletos basada eninformaci贸nn propioceptiva

    No full text
    Trabajo presentado en el Congreso Regional en Instrumentaci贸n Avanzada (CRIA 2014), celebrado en San Jos茅 (Costa Rica) del 17 al 19 de diciembre de 2014.Los robots "vestibles" (Wearable Robots) son dispositivos orientados a la persona, normalmente en formade exoesqueletos. Una manera de caracterizar y establecer la interacci贸n entre los humanos y los WRs es sintetizar el comportamiento y la adaptaci贸n a la marcha. Un problema importante al que se enfrentan estos sistemas es la capacidad de recuperaci贸n ante perturbaciones externas. Este trabajo presenta el sistema utilizado, desarrolla la instrumentaci贸n del mismo, y expone un estudio piloto de estabilidad. El sistema utilizado es un dispositivo de suspensi贸n parcial del peso (Partial Body Weight Support) en combinaci贸n con un exoesqueleto bilateral de miembro inferior. Se presenta adem谩s un algoritmo basado en los sensores de posici贸n angular de las articulaciones del exoesqueleto que permite dar soluci贸n al problema de la estabilidad. El algoritmo proporciona la desviaci贸n del patr贸n de marcha del sujeto en comparaci贸n con el esperado.Este estudio est谩 financiado pro al Comisi贸n Europea dentro del S茅ptimo Programa marco (IFP7-ICT-2013-10-611695:BioMot - Smart Wearable Robots with Bioinspired Sensory-Motor Skills).Peer reviewe

    HYBRID: Ambulatory Robotic Gait Trainer with Movement Induction and Partial Weight Support

    No full text
    Robotic exoskeletons that induce leg movement have proven effective for lower body rehabilitation, but current solutions offer limited gait patterns, lack stabilization, and do not properly stimulate the proprioceptive and balance systems (since the patient remains in place). Partial body weight support (PBWS) systems unload part of the patient鈥檚 body weight during rehabilitation, improving the locomotive capabilities and minimizing the muscular effort. HYBRID is a complete system that combines a 6DoF lower body exoskeleton (H1) with a PBWS system (REMOVI) to produce a solution apt for clinical practice that offers improves on existing devices, moves with the patient, offers a gait cycle extracted from the kinematic analysis of healthy users, records the session data, and can easily transfer the patient from a wheelchair to standing position. This system was developed with input from therapists, and its response times have been measured to ensure it works swiftly and without a perceptible delay.Peer reviewe

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

    Get PDF
    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鈥揝mart Wearable Robots with Bioinspired Sensory-Motor Skills (Grant Agreement number IFP7-ICT-2013-10-611695), also under the ASTONISH Project鈥揂dvancing 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鈥擜 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
    corecore