Control interfaces for active trunk support

People with Duchenne muscular dystrophy (DMD) lose the ability to move due to severe muscular weakness hindering their activities of daily living (ADL). As a consequence, they have difficulties with remaining independent and have to depend on caregivers. Medication cannot prevent or cure DMD but it can increase the life expectancy of patients. Notwithstanding the increase in life expectancy, people with DMD have a lower Health Related Quality of Life (HRQoL) compared to people without DMD. A possible improvement could be achieved with assistive devices to perform ADL and, as a result, to depend less on caregivers.Symbionics (2.1) has been focusing on developing dynamic trunk and head supportive devices for people with neuromuscular disorders to assist them when performing daily activities. Three sub-projects were defined; they investigated user involvement, passive trunk support and active trunk support. User involvement entailed the interaction between the trunk and arm when accomplishing daily tasks. A passive trunk support was designed and tested in an experimental environment by people without and with an early stage of DMD. As the DMD progresses, more assistance is needed which could possibly be provided by an active trunk support. Thus, an active trunk support (which is the focus of this thesis) concentrates on the actuation and control of a passive trunk support.Operating and controlling an active assistive device requires a control interface. The control interface is responsible for converting the intended movement of the user into a device movement. Several control interfaces have been proposed for the control of assistive devices, the most common ones being a joystick, force sensors and sEMG (surface electromyography). We evaluated their performance by building an experimental user-controllable trunk support.The goal of this dissertation, therefore, is to evaluate control interfaces for active trunk support.To this end, several research questions were formulated and investigated:I. Is there an alternative to the intuitive trunk control interface to steer trunk muscles?Current research on the control of orthotic devices that use sEMG signals as control inputs, focuses mainly on muscles that are directly linked to the movement being performed (intuitive control). However, in some cases, it is hard to detect a proper sEMG signal (e.g., when there is a significant amount of fat) or specifically for EMG from trunk muscles, respiratory muscles are located in the trunk as well and can easily disturb the control signal, which can result in poor control performance. A way to overcome this problem might be the introduction of other, non-intuitive forms of control. We performed an explorative, comparative study on the learning behaviour of two different control interfaces, one with trunk muscle sEMGs (intuitive) and one with leg muscle sEMGs (non-intuitive) that can be potentially used for an active trunk support. Six healthy subjects undertook a 2-D Fitts’ law style task. They were asked to steer a cursor towards targets that were radially distributed symmetrically in five directions. II. Which control interface aids an active trunk support better?A feasibility study evaluated control interface performance with a novel trunk support assistive device (Trunk Drive) for adult men with Duchenne Muscular Dystrophy (DMD) namely, joystick, force on sternum, force on feet and sEMG (electromyography). This was done as a discrete position tracking task. We built a one degree of freedom active trunk support device that was tested on 10 healthy men. An experiment, based on Fitts’ law, was conducted for the evaluation. III. Which assistive admittance controller performs best in a 1-D Fitts’ law task?This study was dedicated to the development and assessment of three different admittance control algorithms for a trunk supporting robot; a law with constant parameters, a law with added feedforward force, and a law with variable parameters. A Fitts’-like experiment with 12 healthy subjects was performed to compare the control laws. IV. Do people with DMD generate satisfactory signals which can potentially drive an active trunk support?In a previous study, we showed that healthy people were able to control an active trunk support using four different control interfaces (based on joystick, force on feet, force on sternum and sEMG). All four control interfaces had different advantages and disadvantages. The aim of this study was to explore which of the four inputs could be detectably used by people with DMD to control an active trunk support. Three subjects with DMD participated in two experiments: an active experiment with an active trunk support assistive device and a static experiment without the active trunk support. The challenge in both experiments was to steer the cursor into a target of a graphical user interface using the signals from the different control interfaces. We concluded that, although the non-intuitive force on feet control is one of the best interfaces for people with DMD to control an active trunk support some DMD patients find it easier to use the EMG from their leg muscles. The joystick is the only usable intuitive control interface but, the function of one hand has to be sacrificed. The decision, as to which control interface works best, must be made per individual.<br/

Exercise interventions for adults and children with cerebral palsy (Protocol)

This is the protocol for a review and there is no abstract. The objectives are as follows: - The primary aim of this systematic review is to evaluate the effect of exercise interventions on activity, participation, and health-related quality of life (HRQoL) in adults and children with CP. - The secondary aim is to evaluate the effect of exercise interventions on body functions and body structures.Jennifer M Ryan is receiving funding from Action Medical Research and the Chartered Society of Physiotherapy Charitable Trust to evaluate the feasibility, acceptability, and efficacy of resistance training in adolescents with cerebral palsy

Clinical validation of a novel postural support device for hospitalized sub-acute post stroke wheelchair users

Purpose: We present a novel wheelchair posture support device (WPSD) and its clinical validation. The device was developed in order to assure correct sitting posture and to reduce the time spent by caregivers for re-positioning of hospitalized, wheelchair-bound, post-acute stroke patients. Method: The device was validated with 16 subjects during a period of 5 days in which use of the device was compared with regular care practice. Results: The device was used for the five consecutive days in 69% of patients, while for 6% it was not suitable; 25% did not complete the 5 days for reasons unrelated to the device. Caregivers needed to re-position the patients that used the device for the full 5 days (n=11) on an average 52% less often when using the device, as compared to regular practice. Furthermore, the device was rated as usable and functional by the caregivers while significantly reducing perception of trunk and shoulder pain in patients during its use. Conclusions: The newly designed WPSD is a valuable system for the improvement of medical assistance to wheelchair-bound post-stroke patients by reducing pain and number of re-positioning manoeuvres. The WPSD might be applicable to any group of patients who need posture control in either wheelchair or common chair with arms support.The FIK initiative; funding the development of the Varstiff material technology. Fundaci on Bot ın’s ‘‘Mind the Gap’’ program co-funding the design process of the WPSD. Spherium Biomed co-funding the study with the WPSD

How to Grow Tree Fruits in the Home Garden

PDF pages: 1

Evaluation of cervical posture improvement of children with cerebral palsy after physical therapy based on head movements and serious games

Background: This paper presents the preliminary results of a novel rehabilitation therapy for cervical and trunk control of children with cerebral palsy (CP) based on serious videogames and physical exercise. Materials: The therapy is based on the use of the ENLAZA Interface, a head mouse based on inertial technology that will be used to control a set of serious videogames with movements of the head. Methods: Ten users with CP participated in the study. Whereas the control group (n=5) followed traditional therapies, the experimental group (n=5) complemented these therapies with a series of ten sessions of gaming with ENLAZA to exercise cervical flexion-extensions, rotations and inclinations in a controlled, engaging environment. Results: The ten work sessions yielded improvements in head and trunk control that were higher in the experimental group for Visual Analogue Scale, Goal Attainment Scaling and Trunk Control Measurement Scale (TCMS). Significant differences (27% vs. 2% of percentage improvement) were found between the experimental and control groups for TCMS (p<0.05). The kinematic assessment shows that there were some improvements in the active and the passive range of motion. However, no significant differences were found pre- and post-intervention. Conclusions:Physical therapy that combines serious games with traditional rehabilitation could allow children with CP to achieve larger function improvements in the trunk and cervical regions. However, given the limited scope of this trial (n=10) additional studies are needed to corroborate this hypothesis

Powered exoskeleton for trunk assistance in industrial tasks

L'abstract è presente nell'allegato / the abstract is in the attachmen