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Sample records for rehabilitation robotics pilot

  1. Development and pilot testing of HEXORR: Hand EXOskeleton Rehabilitation Robot

    Directory of Open Access Journals (Sweden)

    Godfrey Sasha B

    2010-07-01

    Full Text Available Abstract Background Following acute therapeutic interventions, the majority of stroke survivors are left with a poorly functioning hemiparetic hand. Rehabilitation robotics has shown promise in providing patients with intensive therapy leading to functional gains. Because of the hand's crucial role in performing activities of daily living, attention to hand therapy has recently increased. Methods This paper introduces a newly developed Hand Exoskeleton Rehabilitation Robot (HEXORR. This device has been designed to provide full range of motion (ROM for all of the hand's digits. The thumb actuator allows for variable thumb plane of motion to incorporate different degrees of extension/flexion and abduction/adduction. Compensation algorithms have been developed to improve the exoskeleton's backdrivability by counteracting gravity, stiction and kinetic friction. We have also designed a force assistance mode that provides extension assistance based on each individual's needs. A pilot study was conducted on 9 unimpaired and 5 chronic stroke subjects to investigate the device's ability to allow physiologically accurate hand movements throughout the full ROM. The study also tested the efficacy of the force assistance mode with the goal of increasing stroke subjects' active ROM while still requiring active extension torque on the part of the subject. Results For 12 of the hand digits'15 joints in neurologically normal subjects, there were no significant ROM differences (P > 0.05 between active movements performed inside and outside of HEXORR. Interjoint coordination was examined in the 1st and 3rd digits, and no differences were found between inside and outside of the device (P > 0.05. Stroke subjects were capable of performing free hand movements inside of the exoskeleton and the force assistance mode was successful in increasing active ROM by 43 ± 5% (P Conclusions Our pilot study shows that this device is capable of moving the hand's digits through

  2. Rehabilitation robotics.

    Science.gov (United States)

    Krebs, H I; Volpe, B T

    2013-01-01

    This chapter focuses on rehabilitation robotics which can be used to augment the clinician's toolbox in order to deliver meaningful restorative therapy for an aging population, as well as on advances in orthotics to augment an individual's functional abilities beyond neurorestoration potential. The interest in rehabilitation robotics and orthotics is increasing steadily with marked growth in the last 10 years. This growth is understandable in view of the increased demand for caregivers and rehabilitation services escalating apace with the graying of the population. We provide an overview on improving function in people with a weak limb due to a neurological disorder who cannot properly control it to interact with the environment (orthotics); we then focus on tools to assist the clinician in promoting rehabilitation of an individual so that s/he can interact with the environment unassisted (rehabilitation robotics). We present a few clinical results occurring immediately poststroke as well as during the chronic phase that demonstrate superior gains for the upper extremity when employing rehabilitation robotics instead of usual care. These include the landmark VA-ROBOTICS multisite, randomized clinical study which demonstrates clinical gains for chronic stroke that go beyond usual care at no additional cost.

  3. Rehabilitation robotics

    Science.gov (United States)

    KREBS, H.I.; VOLPE, B.T.

    2015-01-01

    This chapter focuses on rehabilitation robotics which can be used to augment the clinician’s toolbox in order to deliver meaningful restorative therapy for an aging population, as well as on advances in orthotics to augment an individual’s functional abilities beyond neurorestoration potential. The interest in rehabilitation robotics and orthotics is increasing steadily with marked growth in the last 10 years. This growth is understandable in view of the increased demand for caregivers and rehabilitation services escalating apace with the graying of the population. We will provide an overview on improving function in people with a weak limb due to a neurological disorder who cannot properly control it to interact with the environment (orthotics); we will then focus on tools to assist the clinician in promoting rehabilitation of an individual so that s/he can interact with the environment unassisted (rehabilitation robotics). We will present a few clinical results occurring immediately poststroke as well as during the chronic phase that demonstrate superior gains for the upper extremity when employing rehabilitation robotics instead of usual care. These include the landmark VA-ROBOTICS multisite, randomized clinical study which demonstrates clinical gains for chronic stroke that go beyond usual care at no additional cost. PMID:23312648

  4. Tailor-made rehabilitation approach using multiple types of hybrid assistive limb robots for acute stroke patients: A pilot study.

    Science.gov (United States)

    Fukuda, Hiroyuki; Morishita, Takashi; Ogata, Toshiyasu; Saita, Kazuya; Hyakutake, Koichi; Watanabe, Junko; Shiota, Etsuji; Inoue, Tooru

    2016-01-01

    This article investigated the feasibility of a tailor-made neurorehabilitation approach using multiple types of hybrid assistive limb (HAL) robots for acute stroke patients. We investigated the clinical outcomes of patients who underwent rehabilitation using the HAL robots. The Brunnstrom stage, Barthel index (BI), and functional independence measure (FIM) were evaluated at baseline and when patients were transferred to a rehabilitation facility. Scores were compared between the multiple-robot rehabilitation and single-robot rehabilitation groups. Nine hemiplegic acute stroke patients (five men and four women; mean age 59.4 ± 12.5 years; four hemorrhagic stroke and five ischemic stroke) underwent rehabilitation using multiple types of HAL robots for 19.4 ± 12.5 days, and 14 patients (six men and eight women; mean age 63.2 ± 13.9 years; nine hemorrhagic stroke and five ischemic stroke) underwent rehabilitation using a single type of HAL robot for 14.9 ± 8.9 days. The multiple-robot rehabilitation group showed significantly better outcomes in the Brunnstrom stage of the upper extremity, BI, and FIM scores. To the best of the authors' knowledge, this is the first pilot study demonstrating the feasibility of rehabilitation using multiple exoskeleton robots. The tailor-made rehabilitation approach may be useful for the treatment of acute stroke.

  5. Rehabilitation robotics: pilot trial of a spatial extension for MIT-Manus

    Directory of Open Access Journals (Sweden)

    Krebs Hermano

    2004-10-01

    Full Text Available Abstract Background Previous results with the planar robot MIT-MANUS demonstrated positive benefits in trials with over 250 stroke patients. Consistent with motor learning, the positive effects did not generalize to other muscle groups or limb segments. Therefore we are designing a new class of robots to exercise other muscle groups or limb segments. This paper presents basic engineering aspects of a novel robotic module that extends our approach to anti-gravity movements out of the horizontal plane and a pilot study with 10 outpatients. Patients were trained during the initial six-weeks with the planar module (i.e., performance-based training limited to horizontal movements with gravity compensation. This training was followed by six-weeks of robotic therapy that focused on performing vertical arm movements against gravity. The 12-week protocol includes three one-hour robot therapy sessions per week (total 36 robot treatment sessions. Results Pilot study demonstrated that the protocol was safe and well tolerated with no patient presenting any adverse effect. Consistent with our past experience with persons with chronic strokes, there was a statistically significant reduction in tone measurement from admission to discharge of performance-based planar robot therapy and we have not observed increases in muscle tone or spasticity during the anti-gravity training protocol. Pilot results showed also a reduction in shoulder-elbow impairment following planar horizontal training. Furthermore, it suggested an additional reduction in shoulder-elbow impairment following the anti-gravity training. Conclusion Our clinical experiments have focused on a fundamental question of whether task specific robotic training influences brain recovery. To date several studies demonstrate that in mature and damaged nervous systems, nurture indeed has an effect on nature. The improved recovery is most pronounced in the trained limb segments. We have now embarked on

  6. Robotics in Neuro-Rehabilitation

    National Research Council Canada - National Science Library

    Pignolo, Loris

    2009-01-01

    Objective: The aims of this study were to review robot-assisted motor and functional rehabilitation of the upper limb in patients with stroke and to outline possible clinical applications of robotics in neuro-rehabilitation. Methods...

  7. Recent Development of Rehabilitation Robots

    Directory of Open Access Journals (Sweden)

    Zhiqin Qian

    2015-02-01

    Full Text Available We have conducted a critical review on the development of rehabilitation robots to identify the limitations of existing studies and clarify some promising research directions in this field. This paper is presented to summarize our findings and understanding. The demands for assistive technologies for elderly and disabled population have been discussed, the advantages and disadvantages of rehabilitation robots as assistive technologies have been explored, the issues involved in the development of rehabilitation robots are investigated, some representative robots in this field by leading research institutes have been introduced, and a few of critical challenges in developing advanced rehabilitation robots have been identified. Finally to meet the challenges of developing practical rehabilitation robots, reconfigurable and modular systems have been proposed to meet the identified challenges, and a few of critical areas leading to the potential success of rehabilitation robots have been discussed.

  8. The Resonating Arm Exerciser: design and pilot testing of a mechanically passive rehabilitation device that mimics robotic active assistance.

    Science.gov (United States)

    Zondervan, Daniel K; Palafox, Lorena; Hernandez, Jorge; Reinkensmeyer, David J

    2013-04-18

    Robotic arm therapy devices that incorporate actuated assistance can enhance arm recovery, motivate patients to practice, and allow therapists to deliver semi-autonomous training. However, because such devices are often complex and actively apply forces, they have not achieved widespread use in rehabilitation clinics or at home. This paper describes the design and pilot testing of a simple, mechanically passive device that provides robot-like assistance for active arm training using the principle of mechanical resonance. The Resonating Arm Exerciser (RAE) consists of a lever that attaches to the push rim of a wheelchair, a forearm support, and an elastic band that stores energy. Patients push and pull on the lever to roll the wheelchair back and forth by about 20 cm around a neutral position. We performed two separate pilot studies of the device. In the first, we tested whether the predicted resonant properties of RAE amplified a user's arm mobility by comparing his or her active range of motion (AROM) in the device achieved during a single, sustained push and pull to the AROM achieved during rocking. In a second pilot study designed to test the therapeutic potential of the device, eight participants with chronic stroke (35 ± 24 months since injury) and a mean, stable, initial upper extremity Fugl-Meyer (FM) score of 17 ± 8 / 66 exercised with RAE for eight 45 minute sessions over three weeks. The primary outcome measure was the average AROM measured with a tilt sensor during a one minute test, and the secondary outcome measures were the FM score and the visual analog scale for arm pain. In the first pilot study, we found people with a severe motor impairment after stroke intuitively found the resonant frequency of the chair, and the mechanical resonance of RAE amplified their arm AROM by a factor of about 2. In the second pilot study, AROM increased by 66% ± 20% (p = 0.003). The mean FM score increase was 8.5 ± 4 pts (p = 0.009). Subjects did not report

  9. Cardiovascular rehabilitation soon after stroke using feedback-controlled robotics-assisted treadmill exercise: study protocol of a randomised controlled pilot trial.

    Science.gov (United States)

    Stoller, Oliver; de Bruin, Eling D; Schuster-Amft, Corina; Schindelholz, Matthias; de Bie, Rob A; Hunt, Kenneth J

    2013-09-22

    After experiencing a stroke, most individuals also suffer from cardiac disease, are immobile and thus have low endurance for exercise. Aerobic capacity is seriously reduced in these individuals and does not reach reasonable levels after conventional rehabilitation programmes. Cardiovascular exercise is beneficial for improvement of aerobic capacity in mild to moderate stroke. However, less is known about its impact on aerobic capacity, motor recovery, and quality-of-life in severely impaired individuals. The aim of this pilot study is to explore the clinical efficacy and feasibility of cardiovascular exercise with regard to aerobic capacity, motor recovery, and quality-of-life using feedback-controlled robotics-assisted treadmill exercise in non-ambulatory individuals soon after experiencing a stroke. This will be a single-centred single blind, randomised control trial with a pre-post intervention design. Subjects will be recruited early after their first stroke (≤20 weeks) at a neurological rehabilitation clinic and will be randomly allocated to an inpatient cardiovascular exercise programme that uses feedback-controlled robotics-assisted treadmill exercise (experimental) or to conventional robotics-assisted treadmill exercise (control). Intervention duration depends on the duration of each subject's inpatient rehabilitation period. Aerobic capacity, as the primary outcome measure, will be assessed using feedback-controlled robotics-assisted treadmill-based cardiopulmonary exercise testing. Secondary outcome measures will include gait speed, walking endurance, standing function, and quality-of-life. Outcome assessment will be conducted at baseline, after each 4-week intervention period, and before clinical discharge. Ethical approval has been obtained. Whether cardiovascular exercise in non-ambulatory individuals early after stroke has an impact on aerobic capacity, motor recovery, and quality-of-life is not yet known. Feedback-controlled robotics

  10. Robot-assisted Therapy in Stroke Rehabilitation

    OpenAIRE

    Chang, Won Hyuk; Kim, Yun-Hee

    2013-01-01

    Research into rehabilitation robotics has grown rapidly and the number of therapeutic rehabilitation robots has expanded dramatically during the last two decades. Robotic rehabilitation therapy can deliver high-dosage and high-intensity training, making it useful for patients with motor disorders caused by stroke or spinal cord disease. Robotic devices used for motor rehabilitation include end-effector and exoskeleton types; herein, we review the clinical use of both types. One application of...

  11. Development of Activity-Related Muscle Fatigue during Robot-Mediated Upper Limb Rehabilitation Training in Persons with Multiple Sclerosis: A Pilot Trial

    Directory of Open Access Journals (Sweden)

    Johanna Renny Octavia

    2015-01-01

    Full Text Available Robot-assisted rehabilitation facilitates high-intensity training of the impaired upper limb in neurological rehabilitation. It has been clinically observed that persons with Multiple Sclerosis (MS have difficulties in sustaining the training intensity during a session due to the development of activity-related muscle fatigue. An experimental observational pilot study was conducted to examine whether or not the muscle fatigue develops in MS patients during one session of robot-assisted training within a virtual learning environment. Six MS patients with upper limb impairment (motricity index ranging from 50 to 91/100 and six healthy persons completed five training bouts of three minutes each performing lifting tasks, while EMG signals of anterior deltoid and lower trapezius muscles were measured and their subjective perceptions on muscle fatigue were registered. Decreased performance and higher subjective fatigue perception were present in the MS group. Increased mean EMG amplitudes and subjective perception levels on muscle fatigue were observed in both groups. Muscle fatigue development during 15′ training has been demonstrated in the arm of MS patients, which influences the sustainability of training intensity in MS patients. To optimize the training performance, adaptivity based on the detection of MS patient’s muscle fatigue could be provided by means of training program adjustment.

  12. Compliant actuation of rehabilitation robots

    NARCIS (Netherlands)

    Vallery, Heike; Veneman, Jan; Asseldonk, van Edwin; Ekkelenkamp, Ralf; Buss, Martin; Kooij, van der Herman

    2008-01-01

    This article discusses the pros and cons of compliant actuation for rehabilitation robots on the example of LOPES, focusing on the cons. After illustrating the bandwidth limitations, a new result has been derived: if stability in terms of passivity of the haptic device is desired, the renderable sti

  13. Biofeedback for robotic gait rehabilitation

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    Colombo Gery

    2007-01-01

    Full Text Available Abstract Background Development and increasing acceptance of rehabilitation robots as well as advances in technology allow new forms of therapy for patients with neurological disorders. Robot-assisted gait therapy can increase the training duration and the intensity for the patients while reducing the physical strain for the therapist. Optimal training effects during gait therapy generally depend on appropriate feedback about performance. Compared to manual treadmill therapy, there is a loss of physical interaction between therapist and patient with robotic gait retraining. Thus, it is difficult for the therapist to assess the necessary feedback and instructions. The aim of this study was to define a biofeedback system for a gait training robot and test its usability in subjects without neurological disorders. Methods To provide an overview of biofeedback and motivation methods applied in gait rehabilitation, previous publications and results from our own research are reviewed. A biofeedback method is presented showing how a rehabilitation robot can assess the patients' performance and deliver augmented feedback. For validation, three subjects without neurological disorders walked in a rehabilitation robot for treadmill training. Several training parameters, such as body weight support and treadmill speed, were varied to assess the robustness of the biofeedback calculation to confounding factors. Results The biofeedback values correlated well with the different activity levels of the subjects. Changes in body weight support and treadmill velocity had a minor effect on the biofeedback values. The synchronization of the robot and the treadmill affected the biofeedback values describing the stance phase. Conclusion Robot-aided assessment and feedback can extend and improve robot-aided training devices. The presented method estimates the patients' gait performance with the use of the robot's existing sensors, and displays the resulting biofeedback

  14. Socially assistive robotics for post-stroke rehabilitation

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    Matarić, Maja J; Eriksson, Jon; Feil-Seifer, David J; Winstein, Carolee J

    2007-01-01

    Background Although there is a great deal of success in rehabilitative robotics applied to patient recovery post stroke, most of the research to date has dealt with providing physical assistance. However, new rehabilitation studies support the theory that not all therapy need be hands-on. We describe a new area, called socially assistive robotics, that focuses on non-contact patient/user assistance. We demonstrate the approach with an implemented and tested post-stroke recovery robot and discuss its potential for effectiveness. Results We describe a pilot study involving an autonomous assistive mobile robot that aids stroke patient rehabilitation by providing monitoring, encouragement, and reminders. The robot navigates autonomously, monitors the patient's arm activity, and helps the patient remember to follow a rehabilitation program. We also show preliminary results from a follow-up study that focused on the role of robot physical embodiment in a rehabilitation context. Conclusion We outline and discuss future experimental designs and factors toward the development of effective socially assistive post-stroke rehabilitation robots. PMID:17309795

  15. Socially assistive robotics for post-stroke rehabilitation

    Directory of Open Access Journals (Sweden)

    Feil-Seifer David J

    2007-02-01

    Full Text Available Abstract Background Although there is a great deal of success in rehabilitative robotics applied to patient recovery post stroke, most of the research to date has dealt with providing physical assistance. However, new rehabilitation studies support the theory that not all therapy need be hands-on. We describe a new area, called socially assistive robotics, that focuses on non-contact patient/user assistance. We demonstrate the approach with an implemented and tested post-stroke recovery robot and discuss its potential for effectiveness. Results We describe a pilot study involving an autonomous assistive mobile robot that aids stroke patient rehabilitation by providing monitoring, encouragement, and reminders. The robot navigates autonomously, monitors the patient's arm activity, and helps the patient remember to follow a rehabilitation program. We also show preliminary results from a follow-up study that focused on the role of robot physical embodiment in a rehabilitation context. Conclusion We outline and discuss future experimental designs and factors toward the development of effective socially assistive post-stroke rehabilitation robots.

  16. [Rehabilitation and nursing-care robots].

    Science.gov (United States)

    Hachisuka, Kenji

    2016-04-01

    In the extremely aged society, rehabilitation staff will be required to provide ample rehabilitation training for more stroke patients and more aged people with disabilities despite limitations in human resources. A nursing-care robot is one potential solution from the standpoint of rehabilitation. The nursing-care robot is defined as a robot which assists aged people and persons with disabilities in daily life and social life activities. The nursing-care robot consists of an independent support robot, caregiver support robot, and life support robot. Although many nursing-care robots have been developed, the most appropriate robot must be selected according to its features and the needs of patients and caregivers in the field of nursing-care.

  17. A pilot study on the optimal speeds for passive wrist movements by a rehabilitation robot of stroke patients: A functional NIRS study.

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    Bae, Sung Jin; Jang, Sung Ho; Seo, Jeong Pyo; Chang, Pyung Hun

    2017-07-01

    The optimal conditions inducing proper brain activation during performance of rehabilitation robots should be examined to enhance the efficiency of robot rehabilitation based on the concept of brain plasticity. In this study, we attempted to investigate differences in cortical activation according to the speeds of passive wrist movements performed by a rehabilitation robot for stroke patients. 9 stroke patients with right hemiparesis participated in this study. Passive movements of the affected wrist were performed by the rehabilitation robot at three different speeds: 0.25 Hz; slow, 0.5Hz; moderate and 0.75 Hz; fast. We used functional near-infrared spectroscopy to measure the brain activity during the passive movements performed by a robot. Group-average activation map and the relative changes in oxy-hemoglobin (ΔOxyHb) in two regions of interest: the primary sensory-motor cortex (SM1); premotor area (PMA) and region of all channels were measured. In the result of group-averaged activation map, the contralateral SM1, PMA and somatosensory association cortex (SAC) showed the greatest significant activation according to the movements at 0.75 Hz, while there is no significantly activated area at 0.5 Hz. Regarding ΔOxyHb, no significant diiference was observed among three speeds regardless of region. In conclusion, the contralateral SM1, PMA and SAC showed the greatest activation by a fast speed (0.75 Hz) rather than slow (0.25 Hz) and moderate (0. 5 Hz) speed. Our results suggest an optimal speed for execution of the wrist rehabilitation robot. Therefore, we believe that our findings might point to several promising applications for future research regarding useful and empirically-based robot rehabilitation therapy.

  18. Lower-Limb Rehabilitation Robot Design

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    Bouhabba, E. M.; Shafie, A. A.; Khan, M. R.; Ariffin, K.

    2013-12-01

    It is a general assumption that robotics will play an important role in therapy activities within rehabilitation treatment. In the last decade, the interest in the field has grown exponentially mainly due to the initial success of the early systems and the growing demand caused by increasing numbers of stroke patients and their associate rehabilitation costs. As a result, robot therapy systems have been developed worldwide for training of both the upper and lower extremities. This paper investigates and proposes a lower-limb rehabilitation robot that is used to help patients with lower-limb paralysis to improve and resume physical functions. The proposed rehabilitation robot features three rotary joints forced by electric motors providing linear motions. The paper covers mechanism design and optimization, kinematics analysis, trajectory planning, wearable sensors, and the control system design. The design and control system demonstrate that the proposed rehabilitation robot is safe and reliable with the effective design and better kinematic performance.

  19. Pneumatic robotic systems for upper limb rehabilitation.

    Science.gov (United States)

    Morales, Ricardo; Badesa, Francisco Javier; García-Aracil, Nicolás; Sabater, José María; Pérez-Vidal, Carlos

    2011-10-01

    The aim of rehabilitation robotic area is to research on the application of robotic devices to therapeutic procedures. The goal is to achieve the best possible motor, cognitive and functional recovery for people with impairments following various diseases. Pneumatic actuators are attractive for robotic rehabilitation applications because they are lightweight, powerful, and compliant, but their control has historically been difficult, limiting their use. This article first reviews the current state-of-art in rehabilitation robotic devices with pneumatic actuation systems reporting main features and control issues of each therapeutic device. Then, a new pneumatic rehabilitation robot for proprioceptive neuromuscular facilitation therapies and for relearning daily living skills: like taking a glass, drinking, and placing object on shelves is described as a case study and compared with the current pneumatic rehabilitation devices.

  20. Simple Obstacle Avoidance Algorithm for Rehabilitation Robots

    NARCIS (Netherlands)

    Stuyt, F.H.A.; Römer, G.R.B.; Stuyt, H.J.A.

    2007-01-01

    The efficiency of a rehabilitation robot is improved by offering record-and-replay to operate the robot. While automatically moving to a stored target (replay) collisions of the robot with obstacles in its work space must be avoided. A simple, though effective, generic and deterministic algorithm fo

  1. Rehabilitation robotics ontology on the cloud.

    Science.gov (United States)

    Dogmus, Zeynep; Papantoniou, Agis; Kilinc, Muhammed; Yildirim, Sibel A; Erdem, Esra; Patoglu, Volkan

    2013-06-01

    We introduce the first formal rehabilitation robotics ontology, called RehabRobo-Onto, to represent information about rehabilitation robots and their properties; and a software system RehabRobo-Query to facilitate access to this ontology. RehabRobo-Query is made available on the cloud, utilizing Amazon Web services, so that 1) rehabilitation robot designers around the world can add/modify information about their robots in RehabRobo-Onto, and 2) rehabilitation robot designers and physical medicine experts around the world can access the knowledge in RehabRobo-Onto by means of questions about robots, in natural language, with the guide of the intelligent userinterface of RehabRobo-Query. The ontology system consisting of RehabRobo-Onto and RehabRobo-Query is of great value to robot designers as well as physical therapists and medical doctors. On the one hand, robot designers can access various properties of the existing robots and to the related publications to further improve the state-of-the-art. On the other hand, physical therapists and medical doctors can utilize the ontology to compare rehabilitation robots and to identify the ones that serve best to cover their needs, or to evaluate the effects of various devices for targeted joint exercises on patients with specific disorders.

  2. [Robot-aided training in rehabilitation].

    Science.gov (United States)

    Hachisuka, Kenji

    2010-02-01

    Recently, new training techniques that involve the use of robots have been used in the rehabilitation of patients with hemiplegia and paraplegia. Robots used for training the arm include the MIT-MANUS, Arm Trainer, mirror-image motion enabler (MIME) robot, and the assisted rehabilitation and measurement (ARM) Guide. Robots that are used for lower-limb training are the Rehabot, Gait Trainer, Lokomat, LOPES Exoskeleton Robot, and Gait Assist Robot. Robot-aided therapy has enabled the functional training of the arm and the lower limbs in an effective, easy, and comfortable manner. Therefore, with this type of therapy, the patients can repeatedly undergo sufficient and accurate training for a prolonged period. However, evidence of the benefits of robot-aided training has not yet been established.

  3. Rehabilitation Robots: Concepts and Applications in Stroke Rehabilitation

    Directory of Open Access Journals (Sweden)

    Mohammad Ali Ahmadi-Pajouh

    2017-02-01

    Full Text Available Robotics is a tool to assist human in different applications from industry to medicine. There are many reasons that human tends to use these machines. They are very reliable in repetitive, high precision, preprogrammed and high risk jobs in which human is not too good enough. In medicine, robotic applications are evolving so fast that in near future nobody can imagine a surgery without a robot involved. In Rehabilitation we have the same scenario; there are commercialized robots to assist disable people to eat and perform daily activities. There are also clinical rehabilitation robots which can train handicaps. They can help subjects as a passive tool that improves low level impairments such as rigidity. On the other hand robots can train brain as an active tool to have a better movement again. We will see how robots can help therapist to apply repetitive passive movements in quadriplegic subject (i.e. in Brunnstrom stages 1 to 3. On the other hand they can teach subjects how to complete a task in an active manner (i.e. in stages 5 and 6 which can facilitate neuroplasticity. There are different robots designed for different organs; for example rehabilitation of upper extremities (e.g. Gloreha or lower extremities (e.g. Lokomat. There are also exoskeleton robots to help subjects to grip objects and perform ADLs easily (e.g. Bioservo or help paraplegic patient to walk again (e.g. Rewalk. In this talk, we will also discuss about how robots are helping rehab specialist to improve standard protocols. For example we will show how action observation therapy, bimanual therapy, assistive active therapy, proprioceptive facilitation and passive mobilization therapy are realized using an upper extremity rehabilitation robot. Robotics is the future of technology and rehabilitation needs this technology. Be part of this technology!

  4. Robot-mediated ACtive REhabilitation (ACRE2) for the hemiplegic upper limb after a stroke: A pilot study

    NARCIS (Netherlands)

    Doornebosch, A.J.; Cools, H.J.M.; Slee-Turkenburg, M.E.C.; Elk, M.G. van; Schoone-Harmsen, M.

    2007-01-01

    Although scientific evidence shows that therapy improves movement recovery following a stroke, the duration of the reimbursed therapy available to patients is decreasing. To compensate for the reduction in personal therapy self-training procedures using robotic arms have been developed for

  5. Robot-mediated ACtive REhabilitation (ACRE2) for the hemiplegic upper limb after a stroke: A pilot study

    NARCIS (Netherlands)

    Doornebosch, A.J.; Cools, H.J.M.; Slee-Turkenburg, M.E.C.; Elk, M.G. van; Schoone-Harmsen, M.

    2007-01-01

    Although scientific evidence shows that therapy improves movement recovery following a stroke, the duration of the reimbursed therapy available to patients is decreasing. To compensate for the reduction in personal therapy self-training procedures using robotic arms have been developed for hemiplegi

  6. Bilateral robotic priming before task-oriented approach in subacute stroke rehabilitation: a pilot randomized controlled trial.

    Science.gov (United States)

    Hsieh, Yu-Wei; Wu, Ching-Yi; Wang, Wei-En; Lin, Keh-Chung; Chang, Ku-Chou; Chen, Chih-Chi; Liu, Chien-Ting

    2017-02-01

    To investigate the treatment effects of bilateral robotic priming combined with the task-oriented approach on motor impairment, disability, daily function, and quality of life in patients with subacute stroke. A randomized controlled trial. Occupational therapy clinics in medical centers. Thirty-one subacute stroke patients were recruited. Participants were randomly assigned to receive bilateral priming combined with the task-oriented approach (i.e., primed group) or to the task-oriented approach alone (i.e., unprimed group) for 90 minutes/day, 5 days/week for 4 weeks. The primed group began with the bilateral priming technique by using a bimanual robot-aided device. Motor impairments were assessed by the Fugal-Meyer Assessment, grip strength, and the Box and Block Test. Disability and daily function were measured by the modified Rankin Scale, the Functional Independence Measure, and actigraphy. Quality of life was examined by the Stroke Impact Scale. The primed and unprimed groups improved significantly on most outcomes over time. The primed group demonstrated significantly better improvement on the Stroke Impact Scale strength subscale ( p = 0.012) and a trend for greater improvement on the modified Rankin Scale ( p = 0.065) than the unprimed group. Bilateral priming combined with the task-oriented approach elicited more improvements in self-reported strength and disability degrees than the task-oriented approach by itself. Further large-scale research with at least 31 participants in each intervention group is suggested to confirm the study findings.

  7. Robotics in Upper Limb Rehabilitation Nursing : A Literature Review

    OpenAIRE

    2016-01-01

    Purpose of this final thesis is to view what kind of robots there are in use in stroke rehabilitation nursing, focusing on upper limb rehabilitation. At the same time this work will view the attitudes of patients and therapist towards robotics in the health care field. Robots are present and with robots engineers are trying to develop the health care services. Robots have come to different health care fields different technology is used in rehabilitation nursing. Robots help patients to r...

  8. Robot-assisted Therapy in Stroke Rehabilitation.

    Science.gov (United States)

    Chang, Won Hyuk; Kim, Yun-Hee

    2013-09-01

    Research into rehabilitation robotics has grown rapidly and the number of therapeutic rehabilitation robots has expanded dramatically during the last two decades. Robotic rehabilitation therapy can deliver high-dosage and high-intensity training, making it useful for patients with motor disorders caused by stroke or spinal cord disease. Robotic devices used for motor rehabilitation include end-effector and exoskeleton types; herein, we review the clinical use of both types. One application of robot-assisted therapy is improvement of gait function in patients with stroke. Both end-effector and the exoskeleton devices have proven to be effective complements to conventional physiotherapy in patients with subacute stroke, but there is no clear evidence that robotic gait training is superior to conventional physiotherapy in patients with chronic stroke or when delivered alone. In another application, upper limb motor function training in patients recovering from stroke, robot-assisted therapy was comparable or superior to conventional therapy in patients with subacute stroke. With end-effector devices, the intensity of therapy was the most important determinant of upper limb motor recovery. However, there is insufficient evidence for the use of exoskeleton devices for upper limb motor function in patients with stroke. For rehabilitation of hand motor function, either end-effector and exoskeleton devices showed similar or additive effects relative to conventional therapy in patients with chronic stroke. The present evidence supports the use of robot-assisted therapy for improving motor function in stroke patients as an additional therapeutic intervention in combination with the conventional rehabilitation therapies. Nevertheless, there will be substantial opportunities for technical development in near future.

  9. ROAD: domestic assistant and rehabilitation robot.

    Science.gov (United States)

    Carrera, Isela; Moreno, Héctor A; Saltarén, Roque; Pérez, Carlos; Puglisi, Lisandro; Garcia, Cecilia

    2011-10-01

    This study introduces the concept design and analysis of a robotic system for the assistance and rehabilitation of disabled people. Based on the statistical data of the most common types of disabilities in Spain and other industrialized countries, the different tasks that the device must be able to perform have been determined. In this study, different robots for rehabilitation and assistance previously introduced have been reviewed. This survey is focused on those robots that assist with gait, balance and standing up. The structure of the ROAD robot presents various advantages over these robots, we discuss some of them. The performance of the proposed architecture is analyzed when it performs the sit to stand activity.

  10. Technology-assisted stroke rehabilitation in Mexico: a pilot randomized trial comparing traditional therapy to circuit training in a Robot/technology-assisted therapy gym.

    Science.gov (United States)

    Bustamante Valles, Karla; Montes, Sandra; Madrigal, Maria de Jesus; Burciaga, Adan; Martínez, María Elena; Johnson, Michelle J

    2016-09-15

    Stroke rehabilitation in low- and middle-income countries, such as Mexico, is often hampered by lack of clinical resources and funding. To provide a cost-effective solution for comprehensive post-stroke rehabilitation that can alleviate the need for one-on-one physical or occupational therapy, in lower and upper extremities, we proposed and implemented a technology-assisted rehabilitation gymnasium in Chihuahua, Mexico. The Gymnasium for Robotic Rehabilitation (Robot Gym) consisted of low- and high-tech systems for upper and lower limb rehabilitation. Our hypothesis is that the Robot Gym can provide a cost- and labor-efficient alternative for post-stroke rehabilitation, while being more or as effective as traditional physical and occupational therapy approaches. A typical group of stroke patients was randomly allocated to an intervention (n = 10) or a control group (n = 10). The intervention group received rehabilitation using the devices in the Robot Gym, whereas the control group (n = 10) received time-matched standard care. All of the study subjects were subjected to 24 two-hour therapy sessions over a period of 6 to 8 weeks. Several clinical assessments tests for upper and lower extremities were used to evaluate motor function pre- and post-intervention. A cost analysis was done to compare the cost effectiveness for both therapies. No significant differences were observed when comparing the results of the pre-intervention Mini-mental, Brunnstrom Test, and Geriatric Depression Scale Test, showing that both groups were functionally similar prior to the intervention. Although, both training groups were functionally equivalent, they had a significant age difference. The results of all of the upper extremity tests showed an improvement in function in both groups with no statistically significant differences between the groups. The Fugl-Meyer and the 10 Meters Walk lower extremity tests showed greater improvement in the intervention group compared to the

  11. An EMG-Controlled Robotic Hand Exoskeleton for Bilateral Rehabilitation.

    Science.gov (United States)

    Leonardis, Daniele; Barsotti, Michele; Loconsole, Claudio; Solazzi, Massimiliano; Troncossi, Marco; Mazzotti, Claudio; Castelli, Vincenzo Parenti; Procopio, Caterina; Lamola, Giuseppe; Chisari, Carmelo; Bergamasco, Massimo; Frisoli, Antonio

    2015-01-01

    This paper presents a novel electromyography (EMG)-driven hand exoskeleton for bilateral rehabilitation of grasping in stroke. The developed hand exoskeleton was designed with two distinctive features: (a) kinematics with intrinsic adaptability to patient's hand size, and (b) free-palm and free-fingertip design, preserving the residual sensory perceptual capability of touch during assistance in grasping of real objects. In the envisaged bilateral training strategy, the patient's non paretic hand acted as guidance for the paretic hand in grasping tasks. Grasping force exerted by the non paretic hand was estimated in real-time from EMG signals, and then replicated as robotic assistance for the paretic hand by means of the hand-exoskeleton. Estimation of the grasping force through EMG allowed to perform rehabilitation exercises with any, non sensorized, graspable objects. This paper presents the system design, development, and experimental evaluation. Experiments were performed within a group of six healthy subjects and two chronic stroke patients, executing robotic-assisted grasping tasks. Results related to performance in estimation and modulation of the robotic assistance, and to the outcomes of the pilot rehabilitation sessions with stroke patients, positively support validity of the proposed approach for application in stroke rehabilitation.

  12. Parallel Robot for Lower Limb Rehabilitation Exercises

    Science.gov (United States)

    Saadat, Mozafar; Borboni, Alberto

    2016-01-01

    The aim of this study is to investigate the capability of a 6-DoF parallel robot to perform various rehabilitation exercises. The foot trajectories of twenty healthy participants have been measured by a Vicon system during the performing of four different exercises. Based on the kinematics and dynamics of a parallel robot, a MATLAB program was developed in order to calculate the length of the actuators, the actuators' forces, workspace, and singularity locus of the robot during the performing of the exercises. The calculated length of the actuators and the actuators' forces were used by motion analysis in SolidWorks in order to simulate different foot trajectories by the CAD model of the robot. A physical parallel robot prototype was built in order to simulate and execute the foot trajectories of the participants. Kinect camera was used to track the motion of the leg's model placed on the robot. The results demonstrate the robot's capability to perform a full range of various rehabilitation exercises. PMID:27799727

  13. Parallel Robot for Lower Limb Rehabilitation Exercises.

    Science.gov (United States)

    Rastegarpanah, Alireza; Saadat, Mozafar; Borboni, Alberto

    2016-01-01

    The aim of this study is to investigate the capability of a 6-DoF parallel robot to perform various rehabilitation exercises. The foot trajectories of twenty healthy participants have been measured by a Vicon system during the performing of four different exercises. Based on the kinematics and dynamics of a parallel robot, a MATLAB program was developed in order to calculate the length of the actuators, the actuators' forces, workspace, and singularity locus of the robot during the performing of the exercises. The calculated length of the actuators and the actuators' forces were used by motion analysis in SolidWorks in order to simulate different foot trajectories by the CAD model of the robot. A physical parallel robot prototype was built in order to simulate and execute the foot trajectories of the participants. Kinect camera was used to track the motion of the leg's model placed on the robot. The results demonstrate the robot's capability to perform a full range of various rehabilitation exercises.

  14. Arm-eye coordination test to objectively quantify motor performance and muscles activation in persons after stroke undergoing robot-aided rehabilitation training: a pilot study.

    Science.gov (United States)

    Song, Rong; Tong, Kai-Yu; Hu, Xiaoling; Li, Le; Sun, Rui

    2013-09-01

    This study designed an arm-eye coordination test to investigate the effectiveness of the robot-aided rehabilitation for persons after stroke. Six chronic poststroke subjects were recruited to attend a 20-session robot-aided rehabilitation training of elbow joint. Before and after the training program, subjects were asked to perform voluntary movements of elbow flection and extension by following sinusoidal trajectories at different velocities with visual feedback on their joint positions. The elbow angle and the electromyographic signal of biceps and triceps as well as clinical scores were evaluated together with the parameters. Performance was objectively quantified by root mean square error (RMSE), root mean square jerk (RMSJ), range of motion (ROM), and co-contraction index (CI). After 20 sessions, RMSE and ROM improved significantly in both the affected and the unaffected side based on two-way ANOVA (P effects of different types of treatment and design progress-based training method to accelerate the processes of recovery.

  15. Robotic arm skate for stroke rehabilitation.

    Science.gov (United States)

    Wong, Chee Kit; Jordan, Kimberlee; King, Marcus

    2011-01-01

    Upper limb paresis after stroke greatly affects the performance of Activities of Daily Living (ADL). Unfortunately, rehabilitation for upper limb impairment can have poor results. The current robot-assisted devices are expensive and not readily accessible for homecare. This paper presents the development of a low-cost tabletop robotic device for upper limb rehabilitation. Conceptually, patients perform computer-based goal-directed tasks using the robotic platform. Their progress is monitored and intervention, in the form of assistance or resistance, is introduced accordingly. A prototype platform is described. Experiments demonstrate the ability of the device to provide the necessary forces during movement exercises, in relation to task completion progress, device and target location. Appropriate exercises need to be developed before clinical trials can proceed. © 2011 CROWN

  16. Parallel Robot for Lower Limb Rehabilitation Exercises

    Directory of Open Access Journals (Sweden)

    Alireza Rastegarpanah

    2016-01-01

    Full Text Available The aim of this study is to investigate the capability of a 6-DoF parallel robot to perform various rehabilitation exercises. The foot trajectories of twenty healthy participants have been measured by a Vicon system during the performing of four different exercises. Based on the kinematics and dynamics of a parallel robot, a MATLAB program was developed in order to calculate the length of the actuators, the actuators’ forces, workspace, and singularity locus of the robot during the performing of the exercises. The calculated length of the actuators and the actuators’ forces were used by motion analysis in SolidWorks in order to simulate different foot trajectories by the CAD model of the robot. A physical parallel robot prototype was built in order to simulate and execute the foot trajectories of the participants. Kinect camera was used to track the motion of the leg’s model placed on the robot. The results demonstrate the robot’s capability to perform a full range of various rehabilitation exercises.

  17. Adaptive strategy for multi-user robotic rehabilitation games.

    Science.gov (United States)

    Caurin, Glauco A P; Siqueira, Adriano A G; Andrade, Kleber O; Joaquim, Ricardo C; Krebs, Hermano I

    2011-01-01

    In this paper, we discuss a strategy for the adaptation of the "difficulty level" in games intended to include motor planning during robotic rehabilitation. We consider concurrently the motivation of the user and his/her performance in a Pong game. User motivation is classified in three levels (not motivated, well motivated and overloaded). User performance is measured as a combination of knowledge of results--achieved goals and score points in the game--and knowledge of performance--joint displacement, speed, aiming, user work, etc. Initial results of a pilot test with unimpaired healthy young volunteers are also presented showing a tendency for individualization of the parameter values.

  18. Myoelectric Control Techniques for a Rehabilitation Robot

    Directory of Open Access Journals (Sweden)

    Alan Smith

    2011-01-01

    Full Text Available This work examines two different types of myoelectric control schemes for the purpose of rehabilitation robot applications. The first is a commonly used technique based on a Gaussian classifier. It is implemented in real time for healthy subjects in addition to a subject with Central Cord Syndrome (CCS. The myoelectric control scheme is used to control three degrees of freedom (DOF on a robot manipulator which corresponded to the robot's elbow joint, wrist joint, and gripper. The classes of motion controlled include elbow flexion and extension, wrist pronation and supination, hand grasping and releasing, and rest. Healthy subjects were able to achieve 90% accuracy. Single DOF controllers were first tested on the subject with CCS and he achieved 100%, 96%, and 85% accuracy for the elbow, gripper, and wrist controllers respectively. Secondly, he was able to control the three DOF controller at 68% accuracy. The potential applications for this scheme are rehabilitation and teleoperation. To overcome limitations in the pattern recognition based scheme, a second myoelectric control scheme is also presented which is trained using electromyographic (EMG data derived from natural reaching motions in the sagittal plane. This second scheme is based on a time delayed neural network (TDNN which has the ability to control multiple DOF at once. The controller tracked a subject's elbow and shoulder joints in the sagittal plane. Results showed an average error of 19° for the two joints. This myoelectric control scheme has the potential of being used in the development of exoskeleton and orthotic rehabilitation applications.

  19. Towards Rehabilitation Robotics: Off-the-Shelf BCI Control of Anthropomorphic Robotic Arms

    Science.gov (United States)

    Xygonakis, Ioannis; Pandria, Niki; Kartsidis, Panagiotis; Arfaras, George; Kavazidi, Kyriaki Rafailia; Foroglou, Nicolas

    2017-01-01

    Advances in neural interfaces have demonstrated remarkable results in the direction of replacing and restoring lost sensorimotor function in human patients. Noninvasive brain-computer interfaces (BCIs) are popular due to considerable advantages including simplicity, safety, and low cost, while recent advances aim at improving past technological and neurophysiological limitations. Taking into account the neurophysiological alterations of disabled individuals, investigating brain connectivity features for implementation of BCI control holds special importance. Off-the-shelf BCI systems are based on fast, reproducible detection of mental activity and can be implemented in neurorobotic applications. Moreover, social Human-Robot Interaction (HRI) is increasingly important in rehabilitation robotics development. In this paper, we present our progress and goals towards developing off-the-shelf BCI-controlled anthropomorphic robotic arms for assistive technologies and rehabilitation applications. We account for robotics development, BCI implementation, and qualitative assessment of HRI characteristics of the system. Furthermore, we present two illustrative experimental applications of the BCI-controlled arms, a study of motor imagery modalities on healthy individuals' BCI performance, and a pilot investigation on spinal cord injured patients' BCI control and brain connectivity. We discuss strengths and limitations of our design and propose further steps on development and neurophysiological study, including implementation of connectivity features as BCI modality. PMID:28948168

  20. Towards Rehabilitation Robotics: Off-the-Shelf BCI Control of Anthropomorphic Robotic Arms.

    Science.gov (United States)

    Athanasiou, Alkinoos; Xygonakis, Ioannis; Pandria, Niki; Kartsidis, Panagiotis; Arfaras, George; Kavazidi, Kyriaki Rafailia; Foroglou, Nicolas; Astaras, Alexander; Bamidis, Panagiotis D

    2017-01-01

    Advances in neural interfaces have demonstrated remarkable results in the direction of replacing and restoring lost sensorimotor function in human patients. Noninvasive brain-computer interfaces (BCIs) are popular due to considerable advantages including simplicity, safety, and low cost, while recent advances aim at improving past technological and neurophysiological limitations. Taking into account the neurophysiological alterations of disabled individuals, investigating brain connectivity features for implementation of BCI control holds special importance. Off-the-shelf BCI systems are based on fast, reproducible detection of mental activity and can be implemented in neurorobotic applications. Moreover, social Human-Robot Interaction (HRI) is increasingly important in rehabilitation robotics development. In this paper, we present our progress and goals towards developing off-the-shelf BCI-controlled anthropomorphic robotic arms for assistive technologies and rehabilitation applications. We account for robotics development, BCI implementation, and qualitative assessment of HRI characteristics of the system. Furthermore, we present two illustrative experimental applications of the BCI-controlled arms, a study of motor imagery modalities on healthy individuals' BCI performance, and a pilot investigation on spinal cord injured patients' BCI control and brain connectivity. We discuss strengths and limitations of our design and propose further steps on development and neurophysiological study, including implementation of connectivity features as BCI modality.

  1. Rehabilitation robotics: an academic engineer perspective.

    Science.gov (United States)

    Krebs, Hermano I

    2011-01-01

    In this paper, we present a retrospective review of our efforts to revolutionize the way physical medicine is practiced by developing and deploying rehabilitation robots. We present a sample of our clinical results with well over 600 stroke patients, both inpatients and outpatients. We discuss the different robots developed at our laboratory over the past 20 years and their unique characteristics. All are configured both to deliver reproducible interactive therapy and also to measure outcomes with minimal encumbrance, thus providing critical measurement tools to help unravel the key remaining question: what constitutes "best practice"? While success to date indicates that this therapeutic application of robots has opened an emerging new frontier in physical medicine and rehabilitation, the barrier to further progress lies not in developing new hardware but rather in finding the most effective way to enhance neuro-recovery. We close this manuscript discussing some of the tools required for advancing the effort beyond the present state to what we believe will be the central feature of research during the next 10 years.

  2. Clinical application of a modular ankle robot for stroke rehabilitation

    Science.gov (United States)

    Forrester, Larry W.; Roy, Anindo; Goodman, Ronald N.; Rietschel, Jeremy; Barton, Joseph E.; Krebs, Hermano Igo; Macko, Richard F.

    2015-01-01

    Background Advances in our understanding of neuroplasticity and motor learning post-stroke are now being leveraged with the use of robotics technology to enhance physical rehabilitation strategies. Major advances have been made with upper extremity robotics, which have been tested for efficacy in multi-site trials across the subacute and chronic phases of stroke. In contrast, use of lower extremity robotics to promote locomotor re-learning has been more recent and presents unique challenges by virtue of the complex multi-segmental mechanics of gait. Objectives Here we review a programmatic effort to develop and apply the concept of joint-specific modular robotics to the paretic ankle as a means to improve underlying impairments in distal motor control that may have a significant impact on gait biomechanics and balance. Methods An impedance controlled ankle robot module (anklebot) is described as a platform to test the idea that a modular approach can be used to modify training and measure the time profile of treatment response. Results Pilot studies using seated visuomotor anklebot training with chronic patients are reviewed, along with results from initial efforts to evaluate the anklebot's utility as a clinical tool for assessing intrinsic ankle stiffness. The review includes a brief discussion of future directions for using the seated anklebot training in the earliest phases of sub-acute therapy, and to incorporate neurophysiological measures of cerebro-cortical activity as a means to reveal underlying mechanistic processes of motor learning and brain plasticity associated with robotic training. Conclusions Finally we conclude with an initial control systems strategy for utilizing the anklebot as a gait training tool that includes integrating an Internal Model-based adaptive controller to both accommodate individual deficit severities and adapt to changes in patient performance. PMID:23949045

  3. Clinical application of a modular ankle robot for stroke rehabilitation.

    Science.gov (United States)

    Forrester, Larry W; Roy, Anindo; Goodman, Ronald N; Rietschel, Jeremy; Barton, Joseph E; Krebs, Hermano Igo; Macko, Richard F

    2013-01-01

    Advances in our understanding of neuroplasticity and motor learning post-stroke are now being leveraged with the use of robotics technology to enhance physical rehabilitation strategies. Major advances have been made with upper extremity robotics, which have been tested for efficacy in multi-site trials across the subacute and chronic phases of stroke. In contrast, use of lower extremity robotics to promote locomotor re-learning has been more recent and presents unique challenges by virtue of the complex multi-segmental mechanics of gait. Here we review a programmatic effort to develop and apply the concept of joint-specific modular robotics to the paretic ankle as a means to improve underlying impairments in distal motor control that may have a significant impact on gait biomechanics and balance. An impedance controlled ankle robot module (anklebot) is described as a platform to test the idea that a modular approach can be used to modify training and measure the time profile of treatment response. Pilot studies using seated visuomotor anklebot training with chronic patients are reviewed, along with results from initial efforts to evaluate the anklebot's utility as a clinical tool for assessing intrinsic ankle stiffness. The review includes a brief discussion of future directions for using the seated anklebot training in the earliest phases of sub-acute therapy, and to incorporate neurophysiological measures of cerebro-cortical activity as a means to reveal underlying mechanistic processes of motor learning and brain plasticity associated with robotic training. Finally we conclude with an initial control systems strategy for utilizing the anklebot as a gait training tool that includes integrating an Internal Model-based adaptive controller to both accommodate individual deficit severities and adapt to changes in patient performance.

  4. Review on design and control aspects of ankle rehabilitation robots.

    Science.gov (United States)

    Jamwal, Prashant K; Hussain, Shahid; Xie, Sheng Q

    2015-03-01

    Ankle rehabilitation robots can play an important role in improving outcomes of the rehabilitation treatment by assisting therapists and patients in number of ways. Consequently, few robot designs have been proposed by researchers which fall under either of the two categories, namely, wearable robots or platform-based robots. This paper presents a review of both kinds of ankle robots along with a brief analysis of their design, actuation and control approaches. While reviewing these designs it was observed that most of them are undesirably inspired by industrial robot designs. Taking note of the design concerns of current ankle robots, few improvements in the ankle robot designs have also been suggested. Conventional position control or force control approaches, being used in the existing ankle robots, have been reviewed. Apparently, opportunities of improvement also exist in the actuation as well as control of ankle robots. Subsequently, a discussion on most recent research in the development of novel actuators and advanced controllers based on appropriate physical and cognitive human-robot interaction has also been included in this review. Implications for Rehabilitation Ankle joint functions are restricted/impaired as a consequence of stroke or injury during sports or otherwise. Robots can help in reinstating functions faster and can also work as tool for recording rehabilitation data useful for further analysis. Evolution of ankle robots with respect to their design and control aspects has been discussed in the present paper and a novel design with futuristic control approach has been proposed.

  5. Robotics in Lower-Limb Rehabilitation after Stroke

    Directory of Open Access Journals (Sweden)

    Xue Zhang

    2017-01-01

    Full Text Available With the increase in the elderly, stroke has become a common disease, often leading to motor dysfunction and even permanent disability. Lower-limb rehabilitation robots can help patients to carry out reasonable and effective training to improve the motor function of paralyzed extremity. In this paper, the developments of lower-limb rehabilitation robots in the past decades are reviewed. Specifically, we provide a classification, a comparison, and a design overview of the driving modes, training paradigm, and control strategy of the lower-limb rehabilitation robots in the reviewed literature. A brief review on the gait detection technology of lower-limb rehabilitation robots is also presented. Finally, we discuss the future directions of the lower-limb rehabilitation robots.

  6. Robotics in Lower-Limb Rehabilitation after Stroke.

    Science.gov (United States)

    Zhang, Xue; Yue, Zan; Wang, Jing

    2017-01-01

    With the increase in the elderly, stroke has become a common disease, often leading to motor dysfunction and even permanent disability. Lower-limb rehabilitation robots can help patients to carry out reasonable and effective training to improve the motor function of paralyzed extremity. In this paper, the developments of lower-limb rehabilitation robots in the past decades are reviewed. Specifically, we provide a classification, a comparison, and a design overview of the driving modes, training paradigm, and control strategy of the lower-limb rehabilitation robots in the reviewed literature. A brief review on the gait detection technology of lower-limb rehabilitation robots is also presented. Finally, we discuss the future directions of the lower-limb rehabilitation robots.

  7. Maintaining trust while fixated to a rehabilitative robot

    DEFF Research Database (Denmark)

    Jensen, Laura U.; Winther, Trine Straarup; Jørgensen, Rasmus

    2016-01-01

    This paper investigates the trust relationship between humans and a rehabilitation robot, the RoboTrainer. We present a study in which participants let the robot guide their arms through a series of preset coordinates in a 3D space. Each participant interact with the robot twice, one time where...... participants hold on to the robotic arm, and a second time where participants are fixated to the robotic arm. Our findings show that in general participants did not feel more insecure when fixated to the robot. However, when the robot arm moves close to participants and enter their intimate space, or when...

  8. The potential power of robotics for upper extremity stroke rehabilitation.

    Science.gov (United States)

    Dukelow, Sean P

    2017-01-01

    Two decades of research on robots and upper extremity rehabilitation has resulted in recommendations from systematic reviews and guidelines on their use in stroke. Robotics are often cited for their ability to encourage mass practice as a means to enhance recovery of movement. Yet, stroke recovery is a complex process occurring across many aspects of neurologic function beyond movement. As newer devices are developed and enhanced assessments are integrated into treatment protocols, the potential of robotics to advance rehabilitation will continue to grow.

  9. Socially assistive robotics for post-stroke rehabilitation

    OpenAIRE

    Feil-Seifer David J; Eriksson Jon; Matarić Maja J; Winstein Carolee J

    2007-01-01

    Abstract Background Although there is a great deal of success in rehabilitative robotics applied to patient recovery post stroke, most of the research to date has dealt with providing physical assistance. However, new rehabilitation studies support the theory that not all therapy need be hands-on. We describe a new area, called socially assistive robotics, that focuses on non-contact patient/user assistance. We demonstrate the approach with an implemented and tested post-stroke recovery robot...

  10. Robots testing robots: ALAN-Arm, a humanoid arm for the testing of robotic rehabilitation systems.

    Science.gov (United States)

    Brookes, Jack; Kuznecovs, Maksims; Kanakis, Menelaos; Grigals, Arturs; Narvidas, Mazvydas; Gallagher, Justin; Levesley, Martin

    2017-07-01

    Robotics is increasing in popularity as a method of providing rich, personalized and cost-effective physiotherapy to individuals with some degree of upper limb paralysis, such as those who have suffered a stroke. These robotic rehabilitation systems are often high powered, and exoskeletal systems can attach to the person in a restrictive manner. Therefore, ensuring the mechanical safety of these devices before they come in contact with individuals is a priority. Additionally, rehabilitation systems may use novel sensor systems to measure current arm position. Used to capture and assess patient movements, these first need to be verified for accuracy by an external system. We present the ALAN-Arm, a humanoid robotic arm designed to be used for both accuracy benchmarking and safety testing of robotic rehabilitation systems. The system can be attached to a rehabilitation device and then replay generated or human movement trajectories, as well as autonomously play rehabilitation games or activities. Tests of the ALAN-Arm indicated it could recreate the path of a generated slow movement path with a maximum error of 14.2mm (mean = 5.8mm) and perform cyclic movements up to 0.6Hz with low gain (<1.5dB). Replaying human data trajectories showed the ability to largely preserve human movement characteristics with slightly higher path length and lower normalised jerk.

  11. Robot-Aided Neurorehabilitation: A Pediatric Robot for Ankle Rehabilitation.

    Science.gov (United States)

    Michmizos, Konstantinos P; Rossi, Stefano; Castelli, Enrico; Cappa, Paolo; Krebs, Hermano Igo

    2015-11-01

    This paper presents the pediAnklebot, an impedance-controlled low-friction, backdriveable robotic device developed at the Massachusetts Institute of Technology that trains the ankle of neurologically impaired children of ages 6-10 years old. The design attempts to overcome the known limitations of the lower extremity robotics and the unknown difficulties of what constitutes an appropriate therapeutic interaction with children. The robot's pilot clinical evaluation is on-going and it incorporates our recent findings on the ankle sensorimotor control in neurologically intact subjects, namely the speed-accuracy tradeoff, the deviation from an ideally smooth ankle trajectory, and the reaction time. We used these concepts to develop the kinematic and kinetic performance metrics that guided the ankle therapy in a similar fashion that we have done for our upper extremity devices. Here we report on the use of the device in at least nine training sessions for three neurologically impaired children. Results demonstrated a statistically significant improvement in the performance metrics assessing explicit and implicit motor learning. Based on these initial results, we are confident that the device will become an effective tool that harnesses plasticity to guide habilitation during childhood.

  12. The place of robotics in post-stroke rehabilitation.

    Science.gov (United States)

    Rosati, Giulio

    2010-11-01

    Reducing the impact of stroke on the independence of elderly patients during daily life is becoming a primary societal goal in developed countries owing to population aging and to the incidence of stroke in elderly people. Rehabilitation plays a fundamental role in reducing the residual motor deficits of stroke patients, both during hospitalization (acute/subacute phase, inpatient rehabilitation) and after discharge (chronic phase, ambulatory/home rehabilitation). Since 1995, when the first pioneering robotic system for rehabilitation was presented, the use of robotics in post-stroke rehabilitation has been investigated intensely, and positive, although not yet fully satisfactory, clinical results were obtained. This article presents the most recent developments in this young research field, outlining the state of the art and the prospective role of robotics in post-stroke rehabilitation.

  13. Robotics in Lower-Limb Rehabilitation after Stroke

    OpenAIRE

    Xue Zhang; Zan Yue; Jing Wang

    2017-01-01

    With the increase in the elderly, stroke has become a common disease, often leading to motor dysfunction and even permanent disability. Lower-limb rehabilitation robots can help patients to carry out reasonable and effective training to improve the motor function of paralyzed extremity. In this paper, the developments of lower-limb rehabilitation robots in the past decades are reviewed. Specifically, we provide a classification, a comparison, and a design overview of the driving modes, traini...

  14. Robotic Technologies and Rehabilitation: New Tools for Stroke Patients’ Therapy

    Directory of Open Access Journals (Sweden)

    Patrizia Poli

    2013-01-01

    Full Text Available Introduction. The role of robotics in poststroke patients’ rehabilitation has been investigated intensively. This paper presents the state-of-the-art and the possible future role of robotics in poststroke rehabilitation, for both upper and lower limbs. Materials and Methods. We performed a comprehensive search of PubMed, Cochrane, and PeDRO databases using as keywords “robot AND stroke AND rehabilitation.” Results and Discussion. In upper limb robotic rehabilitation, training seems to improve arm function in activities of daily living. In addition, electromechanical gait training after stroke seems to be effective. It is still unclear whether robot-assisted arm training may improve muscle strength, and which electromechanical gait-training device may be the most effective for walking training implementation. Conclusions. In the field of robotic technologies for stroke patients’ rehabilitation we identified currently relevant growing points and areas timely for developing research. Among the growing points there is the development of new easily transportable, wearable devices that could improve rehabilitation also after discharge, in an outpatient or home-based setting. For developing research, efforts are being made to establish the ideal type of treatment, the length and amount of training protocol, and the patient’s characteristics to be successfully enrolled to this treatment.

  15. Robotic technologies and rehabilitation: new tools for stroke patients' therapy.

    Science.gov (United States)

    Poli, Patrizia; Morone, Giovanni; Rosati, Giulio; Masiero, Stefano

    2013-01-01

    The role of robotics in poststroke patients' rehabilitation has been investigated intensively. This paper presents the state-of-the-art and the possible future role of robotics in poststroke rehabilitation, for both upper and lower limbs. We performed a comprehensive search of PubMed, Cochrane, and PeDRO databases using as keywords "robot AND stroke AND rehabilitation." In upper limb robotic rehabilitation, training seems to improve arm function in activities of daily living. In addition, electromechanical gait training after stroke seems to be effective. It is still unclear whether robot-assisted arm training may improve muscle strength, and which electromechanical gait-training device may be the most effective for walking training implementation. In the field of robotic technologies for stroke patients' rehabilitation we identified currently relevant growing points and areas timely for developing research. Among the growing points there is the development of new easily transportable, wearable devices that could improve rehabilitation also after discharge, in an outpatient or home-based setting. For developing research, efforts are being made to establish the ideal type of treatment, the length and amount of training protocol, and the patient's characteristics to be successfully enrolled to this treatment.

  16. Reference trajectory generation for rehabilitation robots: complementary limb motion estimation

    NARCIS (Netherlands)

    Vallery, H.; van Asseldonk, Edwin H.F.; Buss, M.; van der Kooij, Herman

    2009-01-01

    For gait rehabilitation robots, an important question is how to ensure stable gait, while avoiding any interaction forces between robot and human in case the patient walks correctly. To achieve this, the definition of ldquocorrectrdquo gait needs to adapted both to the individual patient and to the

  17. Reference Trajectory Generation for Rehabilitation Robots: Complementary Limb Motion Estimation

    NARCIS (Netherlands)

    Vallery, H.; Asseldonk, van E.H.F.; Buss, M.; Kooij, van der H.

    2009-01-01

    For gait rehabilitation robots, an important question is how to ensure stable gait, while avoiding any interaction forces between robot and human in case the patient walks correctly. To achieve this, the definition of ldquocorrectrdquo gait needs to adapted both to the individual patient and to the

  18. Recent trends for practical rehabilitation robotics, current challenges and the future.

    Science.gov (United States)

    Yakub, Fitri; Md Khudzari, Ahmad Zahran; Mori, Yasuchika

    2014-03-01

    This paper presents and studies various selected literature primarily from conference proceedings, journals and clinical tests of the robotic, mechatronics, neurology and biomedical engineering of rehabilitation robotic systems. The present paper focuses of three main categories: types of rehabilitation robots, key technologies with current issues and future challenges. Literature on fundamental research with some examples from commercialized robots and new robot development projects related to rehabilitation are introduced. Most of the commercialized robots presented in this paper are well known especially to robotics engineers and scholars in the robotic field, but are less known to humanities scholars. The field of rehabilitation robot research is expanding; in light of this, some of the current issues and future challenges in rehabilitation robot engineering are recalled, examined and clarified with future directions. This paper is concluded with some recommendations with respect to rehabilitation robots.

  19. Tele-rehabilitation using in-house wearable ankle rehabilitation robot.

    Science.gov (United States)

    Jamwal, Prashant K; Hussain, Shahid; Mir-Nasiri, Nazim; Ghayesh, Mergen H; Xie, Sheng Q

    2016-09-22

    This article explores wide-ranging potential of the wearable ankle robot for in-house rehabilitation. The presented robot has been conceptualized following a brief analysis of the existing technologies, systems, and solutions for in-house physical ankle rehabilitation. Configuration design analysis and component selection for ankle robot have been discussed as part of the conceptual design. The complexities of human robot interaction are closely encountered while maneuvering a rehabilitation robot. We present a fuzzy logic-based controller to perform the required robot-assisted ankle rehabilitation treatment. Designs of visual haptic interfaces have also been discussed, which will make the treatment interesting, and the subject will be motivated to exert more and regain lost functions rapidly. The complex nature of web-based communication between user and remotely sitting physiotherapy staff has also been discussed. A high-level software architecture appended with robot ensures user-friendly operations. This software is made up of three important components: patient-related database, graphical user interface (GUI), and a library of exercises creating virtual reality-specifically developed for ankle rehabilitation.

  20. Robotics in the rehabilitation treatment of patients with stroke.

    Science.gov (United States)

    Volpe, Bruce T; Ferraro, Mark; Krebs, Hermano I; Hogan, Neville

    2002-07-01

    Stroke is the leading cause of permanent disability despite continued advances in prevention and novel interventional treatments. Post-stroke neuro-rehabilitation programs teach compensatory strategies that alter the degree of permanent disability. Robotic devices are new tools for therapists to deliver enhanced sensorimotor training and concentrate on impairment reduction. Results from several groups have registered success in reducing impairment and increasing motor power with task-specific exercise delivered by the robotic devices. Enhancing the rehabilitation experience with task-specific repetitive exercise marks a different approach to the patient with stroke. The clinical challenge will be to streamline, adapt, and expand the robot protocols to accommodate healthcare economies, to determine which patients sustain the greatest benefit, and to explore the relationship between impairment reduction and disability level. With these new tools, therapists will measure aspects of outcome objectively and contribute to the emerging scientific basis of neuro-rehabilitation.

  1. Neuro-robotics from brain machine interfaces to rehabilitation robotics

    CERN Document Server

    Artemiadis

    2014-01-01

    Neuro-robotics is one of the most multidisciplinary fields of the last decades, fusing information and knowledge from neuroscience, engineering and computer science. This book focuses on the results from the strategic alliance between Neuroscience and Robotics that help the scientific community to better understand the brain as well as design robotic devices and algorithms for interfacing humans and robots. The first part of the book introduces the idea of neuro-robotics, by presenting state-of-the-art bio-inspired devices. The second part of the book focuses on human-machine interfaces for pe

  2. Trajectory planning of a robot for lower limb rehabilitation.

    Science.gov (United States)

    Pei, Y; Kim, Y; Obinata, G; Hase, K; Stefanov, D

    2011-01-01

    We introduce a method for lower-limb physical rehabilitation by means of a robot that applies preliminary defined forces to a patient's foot while moving it on a preliminary defined trajectory. We developed a special musculoskeletal model that takes into consideration the generated muscle forces of 27 musculotendon actuators and joint stiffness of the leg and allows the calculation of the motion trajectory of the robot and the forces that the robot needs to apply to the foot in each moment of the therapeutic exercise. Robotic treatment programs are customized for the individual patient by using a genetic algorithm (GA) that refers to the musculoskeletal model and calculates the parameters of the spline curves of the motion trajectory of the robot and forces acting on the foot.

  3. Effect of a robotic rehabilitation device on upper limb function in a sub-acute cervical spinal cord injury population.

    Science.gov (United States)

    Zariffa, José; Kapadia, Naaz; Kramer, John L K; Taylor, Philippa; Alizadeh-Meghrazi, Milad; Zivanovic, Vera; Willms, Rhonda; Townson, Andrea; Curt, Armin; Popovic, Milos R; Steeves, John D

    2011-01-01

    Robotic rehabilitation devices have been suggested as a tool to increase the amount of rehabilitation delivered after a neurological injury. Clinical robotic rehabilitation studies of the upper extremity have generally focused on stroke survivors. We present the results of a multi-center pilot study where an upper-limb robotic rehabilitation device (Armeo Spring®, Hocoma AG) was incorporated into the rehabilitation program of 12 subjects with sub-acute cervical spinal cord injury (motor level C4-C6, AIS A-D). Outcomes were measured using two tests of upper extremity function: ARAT and GRASSP. The change in scores for the arm receiving the Armeo training were not statistically significant when compared to the arm not receiving the Armeo training at discharge from therapy and over follow up assessments (8.7 +/- 2.9 compared to 7.4 +/- 2.5 for ARAT at discharge, p = 0.98, and 13.0 +/- 3.2 compared to 13.3 +/- 3.3 for GRASSP at discharge, p = 0.69). Nevertheless, subjects with some minimal (partial) hand function at baseline had a significantly larger increase in GRASSP scores than subjects with no minimal hand function preserved at baseline (19.3 +/- 2.4 compared to 6.6 +/- 4.7, p = 0.02). This suggests that the initial functional capabilities of patients can influence the benefits measured after robotic rehabilitation training and heterogeneous subject populations should be avoided in early phase studies. © 2011 IEEE

  4. Advanced robotics for medical rehabilitation current state of the art and recent advances

    CERN Document Server

    Xie, Shane

    2016-01-01

    Focussing on the key technologies in developing robots for a wide range of medical rehabilitation activities – which will include robotics basics, modelling and control, biomechanics modelling, rehabilitation strategies, robot assistance, clinical setup/implementation as well as neural and muscular interfaces for rehabilitation robot control – this book is split into two parts; a review of the current state of the art, and recent advances in robotics for medical rehabilitation. Both parts will include five sections for the five key areas in rehabilitation robotics: (i) the upper limb; (ii) lower limb for gait rehabilitation (iii) hand, finger and wrist; (iv) ankle for strains and sprains; and (v) the use of EEG and EMG to create interfaces between the neurological and muscular functions of the patients and the rehabilitation robots. Each chapter provides a description of the design of the device, the control system used, and the implementation and testing to show how it fulfils the needs of that specific ...

  5. Human--machine load sharing in rehabilitation robotics.

    Science.gov (United States)

    Rahman, T; McClenathan, K

    1999-01-01

    A force-assist mechanism has been developed to mount on the Chameleon - a wheelchair mounted rehabilitation robot. The device will amplify the forces applied by the user, making it possible to lift a large weight with a small force. This paper describes the test-bed development; instrumentation of the Chameleon with power assistance; and preliminary results on system efficacy.

  6. Robot-mediated Active Rehabilitation (ACRE) : A user trial

    NARCIS (Netherlands)

    Schoone, M.; Os, P. van; Campagne, A.

    2007-01-01

    ACRE is a robotic training device for rehabilitation of the upper limbs. ACRE stimulates patients to train their affected arm more frequently and repetitively, via so called game based therapy. A prototype of ACRE (ACRE2) was tested in a user trial with patients who had recently suffered a stroke. T

  7. A Finger Exoskeleton Robot for Finger Movement Rehabilitation

    Directory of Open Access Journals (Sweden)

    Tzu-Heng Hsu

    2017-07-01

    Full Text Available In this study, a finger exoskeleton robot has been designed and presented. The prototype device was designed to be worn on the dorsal side of the hand to assist in the movement and rehabilitation of the fingers. The finger exoskeleton is 3D-printed to be low-cost and has a transmission mechanism consisting of rigid serial links which is actuated by a stepper motor. The actuation of the robotic finger is by a sliding motion and mimics the movement of the human finger. To make it possible for the patient to use the rehabilitation device anywhere and anytime, an Arduino™ control board and a speech recognition board were used to allow voice control. As the robotic finger follows the patients voice commands the actual motion is analyzed by Tracker image analysis software. The finger exoskeleton is designed to flex and extend the fingers, and has a rotation range of motion (ROM of 44.2°.

  8. A hybrid Force Position Control for a Upper Limb Rehabilitation Robot of Series Mechanism

    OpenAIRE

    Liu Yali; Ji Linhong

    2016-01-01

    Interactive rehabilitation robot which has better interaction is one main method to improve the patients’ motion performance. The rehabilitation robot developed by Tsinghua University UECM for patients having weakness with shoulder and elbow should be improved by increasing interactive parts to adapt to patients’ state. This paper described one control strategy to increase the interaction between robot and patients. The hybrid force position control for the upper limb rehabilitation robot UEC...

  9. Robot assisted physiotherapy to support rehabilitation of facial paralysis.

    Science.gov (United States)

    Jayatilake, Dushyantha; Isezaki, Takashi; Teramoto, Yohei; Eguchi, Kiyoshi; Suzuki, Kenji

    2014-05-01

    We have been developing the Robot Mask with shape memory alloy based actuators that follows an approach of manipulating the skin through a minimally obtrusive wires, transparent strips and tapes based pulling mechanism to enhance the expressiveness of the face. For achieving natural looking facial expressions by taking the advantage of specific characteristics of the skin, the Robot Mask follows a human anatomy based criteria in selecting these manipulation points and directions. In this paper, we describe a case study of using the Robot Mask to assist physiotherapy of a hemifacial paralyzed patient. The significant differences in shape and size of the human head between different individuals demands proper customizations of the Robot Mask. This paper briefly describes the adjusting and customizing stages employed from the design level to the implementation level of the Robot Mask. We will also introduce a depth image sensor data based analysis, which can remotely evaluate dynamic characteristics of facial expressions in a continuous manner. We then investigate the effectiveness of the Robot Mask by analyzing the range sensor data. From the case study, we found that the Robot Mask could automate the physiotherapy tasks of rehabilitation of facial paralysis. We also verify that, while providing quick responses, the Robot Mask can reduce the asymmetry of a smiling face and manipulate the facial skin to formations similar to natural facial expressions.

  10. Pilot study of vibration stimulation on neurological rehabilitation.

    Science.gov (United States)

    Sui, Jianfeng; Shull, Pete; Ji, Linhong

    2014-01-01

    Robot-assisted therapy has been proved effective for dyskinesia, and has many unique advantages compared with traditional treatment, such as repeatability, accuracy, objectivity. But some studies show that the effect of the robot-assisted rehabilitation for improving patients' activities of daily life (ADLs) is not obvious. This study introduces a novel auxiliary method-vibration stimulation combined with robots which may improve patients' ADLs. In controlled trials, two kinds of feedback-vibration and visual feedback are applied to prompt subjects for rehabilitation, and electromyographic signals (EMGs) and motion parameters are recorded in real time. Experimental results show that subjects' EMGs using vibration feedback are similar to healthy people, and characteristics of motion are closer to the theoretical value compared with control group. Vibration stimulation may serve as a kind of efficient auxiliary means to improve the efficiency of neurological rehabilitation.

  11. Current status of robotic stroke rehabilitation and opportunities for a cyber-physically assisted upper limb stroke rehabilitation

    NARCIS (Netherlands)

    Li, C.; Rusak, Z.; Horvath, I.; Ji, L.; Hou, Y.

    2014-01-01

    In the last two decades, robotics-assisted stroke reha-bilitation has been wide-spread, in particular for movement rehabilitation of upper limbs. Several studies have reported on the clinical effectiveness of this kind of therapy. The results of these studies show that robot assisted therapy can be

  12. Current status of robotic stroke rehabilitation and opportunities for a cyber-physically assisted upper limb stroke rehabilitation

    NARCIS (Netherlands)

    Li, C.; Rusak, Z.; Horvath, I.; Ji, L.; Hou, Y.

    2014-01-01

    In the last two decades, robotics-assisted stroke reha-bilitation has been wide-spread, in particular for movement rehabilitation of upper limbs. Several studies have reported on the clinical effectiveness of this kind of therapy. The results of these studies show that robot assisted therapy can be

  13. Visual feedback distortion in a robotic environment for hand rehabilitation.

    Science.gov (United States)

    Brewer, Bambi Roberts; Klatzky, Roberta; Matsuoka, Yoky

    2008-04-15

    Robotic therapy offers a means of enhancing rehabilitation for individuals with chronic stroke or traumatic brain injury. The present research targets members of this population who demonstrate learned nonuse, a tendency to use affected limbs below the level of the individual's true capability. These individuals may not strive for difficult goals in therapy, which ultimately hampers their progress and the outcome of rehabilitation. Our research uses a paradigm called visual feedback distortion in which the visual feedback corresponding to force or distance is gradually changed by an imperceptible amount to encourage improved performance. Our first set of experiments was designed to assess the limits of imperceptible distortion for visual feedback concerning the force exerted or the distance moved by the index finger. A second set of experiments used these limits to gradually distort visual feedback in order to manipulate a subject's force or distance response. Based on this work, we designed a paradigm applying visual feedback distortion to the rehabilitation of individuals with chronic stroke and traumatic brain injury. Initial tests are reported for two subjects who participated in a six-week rehabilitation protocol. Each patient followed visual feedback distortion to levels of performance above that predicted by her performance during an initial assessment. Both patients showed functional improvements after participating in the study. Visual feedback distortion may provide a way to help a patient move beyond his or her self-assessed "best" performance, improving the outcome of robotic rehabilitation.

  14. Reference trajectory generation for rehabilitation robots: complementary limb motion estimation.

    Science.gov (United States)

    Vallery, Heike; van Asseldonk, Edwin H F; Buss, Martin; van der Kooij, Herman

    2009-02-01

    For gait rehabilitation robots, an important question is how to ensure stable gait, while avoiding any interaction forces between robot and human in case the patient walks correctly. To achieve this, the definition of "correct" gait needs to adapted both to the individual patient and to the situation. Recently, we proposed a method for online trajectory generation that can be applied for hemiparetic subjects. Desired states for one (disabled) leg are generated online based on the movements of the other (sound) leg. An instantaneous mapping between legs is performed by exploiting physiological interjoint couplings. This way, the patient generates the reference motion for the affected leg autonomously. The approach, called Complementary Limb Motion Estimation (CLME), is implemented on the LOPES gait rehabilitation robot and evaluated with healthy subjects in two different experiments. In a previously described study, subjects walk only with one leg, while the robot's other leg acts as a fake prosthesis, to simulate complete loss of function in one leg. This study showed that CLME ensures stable gait. In a second study, to be presented in this paper, healthy subjects walk with both their own legs to assess the interference with self-determined walking. Evaluation criteria are: Power delivered to the joints by the robot, electromyography (EMG) distortions, and kinematic distortions, all compared to zero torque control, which is the baseline of minimum achievable interference. Results indicate that interference of the robot is lower with CLME than with a fixed reference trajectory, mainly in terms of lowered exchanged power and less alteration of EMG. This implies that subjects can walk more naturally with CLME, and they are assisted less by the robot when it is not needed. Future studies with patients are yet to show whether these properties of CLME transfer to the clinical domain.

  15. PARTIAL MATCHING FACE RECOGNITION METHOD FOR REHABILITATION NURSING ROBOTS BEDS

    Directory of Open Access Journals (Sweden)

    Dongmei LIANG

    2015-06-01

    Full Text Available In order to establish face recognition system in rehabilitation nursing robots beds and achieve real-time monitor the patient on the bed. We propose a face recognition method based on partial matching Hu moments which apply for rehabilitation nursing robots beds. Firstly we using Haar classifier to detect human faces automatically in dynamic video frames. Secondly we using Otsu threshold method to extract facial features (eyebrows, eyes, mouth in the face image and its Hu moments. Finally, we using Hu moment feature set to achieve the automatic face recognition. Experimental results show that this method can efficiently identify face in a dynamic video and it has high practical value (the accuracy rate is 91% and the average recognition time is 4.3s.

  16. A survey on robotic devices for upper limb rehabilitation

    Science.gov (United States)

    2014-01-01

    The existing shortage of therapists and caregivers assisting physically disabled individuals at home is expected to increase and become serious problem in the near future. The patient population needing physical rehabilitation of the upper extremity is also constantly increasing. Robotic devices have the potential to address this problem as noted by the results of recent research studies. However, the availability of these devices in clinical settings is limited, leaving plenty of room for improvement. The purpose of this paper is to document a review of robotic devices for upper limb rehabilitation including those in developing phase in order to provide a comprehensive reference about existing solutions and facilitate the development of new and improved devices. In particular the following issues are discussed: application field, target group, type of assistance, mechanical design, control strategy and clinical evaluation. This paper also includes a comprehensive, tabulated comparison of technical solutions implemented in various systems. PMID:24401110

  17. Lower-Limb Robotic Rehabilitation: Literature Review and Challenges

    Directory of Open Access Journals (Sweden)

    Iñaki Díaz

    2011-01-01

    been developed worldwide for training of both the upper and lower extremities. This work reviews all current robotic systems to date for lower-limb rehabilitation, as well as main clinical tests performed with them, with the aim of showing a clear starting point in the field. It also remarks some challenges that current systems still have to meet in order to obtain a broad clinical and market acceptance.

  18. Design and development of a hand robotic rehabilitation device for post stroke patients.

    Science.gov (United States)

    Rashedi, E; Mirbagheri, A; Taheri, B; Farahmand, F; Vossoughi, G R; Parnianpour, M

    2009-01-01

    Robot-mediated rehabilitation is a rapidly advancing discipline that seeks to develop improved treatment procedures using new technologies, e.g., robotics, coupled with modern theories in neuroscience and rehabilitation. A robotic device was designed and developed for rehabilitation of upper limbs of post stroke patients. A novel force feedback bimanual working mode provided real-time dynamic sensation of the paretic hand. Results of the preliminary clinical tests revealed a quantitative evaluation of the patient's level of paresis and disability.

  19. Upper limb rehabilitation robotics after stroke: a perspective from the University of Padua, Italy.

    Science.gov (United States)

    Masiero, Stefano; Carraro, Elena; Ferraro, Claudio; Gallina, Paolo; Rossi, Aldo; Rosati, Giulio

    2009-11-01

    Rehabilitation robotics is an emerging research field that aims to employ leading-edge robotic technology and virtual reality systems in the rehabilitation treatment of neuro-logical patients. In post-stroke patients with upper limb impairment, clinical trials have so far shown positive results in terms of motor recovery, but poor efficacy in terms of functional outcome. Much work is needed to develop a new generation of rehabilitation robots and clinical protocols that will be more effective in helping patients to regain their abilities in activities of daily living. This paper presents some key issues in the future perspective of upper limb robotic rehabilitation after stroke.

  20. An arm for a leg: Adapting a robotic arm for gait rehabilitation.

    Science.gov (United States)

    Franchi, Giulia; Viereck, Ulrich; Platt, Robert; Yen, Sheng-Che; Hasson, Christopher J

    2015-01-01

    The purpose of this study was to adapt a multipurpose robotic arm for gait rehabilitation. An advantage of this approach is versatility: a robotic arm can be attached to almost any point on the body to assist with lower- and upper-extremity rehabilitation. This may be more cost-effective than purchasing and training rehabilitation staff to use several specialized rehabilitation robots. Robotic arms also have a more human-like morphology, which may make them less intimidating or alien to patients. In this study a mechanical interface was developed that allows a fast, secure, and safe attachment between a robotic arm and a human limb. The effectiveness of this interface was assessed by having two healthy subjects walk on a treadmill with and without a robotic arm attached to their legs. The robot's ability to follow the subjects' swinging legs was evaluated at slow and fast walking speeds. Two different control schemes were evaluated: one using the standard manufacturer-provided control algorithm, and another using a custom algorithm that actively compensated for robot-human interaction forces. The results showed that both robot control schemes performed well for slow walking. There were negligible differences between subjects' gait kinematics with and without the robot. During fast walking with the robot, similar results were obtained for one subject; however, the second subject demonstrated noticeable gait modifications. Together, these results show the feasibility of adapting a multipurpose robotic arm for gait rehabilitation.

  1. Can the IROMEC robot support play in children with severe physical disabilities? A pilot study.

    Science.gov (United States)

    van den Heuvel, Renée J F; Lexis, Monique A S; de Witte, Luc P

    2017-03-01

    The aim of this study was to explore the application of the IROMEC (Interactive social RObotic Mediators as Companions) robot to support play for children with severe physical disabilities in rehabilitation and special education. Within a 2-month pilot study, physically disabled children with a developmental age between 2 and 8 years participated in sessions with the robot. A combination of qualitative and quantitative outcome measures was used to collect data on aspects of feasibility, usability, barriers for the child as well as the therapist and an indication of the effects on playfulness and the achievement of therapeutic and educational goals. A total of 11 children participated in this study (four boys, seven girls). Individually Prioritized Problem Assessment scores indicated a positive effect of the IROMEC robot on the achievement of goals for the children. Professionals did observe meaningful application possibilities, but the lacking adaptability, expandability and technical stability of the robot platform make application in daily care practice impossible. The application of a robot like IROMEC for children with severe physical disabilities seems to be positive and worthwhile, but usability and feasibility aspects are crucial for success.

  2. Development of wrist rehabilitation robot and interface system.

    Science.gov (United States)

    Yamamoto, Ikuo; Matsui, Miki; Inagawa, Naohiro; Hachisuka, Kenji; Wada, Futoshi; Hachisuka, Akiko; Saeki, Satoru

    2015-01-01

    The authors have developed a practical wrist rehabilitation robot for hemiplegic patients. It consists of a mechanical rotation unit, sensor, grip, and computer system. A myoelectric sensor is used to monitor the extensor carpi radialis longus/brevis muscle and flexor carpi radialis muscle activity during training. The training robot can provoke training through myoelectric sensors, a biological signal detector and processor in advance, so that patients can undergo effective training of extention and flexion in an excited condition. In addition, both-wrist system has been developed for mirror effect training, which is the most effective function of the system, so that autonomous training using both wrists is possible. Furthermore, a user-friendly screen interface with easily recognizable touch panels has been developed to give effective training for patients. The developed robot is small size and easy to carry. The developed aspiring interface system is effective to motivate the training of patients. The effectiveness of the robot system has been verified in hospital trails.

  3. Design of rehabilitation robot hand for fingers CPM training

    Science.gov (United States)

    Zhou, Hongfu; Chan, T. W.; Tong, K. Y.; Kwong, K. K.; Yao, Xifan

    2008-10-01

    This paper presents a low-cost prototype for rehabilitation robot aide patient do hands CPM (continuous passive motion) training. The design of the prototype is based on the principle of Rutgers Master II glove, but it is better in performance for more improvement made. In the design, it uses linear motors to replace pneumatic actuators to make the product more portable and mobile. It increases finger training range to 180 degree for the full range training of hand finger holding and extension. Also the prototype can not only be wearing on palm and fore arm do training for face to face with finger move together, but also be put in the opposite hand glove wear direction for hand rehabilitation training. During the research, Solidworks is used as the tool for mechanical design and movement simulation. It proved through experiment that the prototype made in the research is appropriate for hand do CPM training.

  4. Current status of robotic stroke rehabilitation and opportunities for a cyber-physically assisted upper limb stroke rehabilitation

    OpenAIRE

    Li, C.; Rusak, Z.; Horvath, I; Ji, L.; Hou, Y

    2014-01-01

    In the last two decades, robotics-assisted stroke reha-bilitation has been wide-spread, in particular for movement rehabilitation of upper limbs. Several studies have reported on the clinical effectiveness of this kind of therapy. The results of these studies show that robot assisted therapy can be more effective in recovering motor control abilities than conventional therapy. On the other hand, studies found no signifi-cant improvement on motor function abilities of pa-tients. These contradi...

  5. Emergence of Socially Assistive Robotics in Rehabilitation for Children with Cerebral Palsy: A Review

    Directory of Open Access Journals (Sweden)

    Norjasween Abdul Malik

    2016-06-01

    Full Text Available Robotic assistive technology is today widely used in rehabilitation. Social assistive robotics (SAR is one of the developing areas of research with potential advantages for areas involving elderly care, people with cognitive impairment, rehabilitation for people with physical disabilities and for educational purposes. Cerebral palsy (CP is a common neurological disorder among children that impairs motor function and may involve cognitive function. The use of social assistive robotic technology serves as a potential approach for CP rehabilitation. The objective of this paper is to review published articles regarding SAR in rehabilitation for children with CP. Twelve published studies have been identified and will be discussed in this review paper.

  6. Emergence of Socially Assistive Robotics in Rehabilitation for Children with Cerebral Palsy: A Review

    Directory of Open Access Journals (Sweden)

    Norjasween Abdul Malik

    2016-06-01

    Full Text Available Robotic assistive technology is today widely used in rehabilitation. Social assistive robotics (SAR is one of the developing areas of research with potential advantages for areas involving elderly care, people with cognitive impairment, rehabilitation for people with physical disabilities and for educational purposes. Cerebral palsy (CP is a common neurological disorder among children that impairs motor function and may involve cognitive function. The use of social assistive robotic technology serves as a potential approach for CP rehabilitation. The objective of this paper is to review published articles regarding SAR in rehabilitation for children with CP. Twelve published studies have been identified and will be discussed in this review paper.

  7. Research and Design of a New Horizontal Lower Limb Rehabilitation Training Robot

    Directory of Open Access Journals (Sweden)

    Bingjing Guo

    2016-01-01

    Full Text Available This project focuses on the design of one robot to help long-time bedridden patients complete their daily leg rehabilitation training while lying in bed. Based on an analysis of many rehabilitation training modes and integrated with a traditional Chinese medicine (TCM massage technique, a new horizontal lower limb rehabilitation training robot with four degrees of freedom is presented in this paper. The mechanical structural design, kinematic calculation and control system are introduced in detail. A robot prototype is fabricated and rehabilitation training experiments are carried out. The experimental results show that the robot can satisfy the requirements of a variety of rehabilitation training modes and has a certain degree of rehabilitation effectiveness.

  8. Haptic-based neurorehabilitation in poststroke patients: a feasibility prospective multicentre trial for robotics hand rehabilitation.

    Science.gov (United States)

    Turolla, Andrea; Daud Albasini, Omar A; Oboe, Roberto; Agostini, Michela; Tonin, Paolo; Paolucci, Stefano; Sandrini, Giorgio; Venneri, Annalena; Piron, Lamberto

    2013-01-01

    Background. Haptic robots allow the exploitation of known motor learning mechanisms, representing a valuable option for motor treatment after stroke. The aim of this feasibility multicentre study was to test the clinical efficacy of a haptic prototype, for the recovery of hand function after stroke. Methods. A prospective pilot clinical trial was planned on 15 consecutive patients enrolled in 3 rehabilitation centre in Italy. All the framework features of the haptic robot (e.g., control loop, external communication, and graphic rendering for virtual reality) were implemented into a real-time MATLAB/Simulink environment, controlling a five-bar linkage able to provide forces up to 20 [N] at the end effector, used for finger and hand rehabilitation therapies. Clinical (i.e., Fugl-Meyer upper extremity scale; nine hold pegboard test) and kinematics (i.e., time; velocity; jerk metric; normalized jerk of standard movements) outcomes were assessed before and after treatment to detect changes in patients' motor performance. Reorganization of cortical activation was detected in one patient by fMRI. Results and Conclusions. All patients showed significant improvements in both clinical and kinematic outcomes. Additionally, fMRI results suggest that the proposed approach may promote a better cortical activation in the brain.

  9. Haptic-Based Neurorehabilitation in Poststroke Patients: A Feasibility Prospective Multicentre Trial for Robotics Hand Rehabilitation

    Science.gov (United States)

    Daud Albasini, Omar A.; Oboe, Roberto; Tonin, Paolo; Paolucci, Stefano; Sandrini, Giorgio; Piron, Lamberto

    2013-01-01

    Background. Haptic robots allow the exploitation of known motor learning mechanisms, representing a valuable option for motor treatment after stroke. The aim of this feasibility multicentre study was to test the clinical efficacy of a haptic prototype, for the recovery of hand function after stroke. Methods. A prospective pilot clinical trial was planned on 15 consecutive patients enrolled in 3 rehabilitation centre in Italy. All the framework features of the haptic robot (e.g., control loop, external communication, and graphic rendering for virtual reality) were implemented into a real-time MATLAB/Simulink environment, controlling a five-bar linkage able to provide forces up to 20 [N] at the end effector, used for finger and hand rehabilitation therapies. Clinical (i.e., Fugl-Meyer upper extremity scale; nine hold pegboard test) and kinematics (i.e., time; velocity; jerk metric; normalized jerk of standard movements) outcomes were assessed before and after treatment to detect changes in patients' motor performance. Reorganization of cortical activation was detected in one patient by fMRI. Results and Conclusions. All patients showed significant improvements in both clinical and kinematic outcomes. Additionally, fMRI results suggest that the proposed approach may promote a better cortical activation in the brain. PMID:24319496

  10. Haptic-Based Neurorehabilitation in Poststroke Patients: A Feasibility Prospective Multicentre Trial for Robotics Hand Rehabilitation

    Directory of Open Access Journals (Sweden)

    Andrea Turolla

    2013-01-01

    Full Text Available Background. Haptic robots allow the exploitation of known motorlearning mechanisms, representing a valuable option for motor treatment after stroke. The aim of this feasibility multicentre study was to test the clinical efficacy of a haptic prototype, for the recovery of hand function after stroke. Methods. A prospective pilot clinical trial was planned on 15 consecutive patients enrolled in 3 rehabilitation centre in Italy. All the framework features of the haptic robot (e.g., control loop, external communication, and graphic rendering for virtual reality were implemented into a real-time MATLAB/Simulink environment, controlling a five-bar linkage able to provide forces up to 20 [N] at the end effector, used for finger and hand rehabilitation therapies. Clinical (i.e., Fugl-Meyer upper extremity scale; nine hold pegboard test and kinematics (i.e., time; velocity; jerk metric; normalized jerk of standard movements outcomes were assessed before and after treatment to detect changes in patients' motor performance. Reorganization of cortical activation was detected in one patient by fMRI. Results and Conclusions. All patients showed significant improvements in both clinical and kinematic outcomes. Additionally, fMRI results suggest that the proposed approach may promote a better cortical activation in the brain.

  11. Emergence of Socially Assistive Robotics in Rehabilitation for Children with Cerebral Palsy: A Review

    OpenAIRE

    Norjasween Abdul Malik; Fazah Akhtar Hanapiah; Rabiatul Adawiah Abdul Rahman; Hanafiah Yussof

    2016-01-01

    Robotic assistive technology is today widely used in rehabilitation. Social assistive robotics (SAR) is one of the developing areas of research with potential advantages for areas involving elderly care, people with cognitive impairment, rehabilitation for people with physical disabilities and for educational purposes. Cerebral palsy (CP) is a common neurological disorder among children that impairs motor function and may involve cognitive function. The use of social assistive robotic technol...

  12. Will Robots Ever Replace Attendants? Exploring the Current Capabilities and Future Potential of Robots in Education and Rehabilitation.

    Science.gov (United States)

    Lees, David; LePage, Pamela

    1994-01-01

    This article describes the current capabilities and future potential of robots designed as supplements or replacements for human assistants or as tools for education and rehabilitation of people with disabilities. Review of robots providing educational, vocational, or independent living assistance concludes that eventually effective, reliable…

  13. A Human–Robot Interaction Perspective on Assistive and Rehabilitation Robotics

    Science.gov (United States)

    Beckerle, Philipp; Salvietti, Gionata; Unal, Ramazan; Prattichizzo, Domenico; Rossi, Simone; Castellini, Claudio; Hirche, Sandra; Endo, Satoshi; Amor, Heni Ben; Ciocarlie, Matei; Mastrogiovanni, Fulvio; Argall, Brenna D.; Bianchi, Matteo

    2017-01-01

    Assistive and rehabilitation devices are a promising and challenging field of recent robotics research. Motivated by societal needs such as aging populations, such devices can support motor functionality and subject training. The design, control, sensing, and assessment of the devices become more sophisticated due to a human in the loop. This paper gives a human–robot interaction perspective on current issues and opportunities in the field. On the topic of control and machine learning, approaches that support but do not distract subjects are reviewed. Options to provide sensory user feedback that are currently missing from robotic devices are outlined. Parallels between device acceptance and affective computing are made. Furthermore, requirements for functional assessment protocols that relate to real-world tasks are discussed. In all topic areas, the design of human-oriented frameworks and methods is dominated by challenges related to the close interaction between the human and robotic device. This paper discusses the aforementioned aspects in order to open up new perspectives for future robotic solutions. PMID:28588473

  14. A Human–Robot Interaction Perspective on Assistive and Rehabilitation Robotics

    Directory of Open Access Journals (Sweden)

    Philipp Beckerle

    2017-05-01

    Full Text Available Assistive and rehabilitation devices are a promising and challenging field of recent robotics research. Motivated by societal needs such as aging populations, such devices can support motor functionality and subject training. The design, control, sensing, and assessment of the devices become more sophisticated due to a human in the loop. This paper gives a human–robot interaction perspective on current issues and opportunities in the field. On the topic of control and machine learning, approaches that support but do not distract subjects are reviewed. Options to provide sensory user feedback that are currently missing from robotic devices are outlined. Parallels between device acceptance and affective computing are made. Furthermore, requirements for functional assessment protocols that relate to real-world tasks are discussed. In all topic areas, the design of human-oriented frameworks and methods is dominated by challenges related to the close interaction between the human and robotic device. This paper discusses the aforementioned aspects in order to open up new perspectives for future robotic solutions.

  15. A Human-Robot Interaction Perspective on Assistive and Rehabilitation Robotics.

    Science.gov (United States)

    Beckerle, Philipp; Salvietti, Gionata; Unal, Ramazan; Prattichizzo, Domenico; Rossi, Simone; Castellini, Claudio; Hirche, Sandra; Endo, Satoshi; Amor, Heni Ben; Ciocarlie, Matei; Mastrogiovanni, Fulvio; Argall, Brenna D; Bianchi, Matteo

    2017-01-01

    Assistive and rehabilitation devices are a promising and challenging field of recent robotics research. Motivated by societal needs such as aging populations, such devices can support motor functionality and subject training. The design, control, sensing, and assessment of the devices become more sophisticated due to a human in the loop. This paper gives a human-robot interaction perspective on current issues and opportunities in the field. On the topic of control and machine learning, approaches that support but do not distract subjects are reviewed. Options to provide sensory user feedback that are currently missing from robotic devices are outlined. Parallels between device acceptance and affective computing are made. Furthermore, requirements for functional assessment protocols that relate to real-world tasks are discussed. In all topic areas, the design of human-oriented frameworks and methods is dominated by challenges related to the close interaction between the human and robotic device. This paper discusses the aforementioned aspects in order to open up new perspectives for future robotic solutions.

  16. Acceptability of robotic technology in neuro-rehabilitation: preliminary results on chronic stroke patients.

    Science.gov (United States)

    Mazzoleni, Stefano; Turchetti, Giuseppe; Palla, Ilaria; Posteraro, Federico; Dario, Paolo

    2014-09-01

    During the last decade, different robotic devices have been developed for motor rehabilitation of stroke survivors. These devices have been shown to improve motor impairment and contribute to the understanding of mechanisms underlying motor recovery after a stroke. The assessment of the robotic technology for rehabilitation assumes great importance. The aim of this study is to present preliminary results on the assessment of the acceptability of the robotic technology for rehabilitation on a group of thirty-four chronic stroke patients. The results from questionnaires on the patients' acceptability of two different robot-assisted rehabilitation scenarios show that the robotic approach was well accepted and tolerated by the patients. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  17. Control system design of a 3-DOF upper limbs rehabilitation robot.

    Science.gov (United States)

    Denève, Alexandre; Moughamir, Saïd; Afilal, Lissan; Zaytoon, Janan

    2008-02-01

    This paper presents the control system design of a rehabilitation and training robot for the upper limbs. Based on a hierarchical structure, this control system allows the execution of sequence of switching control laws (position, force, impedance and force/impedance) corresponding to the required training configuration. A model-based nonlinear controller is used to impose the desired environment to the patient's arm. The knowledge of robot kinematics and dynamics is thus necessary to ensure haptic transparency and patient safety. The identification process of robot dynamics is emphasised and experimental identification results are given for the designed robot. The paper also presents a particular rehabilitation mode named Active-Assisted. Simulation results of this rehabilitation mode illustrate the potentialities of the overall control scheme, which can also be applied to other rehabilitation robots.

  18. Hand Robotics Rehabilitation: Feasibility and Preliminary Results of a Robotic Treatment in Patients with Hemiparesis

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    Patrizio Sale

    2012-01-01

    Full Text Available Background. No strongly clinical evidence about the use of hand robot-assisted therapy in stroke patients was demonstrated. This preliminary observer study was aimed at evaluating the efficacy of intensive robot-assisted therapy in hand function recovery, in the early phase after a stroke onset. Methods. Seven acute ischemic stroke patients at their first-ever stroke were enrolled. Treatment was performed using Amadeo robotic system (Tyromotion GmbH Graz, Austria. Each participant received, in addition to inpatients standard rehabilitative treatment, 20 sessions of robotic treatment for 4 consecutive weeks (5 days/week. Each session lasted for 40 minutes. The exercises were carried out as follows: passive modality (5 minutes, passive/plus modality (5 minutes, assisted therapy (10 minutes, and balloon (10 minutes. The following impairment and functional evaluations, Fugl-Meyer Scale (FM, Medical Research Council Scale for Muscle Strength (hand flexor and extensor muscles (MRC, Motricity Index (MI, and modified Ashworth Scale for wrist and hand muscles (AS, were performed at the beginning (T0, after 10 sessions (T1, and at the end of the treatment (T2. The strength hand flexion and extension performed by Robot were assessed at T0 and T2. The Barthel Index and COMP (performance and satisfaction subscale were assessed at T0 and T2. Results. Clinical improvements were found in all patients. No dropouts were recorded during the treatment and all subjects fulfilled the protocol. Evidence of a significant improvement was demonstrated by the Friedman test for the MRC (P<0.0123. Evidence of an improvement was demonstrated for AS, FM, and MI. Conclusions. This original rehabilitation treatment could contribute to increase the hand motor recovery in acute stroke patients. The simplicity of the treatment, the lack of side effects, and the first positive results in acute stroke patients support the recommendations to extend the clinical trial of this

  19. A novel 5-DOF exoskeletal rehabilitation robot system for upper limbs

    Institute of Scientific and Technical Information of China (English)

    Li Qingling; Kong Minxiu; Du Zhijiang; Sun Lining

    2009-01-01

    A novel 5-DOF exoskeletal rehabilitation robot for upper limbs of hemiplegic patients caused by stroke is proposed in this paper. Its hardware structure is introduced and the control methods are analyzed. To implement intelligent and interactive rehabilitation exercises, motion intention of patients' upper limb is introduced into control methods of rehabilitation exercises. In passive motions, according to the character of unilateral impaired, multi-channels surface electromyogram (sEMG) signals of patients' healthy arm muscles are acquired and analyzed to recognize the upper limb motions, then drive the robot and assist paralysis arm's rehabilitation exercises. In active-resistant motions, because patients are recovered with some muscle forces and active motion ability after a rehabilitation period, the terminal force loaded on the robot by an impaired arm are estimated with multi-channel joint torque sensors, according to which, the terminal velocity of the robot is controlled to drive the joint motions with a damp controller.

  20. Control strategies for effective robot assisted gait rehabilitation: the state of art and future prospects.

    Science.gov (United States)

    Cao, Jinghui; Xie, Sheng Quan; Das, Raj; Zhu, Guo L

    2014-12-01

    A large number of gait rehabilitation robots, together with a variety of control strategies, have been developed and evaluated during the last decade. Initially, control strategies applied to rehabilitation robots were adapted from those applied to traditional industrial robots. However, these strategies cannot optimise effectiveness of gait rehabilitation. As a result, researchers have been investigating control strategies tailored for the needs of rehabilitation. Among these control strategies, assisted-as-needed (AAN) control is one of the most popular research topics in this field. AAN training strategies have gained the theoretical and practical evidence based backup from motor learning principles and clinical studies. Various approaches to AAN training have been proposed and investigated by research groups all around the world. This article presents a review on control algorithms of gait rehabilitation robots to summarise related knowledge and investigate potential trends of development. There are existing review papers on control strategies of rehabilitation robots. The review by Marchal-Crespo and Reinkensmeyer (2009) had a broad cover of control strategies of all kinds of rehabilitation robots. Hussain et al. (2011) had specifically focused on treadmill gait training robots and covered a limited number of control implementations on them. This review article encompasses more detailed information on control strategies for robot assisted gait rehabilitation, but is not limited to treadmill based training. It also investigates the potential to further develop assist-as-needed gait training based on assessments of patients' ability. In this paper, control strategies are generally divided into the trajectory tracking control and AAN control. The review covers these two basic categories, as well as other control algorithm and technologies derived from them, such as biofeedback control. Assessments on human gait ability are also included to investigate how to

  1. Teaching Training Method of a Lower Limb Rehabilitation Robot

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    Yongfei Feng

    2016-03-01

    Full Text Available This paper presents a new lower limb rehabilitation robot (hereafter, referred to as LLR-Ro to help patients with lower limb disorder recover their movement function. Based on the ergonomics and kinematics principle, the motion of a human lower limb is analysed, which provides a theoretical basis for the leg mechanism design of LLR-Ro. This paper also proposes a teaching training method for improving the training performance of LLR-Ro. When a physician trains the lower limb of a patient, the acceleration data of the patient's lower limb motion will be collected through a wireless data acquisition system. The data can reproduce the movement trajectory of the physician rehabilitation training and this can be used as the training trajectory of LLR-Ro. The experiment results of this study demonstrate that the teaching training method is feasible. The theory analysis and experimental research of LLR-Ro lay the foundations for the future clinical application of this method.

  2. Teaching Training Method of a Lower Limb Rehabilitation Robot

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    Yongfei Feng

    2016-03-01

    Full Text Available This paper presents a new lower limb rehabilitation robot (hereafter, referred to as LLR-Ro to help patients with lower limb disorder recover their movement function. Based on the ergonomics and kinematics principle, the motion of a human lower limb is analysed, which provides a theoretical basis for the leg mechanism design of LLR-Ro. This paper also proposes a teaching training method for improving the training performance of LLR-Ro. When a physician trains the lower limb of a patient, the acceleration data of the patient’s lower limb motion will be collected through a wireless data acquisition system. The data can reproduce the movement trajectory of the physician rehabilitation training and this can be used as the training trajectory of LLR-Ro. The experiment results of this study demonstrate that the teaching training method is feasible. The theory analysis and experimental research of LLR-Ro lay the foundations for the future clinical application of this method.

  3. Robotic upper limb rehabilitation after acute stroke by NeReBot: evaluation of treatment costs.

    Science.gov (United States)

    Stefano, Masiero; Patrizia, Poli; Mario, Armani; Ferlini, Gregorio; Rizzello, Roberto; Rosati, Giulio

    2014-01-01

    Stroke is the first cause of disability. Several robotic devices have been developed for stroke rehabilitation. Robot therapy by NeReBot is demonstrated to be an effective tool for the treatment of poststroke paretic upper limbs, able to improve the activities of daily living of stroke survivors when used both as additional treatment and in partial substitution of conventional rehabilitation therapy in the acute and subacute phases poststroke. This study presents the evaluation of the costs related to delivering such therapy, in comparison with conventional rehabilitation treatment. By comparing several NeReBot treatment protocols, made of different combinations of robotic and nonrobotic exercises, we show that robotic technology can be a valuable and economically sustainable aid in the management of poststroke patient rehabilitation.

  4. Poststroke upper extremity rehabilitation: a review of robotic systems and clinical results.

    Science.gov (United States)

    Brewer, Bambi R; McDowell, Sharon K; Worthen-Chaudhari, Lise C

    2007-01-01

    Although the use of robotic devices to address neuromuscular rehabilitative goals represents a promising technological advance in medical care, the large number of systems being developed and varying levels of clinical study of the devices make it difficult to follow and interpret the results in this new field. This article is a review of the current state-of-the-art in robotic applications in poststroke therapy for the upper extremity, written specifically to help clinicians determine the differences between various systems. We concentrate primarily on systems that have been tested clinically. Robotic systems are grouped by rehabilitation application (e.g., gross motor movement, bilateral training, etc.), and, where possible, the neurorehabilitation strategies employed by each system are described. We close with a discussion of the benefits and concerns of using robotics in rehabilitation and an indication of challenges that must be addressed for therapeutic robots to be applied practically in the clinic.

  5. ROBOTIC MECHANOTHERAPY IN REHABILITATION OF CHILDREN WITH CEREBRAL PALSY AFTER COMBINED ORTHOPEDIC SURGERY

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    Галина Александровна Икоева

    2013-03-01

    Full Text Available The article represents a clinical research of 20 patients with infantile cerebral paralysis, who had got an early motor rehabilitation after complex orthopedic and neurosurgical treatment. The comparative analysis of results after traditional exercise therapy and mechanotherapy was carried out with the use of robotic system “Lokomat”. It was set up that early use of robotized mechanotherapy during postoperative period reduces significantly the time of motor rehabilitation in comparison with traditional exercise therapy.

  6. Effect of lower limb rehabilitation robot on lower limb motor function of hemiplegic patients after stroke

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    Jian-liang LU

    2017-07-01

    Full Text Available Objective To observe the rehabilitation effect of lower limb rehabilitation robot training on the lower limb motor function of hemiplegic patients after stroke. Methods A total of 60 stroke patients (duration < 6 months accepted conventional rehabilitation training combined with body weight support treadmill training (BWSTT group, N = 30 or conventional rehabilitation training combined with lower limb rehabilitation robot training (Robot group, N = 30. Fugl - Meyer Assessment Scale for Lower Extremity (FMA-LE was used to evaluate lower limb motor function. Berg Balance Scale (BBS was used to evaluate balance function. Lower limb rehabilitation robot torque feedback system was used to evaluate lower limb muscle strength. All evaluations were performed before and after 8-week training.   Results Compared with before training, the FMA-LE score (P = 0.000, BBS score (P = 0.000, hemiplegic side of hip joint feedback torque value (HJTV, P = 0.000 and knee joint feedback torque value (KJTV, P = 0.000 were increased in both groups after 8-week training. Compared with BWSTT group, the hemiplegic side of HJTV (P = 0.000 and KJTV (P = 0.000 were increased in Robot group after 8-week training, while the FMA-LE score (P = 0.118 and BBS score (P = 0.159 had no statistically significant difference between 2 groups.  Conclusions The lower limb rehabilitation robot or body weight support treadmill training combined with conventional rehabilitation training could improve the lower limb motor function of hemiplegic patients after stroke. The lower limb rehabilitation robot training was better than body weight support treadmill training on the recovery of lower limb muscle strength. DOI: 10.3969/j.issn.1672-6731.2017.05.004  

  7. Brain-state dependent robotic reaching movement with a multi-joint arm exoskeleton: combining brain-machine interfacing and robotic rehabilitation

    Directory of Open Access Journals (Sweden)

    Daniel eBrauchle

    2015-10-01

    Full Text Available While robot-assisted arm and hand training after stroke allows for intensive task-oriented practice, it has provided only limited additional benefit over dose-matched physiotherapy up to now. These rehabilitation devices are possibly too supportive during the exercises. Neurophysiological signals might be one way of avoiding slacking and providing robotic support only when the brain is particularly responsive to peripheral input.We tested the feasibility of three-dimensional robotic assistance for reach-to-grasp movements with a multi-joint exoskeleton during motor imagery-related desynchronization of sensorimotor oscillations in the β-band only. We also registered task-related network changes of cortical functional connectivity by electroencephalography via the imaginary part of the coherence function.Healthy subjects and stroke survivors showed similar patterns – but different aptitudes – of controlling the robotic movement. All participants in this pilot study with nine healthy subjects and two stroke patients achieved their maximum performance during the early stages of the task. Robotic control was significantly higher and less variable when proprioceptive feedback was provided in addition to visual feedback, i.e. when the orthosis was actually attached to the subject’s arm during the task. A distributed cortical network of task-related coherent activity in the θ-band showed significant differences between healthy subjects and stroke patients as well as between early and late periods of the task.Brain-robot interfaces may successfully link three-dimensional robotic training to the participants’ efforts and allow for task-oriented practice of activities of daily living with a physiologically controlled multi-joint exoskeleton. Changes of cortical physiology during the task might also help to make subject-specific adjustments of task difficulty and guide adjunct interventions to facilitate motor learning for functional restoration.

  8. Brain state-dependent robotic reaching movement with a multi-joint arm exoskeleton: combining brain-machine interfacing and robotic rehabilitation.

    Science.gov (United States)

    Brauchle, Daniel; Vukelić, Mathias; Bauer, Robert; Gharabaghi, Alireza

    2015-01-01

    While robot-assisted arm and hand training after stroke allows for intensive task-oriented practice, it has provided only limited additional benefit over dose-matched physiotherapy up to now. These rehabilitation devices are possibly too supportive during the exercises. Neurophysiological signals might be one way of avoiding slacking and providing robotic support only when the brain is particularly responsive to peripheral input. We tested the feasibility of three-dimensional robotic assistance for reaching movements with a multi-joint exoskeleton during motor imagery (MI)-related desynchronization of sensorimotor oscillations in the β-band. We also registered task-related network changes of cortical functional connectivity by electroencephalography via the imaginary part of the coherence function. Healthy subjects and stroke survivors showed similar patterns-but different aptitudes-of controlling the robotic movement. All participants in this pilot study with nine healthy subjects and two stroke patients achieved their maximum performance during the early stages of the task. Robotic control was significantly higher and less variable when proprioceptive feedback was provided in addition to visual feedback, i.e., when the orthosis was actually attached to the subject's arm during the task. A distributed cortical network of task-related coherent activity in the θ-band showed significant differences between healthy subjects and stroke patients as well as between early and late periods of the task. Brain-robot interfaces (BRIs) may successfully link three-dimensional robotic training to the participants' efforts and allow for task-oriented practice of activities of daily living with a physiologically controlled multi-joint exoskeleton. Changes of cortical physiology during the task might also help to make subject-specific adjustments of task difficulty and guide adjunct interventions to facilitate motor learning for functional restoration, a proposal that warrants

  9. E2Rebot: A robotic platform for upper limb rehabilitation in patients with neuromotor disability

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    Juan C Fraile

    2016-08-01

    Full Text Available The use of robotic platforms for neuro-rehabilitation may boost the neural plasticity process and improve motor recovery in patients with upper limb mobility impairment as a consequence of an acquired brain injury. A robotic platform for this aim must provide ergonomic and friendly design, human safety, intensive task-oriented therapy, and assistive forces. Its implementation is a complex process that involves new developments in the mechanical, electronics, and control fields. This article presents the end-effector rehabilitation robot, a 2-degree-of-freedom planar robotic platform for upper limb rehabilitation in patients with neuromotor disability after a stroke. We describe the ergonomic mechanical design, the system control architecture, and the rehabilitation therapies that can be performed. The impedance-based haptic controller implemented in end-effector rehabilitation robot uses the information provided by a JR3 force sensor to achieve an efficient and friendly patient–robot interaction. Two task-oriented therapy modes have been implemented based on the “assist as needed” paradigm. As a result, the amount of support provided by the robot adapts to the patient’s requirements, maintaining the therapy as intensive as possible without compromising the patient’s health and safety and promoting engagement.

  10. A Clinically Relevant Method of Analyzing Continuous Change in Robotic Upper Extremity Chronic Stroke Rehabilitation.

    Science.gov (United States)

    Massie, Crystal L; Du, Yue; Conroy, Susan S; Krebs, H Igo; Wittenberg, George F; Bever, Christopher T; Whitall, Jill

    2016-09-01

    Robots designed for rehabilitation of the upper extremity after stroke facilitate high rates of repetition during practice of movements and record precise kinematic data, providing a method to investigate motor recovery profiles over time. To determine how motor recovery profiles during robotic interventions provide insight into improving clinical gains. A convenience sample (n = 22), from a larger randomized control trial, was taken of chronic stroke participants completing 12 sessions of arm therapy. One group received 60 minutes of robotic therapy (Robot only) and the other group received 45 minutes on the robot plus 15 minutes of translation-to-task practice (Robot + TTT). Movement time was assessed using the robot without powered assistance. Analyses (ANOVA, random coefficient modeling [RCM] with 2-term exponential function) were completed to investigate changes across the intervention, between sessions, and within a session. Significant improvement (P stroke robotic interventions. © The Author(s) 2015.

  11. Design and Development of a Hand Exoskeleton Robot for Active and Passive Rehabilitation

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    Oscar Sandoval-Gonzalez

    2016-04-01

    Full Text Available The present work, which describes the mechatronic design and development of a novel rehabilitation robotic exoskeleton hand, aims to present a solution for neuromusculoskeletal rehabilitation. It presents a full range of motion for all hand phalanges and was specifically designed to carry out position and force-position control for passive and active rehabilitation routines. System integration and preliminary clinical tests are also presented.

  12. Design and Development of a Hand Exoskeleton Robot for Active and Passive Rehabilitation

    Directory of Open Access Journals (Sweden)

    Oscar Sandoval-Gonzalez

    2016-04-01

    Full Text Available The present work, which describes the mechatronic design and development of a novel rehabilitation robotic exoskeleton hand, aims to present a solution for neuromusculoskeletal rehabilitation. It presents a full range of motion for all hand phalanges and was specifically designed to carry out position and force-position control for passive and active rehabilitation routines. System integration and preliminary clinical tests are also presented.

  13. Design and Implementation of an Assistive Controller for Rehabilitation Robotic Systems

    Directory of Open Access Journals (Sweden)

    Duygun Erol

    2007-09-01

    Full Text Available The goal of our research is to develop an assistive controller for robotic rehabilitation of the upper extremity after stroke. The controller is used to provide robotic assistance to participants to help them to track a desired motion trajectory required for the rehabilitation task in an accurate and concentrated manner. This rehabilitation task is designed to ensure concentrated repetitive motion that requires cognitive processing. Experimental results on unimpaired participants are presented to demonstrate the effectiveness and feasibility of the proposed controller.

  14. Early Stroke Rehabilitation of the Upper Limb Assisted with an Electromyography-Driven Neuromuscular Electrical Stimulation-Robotic Arm.

    Science.gov (United States)

    Qian, Qiuyang; Hu, Xiaoling; Lai, Qian; Ng, Stephanie C; Zheng, Yongping; Poon, Waisang

    2017-01-01

    Effective poststroke motor rehabilitation depends on repeated limb practice with voluntary efforts. An electromyography (EMG)-driven neuromuscular electrical stimulation (NMES)-robot arm was designed for the multi-joint physical training on the elbow, the wrist, and the fingers. To investigate the training effects of the device-assisted approach on subacute stroke patients and to compare the effects with those achieved by the traditional physical treatments. This study was a pilot randomized controlled trial with a 3-month follow-up. Subacute stroke participants were randomly assigned into two groups, and then received 20-session upper limb training with the EMG-driven NMES-robotic arm (NMES-robot group, n = 14) or the time-matched traditional therapy (the control, n = 10). For the evaluation of the training effects, clinical assessments including Fugl-Meyer Assessment (FMA), Modified Ashworth Score (MAS), Action Research Arm Test (ARAT), and Function Independence Measurement (FIM) were conducted before, after the rehabilitation training, and 3 months later. Session-by-session EMG parameters in the NMES-robot group, including normalized co-contraction Indexes (CI) and EMG activation level of target muscles, were used to monitor the progress in muscular coordination patterns. Significant improvements were obtained in FMA (full score and shoulder/elbow), ARAT, and FIM [P  0.279] for both groups. Significant improvement in FMA wrist/hand was only observed in the NMES-robot group (P  0.24), and remained at an elevated level when assessed 3 months later. The EMG parameters indicated a release of muscle co-contraction in the muscle pairs of biceps brachii and flexor carpi radialis and biceps brachii and triceps brachii, as well as a reduction of muscle activation level in the wrist flexor in the NMES-robot group. The NMES-robot-assisted training was effective for early stroke upper limb rehabilitation and promoted independence in the daily living

  15. A review on the mechanical design elements of ankle rehabilitation robot.

    Science.gov (United States)

    Khalid, Yusuf M; Gouwanda, Darwin; Parasuraman, Subramanian

    2015-06-01

    Ankle rehabilitation robots are developed to enhance ankle strength, flexibility and proprioception after injury and to promote motor learning and ankle plasticity in patients with drop foot. This article reviews the design elements that have been incorporated into the existing robots, for example, backdrivability, safety measures and type of actuation. It also discusses numerous challenges faced by engineers in designing this robot, including robot stability and its dynamic characteristics, universal evaluation criteria to assess end-user comfort, safety and training performance and the scientific basis on the optimal rehabilitation strategies to improve ankle condition. This article can serve as a reference to design robot with better stability and dynamic characteristics and good safety measures against internal and external events. It can also serve as a guideline for the engineers to report their designs and findings.

  16. Perspectives on mobile robots as tools for child development and pediatric rehabilitation.

    Science.gov (United States)

    Michaud, François; Salter, Tamie; Duquette, Audrey; Laplante, Jean-François

    2007-01-01

    Mobile robots (i.e., robots capable of translational movements) can be designed to become interesting tools for child development studies and pediatric rehabilitation. In this article, the authors present two of their projects that involve mobile robots interacting with children: One is a spherical robot deployed in a variety of contexts, and the other is mobile robots used as pedagogical tools for children with pervasive developmental disorders. Locomotion capability appears to be key in creating meaningful and sustained interactions with children: Intentional and purposeful motion is an implicit appealing factor in obtaining children's attention and engaging them in interaction and learning. Both of these projects started with robotic objectives but are revealed to be rich sources of interdisciplinary collaborations in the field of assistive technology. This article presents perspectives on how mobile robots can be designed to address the requirements of child-robot interactions and studies. The authors also argue that mobile robot technology can be a useful tool in rehabilitation engineering, reaching its full potential through strong collaborations between roboticists and pediatric specialists.

  17. Wrist Rehabilitation Assisted by an Electromyography-Driven Neuromuscular Electrical Stimulation Robot After Stroke.

    Science.gov (United States)

    Hu, Xiao-Ling; Tong, Raymond Kai-yu; Ho, Newmen S K; Xue, Jing-jing; Rong, Wei; Li, Leonard S W

    2015-09-01

    Augmented physical training with assistance from robot and neuromuscular electrical stimulation (NMES) may introduce intensive motor improvement in chronic stroke. To compare the rehabilitation effectiveness achieved by NMES robot-assisted wrist training and that by robot-assisted training. This study was a single-blinded randomized controlled trial with a 3-month follow-up. Twenty-six hemiplegic subjects with chronic stroke were randomly assigned to receive 20-session wrist training with an electromyography (EMG)-driven NMES robot (NMES robot group, n = 11) and with an EMG-driven robot (robot group, n = 15), completed within 7 consecutive weeks. Clinical scores, Fugl-Meyer Assessment (FMA), Modified Ashworth Score (MAS), and Action Research Arm Test (ARAT) were used to evaluate the training effects before and after the training, as well as 3 months later. An EMG parameter, muscle co-contraction index, was also applied to investigate the session-by-session variation in muscular coordination patterns during the training. The improvement in FMA (shoulder/elbow, wrist/hand) obtained in the NMES robot group was more significant than the robot group (P application in the treatment could bring more improvements in the distal motor functions and faster rehabilitation progress. © The Author(s) 2014.

  18. Towards an SEMG-based tele-operated robot for masticatory rehabilitation.

    Science.gov (United States)

    Kalani, Hadi; Moghimi, Sahar; Akbarzadeh, Alireza

    2016-08-01

    This paper proposes a real-time trajectory generation for a masticatory rehabilitation robot based on surface electromyography (SEMG) signals. We used two Gough-Stewart robots. The first robot was used as a rehabilitation robot while the second robot was developed to model the human jaw system. The legs of the rehabilitation robot were controlled by the SEMG signals of a tele-operator to reproduce the masticatory motion in the human jaw, supposedly mounted on the moving platform, through predicting the location of a reference point. Actual jaw motions and the SEMG signals from the masticatory muscles were recorded and used as output and input, respectively. Three different methods, namely time-delayed neural networks, time delayed fast orthogonal search, and time-delayed Laguerre expansion technique, were employed and compared to predict the kinematic parameters. The optimal model structures as well as the input delays were obtained for each model and each subject through a genetic algorithm. Equations of motion were obtained by the virtual work method. Fuzzy method was employed to develop a fuzzy impedance controller. Moreover, a jaw model was developed to demonstrate the time-varying behavior of the muscle lengths during the rehabilitation process. The three modeling methods were capable of providing reasonably accurate estimations of the kinematic parameters, although the accuracy and training/validation speed of time-delayed fast orthogonal search were higher than those of the other two aforementioned methods. Also, during a simulation study, the fuzzy impedance scheme proved successful in controlling the moving platform for the accurate navigation of the reference point in the desired trajectory. SEMG has been widely used as a control command for prostheses and exoskeleton robots. However, in the current study by employing the proposed rehabilitation robot the complete continuous profile of the clenching motion was reproduced in the sagittal plane.

  19. Perspectives on human-human sensorimotor interactions for the design of rehabilitation robots.

    Science.gov (United States)

    Sawers, Andrew; Ting, Lena H

    2014-10-06

    Physical interactions between patients and therapists during rehabilitation have served as motivation for the design of rehabilitation robots, yet we lack a fundamental understanding of the principles governing such human-human interactions (HHI). Here we review the literature and pose important open questions regarding sensorimotor interaction during HHI that could facilitate the design of human-robot interactions (HRI) and haptic interfaces for rehabilitation. Based on the goals of physical rehabilitation, three subcategories of sensorimotor interaction are identified: sensorimotor collaboration, sensorimotor assistance, and sensorimotor education. Prior research has focused primarily on sensorimotor collaboration and is generally limited to relatively constrained visuomotor tasks. Moreover, the mechanisms by which performance improvements are achieved during sensorimotor cooperation with haptic interaction remains unknown. We propose that the effects of role assignment, motor redundancy, and skill level in sensorimotor cooperation should be explicitly studied. Additionally, the importance of haptic interactions may be better revealed in tasks that do not require visual feedback. Finally, cooperative motor tasks that allow for motor improvement during solo performance to be examined may be particularly relevant for rehabilitation robotics. Identifying principles that guide human-human sensorimotor interactions may lead to the development of robots that can physically interact with humans in more intuitive and biologically inspired ways, thereby enhancing rehabilitation outcomes.

  20. Three upper limb robotic devices for stroke rehabilitation: a review and clinical perspective.

    Science.gov (United States)

    Bishop, Lauri; Stein, Joel

    2013-01-01

    Stroke is a leading cause of disability worldwide. Many survivors of stroke remain with residual disabilities, even years later. Advances in technology have led to the development of a variety of robotic devices for use in rehabilitation. The integration of robotics in the delivery of neurorehabilitation is promising, but still not widely used in clinical settings. The aim of this review is to discuss the general design of three typical upper limb robotic devices, and examine the practical considerations for their use in a clinical environment. Each device is described, the available clinical literature is reviewed and a clinical perspective is given on the usefulness of these robotic devices in rehabilitation of this population. Current literature supports the use of robotics in the clinical environment. However, claims that robotic therapy is more effective than traditional treatment is not substantially supported. The majority of clinical trials reported are small, and lack the use of a control group for comparison treatment. The use of robotics in stroke rehabilitation is still a relatively new treatment platform, and still evolving. As technological advances are made, there is much potential for growth in this field.

  1. A review of lower extremity assistive robotic exoskeletons in rehabilitation therapy.

    Science.gov (United States)

    Chen, Gong; Chan, Chow Khuen; Guo, Zhao; Yu, Haoyong

    2013-01-01

    The rapid advancement of robotics technology in recent years has pushed the development of a distinctive field of robotic applications, namely robotic exoskeletons. Because of the aging population, more people are suffering from neurological disorders such as stroke, central nervous system disorder, and spinal cord injury. As manual therapy seems to be physically demanding for both the patient and therapist, robotic exoskeletons have been developed to increase the efficiency of rehabilitation therapy. Robotic exoskeletons are capable of providing more intensive patient training, better quantitative feedback, and improved functional outcomes for patients compared to manual therapy. This review emphasizes treadmill-based and over-ground exoskeletons for rehabilitation. Analyses of their mechanical designs, actuation systems, and integrated control strategies are given priority because the interactions between these components are crucial for the optimal performance of the rehabilitation robot. The review also discusses the limitations of current exoskeletons and technical challenges faced in exoskeleton development. A general perspective of the future development of more effective robot exoskeletons, specifically real-time biological synergy-based exoskeletons, could help promote brain plasticity among neurologically impaired patients and allow them to regain normal walking ability.

  2. Robot-Aided Upper-Limb Rehabilitation Based on Motor Imagery EEG

    Directory of Open Access Journals (Sweden)

    Baoguo Xu

    2011-09-01

    Full Text Available Stroke is a leading cause of disability worldwide. In this paper, a novel robot‐assisted rehabilitation system based on motor imagery electroencephalography (EEG is developed for regular training of neurological rehabilitation for upper limb stroke patients. Firstly, three‐dimensional animation was used to guide the patient image the upper limb movement and EEG signals were acquired by EEG amplifier. Secondly, eigenvectors were extracted by harmonic wavelet transform (HWT and linear discriminant analysis (LDA classifier was utilized to classify the pattern of the left and right upper limb motor imagery EEG signals. Finally, PC triggered the upper limb rehabilitation robot to perform motor therapy and gave the virtual feedback. Using this robot‐assisted upper limb rehabilitation system, the patientʹs EEG of upper limb movement imagination is translated to control rehabilitation robot directly. Consequently, the proposed rehabilitation system can fully explore the patientʹs motivation and attention and directly facilitate upper limb post‐stroke rehabilitation therapy. Experimental results on unimpaired participants were presented to demonstrate the feasibility of the rehabilitation system. Combining robot‐assisted training with motor imagery‐ based BCI will make future rehabilitation therapy more effective. Clinical testing is still required for further proving this assumption.

  3. Torque Control of a Rehabilitation Teaching Robot Using Magneto-Rheological Fluid Clutches

    Science.gov (United States)

    Hakogi, Hokuto; Ohaba, Motoyoshi; Kuramochi, Naimu; Yano, Hidenori

    A new robot that makes use of MR-fluid clutches for simulating torque is proposed to provide an appropriate device for training physical therapy students in knee-joint rehabilitation. The feeling of torque provided by the robot is expected to correspond to the torque performance obtained by physical therapy experts in a clinical setting. The torque required for knee-joint rehabilitation, which is a function of the rotational angle and the rotational angular velocity of a knee movement, is modeled using a mechanical system composed of typical spring-mass-damper elements. The robot consists of two MR-fluid clutches, two induction motors, and a feedback control system. In the torque experiments, output torque is controlled using the spring and damper coefficients separately. The values of these coefficients are determined experimentally. The experimental results show that the robot would be suitable for training physical therapy students to experience similar torque feelings as needed in a clinical situation.

  4. Bilateral robots for upper-limb stroke rehabilitation: State of the art and future prospects.

    Science.gov (United States)

    Sheng, Bo; Zhang, Yanxin; Meng, Wei; Deng, Chao; Xie, Shengquan

    2016-07-01

    Robot-assisted bilateral upper-limb training grows abundantly for stroke rehabilitation in recent years and an increasing number of devices and robots have been developed. This paper aims to provide a systematic overview and evaluation of existing bilateral upper-limb rehabilitation devices and robots based on their mechanisms and clinical-outcomes. Most of the articles studied here were searched from nine online databases and the China National Knowledge Infrastructure (CNKI) from year 1993 to 2015. Devices and robots were categorized as end-effectors, exoskeletons and industrial robots. Totally ten end-effectors, one exoskeleton and one industrial robot were evaluated in terms of their mechanical characteristics, degrees of freedom (DOF), supported control modes, clinical applicability and outcomes. Preliminary clinical results of these studies showed that all participants could gain certain improvements in terms of range of motion, strength or physical function after training. Only four studies supported that bilateral training was better than unilateral training. However, most of clinical results cannot definitely verify the effectiveness of mechanisms and clinical protocols used in robotic therapies. To explore the actual value of these robots and devices, further research on ingenious mechanisms, dose-matched clinical protocols and universal evaluation criteria should be conducted in the future.

  5. Upper-Extremity Rehabilitation Robot RehabRoby: Methodology, Design, Usability and Validation

    Directory of Open Access Journals (Sweden)

    Fatih Ozkul

    2013-12-01

    Full Text Available In this study, an exoskeleton type robot-assisted rehabilitation system, called RehabRoby, is developed for rehabilitation purposes. A control architecture, which contains a high-level controller and a low-level controller, is designed so that RehabRoby can complete the given rehabilitation task in a desired and safe manner. A hybrid system modelling technique is used for the high-level controller. An admittance control with an inner robust position control loop is used for the low-level control of the RehabRoby. Real-time experiments are performed to evaluate the control architecture of the robot-assisted rehabilitation system, RehabRoby. Furthermore, the usability of RehabRoby is evaluated.

  6. Hybrid robotic systems for upper limb rehabilitation after stroke: A review.

    Science.gov (United States)

    Resquín, Francisco; Cuesta Gómez, Alicia; Gonzalez-Vargas, Jose; Brunetti, Fernando; Torricelli, Diego; Molina Rueda, Francisco; Cano de la Cuerda, Roberto; Miangolarra, Juan Carlos; Pons, José Luis

    2016-11-01

    In recent years the combined use of functional electrical stimulation (FES) and robotic devices, called hybrid robotic rehabilitation systems, has emerged as a promising approach for rehabilitation of lower and upper limb motor functions. This paper presents a review of the state of the art of current hybrid robotic solutions for upper limb rehabilitation after stroke. For this aim, studies have been selected through a search using web databases: IEEE-Xplore, Scopus and PubMed. A total of 10 different hybrid robotic systems were identified, and they are presented in this paper. Selected systems are critically compared considering their technological components and aspects that form part of the hybrid robotic solution, the proposed control strategies that have been implemented, as well as the current technological challenges in this topic. Additionally, we will present and discuss the corresponding evidences on the effectiveness of these hybrid robotic therapies. The review also discusses the future trends in this field. Copyright © 2016 IPEM. Published by Elsevier Ltd. All rights reserved.

  7. Task-specific ankle robotics gait training after stroke: a randomized pilot study

    National Research Council Canada - National Science Library

    Forrester, Larry W; Roy, Anindo; Hafer-Macko, Charlene; Krebs, Hermano I; Macko, Richard F

    2016-01-01

    An unsettled question in the use of robotics for post-stroke gait rehabilitation is whether task-specific locomotor training is more effective than targeting individual joint impairments to improve walking function...

  8. Adapting a robotics program to enhance participation and interest in STEM among children with disabilities: a pilot study.

    Science.gov (United States)

    Lindsay, Sally; Hounsell, Kara Grace

    2017-10-01

    Youth with disabilities are under-represented in science, technology, engineering, and math (STEM) in school and in the workforce. One encouraging approach to engage youth's interest in STEM is through robotics; however, such programs are mostly for typically developing youth. The purpose of this study was to understand the development and implementation of an adapted robotics program for children and youth with disabilities and their experiences within it. Our mixed methods pilot study (pre- and post-workshop surveys, observations, and interviews) involved 41 participants including: 18 youth (aged 6-13), 12 parents and 11 key informants. The robotics program involved 6, two-hour workshops held at a paediatric hospital. Our findings showed that several adaptations made to the robotics program helped to enhance the participation of children with disabilities. Adaptations addressed the educational/curriculum, cognitive and learning, physical and social needs of the children. In regards to experiences within the adapted hospital program, our findings highlight that children enjoyed the program and learned about computer programming and building robots. Clinicians and educators should consider engaging youth with disabilities in robotics to enhance learning and interest in STEM. Implications for Rehabilitation Clinicians and educators should consider adapting curriculum content and mode of delivery of LEGO(®) robotics programs to include youth with disabilities. Appropriate staffing including clinicians and educators who are knowledgeable about youth with disabilities and LEGO(®) robotics are needed. Clinicians should consider engaging youth with disabilities in LEGO(®) to enhance learning and interest in STEM.

  9. Robotic approaches for rehabilitation of hand function after stroke.

    Science.gov (United States)

    Lum, Peter S; Godfrey, Sasha B; Brokaw, Elizabeth B; Holley, Rahsaan J; Nichols, Diane

    2012-11-01

    The goal of this review was to discuss the impairments in hand function after stroke and present previous work on robot-assisted approaches to movement neurorehabilitation. Robotic devices offer a unique training environment that may enhance outcomes beyond what is possible with conventional means. Robots apply forces to the hand, allowing completion of movements while preventing inappropriate movement patterns. Evidence from the literature is emerging that certain characteristics of the human-robot interaction are preferable. In light of this evidence, the robotic hand devices that have undergone clinical testing are reviewed, highlighting the authors' work in this area. Finally, suggestions for future work are offered. The ability to deliver therapy doses far higher than what has been previously tested is a potentially key advantage of robotic devices that needs further exploration. In particular, more efforts are needed to develop highly motivating home-based devices, which can increase access to high doses of assisted movement therapy.

  10. Swarm Robot Control for Human Services and Moving Rehabilitation by Sensor Fusion

    Directory of Open Access Journals (Sweden)

    Tresna Dewi

    2014-01-01

    Full Text Available A current trend in robotics is fusing different types of sensors having different characteristics to improve the performance of a robot system and also benefit from the reduced cost of sensors. One type of robot that requires sensor fusion for its application is the service robot. To achieve better performance, several service robots are preferred to work together, and, hence, this paper concentrates on swarm service robots. Swarm service mobile robots operating within a fixed area need to cope with dynamic changes in the environment, and they must also be capable of avoiding dynamic and static obstacles. This study applies sensor fusion and swarm concept for service mobile robots in human services and rehabilitation environment. The swarm robots follow the human moving trajectory to provide support to human moving and perform several tasks required in their living environment. This study applies a reference control and proportional-integral (PI control for the obstacle avoidance function. Various computer simulations are performed to verify the effectiveness of the proposed method.

  11. Robotic exoskeletons: a perspective for the rehabilitation of arm coordination in stroke patients

    Directory of Open Access Journals (Sweden)

    Nathanael eJarrassé

    2014-12-01

    Full Text Available Upper-limb impairment after stroke is caused by weakness, loss of individual joint control, spasticity and abnormal synergies. Upper limb movement frequently involves abnormal, stereotyped and fixed synergies, likely related to the increased use of subcortical networks following the stroke. The flexible coordination of the shoulder and elbow joints is also disrupted. New methods for motor learning, based on the stimulation of activity-dependent neural plasticity have been developed. These include robots that can adaptively assist active movements and generate many movement repetitions. However, most of these robots only control the movement of the hand in space. The aim of the present text is to analyse the potential of robotic exoskeletons to specifically rehabilitate joint motion and particularly inter-joint coordination. Firstly, a review of studies on upper-limb coordination in stroke patients is presented and the potential for recovery of coordination is examined. Secondly, issues relating to the mechanical design of exoskeletons and the transmission of constraints between the robotic and human limbs are discussed. The third section considers the development of different methods to control exoskeletons: existing rehabilitation devices and approaches to the control and rehabilitation of joint coordinations are then reviewed, along with preliminary clinical results available. Finally, perspectives and future strategies for the design of control mechanisms for rehabilitation exoskeletons are discussed.

  12. Robotic Exoskeletons: A Perspective for the Rehabilitation of Arm Coordination in Stroke Patients

    Science.gov (United States)

    Jarrassé, Nathanaël; Proietti, Tommaso; Crocher, Vincent; Robertson, Johanna; Sahbani, Anis; Morel, Guillaume; Roby-Brami, Agnès

    2014-01-01

    Upper-limb impairment after stroke is caused by weakness, loss of individual joint control, spasticity, and abnormal synergies. Upper-limb movement frequently involves abnormal, stereotyped, and fixed synergies, likely related to the increased use of sub-cortical networks following the stroke. The flexible coordination of the shoulder and elbow joints is also disrupted. New methods for motor learning, based on the stimulation of activity-dependent neural plasticity have been developed. These include robots that can adaptively assist active movements and generate many movement repetitions. However, most of these robots only control the movement of the hand in space. The aim of the present text is to analyze the potential of robotic exoskeletons to specifically rehabilitate joint motion and particularly inter-joint coordination. First, a review of studies on upper-limb coordination in stroke patients is presented and the potential for recovery of coordination is examined. Second, issues relating to the mechanical design of exoskeletons and the transmission of constraints between the robotic and human limbs are discussed. The third section considers the development of different methods to control exoskeletons: existing rehabilitation devices and approaches to the control and rehabilitation of joint coordinations are then reviewed, along with preliminary clinical results available. Finally, perspectives and future strategies for the design of control mechanisms for rehabilitation exoskeletons are discussed. PMID:25520638

  13. Research on Safety and Compliance of a New Lower Limb Rehabilitation Robot

    Directory of Open Access Journals (Sweden)

    Yongfei Feng

    2017-01-01

    Full Text Available The lower limb rehabilitation robot is an application of robotic technology for stroke people with lower limb disabilities. A new applicable and effective sitting/lying lower limb rehabilitation robot (LLR-Ro is proposed, which has the mechanical limit protection, the electrical limit protection, and the software protection to prevent the patient from the secondary damage. Meanwhile, as a new type of the rehabilitation robots, its hip joint rotation ranges are different in the patient sitting training posture and lying training posture. The mechanical leg of the robot has a variable workspace to work in both training postures. So, if the traditional mechanical limit and the electrical limit cannot be used in the hip joint mechanism design, a follow-up limit is first proposed to improve the compatibility of human-machine motion. Besides, to eliminate the accident interaction force between the patient and LLR-Ro in the process of the passive training, an amendment impedance control strategy based on the position control is proposed to improve the compliance of the LLR-Ro. A simulation experiment and an experiment with a participant show that the passive training of LLR-Ro has compliance.

  14. Hand Robotic Therapy in Children with Hemiparesis: A Pilot Study.

    Science.gov (United States)

    Bishop, Lauri; Gordon, Andrew M; Kim, Heakyung

    2017-01-01

    The aim of this study was to understand the impact of training with a hand robotic device on hand paresis and function in a population of children with hemiparesis. Twelve children with hemiparesis (mean age, 9 [SD, 3.64] years) completed participation in this prospective, experimental, pilot study. Participants underwent clinical assessments at baseline and again 6 weeks later with instructions to not initiate new therapies. After these assessments, participants received 6 weeks of training with a hand robotic device, consisting of 1-hour sessions, 3 times weekly. Assessments were repeated on completion of training. Results showed significant improvements after training on the Assisting Hand Assessment (mean difference, 2.0 Assisting Hand Assessment units; P = 0.011) and on the upper-extremity component of the Fugl-Meyer scale (raw score mean difference, 4.334; P = 0.001). No significant improvements between pretest and posttest were noted on the Jebsen-Taylor Test of Hand Function, the Quality of Upper Extremity Skills Test, or the Pediatric Evaluation of Disability Inventory after intervention. Total active mobility of digits and grip strength also failed to demonstrate significant changes after training. Participants tolerated training with the hand robotic device, and significant improvements in bimanual hand use, as well as impairment-based scales, were noted. Improvements were carried over into bimanual skills during play. Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME CME OBJECTIVES: Upon completion of this article, the reader should be able to: (1) Understand key components of neuroplasticity; (2) Discuss the benefits of robotic therapy in the recovery of hand function in pediatric patients with hemiplegia; and (3) Appropriately incorporate robotic therapy into the treatment plan of pediatric patients with hemiplegia. Advanced ACCREDITATION: The Association of Academic Physiatrists is accredited by the

  15. Effects of a multidisciplinary group rehabilitation programme on participation of the visually impaired elderly : a pilot study

    NARCIS (Netherlands)

    Alma, Manna A.; Groothoff, Johan W.; Melis-Dankers, Bart J. M.; Post, Marcel W. M.; Suurmeijer, Theo P. B. M.; van der Mei, Sijrike F.

    2012-01-01

    Purpose: To pilot test the newly developed multidisciplinary group rehabilitation programme Visually Impaired elderly Persons Participating (VIPP). Method: A single group pretest-posttest design pilot study included 29 visually impaired persons (>= 55 years). The intervention (20 weekly meetings) co

  16. Design and Optimization of a Hybrid-Driven Waist Rehabilitation Robot

    Directory of Open Access Journals (Sweden)

    Bin Zi

    2016-12-01

    Full Text Available In this paper a waist rehabilitation robot driven by cables and pneumatic artificial muscles (PAMs has been conceptualized and designed. In the process of mechanism design, the human body structure, the waist movement characteristics, and the actuators’ driving characteristics are the main considerable factors to make the hybrid-driven waist rehabilitation robot (HWRR cost-effective, safe, flexible, and well-adapted. A variety of sensors are chosen to measure the position and orientation of the recovery patient to ensure patient safety at the same time as the structure design. According to the structure specialty and function, the HWRR is divided into two independent parallel robots: the waist twist device and the lower limb traction device. Then these two devices are analyzed and evaluated, respectively. Considering the characters of the human body in the HWRR, the inverse kinematics and statics are studied when the waist and the lower limb are considered as a spring and link, respectively. Based on the inverse kinematics and statics, the effect of the contraction parameter of the PAM is considered in the optimization of the waist twist device, and the lower limb traction device is optimized using particle swarm optimization (PSO to minimize the global conditioning number over the feasible workspace. As a result of the optimization, an optimal rehabilitation robot design is obtained and the condition number of the Jacobian matrix over the feasible workspace is also calculated.

  17. A Systematic Review on Existing Measures for the Subjective Assessment of Rehabilitation and Assistive Robot Devices

    Directory of Open Access Journals (Sweden)

    Yiannis Koumpouros

    2016-01-01

    Full Text Available The objective of the current study is to identify and classify outcome measures currently used for the assessment of rehabilitation or assistive robot devices. We conducted a systematic review of the literature using PubMed, MEDLINE, CIRRIE, and Scopus databases for studies that assessed rehabilitation or assistive robot devices from 1980 through January 2016. In all, 31 articles met all inclusion criteria. Tailor-made questionnaires were the most commonly used tool at 66.7%, while the great majority (93.9% of the studies used nonvalidated instruments. The study reveals the absence of a standard scale which makes it difficult to compare the results from different researchers. There is a great need, therefore, for a valid and reliable instrument to be available for use by the intended end users for the subjective assessment of robot devices. The study concludes by identifying two scales that have been validated in general assistive technology devices and could support the scope of subjective assessment in rehabilitation or assistive robots (however, with limited coverage and a new one called PYTHEIA, recently published. The latter intends to close the gap and help researchers and developers to evaluate, assess, and produce products that satisfy the real needs of the end users.

  18. Effects of robotic gait rehabilitation on biomechanical parameters in the chronic hemiplegic patients.

    Science.gov (United States)

    Wallard, L; Dietrich, G; Kerlirzin, Y; Bredin, J

    2015-09-01

    Hemiplegia is a more or less complete loss of hemibody voluntary motricity following a brain injury, usually resulting in alterations of the locomotor system with persistent disorders of movement and posture. We were interested in studying the gait pattern called "stiff knee gait" with the main objective to highlight the role of a robotic rehabilitation in improving or modifying/changing the walking pattern in adults with chronic hemiplegic disorders. Data were collected by a motion analysis system (Vicon(®)--Oxford Metrics, Oxford, UK) in order to achieve a Clinical Gait Analysis before and after a robotic gait rehabilitation (Lokomat(®)). Four intensive sessions per weeks during five weeks were performed by ten chronic hemiplegic adults. The results show a significant improvement in locomotor parameters (walking speed, step length, single and double support time) and in the knee kinematics. This first study provides experimental evidence of the importance and usefulness of the robotic rehabilitation as an aid in the rehabilitation of gait pattern in adults with chronic hemiplegia. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  19. Lower Extremity Rehabilitation Robot%下肢康复训练机器人

    Institute of Scientific and Technical Information of China (English)

    刘合岭; 蒋延丰; 魏斌; 汪艳; 李敏佳; 黄杨; 邹凯

    2015-01-01

    结合国内外机构对康复训练机器人的研究热点和现阶段我国卫生政策、人民康复需求,对国外Reha Technology公司生产的G-EO下肢康复机器人的结构和功能进行介绍,旨在为我国康复医院和康复医学工程有关康复设备的研究提供参考。%We make an instruction on the G-EO lower extremity rehabilitation robot on the basis of the study hot from the Institutions at home and abroad, health policies and people’s recovery demand of our country to provide the reference for the rehabilitation hospital and rehabilitation medical engineering on the study of the rehabilitation equipment.

  20. An intelligent end-effector for a rehabilitation robot.

    Science.gov (United States)

    Gosine, R G; Harwin, W S; Furby, L J; Jackson, R D

    1989-01-01

    A UMI RTX robot, modified with limited end-effector sensors and a restricted but effective vision system, is currently used in a developmental education setting for severely physically disabled children. The low physical and cognitive abilities of the children involved in the project require a semi-autonomous robot with environmental sensing capability to operate in a task oriented mode. A variety of low-cost sensors including proximity, distance, force and slip sensors, have been investigated for integration in end-effectors for the RTX robot. The sensors employed on a modified end-effector are detailed and experimental results are presented. A design for an end-effector with integrated sensors is discussed. The integration of the sensor information into a high-level, task-oriented programming language is detailed and examples of high-level control sequences using sensor inputs are presented. Finally, the development of intelligent gripping strategies based on sensor information is discussed.

  1. Bimanual elbow robotic orthoses: preliminary investigations on an impairment force feedback rehabilitation method

    Directory of Open Access Journals (Sweden)

    Gil eHerrnstadt

    2015-03-01

    Full Text Available Modern rehabilitation practices have begun integrating robots, recognizing their significant role in recovery. New and alternative stroke rehabilitation treatments are essential to enhance efficacy and mitigate associated health costs. Today’s robotic interventions can play a significant role in advancing rehabilitation. In addition, robots have an inherent ability to perform tasks accurately and reliably and are typically well suited to measure and quantify performance.Most rehabilitation strategies predominantly target activation of the paretic arm. However, bimanual upper limb rehabilitation research suggests potential in enhancing functional recovery. Moreover studies suggest limb coordination and synchronization can improve treatment efficacy.In this preliminary study, we aimed to investigate and validate our user-driven bimanual system in a reduced intensity rehab practice. A Bimanual Wearable Robotic Device (BWRD with a Master-Slave configuration for the elbow joint was developed to carry out the investigation. The BWRD incorporates position and force sensors for which respective control loops are implemented, and offers varying modes of operation ranging from passive to active training. The proposed system enables the perception of the movements, as well as the forces applied by the hemiparetic arm, with the non-hemiparetic arm. Eight participants with chronic unilateral stroke were recruited to participate in a total of three one-hour sessions per participant, delivered in a week. Participants underwent pre and post training functional assessments along with proprioceptive measures. The post assessment was performed at the end of the last training session.The protocol was designed to engage the user in an assortment of static and dynamic arm matching and opposing tasks. The training incorporates force feedback movements, force feedback positioning, and force matching tasks with same and opposite direction movements. We are able to

  2. Towards more effective robotic gait training for stroke rehabilitation: a review

    Directory of Open Access Journals (Sweden)

    Pennycott Andrew

    2012-09-01

    Full Text Available Abstract Background Stroke is the most common cause of disability in the developed world and can severely degrade walking function. Robot-driven gait therapy can provide assistance to patients during training and offers a number of advantages over other forms of therapy. These potential benefits do not, however, seem to have been fully realised as of yet in clinical practice. Objectives This review determines ways in which robot-driven gait technology could be improved in order to achieve better outcomes in gait rehabilitation. Methods The literature on gait impairments caused by stroke is reviewed, followed by research detailing the different pathways to recovery. The outcomes of clinical trials investigating robot-driven gait therapy are then examined. Finally, an analysis of the literature focused on the technical features of the robot-based devices is presented. This review thus combines both clinical and technical aspects in order to determine the routes by which robot-driven gait therapy could be further developed. Conclusions Active subject participation in robot-driven gait therapy is vital to many of the potential recovery pathways and is therefore an important feature of gait training. Higher levels of subject participation and challenge could be promoted through designs with a high emphasis on robotic transparency and sufficient degrees of freedom to allow other aspects of gait such as balance to be incorporated.

  3. [NEW OPPORTUNITIES IN NEURO-REHABILITATION: ROBOT MEDIATED THERAPY IN CONDITONS POST CENTRAL NERVOUS SYSTEM IMPAIRMENTS].

    Science.gov (United States)

    Fazekas, Gábor; Tavaszi, Ibolya; Tóth, András

    2016-03-30

    Decreasing the often-seen multiple disabilities as a consequence of central nervous system impairments requires broadening of the tools of rehabilitation. A promising opportunity for this purpose is the application of physiotherapy robots. The development of such devices goes back a quarter of century. Nowadays several robots are commercially available both for supporting upper and lower limb therapy. The aim is never to replace the therapists, but rather to support and supplement their work. It is worthwhile applying these devices for goal-oriented exercises in high repetition, which one physically fatiguing for the therapist or for the correction of functional movement by various strategies. Robot mediated therapy is also useful for motivation of the patient and making the rehabilitation programme more versatile. Robots can be used for assessment of the neuromotor status as well. Several clinical studies have been executed in this field, all over the world. Meta-analyses based on randomized, controlled trials show that supplementing the traditional physiotherapy with a robot-mediated component presents advantage for the patients. Further studies are necessary to clarify which modality and intensity of the exercises, in which group of patients, in which stage lead to the expected outcome.

  4. Creating gesture controlled games for robot-assisted stroke rehabilitation

    NARCIS (Netherlands)

    Basteris, A.; Johansson, E.; Klein, P.; Nasr, N.; Nijenhuis, S.; Sale, P.; Schätzlein, F.; Stienen, A.H.A.

    2014-01-01

    Regular training exercises are fundamental to regain functional use of arm and hand control after a stroke. With the SCRIPT system, the patient can practice hand excercising independently at home by playing gesture controlled games using a robotic glove (orthosis). The system could offer prolonged r

  5. Application of a disturbance-rejection controller for robotic-enhanced limb rehabilitation trainings.

    Science.gov (United States)

    Madoński, R; Kordasz, M; Sauer, P

    2014-07-01

    The paper presents an application of a special case of an Active Disturbance Rejection Controller (ADRC) in governing a proper realization of basic limb rehabilitation trainings. The experimental study is performed on a model of a flexible joint manipulator, whose behavior resembles a real robotic rehabilitation device. The multidimensional character of the considered assisting mechanism makes it a nontrivial modeling and control problem. However, by the use of the ADRC approach, the modeling uncertainty in the plant is partially decoupled from the system, which increases the robustness of the whole control framework against both internal and external disturbances.

  6. Adaptive training algorithm for robot-assisted upper-arm rehabilitation, applicable to individualised and therapeutic human-robot interaction.

    Science.gov (United States)

    Chemuturi, Radhika; Amirabdollahian, Farshid; Dautenhahn, Kerstin

    2013-09-28

    Rehabilitation robotics is progressing towards developing robots that can be used as advanced tools to augment the role of a therapist. These robots are capable of not only offering more frequent and more accessible therapies but also providing new insights into treatment effectiveness based on their ability to measure interaction parameters. A requirement for having more advanced therapies is to identify how robots can 'adapt' to each individual's needs at different stages of recovery. Hence, our research focused on developing an adaptive interface for the GENTLE/A rehabilitation system. The interface was based on a lead-lag performance model utilising the interaction between the human and the robot. The goal of the present study was to test the adaptability of the GENTLE/A system to the performance of the user. Point-to-point movements were executed using the HapticMaster (HM) robotic arm, the main component of the GENTLE/A rehabilitation system. The points were displayed as balls on the screen and some of the points also had a real object, providing a test-bed for the human-robot interaction (HRI) experiment. The HM was operated in various modes to test the adaptability of the GENTLE/A system based on the leading/lagging performance of the user. Thirty-two healthy participants took part in the experiment comprising of a training phase followed by the actual-performance phase. The leading or lagging role of the participant could be used successfully to adjust the duration required by that participant to execute point-to-point movements, in various modes of robot operation and under various conditions. The adaptability of the GENTLE/A system was clearly evident from the durations recorded. The regression results showed that the participants required lower execution times with the help from a real object when compared to just a virtual object. The 'reaching away' movements were longer to execute when compared to the 'returning towards' movements irrespective of the

  7. Non-contact versus contact-based sensing methodologies for in-home upper arm robotic rehabilitation.

    Science.gov (United States)

    Howard, Ayanna; Brooks, Douglas; Brown, Edward; Gebregiorgis, Adey; Chen, Yu-Ping

    2013-06-01

    In recent years, robot-assisted rehabilitation has gained momentum as a viable means for improving outcomes for therapeutic interventions. Such therapy experiences allow controlled and repeatable trials and quantitative evaluation of mobility metrics. Typically though these robotic devices have been focused on rehabilitation within a clinical setting. In these traditional robot-assisted rehabilitation studies, participants are required to perform goal-directed movements with the robot during a therapy session. This requires physical contact between the participant and the robot to enable precise control of the task, as well as a means to collect relevant performance data. On the other hand, non-contact means of robot interaction can provide a safe methodology for extracting the control data needed for in-home rehabilitation. As such, in this paper we discuss a contact and non-contact based method for upper-arm rehabilitation exercises that enables quantification of upper-arm movements. We evaluate our methodology on upper-arm abduction/adduction movements and discuss the advantages and limitations of each approach as applied to an in-home rehabilitation scenario.

  8. Hand Rehabilitation Learning System With an Exoskeleton Robotic Glove.

    Science.gov (United States)

    Ma, Zhou; Ben-Tzvi, Pinhas; Danoff, Jerome

    2016-12-01

    This paper presents a hand rehabilitation learning system, the SAFE Glove, a device that can be utilized to enhance the rehabilitation of subjects with disabilities. This system is able to learn fingertip motion and force for grasping different objects and then record and analyze the common movements of hand function including grip and release patterns. The glove is then able to reproduce these movement patterns in playback fashion to assist a weakened hand to accomplish these movements, or to modulate the assistive level based on the user's or therapist's intent for the purpose of hand rehabilitation therapy. Preliminary data have been collected from healthy hands. To demonstrate the glove's ability to manipulate the hand, the glove has been fitted on a wooden hand and the grasping of various objects was performed. To further prove that hands can be safely driven by this haptic mechanism, force sensor readings placed between each finger and the mechanism are plotted. These experimental results demonstrate the potential of the proposed system in rehabilitation therapy.

  9. Compensating the effects of FES-induced muscle fatigue by rehabilitation robotics during arm weight support

    Directory of Open Access Journals (Sweden)

    Meyer-Rachner Paul

    2017-03-01

    Full Text Available Motor functions can be hindered in consequence to a stroke or a spinal cord injury. This often results in partial paralyses of the upper limb. The effectiveness of rehabilitation therapy can be improved by the use of rehabilitation robotics and Functional Electrical Stimulation (FES. We consider a hybrid arm weight support combining both. In order to compensate the effect of FES-induced muscle fatigue, we introduce a method to substitute the decreasing level of FES support by cable-driven robotics. We evaluated the approach in a trial with one healthy subject performing repetitive arm lifting. The controller automatically adapted the support and thus no increase in user generated volitional effort was observed when FES induced muscle fatigue occured.

  10. Combining Upper Limb Robotic Rehabilitation with Other Therapeutic Approaches after Stroke: Current Status, Rationale, and Challenges

    Directory of Open Access Journals (Sweden)

    Stefano Mazzoleni

    2017-01-01

    Full Text Available A better understanding of the neural substrates that underlie motor recovery after stroke has led to the development of innovative rehabilitation strategies and tools that incorporate key elements of motor skill relearning, that is, intensive motor training involving goal-oriented repeated movements. Robotic devices for the upper limb are increasingly used in rehabilitation. Studies have demonstrated the effectiveness of these devices in reducing motor impairments, but less so for the improvement of upper limb function. Other studies have begun to investigate the benefits of combined approaches that target muscle function (functional electrical stimulation and botulinum toxin injections, modulate neural activity (noninvasive brain stimulation, and enhance motivation (virtual reality in an attempt to potentialize the benefits of robot-mediated training. The aim of this paper is to overview the current status of such combined treatments and to analyze the rationale behind them.

  11. Multicenter randomized trial of robot-assisted rehabilitation for chronic stroke: methods and entry characteristics for VA ROBOTICS.

    Science.gov (United States)

    Lo, Albert C; Guarino, Peter; Krebs, Hermano I; Volpe, Bruce T; Bever, Christopher T; Duncan, Pamela W; Ringer, Robert J; Wagner, Todd H; Richards, Lorie G; Bravata, Dawn M; Haselkorn, Jodie K; Wittenberg, George F; Federman, Daniel G; Corn, Barbara H; Maffucci, Alysia D; Peduzzi, Peter

    2009-10-01

    Chronic upper extremity impairment due to stroke has significant medical, psychosocial, and financial consequences, but few studies have examined the effectiveness of rehabilitation therapy during the chronic stroke period. . To test the safety and efficacy of the MIT-Manus robotic device for chronic upper extremity impairment following stroke. . The VA Cooperative Studies Program initiated a multicenter, randomized, controlled trial in November 2006 (VA ROBOTICS). Participants with upper extremity impairment >/=6 months poststroke were randomized to robot-assisted therapy (RT), intensive comparison therapy (ICT), or usual care (UC). RT and ICT consisted of three 1-hour treatment sessions per week for 12 weeks. The primary outcome was change in the Fugl-Meyer Assessment upper extremity motor function score at 12 weeks relative to baseline. Secondary outcomes included the Wolf Motor Function Test and the Stroke Impact Scale. . A total of 127 participants were randomized: 49 to RT, 50 to ICT, and 28 to UC. The majority of participants were male (96%), with a mean age of 65 years. The primary stroke type was ischemic (85%), and 58% of strokes occurred in the anterior circulation. Twenty percent of the participants reported a stroke in addition to their index stroke. The average time from the index stroke to enrollment was 56 months (range, 6 months to 24 years). The mean Fugl-Meyer score at entry was 18.9. . VA ROBOTICS demonstrates the feasibility of conducting multicenter clinical trials to rigorously test new rehabilitative devices before their introduction to clinical practice. The results are expected in early 2010.

  12. Robot-assisted Guitar Hero for finger rehabilitation after stroke.

    Science.gov (United States)

    Taheri, Hossein; Rowe, Justin B; Gardner, David; Chan, Vicky; Reinkensmeyer, David J; Wolbrecht, Eric T

    2012-01-01

    This paper describes the design and testing of a robotic device for finger therapy after stroke: FINGER (Finger Individuating Grasp Exercise Robot). FINGER makes use of stacked single degree-of-freedom mechanisms to assist subjects in moving individual fingers in a naturalistic grasping pattern through much of their full range of motion. The device has a high bandwidth of control (-3dB at approximately 8 Hz) and is backdriveable. These characteristics make it capable of assisting in grasping tasks that require precise timing. We therefore used FINGER to assist individuals with a stroke (n= 8) and without impairment (n= 4) in playing a game similar to Guitar Hero©. The subjects attempted to move their fingers to target positions at times specified by notes that were graphically streamed to popular music. We show here that by automatically adjusting the robot gains, it is possible to use FINGER to modulate the subject's success rate at the game, across a range of impairment levels. Modulating success rates did not alter the stroke subject's effort, although the unimpaired subjects exerted more force when they were made less successful. We also present a novel measure of finger individuation that can be assessed as individuals play Guitar Hero with FINGER. The results demonstrate the ability of FINGER to provide controlled levels of assistance during an engaging computer game, and to quantify finger individuation after stroke.

  13. Animal Robot Assisted-therapy for Rehabilitation of Patient with Post-Stroke Depression

    Science.gov (United States)

    Zikril Zulkifli, Winal; Shamsuddin, Syamimi; Hwee, Lim Thiam

    2017-06-01

    Recently, the utilization of therapeutic animal robots has expanded. This research aims to explore robotics application for mental healthcare in Malaysia through human-robot interaction (HRI). PARO, the robotic seal PARO was developed to give psychological effects on humans. Major Depressive Disorder (MDD) is a common but severe mood disorder. This study focuses on the interaction protocol between PARO and patients with MDD. Initially, twelve rehabilitation patients gave subjective evaluation on their first interaction with PARO. Next, therapeutic interaction environment was set-up with PARO in it to act as an augmentation strategy with other psychological interventions for post-stroke depression. Patient was exposed to PARO for 20 minutes. The results of behavioural analysis complemented with information from HRI survey question. The analysis also observed that the individual interactors engaged with the robot in diverse ways based on their needs Results show positive reaction toward the acceptance of an animal robot. Next, therapeutic interaction is set-up for PARO to contribute as an augmentation strategy with other psychological interventions for post-stroke depression. The outcome is to reduce the stress level among patients through facilitated therapy session with PARO

  14. Early Poststroke Rehabilitation Using a Robotic Tilt-Table Stepper and Functional Electrical Stimulation

    Directory of Open Access Journals (Sweden)

    Alexey N. Kuznetsov

    2013-01-01

    Full Text Available Background. Stroke frequently leaves survivors with hemiparesis. To prevent persistent deficits, rehabilitation may be more effective if started early. Early training is often limited because of orthostatic reactions. Tilt-table stepping robots and functional electrical stimulation (FES may prevent these reactions. Objective. This controlled convenience sample study compares safety and feasibility of robotic tilt-table training plus FES (ROBO-FES and robotic tilt-table training (ROBO against tilt-table training alone (control. A preliminary assessment of efficacy is performed. Methods. Hemiparetic ischemic stroke survivors (age years, days after stroke were assigned to 30 days of ROBO-FES (, ROBO (, or control ( in addition to conventional physical therapy. Impedance cardiography and transcranial doppler sonography were performed before, during, and after training. Hemiparesis was assessed using the British Medical Research Council (MRC strength scale. Results. No serious adverse events occurred; 8 patients in the tilt-table group prematurely quit the study because of orthostatic reactions. Blood pressure and CBFV dipped % during robot training. In 52% of controls mean arterial pressure decreased by %. ROBO-FES increased leg strength by points, ROBO by more than control (, . CBFV increased in both robotic groups more than in controls (. Conclusions. Robotic tilt-table exercise with or without FES is safe and may be more effective in improving leg strength and cerebral blood flow than tilt table alone.

  15. Dynamic Characterization and Interaction Control of the CBM-Motus Robot for Upper-Limb Rehabilitation

    Directory of Open Access Journals (Sweden)

    Loredana Zollo

    2013-10-01

    Full Text Available This paper presents dynamic characterization and control of an upper-limb rehabilitation machine aimed at improving robot performance in the interaction with the patient. An integrated approach between mechanics and control is the key issue of the paper for the development of a robotic machine with desirable dynamic properties. Robot inertial and acceleration properties are studied in the workspace via a graphical representation based on ellipses. Robot friction is experimentally retrieved by means of a parametric identification procedure. A current-based impedance control is developed in order to compensate for friction and enhance control performance in the interaction with the patient by means of force feedback, without increasing system inertia. To this end, servo-amplifier motor currents are monitored to provide force feedback in the interaction, thus avoiding the need for force sensors mounted at the robot end-effector. Current-based impedance control is implemented on the robot; experimental results in free space as well as in constrained space are provided.

  16. Supinator Extender (SUE): a pneumatically actuated robot for forearm/wrist rehabilitation after stroke.

    Science.gov (United States)

    Allington, James; Spencer, Steven J; Klein, Julius; Buell, Meghan; Reinkensmeyer, David J; Bobrow, James

    2011-01-01

    The robot described in this paper, SUE (Supinator Extender), adds forearm/wrist rehabilitation functionality to the UCI BONES exoskeleton robot and to the ArmeoSpring rehabilitation device. SUE is a 2-DOF serial chain that can measure and assist forearm supination-pronation and wrist flexion-extension. The large power to weight ratio of pneumatic actuators allows SUE to achieve the forces needed for rehabilitation therapy while remaining lightweight enough to be carried by BONES and ArmeoSpring. Each degree of freedom has a range of 90 degrees, and a nominal torque of 2 ft-lbs. The cylinders are mounted away from the patient's body on the lateral aspect of the arm. This is to prevent the danger of a collision and maximize the workspace of the arm robot. The rotation axis used for supination-pronation is a small bearing just below the subject's wrist. The flexion-extension motion is actuated by a cantilevered pneumatic cylinder, which allows the palm of the hand to remain open. Data are presented that demonstrate the ability of SUE to measure and cancel forearm/wrist passive tone, thereby extending the active range of motion for people with stroke.

  17. A crossover pilot study evaluating the functional outcomes of two different types of robotic movement training in chronic stroke survivors using the arm exoskeleton BONES.

    Science.gov (United States)

    Milot, Marie-Hélène; Spencer, Steven J; Chan, Vicky; Allington, James P; Klein, Julius; Chou, Cathy; Bobrow, James E; Cramer, Steven C; Reinkensmeyer, David J

    2013-12-19

    To date, the limited degrees of freedom (DOF) of most robotic training devices hinders them from providing functional training following stroke. We developed a 6-DOF exoskeleton ("BONES") that allows movement of the upper limb to assist in rehabilitation. The objectives of this pilot study were to evaluate the impact of training with BONES on function of the affected upper limb, and to assess whether multijoint functional robotic training would translate into greater gains in arm function than single joint robotic training also conducted with BONES. Twenty subjects with mild to moderate chronic stroke participated in this crossover study. Each subject experienced multijoint functional training and single joint training three sessions per week, for four weeks, with the order of presentation randomized. The primary outcome measure was the change in Box and Block Test (BBT). The secondary outcome measures were the changes in Fugl-Meyer Arm Motor Scale (FMA), Wolf Motor Function Test (WMFT), Motor Activity Log (MAL), and quantitative measures of strength and speed of reaching. These measures were assessed at baseline, after each training period, and at a 3-month follow-up evaluation session. Training with the robotic exoskeleton resulted in significant improvements in the BBT, FMA, WMFT, MAL, shoulder and elbow strength, and reaching speed (p functional and single joint robotic training programs. However, for the BBT, WMFT and MAL, inequality of carryover effects were noted; subsequent analysis on the change in score between the baseline and first period of training again revealed no difference in the gains obtained between the types of training. Training with the 6 DOF arm exoskeleton improved motor function after chronic stroke, challenging the idea that robotic therapy is only useful for impairment reduction. The pilot results presented here also suggest that multijoint functional robotic training is not decisively superior to single joint robotic training. This

  18. Hybrid FES-robot cooperative control of ambulatory gait rehabilitation exoskeleton.

    Science.gov (United States)

    del-Ama, Antonio J; Gil-Agudo, Angel; Pons, José L; Moreno, Juan C

    2014-03-04

    Robotic and functional electrical stimulation (FES) approaches are used for rehabilitation of walking impairment of spinal cord injured individuals. Although devices are commercially available, there are still issues that remain to be solved. Control of hybrid exoskeletons aims at blending robotic exoskeletons and electrical stimulation to overcome the drawbacks of each approach while preserving their advantages. Hybrid actuation and control have a considerable potential for walking rehabilitation but there is a need of novel control strategies of hybrid systems that adequately manage the balance between FES and robotic controllers. Combination of FES and robotic control is a challenging issue, due to the non-linear behavior of muscle under stimulation and the lack of developments in the field of hybrid control. In this article, a cooperative control strategy of a hybrid exoskeleton is presented. This strategy is designed to overcome the main disadvantages of muscular stimulation: electromechanical delay and change in muscle performance over time, and to balance muscular and robotic actuation during walking.Experimental results in healthy subjects show the ability of the hybrid FES-robot cooperative control to balance power contribution between exoskeleton and muscle stimulation. The robotic exoskeleton decreases assistance while adequate knee kinematics are guaranteed. A new technique to monitor muscle performance is employed, which allows to estimate muscle fatigue and implement muscle fatigue management strategies. Kinesis is therefore the first ambulatory hybrid exoskeleton that can effectively balance robotic and FES actuation during walking. This represents a new opportunity to implement new rehabilitation interventions to induce locomotor activity in patients with paraplegia.Acronym list: 10 mWT: ten meters walking test; 6 MWT: six minutes walking test; FSM: finite-state machine; t-FSM: time-domain FSM; c-FSM: cycle-domain FSM; FES: functional electrical

  19. Results of Clinicians Using a Therapeutic Robotic System in an Inpatient Stroke Rehabilitation Unit

    Science.gov (United States)

    2011-01-01

    Background Physical rehabilitation is an area where robotics could contribute significantly to improved motor return for individuals following a stroke. This paper presents the results of a preliminary randomized controlled trial (RCT) of a robot system used in the rehabilitation of the paretic arm following a stroke. Methods The study's objectives were to explore the efficacy of this new type of robotic therapy as compared to standard physiotherapy treatment in treating the post-stroke arm; to evaluate client satisfaction with the proposed robotic system; and to provide data for sample size calculations for a proposed larger multicenter RCT. Twenty clients admitted to an inpatient stroke rehabilitation unit were randomly allocated to one of two groups, an experimental (robotic arm therapy) group or a control group (conventional therapy). An occupational therapist blinded to patient allocation administered two reliable measures, the Chedoke Arm and Hand Activity Inventory (CAHAI-7) and the Chedoke McMaster Stroke Assessment of the Arm and Hand (CMSA) at admission and discharge. For both groups, at admission, the CMSA motor impairment stage of the affected arm was between 1 and 3. Results Data were compared to determine the effectiveness of robot-assisted versus conventional therapy treatments. At the functional level, both groups performed well, with improvement in scores on the CAHAI-7 showing clinical and statistical significance. The CAHAI-7 (range7-49) is a measure of motor performance using functional items. Individuals in the robotic therapy group, on average, improved by 62% (95% CI: 26% to 107%) while those in the conventional therapy group changed by 30% (95% CI: 4% to 61%). Although performance on this measure is influenced by hand recovery, our results showed that both groups had similar stages of motor impairment in the hand. Furthermore, the degree of shoulder pain, as measured by the CMSA pain inventory scale, did not worsen for either group over the

  20. Results of Clinicians Using a Therapeutic Robotic System in an Inpatient Stroke Rehabilitation Unit

    Directory of Open Access Journals (Sweden)

    Barreca Susan

    2011-08-01

    Full Text Available Abstract Background Physical rehabilitation is an area where robotics could contribute significantly to improved motor return for individuals following a stroke. This paper presents the results of a preliminary randomized controlled trial (RCT of a robot system used in the rehabilitation of the paretic arm following a stroke. Methods The study's objectives were to explore the efficacy of this new type of robotic therapy as compared to standard physiotherapy treatment in treating the post-stroke arm; to evaluate client satisfaction with the proposed robotic system; and to provide data for sample size calculations for a proposed larger multicenter RCT. Twenty clients admitted to an inpatient stroke rehabilitation unit were randomly allocated to one of two groups, an experimental (robotic arm therapy group or a control group (conventional therapy. An occupational therapist blinded to patient allocation administered two reliable measures, the Chedoke Arm and Hand Activity Inventory (CAHAI-7 and the Chedoke McMaster Stroke Assessment of the Arm and Hand (CMSA at admission and discharge. For both groups, at admission, the CMSA motor impairment stage of the affected arm was between 1 and 3. Results Data were compared to determine the effectiveness of robot-assisted versus conventional therapy treatments. At the functional level, both groups performed well, with improvement in scores on the CAHAI-7 showing clinical and statistical significance. The CAHAI-7 (range7-49 is a measure of motor performance using functional items. Individuals in the robotic therapy group, on average, improved by 62% (95% CI: 26% to 107% while those in the conventional therapy group changed by 30% (95% CI: 4% to 61%. Although performance on this measure is influenced by hand recovery, our results showed that both groups had similar stages of motor impairment in the hand. Furthermore, the degree of shoulder pain, as measured by the CMSA pain inventory scale, did not worsen for

  1. Task-specific ankle robotics gait training after stroke: a randomized pilot study

    OpenAIRE

    Forrester, Larry W.; Roy, Anindo; Hafer-Macko, Charlene; Krebs, Hermano I.; Macko, Richard F.

    2016-01-01

    Background An unsettled question in the use of robotics for post-stroke gait rehabilitation is whether task-specific locomotor training is more effective than targeting individual joint impairments to improve walking function. The paretic ankle is implicated in gait instability and fall risk, but is difficult to therapeutically isolate and refractory to recovery. We hypothesize that in chronic stroke, treadmill-integrated ankle robotics training is more effective to improve gait function than...

  2. Individualised and adaptive upper limb rehabilitation with industrial robot using dynamic movement primitives

    DEFF Research Database (Denmark)

    Nielsen, Jacob; Sørensen, Anders Stengaard; Christensen, Thomas Søndergaard

    Stroke is a leading cause of serious long-term disability. Post-stroke rehabilitation is a demanding task for the patient and a costly challenge for both society and healthcare systems. We present a novel approach for training of upper extremities after a stroke by utilising an industrial robotic...... arm and dynamic movement primitives (DMPs) with force feedback. We show how pre-recorded and learned DMPs can act as basis exercises, that can be modified into individualized and adaptive rehabilitation exercises that fit with the patient’s physical prop- erties and impairments. We conclude that our...... novel approach allows for easy and flexible set-up of rehabilitation exercises and has the potential to provide the therapists and patients much easier interaction with such complex technology...

  3. Robot-assisted reaching exercise promotes arm movement recovery in chronic hemiparetic stroke: a randomized controlled pilot study

    Directory of Open Access Journals (Sweden)

    Rymer W Zev

    2006-06-01

    Full Text Available Abstract Background and purpose Providing active assistance to complete desired arm movements is a common technique in upper extremity rehabilitation after stroke. Such active assistance may improve recovery by affecting somatosensory input, motor planning, spasticity or soft tissue properties, but it is labor intensive and has not been validated in controlled trials. The purpose of this study was to investigate the effects of robotically administered active-assistive exercise and compare those with free reaching voluntary exercise in improving arm movement ability after chronic stroke. Methods Nineteen individuals at least one year post-stroke were randomized into one of two groups. One group performed 24 sessions of active-assistive reaching exercise with a simple robotic device, while a second group performed a task-matched amount of unassisted reaching. The main outcome measures were range and speed of supported arm movement, range, straightness and smoothness of unsupported reaching, and the Rancho Los Amigos Functional Test of Upper Extremity Function. Results and discussion There were significant improvements with training for range of motion and velocity of supported reaching, straightness of unsupported reaching, and functional movement ability. These improvements were not significantly different between the two training groups. The group that performed unassisted reaching exercise improved the smoothness of their reaching movements more than the robot-assisted group. Conclusion Improvements with both forms of exercise confirmed that repeated, task-related voluntary activation of the damaged motor system is a key stimulus to motor recovery following chronic stroke. Robotically assisting in reaching successfully improved arm movement ability, although it did not provide any detectable, additional value beyond the movement practice that occurred concurrently with it. The inability to detect any additional value of robot-assisted reaching

  4. Robot-assisted gait training in multiple sclerosis: a pilot randomized trial.

    Science.gov (United States)

    Beer, S; Aschbacher, B; Manoglou, D; Gamper, E; Kool, J; Kesselring, J

    2008-03-01

    To evaluate feasibility and perform an explanatory analysis of the efficacy of robot-assisted gait training (RAGT) in MS patients with severe walking disabilities (Expanded Disability Status Scale [EDSS] 6.0-7.5) in a pilot trial. Prospective, randomized, controlled clinical trial comparing RAGT with conventional walking training (CWT) in a group of stable MS patients (n = 35) during an inpatient rehabilitation stay, 15 sessions over three weeks. All patients participated additionally in a multimodal rehabilitation program. The primary outcome measure was walking velocity and secondary measures were 6-min-walking distance, stride length and knee-extensor strength. All tests were performed by an external blinded assessor at baseline after three weeks and at follow-up after six months. Additionally, Extended Barthel Index (EBI) at entry and discharge was assessed (not blinded), and acceptance/convenience of RAGT rated by patients (Visual Analogue Scale [VAS]) was recorded. Nineteen patients were randomly allocated to RAGT and 16 patients to CWT. Groups were comparable at baseline. There were 5 drop-outs (2 related directly to treatment) in the RAGT group and 1 in the CWT group, leaving 14 RAGT patients and 15 CWT patients for final analysis. Acceptance and convenience of RAGT as rated by patients were high. Effect sizes were moderate to large, although not significant, for walking velocity (0.700, 95% CI -0.089 to 1.489), walking distance (0.401, 95% CI - 0.370 to 1.172) and knee-extensor strength (right: 1.105, 95% CI 0.278 to 1.932, left 0.650, 95% CI -0.135 to 1.436) favouring RAGT. Prepost within-group analysis revealed an increase of walking velocity, walking distance and knee-extensor strength in the RAGT group, whereas in CWT group only walking velocity was improved. In both groups outcome values returned to baseline at follow-up after six months (n = 23). Robot-assisted gait training is feasible and may be an effective therapeutic option in MS patients with

  5. Robot-Assisted Rehabilitation of Ankle Plantar Flexors Spasticity: A Three-Month Study with Proprioceptive Neuromuscular Facilitation

    Directory of Open Access Journals (Sweden)

    Zhihao Zhou

    2016-11-01

    Full Text Available In this paper, we aim to investigate the effect of Proprioceptive Neuromuscular Facilitation (PNF based rehabilitation for ankle plantar flexors spasticity by using a Robotic Ankle-foot Rehabilitation System (RARS. A modified robot-assisted system was proposed and seven post-stroke patients with hemiplegic spastic ankles participated a three-month of robotic PNF training. Their impaired sides were used as the experimental group while their unimpaired sides as the control group. A robotic intervention for the experimental group generally started from a two minutes passive stretching to warm-up or relax the soleus and gastrocnemius muscle and also ended with the same one. Then a PNF training session included 30 trails was activated between them. The rehabilitation trainings were carried out three times a week as an addition of their regular rehabilitation exercise. Passive ankle joint range of motion, resistance torque and stiffness were measured in both ankles before and after the intervention. The changes in Achilles' tendon length, walking speed, and lower limb function were also evaluated by the same physician or physiotherapist for each participant. Biomechanical measurements before interventions showed significant difference between the experimental group and the control group due to ankle spasticity. For the control group, there was no significant difference in the three months with no robotic intervention. But for the experimental group, passive dorsiflexion range of motion increased ( p0.05 . The robotic rehabilitation also improved the muscle strength ( p0.05 and fast walking speed ( p<0.05 . These results indicated that PNF based robotic intervention could significantly alleviate lower limb spasticity and improve the motor function in chronic stroke participant. The robotic system could potentially be used as an effective tool in post-stroke rehabilitation training.

  6. Squat exercise to estimate knee megaprosthesis rehabilitation: a pilot study

    OpenAIRE

    2015-01-01

    [Purpose] This study evaluated a specific rehabilitation protocol using a half squat after total knee reconstruction with distal femur megaprosthesis and tibial allograft-prosthesis composite. [Subject and Methods] Squat execution was recorded by a three-dimensional system before and after a specific rehabilitation program on a 28-year-old patient. Squat duration, body center of mass trajectory, and vertical range of motion were determined. Step width and joint angles and symmetry (hip flexio...

  7. [Does upper limb robot-assisted rehabilitation contribute to improve the prognosis of post-stroke hemiparesis?].

    Science.gov (United States)

    Duret, C; Gracies, J-M

    2014-11-01

    Upper limb robot-assisted rehabilitation is a novel physical treatment for neurological motor impairments. During the last decade, this rehabilitation option utilizing technological tools has been evaluated in hemiparetic patients, mostly after stroke. Studies at acute and chronic stages suggested good tolerance and a significant and persistent reduction of motor impairment; a real impact on disability has been shown in acute/sub acute patients. Improved access to rehabilitation robots and an optimal use will probably be associated with higher efficiency of rehabilitative work in the paretic upper limb. Even if this treatment is still confined to a narrow circle of users, the device's biomechanical properties and clinical suggestions from the literature may show promise for the future of rehabilitation. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  8. Robot-assistant for MRI-guided liver ablation: A pilot study.

    Science.gov (United States)

    Franco, Enrico; Ristic, Mike; Rea, Marc; Gedroyc, Wladyslaw M W

    2016-10-01

    Percutaneous ablation under MRI-guidance allows treating otherwise inoperable liver tumors locally using a catheter probe. However, manually placing the probe is an error-prone and time consuming task that requires a considerable amount of training. The aim of this paper was to present a pneumatically actuated robotic instrument that can assist clinicians in MRI-guided percutaneous intervention of the liver and to assess its functionality in a clinical setting. The robot positions a needle-guide inside the MRI scanner bore and assists manual needle insertions outside the bore. The robot supports double oblique insertions that are particularly challenging for less experienced clinicians. Additionally, the system employs only standard imaging sequences and can therefore be used on different MRI scanners without requiring prior integration. The repeatability and the accuracy of the robot were evaluated with an optical tracking system. The functionality of the robot was assessed in an initial pilot study on two patients that underwent MRI-guided laser ablation of the liver. The robot positioned the needle-guide in a repeatable manner with a mean error of 0.35 mm and a standard deviation of 0.32 mm. The mean position error corresponding to the needle tip, measured for an equivalent needle length of 195 mm over 25 fixed points, was 2.5 mm with a standard deviation of 1.2 mm. The pilot study confirmed that the robot does not interfere with the equipment used for MRI-guided laser ablation and does not visibly affect the MR images. The robot setup integrated seamlessly within the established clinical workflow. The robot-assisted procedure was successfully completed on two patients, one of which required a complex double oblique insertion. For both patients, the insertion depth and the tumor size were within the range reported for previous MRI-guided percutaneous interventions. A third patient initially enrolled in the pilot study and was considerably heavier than the others

  9. Implementing Modular Interactive Tiles for Rehabilitation in Tanzania – a pilot study

    DEFF Research Database (Denmark)

    Lund, Henrik Hautop; Jensen, Line Steiness Dejnbjerg; Ssessanga, Yusuf

    2014-01-01

    The pilot study in the Iringa region, Tanzania, indicates how the modular interactive tiles can be used for playful physical rehabilitation for many diverse patient groups (handicapped children, stroke, cardiac, diabetic patients, etc.) in both urban and rural areas, and how it motivates the user...

  10. Standardized voluntary force measurement in a lower extremity rehabilitation robot

    Directory of Open Access Journals (Sweden)

    Bolliger Marc

    2008-10-01

    Full Text Available Abstract Background Isometric force measurements in the lower extremity are widely used in rehabilitation of subjects with neurological movement disorders (NMD because walking ability has been shown to be related to muscle strength. Therefore muscle strength measurements can be used to monitor and control the effects of training programs. A new method to assess isometric muscle force was implemented in the driven gait orthosis (DGO Lokomat. To evaluate the capabilities of this new measurement method, inter- and intra-rater reliability were assessed. Methods Reliability was assessed in subjects with and without NMD. Subjects were tested twice on the same day by two different therapists to test inter-rater reliability and on two separate days by the same therapist to test intra-rater reliability. Results Results showed fair to good reliability for the new measurement method to assess isometric muscle force of lower extremities. In subjects without NMD, intraclass correlation coefficients (ICC for inter-rater reliability ranged from 0.72 to 0.97 and intra-rater reliability from 0.71 to 0.90. In subjects with NMD, ICC ranged from 0.66 to 0.97 for inter-rater and from 0.50 to 0.96 for intra-rater reliability. Conclusion Inter- and intra- rater reliability of an assessment method for measuring maximal voluntary isometric muscle force of lower extremities was demonstrated. We suggest that this method is a valuable tool for documentation and controlling of the rehabilitation process in patients using a DGO.

  11. Modular robotics for playful physiotherapy

    DEFF Research Database (Denmark)

    Lund, Henrik Hautop

    2009-01-01

    We developed modular robotic tiles to be used for playful physiotherapy, which is supposed to motivate patients to engage in and perform physical rehabilitation exercises. We tested the modular robotic tiles for an extensive period of time (3 years) in daily use in a hospital rehabilitation unit e.......g. for cardiac patients. Also, the tiles were tested for performing physical rehabilitation of stroke patients in their private home. In all pilot test cases qualitative feedback indicate that the patients find the playful use of modular robotic tiles engaging and motivating for them to perform...... the rehabilitation. Also, initial pilot test data suggest that some playful exercises on the tiles demand an average heart rate of 75% and 86% of the maximum heart rate....

  12. Upper Limb Posture Estimation in Robotic and Virtual Reality-Based Rehabilitation

    Directory of Open Access Journals (Sweden)

    Camilo Cortés

    2014-01-01

    Full Text Available New motor rehabilitation therapies include virtual reality (VR and robotic technologies. In limb rehabilitation, limb posture is required to (1 provide a limb realistic representation in VR games and (2 assess the patient improvement. When exoskeleton devices are used in the therapy, the measurements of their joint angles cannot be directly used to represent the posture of the patient limb, since the human and exoskeleton kinematic models differ. In response to this shortcoming, we propose a method to estimate the posture of the human limb attached to the exoskeleton. We use the exoskeleton joint angles measurements and the constraints of the exoskeleton on the limb to estimate the human limb joints angles. This paper presents (a the mathematical formulation and solution to the problem, (b the implementation of the proposed solution on a commercial exoskeleton system for the upper limb rehabilitation, (c its integration into a rehabilitation VR game platform, and (d the quantitative assessment of the method during elbow and wrist analytic training. Results show that this method properly estimates the limb posture to (i animate avatars that represent the patient in VR games and (ii obtain kinematic data for the patient assessment during elbow and wrist analytic rehabilitation.

  13. Upper limb posture estimation in robotic and virtual reality-based rehabilitation.

    Science.gov (United States)

    Cortés, Camilo; Ardanza, Aitor; Molina-Rueda, F; Cuesta-Gómez, A; Unzueta, Luis; Epelde, Gorka; Ruiz, Oscar E; De Mauro, Alessandro; Florez, Julian

    2014-01-01

    New motor rehabilitation therapies include virtual reality (VR) and robotic technologies. In limb rehabilitation, limb posture is required to (1) provide a limb realistic representation in VR games and (2) assess the patient improvement. When exoskeleton devices are used in the therapy, the measurements of their joint angles cannot be directly used to represent the posture of the patient limb, since the human and exoskeleton kinematic models differ. In response to this shortcoming, we propose a method to estimate the posture of the human limb attached to the exoskeleton. We use the exoskeleton joint angles measurements and the constraints of the exoskeleton on the limb to estimate the human limb joints angles. This paper presents (a) the mathematical formulation and solution to the problem, (b) the implementation of the proposed solution on a commercial exoskeleton system for the upper limb rehabilitation, (c) its integration into a rehabilitation VR game platform, and (d) the quantitative assessment of the method during elbow and wrist analytic training. Results show that this method properly estimates the limb posture to (i) animate avatars that represent the patient in VR games and (ii) obtain kinematic data for the patient assessment during elbow and wrist analytic rehabilitation.

  14. Upper Limb Posture Estimation in Robotic and Virtual Reality-Based Rehabilitation

    Science.gov (United States)

    Cortés, Camilo; Ardanza, Aitor; Molina-Rueda, F.; Cuesta-Gómez, A.; Ruiz, Oscar E.

    2014-01-01

    New motor rehabilitation therapies include virtual reality (VR) and robotic technologies. In limb rehabilitation, limb posture is required to (1) provide a limb realistic representation in VR games and (2) assess the patient improvement. When exoskeleton devices are used in the therapy, the measurements of their joint angles cannot be directly used to represent the posture of the patient limb, since the human and exoskeleton kinematic models differ. In response to this shortcoming, we propose a method to estimate the posture of the human limb attached to the exoskeleton. We use the exoskeleton joint angles measurements and the constraints of the exoskeleton on the limb to estimate the human limb joints angles. This paper presents (a) the mathematical formulation and solution to the problem, (b) the implementation of the proposed solution on a commercial exoskeleton system for the upper limb rehabilitation, (c) its integration into a rehabilitation VR game platform, and (d) the quantitative assessment of the method during elbow and wrist analytic training. Results show that this method properly estimates the limb posture to (i) animate avatars that represent the patient in VR games and (ii) obtain kinematic data for the patient assessment during elbow and wrist analytic rehabilitation. PMID:25110698

  15. Taking a lesson from patients' recovery strategies to optimize training during robot-aided rehabilitation.

    Science.gov (United States)

    Colombo, Roberto; Sterpi, Irma; Mazzone, Alessandra; Delconte, Carmen; Pisano, Fabrizio

    2012-05-01

    In robot-assisted neurorehabilitation, matching the task difficulty level to the patient's needs and abilities, both initially and as the relearning process progresses, can enhance the effectiveness of training and improve patients' motivation and outcome. This study presents a Progressive Task Regulation algorithm implemented in a robot for upper limb rehabilitation. It evaluates the patient's performance during training through the computation of robot-measured parameters, and automatically changes the features of the reaching movements, adapting the difficulty level of the motor task to the patient's abilities. In particular, it can select different types of assistance (time-triggered, activity-triggered, and negative assistance) and implement varied therapy practice to promote generalization processes. The algorithm was tuned by assessing the performance data obtained in 22 chronic stroke patients who underwent robotic rehabilitation, in which the difficulty level of the task was manually adjusted by the therapist. Thus, we could verify the patient's recovery strategies and implement task transition rules to match both the patient's and therapist's behavior. In addition, the algorithm was tested in a sample of five chronic stroke patients. The findings show good agreement with the therapist decisions so indicating that it could be useful for the implementation of training protocols allowing individualized and gradual treatment of upper limb disabilities in patients after stroke. The application of this algorithm during robot-assisted therapy should allow an easier management of the different motor tasks administered during training, thereby facilitating the therapist's activity in the treatment of different pathologic conditions of the neuromuscular system.

  16. Electroencephalographic markers of robot-aided therapy in stroke patients for the evaluation of upper limb rehabilitation.

    Science.gov (United States)

    Sale, Patrizio; Infarinato, Francesco; Del Percio, Claudio; Lizio, Roberta; Babiloni, Claudio; Foti, Calogero; Franceschini, Marco

    2015-12-01

    Stroke is the leading cause of permanent disability in developed countries; its effects may include sensory, motor, and cognitive impairment as well as a reduced ability to perform self-care and participate in social and community activities. A number of studies have shown that the use of robotic systems in upper limb motor rehabilitation programs provides safe and intensive treatment to patients with motor impairments because of a neurological injury. Furthermore, robot-aided therapy was shown to be well accepted and tolerated by all patients; however, it is not known whether a specific robot-aided rehabilitation can induce beneficial cortical plasticity in stroke patients. Here, we present a procedure to study neural underpinning of robot-aided upper limb rehabilitation in stroke patients. Neurophysiological recordings use the following: (a) 10-20 system electroencephalographic (EEG) electrode montage; (b) bipolar vertical and horizontal electrooculographies; and (c) bipolar electromyography from the operating upper limb. Behavior monitoring includes the following: (a) clinical data and (b) kinematic and dynamic of the operant upper limb movements. Experimental conditions include the following: (a) resting state eyes closed and eyes open, and (b) robotic rehabilitation task (maximum 80 s each block to reach 4-min EEG data; interblock pause of 1 min). The data collection is performed before and after a program of 30 daily rehabilitation sessions. EEG markers include the following: (a) EEG power density in the eyes-closed condition; (b) reactivity of EEG power density to eyes opening; and (c) reactivity of EEG power density to robotic rehabilitation task. The above procedure was tested on a subacute patient (29 poststroke days) and on a chronic patient (21 poststroke months). After the rehabilitation program, we observed (a) improved clinical condition; (b) improved performance during the robotic task; (c) reduced delta rhythms (1-4 Hz) and increased alpha

  17. Bimanual elbow robotic orthoses: preliminary investigations on an impairment force-feedback rehabilitation method.

    Science.gov (United States)

    Herrnstadt, Gil; Alavi, Nezam; Randhawa, Bubblepreet Kaur; Boyd, Lara A; Menon, Carlo

    2015-01-01

    Modern rehabilitation practices have begun integrating robots, recognizing their significant role in recovery. New and alternative stroke rehabilitation treatments are essential to enhance efficacy and mitigate associated health costs. Today's robotic interventions can play a significant role in advancing rehabilitation. In addition, robots have an inherent ability to perform tasks accurately and reliably and are typically well suited to measure and quantify performance. Most rehabilitation strategies predominantly target activation of the paretic arm. However, bimanual upper-limb rehabilitation research suggests potential in enhancing functional recovery. Moreover, studies suggest that limb coordination and synchronization can improve treatment efficacy. In this preliminary study, we aimed to investigate and validate our user-driven bimanual system in a reduced intensity rehab practice. A bimanual wearable robotic device (BWRD) with a Master-Slave configuration for the elbow joint was developed to carry out the investigation. The BWRD incorporates position and force sensors for which respective control loops are implemented, and offers varying modes of operation ranging from passive to active training. The proposed system enables the perception of the movements, as well as the forces applied by the hemiparetic arm, with the non-hemiparetic arm. Eight participants with chronic unilateral stroke were recruited to participate in a total of three 1-h sessions per participant, delivered in a week. Participants underwent pre- and post-training functional assessments along with proprioceptive measures. The post-assessment was performed at the end of the last training session. The protocol was designed to engage the user in an assortment of static and dynamic arm matching and opposing tasks. The training incorporates force-feedback movements, force-feedback positioning, and force matching tasks with same and opposite direction movements. We are able to suggest

  18. A Sit-to-Stand Training Robot and Its Performance Evaluation: Dynamic Analysis in Lower Limb Rehabilitation Activities

    Science.gov (United States)

    Cao, Enguo; Inoue, Yoshio; Liu, Tao; Shibata, Kyoko

    In many countries in which the phenomenon of population aging is being experienced, motor function recovery activities have aroused much interest. In this paper, a sit-to-stand rehabilitation robot utilizing a double-rope system was developed, and the performance of the robot was evaluated by analyzing the dynamic parameters of human lower limbs. For the robot control program, an impedance control method with a training game was developed to increase the effectiveness and frequency of rehabilitation activities, and a calculation method was developed for evaluating the joint moments of hip, knee, and ankle. Test experiments were designed, and four subjects were requested to stand up from a chair with assistance from the rehabilitation robot. In the experiments, body segment rotational angles, trunk movement trajectories, rope tensile forces, ground reaction forces (GRF) and centers of pressure (COP) were measured by sensors, and the moments of ankle, knee and hip joint were real-time calculated using the sensor-measured data. The experiment results showed that the sit-to-stand rehabilitation robot with impedance control method could maintain the comfortable training postures of users, decrease the moments of limb joints, and enhance training effectiveness. Furthermore, the game control method could encourage collaboration between the brain and limbs, and allow for an increase in the frequency and intensity of rehabilitation activities.

  19. Trunk robot rehabilitation training with active stepping reorganizes and enriches trunk motor cortex representations in spinal transected rats.

    Science.gov (United States)

    Oza, Chintan S; Giszter, Simon F

    2015-05-01

    Trunk motor control is crucial for postural stability and propulsion after low thoracic spinal cord injury (SCI) in animals and humans. Robotic rehabilitation aimed at trunk shows promise in SCI animal models and patients. However, little is known about the effect of SCI and robot rehabilitation of trunk on cortical motor representations. We previously showed reorganization of trunk motor cortex after adult SCI. Non-stepping training also exacerbated some SCI-driven plastic changes. Here we examine effects of robot rehabilitation that promotes recovery of hindlimb weight support functions on trunk motor cortex representations. Adult rats spinal transected as neonates (NTX rats) at the T9/10 level significantly improve function with our robot rehabilitation paradigm, whereas treadmill-only trained do not. We used intracortical microstimulation to map motor cortex in two NTX groups: (1) treadmill trained (control group); and (2) robot-assisted treadmill trained (improved function group). We found significant robot rehabilitation-driven changes in motor cortex: (1) caudal trunk motor areas expanded; (2) trunk coactivation at cortex sites increased; (3) richness of trunk cortex motor representations, as examined by cumulative entropy and mutual information for different trunk representations, increased; (4) trunk motor representations in the cortex moved toward more normal topography; and (5) trunk and forelimb motor representations that SCI-driven plasticity and compensations had caused to overlap were segregated. We conclude that effective robot rehabilitation training induces significant reorganization of trunk motor cortex and partially reverses some plastic changes that may be adaptive in non-stepping paraplegia after SCI.

  20. Trunk Robot Rehabilitation Training with Active Stepping Reorganizes and Enriches Trunk Motor Cortex Representations in Spinal Transected Rats

    Science.gov (United States)

    Oza, Chintan S.

    2015-01-01

    Trunk motor control is crucial for postural stability and propulsion after low thoracic spinal cord injury (SCI) in animals and humans. Robotic rehabilitation aimed at trunk shows promise in SCI animal models and patients. However, little is known about the effect of SCI and robot rehabilitation of trunk on cortical motor representations. We previously showed reorganization of trunk motor cortex after adult SCI. Non-stepping training also exacerbated some SCI-driven plastic changes. Here we examine effects of robot rehabilitation that promotes recovery of hindlimb weight support functions on trunk motor cortex representations. Adult rats spinal transected as neonates (NTX rats) at the T9/10 level significantly improve function with our robot rehabilitation paradigm, whereas treadmill-only trained do not. We used intracortical microstimulation to map motor cortex in two NTX groups: (1) treadmill trained (control group); and (2) robot-assisted treadmill trained (improved function group). We found significant robot rehabilitation-driven changes in motor cortex: (1) caudal trunk motor areas expanded; (2) trunk coactivation at cortex sites increased; (3) richness of trunk cortex motor representations, as examined by cumulative entropy and mutual information for different trunk representations, increased; (4) trunk motor representations in the cortex moved toward more normal topography; and (5) trunk and forelimb motor representations that SCI-driven plasticity and compensations had caused to overlap were segregated. We conclude that effective robot rehabilitation training induces significant reorganization of trunk motor cortex and partially reverses some plastic changes that may be adaptive in non-stepping paraplegia after SCI. PMID:25948267

  1. Complexity analysis of EMG signals for patients after stroke during robot-aided rehabilitation training using fuzzy approximate entropy.

    Science.gov (United States)

    Sun, Rui; Song, Rong; Tong, Kai-yu

    2014-09-01

    The paper presents a novel viewpoint to monitor the motor function improvement during a robot-aided rehabilitation training. Eight chronic poststroke subjects were recruited to attend the 20-session training, and in each session, subjects were asked to perform voluntary movements of elbow flexion and extension together with the robotic system. The robotic system was continuously controlled by the electromyographic (EMG) signal from the affected triceps. Fuzzy approximate entropy (fApEn) was applied to investigate the complexity of the EMG segment, and maximum voluntary contraction (MVC) during elbow flexion and extension was applied to reflect force generating capacity of the affected muscles. The results showed that the group mean fApEn of EMG signals from triceps and biceps increased significantly after the robot-aided rehabilitation training . There was also significant increase in maximum voluntary flexion and extension torques after the robot-aided rehabilitation training . There was significant correlation between fApEn of agonist and MVC , which implied that the increase of motorneuron number is one of factors that may explain the increase in muscle strength. These findings based on fApEn of the EMG signals expand the existing interpretation of training-induced function improvement in patients after stroke, and help us to understand the neurological change induced by the robot-aided rehabilitation training.

  2. Modeling and Simulation to Muscle Strength Training of Lower Limbs Rehabilitation Robots

    Directory of Open Access Journals (Sweden)

    Ke-Yi Wang

    2015-01-01

    Full Text Available Considering the issues of lower limb rehabilitation robots with single control strategies and poor training types, a training method for improving muscle strength was put forward in this paper. Patients’ muscle strength could be achieved by targeted exercises at the end of rehabilitation. This approach could be realized through programming wires’ force. On the one hand, each wires force was measured by tension sensor and force closed loop control was established to control the value of wires’ force which was acted on trainees. On the other hand, the direction of output force was changed by detecting the trainees’ state of motion and the way of putting load to patient was achieved. Finally, the target of enhancing patients’ muscle strength was realized. Dynamic model was built by means of mechanism and training types of robots. Force closed loop control strategy was established based on training pattern. In view of the characteristics of the redundance and economy of wire control, the process for simple wire's load changes was discussed. In order to confirm the characteristics of robot control system, the controller was simulated in Matlab/Simulink. It was verified that command signal could be traced by control system availably and the load during muscle training would be provided effectively.

  3. Impedance control in a wave-based teleoperator for rehabilitation motor therapies assisted by robots.

    Science.gov (United States)

    Mendoza, Marco; Bonilla, Isela; González-Galván, Emilio; Reyes, Fernando

    2016-01-01

    This paper presents an improved wave-based bilateral teleoperation scheme for rehabilitation therapies assisted by robot manipulators. The main feature of this bilateral teleoperator is that both robot manipulators, master and slave, are controlled by impedance. Thus, a pair of motion-based adaptive impedance controllers are integrated into a wave-based configuration, in order to guarantee a stable human-robot interaction and to compensate the position drift, characteristic of the available schemes of bilateral teleoperation. Moreover, the teleoperator stability, in the presence of time delays in the communication channel, is guaranteed because the wave-variable approach is included to encode the force and velocity signals. It should be noted that the proposed structure enables the implementation of several teleoperator schemes, from passive therapies, without the intervention of a human operator on the master side, to fully active therapies where both manipulators interact with humans in a stable manner. The suitable performance of the proposed teleoperator is verified through some results obtained from the simulation of the passive and active-constrained modes, by considering typical tasks in motor-therapy rehabilitation, where an improved behavior is observed when compared to implementations of the classical wave-based approach.

  4. A soft robotic exomusculature glove with integrated sEMG sensing for hand rehabilitation.

    Science.gov (United States)

    Delph, Michael A; Fischer, Sarah A; Gauthier, Phillip W; Luna, Carlos H Martinez; Clancy, Edward A; Fischer, Gregory S

    2013-06-01

    Stroke affects 750,000 people annually, and 80% of stroke survivors are left with weakened limbs and hands. Repetitive hand movement is often used as a rehabilitation technique in order to regain hand movement and strength. In order to facilitate this rehabilitation, a robotic glove was designed to aid in the movement and coordination of gripping exercises. This glove utilizes a cable system to open and close a patients hand. The cables are actuated by servomotors, mounted in a backpack weighing 13.2 lbs including battery power sources. The glove can be controlled in terms of finger position and grip force through switch interface, software program, or surface myoelectric (sEMG) signal. The primary control modes of the system provide: active assistance, active resistance and a preprogrammed mode. This project developed a working prototype of the rehabilitative robotic glove which actuates the fingers over a full range of motion across one degree-of-freedom, and is capable of generating a maximum 15N grip force.

  5. Bilateral control in teleoperation of a rehabilitation robot

    Science.gov (United States)

    Rahman, Tariq; Harwin, William S.

    1993-03-01

    One applications of teleoperation principles is of a manipulator that might be used to augment function in a disabled person. An individual with a paralyzing injury may have complete loss of motor and sensory function in his or her arms, which limits his or her ability to interact with the environment and perform simple tasks such as feeding or turning pages. One way of enhancing functionality is to employ a telemanipulator that might take the place of a care giver, thus providing the person with increased independence. This paper describes how a high level spinal cord injured individual would use head movement to control a robot. It is felt that the key to successful manipulation is in attaining a sense of force and position proprioception. This natural proprioception exists in cable operated prosthetic arms and simple tools such as mouthsticks or laser beam pointers where the user is physically linked to the device. This sense of proprioception is being emulated using a head controlled master-slave arrangement. The goal is for the disabled individual to operate a manipulator and utilize proprioceptive as well as visual feedback. This would lessen the mental burden on the user and ultimately make the device more acceptable.

  6. Rehabilitation robotics in robotics for healthcare ; a roadmap study for the European Commission

    NARCIS (Netherlands)

    Gelderblom, G.J.; Wilt, M.de; Cremers, G.; Rensma, A.R.

    2009-01-01

    To gain understanding in the current status of Robotics in healthcare the European Commission issued a roadmap study into this domain. This paper reports on the main characteristics and results of this study. The study covered the wide domain of Healthcare and in this paper the domains relevant for

  7. Rehabilitation robotics in robotics for healthcare ; a roadmap study for the European Commission

    NARCIS (Netherlands)

    Gelderblom, G.J.; Wilt, M.de; Cremers, G.; Rensma, A.R.

    2009-01-01

    To gain understanding in the current status of Robotics in healthcare the European Commission issued a roadmap study into this domain. This paper reports on the main characteristics and results of this study. The study covered the wide domain of Healthcare and in this paper the domains relevant for

  8. Iterative Learning Impedance for Lower Limb Rehabilitation Robot

    Directory of Open Access Journals (Sweden)

    Chenhui Guo

    2017-01-01

    Full Text Available This paper discusses the problem of squatting training of stroke patients. The main idea is to correct the patient’s training trajectory through an iterative learning control (ILC method. To obtain better rehabilitation effect, a patient will typically be required to practice a reference posture for many times, while most of active training methods can hardly keep the patients training with correct posture. Instead of the conventional ILC strategy, an impedance-based iterative learning method is proposed to regulate the impedance value dynamically and smartly which will help patients correct their posture gradually and perform better. To facilitate impedance-based ILC, we propose two objectives. The first objective is to find the suitable values of impedance based on the ILC scheme. The second objective is to search the moderate learning convergence speed and robustness in the iterative domain. The simulation and experimental results demonstrate that the performance of trajectory tracking will be improved greatly via the proposed algorithm.

  9. Multi-objective Optimization of a Parallel Ankle Rehabilitation Robot Using Modified Differential Evolution Algorithm

    Institute of Scientific and Technical Information of China (English)

    WANG Congzhe; FANG Yuefa; GUO Sheng

    2015-01-01

    Dimensional synthesis is one of the most difficult issues in the field of parallel robots with actuation redundancy. To deal with the optimal design of a redundantly actuated parallel robot used for ankle rehabilitation, a methodology of dimensional synthesis based on multi-objective optimization is presented. First, the dimensional synthesis of the redundant parallel robot is formulated as a nonlinear constrained multi-objective optimization problem. Then four objective functions, separately reflecting occupied space, input/output transmission and torque performances, and multi-criteria constraints, such as dimension, interference and kinematics, are defined. In consideration of the passive exercise of plantar/dorsiflexion requiring large output moment, a torque index is proposed. To cope with the actuation redundancy of the parallel robot, a new output transmission index is defined as well. The multi-objective optimization problem is solved by using a modified Differential Evolution(DE) algorithm, which is characterized by new selection and mutation strategies. Meanwhile, a special penalty method is presented to tackle the multi-criteria constraints. Finally, numerical experiments for different optimization algorithms are implemented. The computation results show that the proposed indices of output transmission and torque, and constraint handling are effective for the redundant parallel robot; the modified DE algorithm is superior to the other tested algorithms, in terms of the ability of global search and the number of non-dominated solutions. The proposed methodology of multi-objective optimization can be also applied to the dimensional synthesis of other redundantly actuated parallel robots only with rotational movements.

  10. Randomized trial of a robotic assistive device for the upper extremity during early inpatient stroke rehabilitation.

    Science.gov (United States)

    Masiero, Stefano; Armani, Mario; Ferlini, Gregorio; Rosati, Giulio; Rossi, Aldo

    2014-05-01

    A recent Cochrane Review showed that early robotic training of the upper limb in stroke survivors can be more effective than other interventions when improving activities of daily living involving the arm function is the aim of therapy. We tested for efficacy of the study a protocol which involved the use of the NeReBot therapy in partial substitution of standard upper limb rehabilitation in post-acute stroke patients. In this dose-matched, randomized controlled clinical trial, 34 hemiparetic participants with movement against gravity in shoulder, elbow, and wrist muscle groups were enrolled within 15 days of the onset of stroke. All participants received a total daily rehabilitation treatment for 120 minutes, 5 days per week for 5 weeks. The control group received standard therapy for the upper limb. The experimental group received standard therapy (65% of exercise time) associated with robotic training (35% of exercise time). Muscle tone (Modified Ashworth Scale), strength (Medical Research Council), and synergism (Fugl-Meyer motor scores) were measured at impairment level, whereas dexterity (Box and Block Test and Frenchay Arm Test) and activities of daily living (Functional Independence Measure) were measured at activity level. All assessments were performed at baseline, at the end of therapy (time T1), at 3 months (time T2), and at 7 months (time T3) after entry. All between-group analyses were tested using nonparametric test with Bonferroni's adjustments for multiple testing. No significant between-group differences were found with respect to demographic characteristics, motor, dexterity, and ADLs at baseline, postintervention (T1) and at follow-up (T2 and T3). The robot therapy by NeReBot did not lead to better outcomes compared with conventional inpatient rehabilitation.

  11. Robotics, Stem Cells and Brain Computer Interfaces in Rehabilitation and Recovery from Stroke; Updates and Advances

    Science.gov (United States)

    Boninger, Michael L; Wechsler, Lawrence R.; Stein, Joel

    2014-01-01

    Objective To describe the current state and latest advances in robotics, stem cells, and brain computer interfaces in rehabilitation and recovery for stroke. Design The authors of this summary recently reviewed this work as part of a national presentation. The paper represents the information included in each area. Results Each area has seen great advances and challenges as products move to market and experiments are ongoing. Conclusion Robotics, stem cells, and brain computer interfaces all have tremendous potential to reduce disability and lead to better outcomes for patients with stroke. Continued research and investment will be needed as the field moves forward. With this investment, the potential for recovery of function is likely substantial PMID:25313662

  12. Task-specific ankle robotics gait training after stroke: a randomized pilot study.

    Science.gov (United States)

    Forrester, Larry W; Roy, Anindo; Hafer-Macko, Charlene; Krebs, Hermano I; Macko, Richard F

    2016-06-02

    An unsettled question in the use of robotics for post-stroke gait rehabilitation is whether task-specific locomotor training is more effective than targeting individual joint impairments to improve walking function. The paretic ankle is implicated in gait instability and fall risk, but is difficult to therapeutically isolate and refractory to recovery. We hypothesize that in chronic stroke, treadmill-integrated ankle robotics training is more effective to improve gait function than robotics focused on paretic ankle impairments. Participants with chronic hemiparetic gait were randomized to either six weeks of treadmill-integrated ankle robotics (n = 14) or dose-matched seated ankle robotics (n = 12) videogame training. Selected gait measures were collected at baseline, post-training, and six-week retention. Friedman, and Wilcoxon Sign Rank and Fisher's exact tests evaluated within and between group differences across time, respectively. Six weeks post-training, treadmill robotics proved more effective than seated robotics to increase walking velocity, paretic single support, paretic push-off impulse, and active dorsiflexion range of motion. Treadmill robotics durably improved gait dorsiflexion swing angle leading 6/7 initially requiring ankle braces to self-discarded them, while their unassisted paretic heel-first contacts increased from 44 % to 99.6 %, versus no change in assistive device usage (0/9) following seated robotics. Treadmill-integrated, but not seated ankle robotics training, durably improves gait biomechanics, reversing foot drop, restoring walking propulsion, and establishing safer foot landing in chronic stroke that may reduce reliance on assistive devices. These findings support a task-specific approach integrating adaptive ankle robotics with locomotor training to optimize mobility recovery. NCT01337960. https://clinicaltrials.gov/ct2/show/NCT01337960?term=NCT01337960&rank=1.

  13. RESEARCH AND DEVELOPMENT OF DSP-BASED FACE RECOGNITION SYSTEM FOR ROBOTIC REHABILITATION NURSING BEDS

    Directory of Open Access Journals (Sweden)

    Ming XING

    2016-04-01

    Full Text Available This article describes the development of DSP as the core of the face recognition system, on the basis of understanding the background, significance and current research situation at home and abroad of face recognition issue, having a in-depth study to face detection, Image preprocessing, feature extraction face facial structure, facial expression feature extraction, classification and other issues during face recognition and have achieved research and development of DSP-based face recognition system for robotic rehabilitation nursing beds. The system uses a fixed-point DSP TMS320DM642 as a central processing unit, with a strong processing performance, high flexibility and programmability.

  14. FUZZY CONTROLLER FOR THE CONTROL OF THE MOBILE PLATFORM OF THE CORBYS ROBOTIC GAIT REHABILITATION SYSTEM

    Directory of Open Access Journals (Sweden)

    Maria Kyrarini

    2014-12-01

    Full Text Available In this paper, an inverse kinematics based control algorithm for the joystick control of the mobile platform of the novel mobile robot-assisted gait rehabilitation system CORBYS is presented. The mobile platform has four independently steered and driven wheels. Given the linear and angular velocities of the mobile platform, the inverse kinematics algorithm gives as its output the steering angle and the driving angular velocity of each of the four wheels. The paper is focused on the steering control of the platform for which a fuzzy logic controller is developed and implemented. The experimental results of the real-world steering of the platform are presented in the paper.

  15. Locomotor training through a novel robotic platform for gait rehabilitation in pediatric population: short report.

    Science.gov (United States)

    Bayón, C; Lerma, S; Ramírez, O; Serrano, J I; Del Castillo, M D; Raya, R; Belda-Lois, J M; Martínez, I; Rocon, E

    2016-11-14

    Cerebral Palsy (CP) is a disorder of posture and movement due to a defect in the immature brain. The use of robotic devices as alternative treatment to improve the gait function in patients with CP has increased. Nevertheless, current gait trainers are focused on controlling complete joint trajectories, avoiding postural control and the adaptation of the therapy to a specific patient. This paper presents the applicability of a new robotic platform called CPWalker in children with spastic diplegia. CPWalker consists of a smart walker with body weight and autonomous locomotion support and an exoskeleton for joint motion support. Likewise, CPWalker enables strategies to improve postural control during walking. The integrated robotic platform provides means for testing novel gait rehabilitation therapies in subjects with CP and similar motor disorders. Patient-tailored therapies were programmed in the device for its evaluation in three children with spastic diplegia for 5 weeks. After ten sessions of personalized training with CPWalker, the children improved the mean velocity (51.94 ± 41.97 %), cadence (29.19 ± 33.36 %) and step length (26.49 ± 19.58 %) in each leg. Post-3D gait assessments provided kinematic outcomes closer to normal values than Pre-3D assessments. The results show the potential of the novel robotic platform to serve as a rehabilitation tool. The autonomous locomotion and impedance control enhanced the children's participation during therapies. Moreover, participants' postural control was substantially improved, which indicates the usefulness of the approach based on promoting the patient's trunk control while the locomotion therapy is executed. Although results are promising, further studies with bigger sample size are required.

  16. Powered robotic exoskeletons in post-stroke rehabilitation of gait: a scoping review.

    Science.gov (United States)

    Louie, Dennis R; Eng, Janice J

    2016-06-08

    Powered robotic exoskeletons are a potential intervention for gait rehabilitation in stroke to enable repetitive walking practice to maximize neural recovery. As this is a relatively new technology for stroke, a scoping review can help guide current research and propose recommendations for advancing the research development. The aim of this scoping review was to map the current literature surrounding the use of robotic exoskeletons for gait rehabilitation in adults post-stroke. Five databases (Pubmed, OVID MEDLINE, CINAHL, Embase, Cochrane Central Register of Clinical Trials) were searched for articles from inception to October 2015. Reference lists of included articles were reviewed to identify additional studies. Articles were included if they utilized a robotic exoskeleton as a gait training intervention for adult stroke survivors and reported walking outcome measures. Of 441 records identified, 11 studies, all published within the last five years, involving 216 participants met the inclusion criteria. The study designs ranged from pre-post clinical studies (n = 7) to controlled trials (n = 4); five of the studies utilized a robotic exoskeleton device unilaterally, while six used a bilateral design. Participants ranged from sub-acute (6 months) stroke. Training periods ranged from single-session to 8-week interventions. Main walking outcome measures were gait speed, Timed Up and Go, 6-min Walk Test, and the Functional Ambulation Category. Meaningful improvement with exoskeleton-based gait training was more apparent in sub-acute stroke compared to chronic stroke. Two of the four controlled trials showed no greater improvement in any walking outcomes compared to a control group in chronic stroke. In conclusion, clinical trials demonstrate that powered robotic exoskeletons can be used safely as a gait training intervention for stroke. Preliminary findings suggest that exoskeletal gait training is equivalent to traditional therapy for chronic stroke

  17. The H2 robotic exoskeleton for gait rehabilitation after stroke: early findings from a clinical study.

    Science.gov (United States)

    Bortole, Magdo; Venkatakrishnan, Anusha; Zhu, Fangshi; Moreno, Juan C; Francisco, Gerard E; Pons, Jose L; Contreras-Vidal, Jose L

    2015-06-17

    Stroke significantly affects thousands of individuals annually, leading to considerable physical impairment and functional disability. Gait is one of the most important activities of daily living affected in stroke survivors. Recent technological developments in powered robotics exoskeletons can create powerful adjunctive tools for rehabilitation and potentially accelerate functional recovery. Here, we present the development and evaluation of a novel lower limb robotic exoskeleton, namely H2 (Technaid S.L., Spain), for gait rehabilitation in stroke survivors. H2 has six actuated joints and is designed to allow intensive overground gait training. An assistive gait control algorithm was developed to create a force field along a desired trajectory, only applying torque when patients deviate from the prescribed movement pattern. The device was evaluated in 3 hemiparetic stroke patients across 4 weeks of training per individual (approximately 12 sessions). The study was approved by the Institutional Review Board at the University of Houston. The main objective of this initial pre-clinical study was to evaluate the safety and usability of the exoskeleton. A Likert scale was used to measure patient's perception about the easy of use of the device. Three stroke patients completed the study. The training was well tolerated and no adverse events occurred. Early findings demonstrate that H2 appears to be safe and easy to use in the participants of this study. The overground training environment employed as a means to enhance active patient engagement proved to be challenging and exciting for patients. These results are promising and encourage future rehabilitation training with a larger cohort of patients. The developed exoskeleton enables longitudinal overground training of walking in hemiparetic patients after stroke. The system is robust and safe when applied to assist a stroke patient performing an overground walking task. Such device opens the opportunity to study means

  18. Pilot study of a robotic protocol to treat shoulder subluxation in patients with chronic stroke

    Science.gov (United States)

    2013-01-01

    Background Shoulder subluxation is a frequent complication of motor impairment after stroke, leading to soft tissue damage, stretching of the joint capsule, rotator cuff injury, and in some cases pain, thus limiting use of the affected extremity beyond weakness. In this pilot study, we determined whether robotic treatment of chronic shoulder subluxation can lead to functional improvement and whether any improvement was robust. Methods 18 patients with chronic stroke (3.9 ± 2.9 years from acute stroke), completed 6 weeks of robotic training using the linear shoulder robot. Training was performed 3 times per week on alternate days. Each session consisted of 3 sets of 320 repetitions of the affected arm, and the robotic protocol alternated between training vertical arm movements, shoulder flexion and extension, in an anti-gravity plane, and training horizontal arm movements, scapular protraction and retraction, in a gravity eliminated plane. Results Training with the linear robot improved shoulder stability, motor power, and resulted in improved functional outcomes that were robust 3 months after training. Conclusion In this uncontrolled pilot study, the robotic protocol effectively treated shoulder subluxation in chronic stroke patients. Treatment of subluxation can lead to improved functional use of the affected arm, likely by increasing motor power in the trained muscles. PMID:23914834

  19. Development and Implementation of an End-Effector Upper Limb Rehabilitation Robot for Hemiplegic Patients with Line and Circle Tracking Training

    Directory of Open Access Journals (Sweden)

    Yali Liu

    2017-01-01

    Full Text Available Numerous robots have been widely used to deliver rehabilitative training for hemiplegic patients to improve their functional ability. Because of the complexity and diversity of upper limb motion, customization of training patterns is one key factor during upper limb rehabilitation training. Most of the current rehabilitation robots cannot intelligently provide adaptive training parameters, and they have not been widely used in clinical rehabilitation. This article proposes a new end-effector upper limb rehabilitation robot, which is a two-link robotic arm with two active degrees of freedom. This work investigated the kinematics and dynamics of the robot system, the control system, and the realization of different rehabilitation therapies. We also explored the influence of constraint in rehabilitation therapies on interaction force and muscle activation. The deviation of the trajectory of the end effector and the required trajectory was less than 1 mm during the tasks, which demonstrated the movement accuracy of the robot. Besides, results also demonstrated the constraint exerted by the robot provided benefits for hemiplegic patients by changing muscle activation in the way similar to the movement pattern of the healthy subjects, which indicated that the robot can improve the patient’s functional ability by training the normal movement pattern.

  20. Robotically facilitated virtual rehabilitation of arm transport integrated with finger movement in persons with hemiparesis

    Directory of Open Access Journals (Sweden)

    Davidow Amy

    2011-05-01

    Full Text Available Abstract Background Recovery of upper extremity function is particularly recalcitrant to successful rehabilitation. Robotic-assisted arm training devices integrated with virtual targets or complex virtual reality gaming simulations are being developed to deal with this problem. Neural control mechanisms indicate that reaching and hand-object manipulation are interdependent, suggesting that training on tasks requiring coordinated effort of both the upper arm and hand may be a more effective method for improving recovery of real world function. However, most robotic therapies have focused on training the proximal, rather than distal effectors of the upper extremity. This paper describes the effects of robotically-assisted, integrated upper extremity training. Methods Twelve subjects post-stroke were trained for eight days on four upper extremity gaming simulations using adaptive robots during 2-3 hour sessions. Results The subjects demonstrated improved proximal stability, smoothness and efficiency of the movement path. This was in concert with improvement in the distal kinematic measures of finger individuation and improved speed. Importantly, these changes were accompanied by a robust 16-second decrease in overall time in the Wolf Motor Function Test and a 24-second decrease in the Jebsen Test of Hand Function. Conclusions Complex gaming simulations interfaced with adaptive robots requiring integrated control of shoulder, elbow, forearm, wrist and finger movements appear to have a substantial effect on improving hemiparetic hand function. We believe that the magnitude of the changes and the stability of the patient's function prior to training, along with maintenance of several aspects of the gains demonstrated at retention make a compelling argument for this approach to training.

  1. Predicting Functional Recovery in Chronic Stroke Rehabilitation Using Event-Related Desynchronization-Synchronization during Robot-Assisted Movement

    Directory of Open Access Journals (Sweden)

    Marco Caimmi

    2016-01-01

    Full Text Available Although rehabilitation robotics seems to be a promising therapy in the rehabilitation of the upper limb in stroke patients, consensus is still lacking on its additive effects. Therefore, there is a need for determining the possible success of robotic interventions on selected patients, which in turn determine the necessity for new investigating instruments supporting the treatment decision-making process and customization. The objective of the work presented in this preliminary study was to verify that fully robot assistance would not affect the physiological oscillatory cortical activity related to a functional movement in healthy subjects. Further, the clinical results following the robotic treatment of a chronic stroke patient, who positively reacted to the robotic intervention, were analyzed and discussed. First results show that there is no difference in EEG activation pattern between assisted and no-assisted movement in healthy subjects. Even more importantly, the patient’s pretreatment EEG activation pattern in no-assisted movement was completely altered, while it recovered to a quasi-physiological one in robot-assisted movement. The functional improvement following treatment was large. Using pretreatment EEG recording during robot-assisted movement might be a valid approach to assess the potential ability of the patient for recovering.

  2. Predicting Functional Recovery in Chronic Stroke Rehabilitation Using Event-Related Desynchronization-Synchronization during Robot-Assisted Movement.

    Science.gov (United States)

    Caimmi, Marco; Visani, Elisa; Digiacomo, Fabio; Scano, Alessandro; Chiavenna, Andrea; Gramigna, Cristina; Molinari Tosatti, Lorenzo; Franceschetti, Silvana; Molteni, Franco; Panzica, Ferruccio

    2016-01-01

    Although rehabilitation robotics seems to be a promising therapy in the rehabilitation of the upper limb in stroke patients, consensus is still lacking on its additive effects. Therefore, there is a need for determining the possible success of robotic interventions on selected patients, which in turn determine the necessity for new investigating instruments supporting the treatment decision-making process and customization. The objective of the work presented in this preliminary study was to verify that fully robot assistance would not affect the physiological oscillatory cortical activity related to a functional movement in healthy subjects. Further, the clinical results following the robotic treatment of a chronic stroke patient, who positively reacted to the robotic intervention, were analyzed and discussed. First results show that there is no difference in EEG activation pattern between assisted and no-assisted movement in healthy subjects. Even more importantly, the patient's pretreatment EEG activation pattern in no-assisted movement was completely altered, while it recovered to a quasi-physiological one in robot-assisted movement. The functional improvement following treatment was large. Using pretreatment EEG recording during robot-assisted movement might be a valid approach to assess the potential ability of the patient for recovering.

  3. A Safe Interaction of Robot Assisted Rehabilitation, Based on Model-Free Impedance Control with Singularity Avoidance

    Directory of Open Access Journals (Sweden)

    Iman Sharifi

    2014-12-01

    Full Text Available In this paper, a singularity-free control methodology for the safe robot-human interaction is proposed using a hybrid control technique in robotic rehabilitation applications. With the use of max-plus algebra, a hybrid controller is designed to guarantee feasible robot motion in the vicinity of the kinematic singularities or going through and staying at the singular configuration. The approach taken in this paper is based on model-free impedance control and hence does not require any information about the model except the upper bounds on the system matrix. The stability of the approach is investigated using multiple Lyapunov function theory. The proposed control algorithm is applied to PUMA 560 robot arm, a six-axis industrial robot. The results demonstrate the validity of the proposed control scheme.

  4. Pilot study of a targeted dance class for physical rehabilitation in children with cerebral palsy

    OpenAIRE

    Citlali López-Ortiz; Tara Egan; Gaebler-Spira, Deborah J.

    2016-01-01

    Introduction: This pilot study evaluates the effects of a targeted dance class utilizing classical ballet principles for rehabilitation of children with cerebral palsy on balance and upper extremity control. Methods: Twelve children with cerebral palsy (ages 7–15 years) with Gross Motor Function Classification scores II–IV participated in this study and were assigned to either a control group or targeted dance class group. Targeted dance class group participated in 1-h classes three times per...

  5. The HAAPI (Home Arm Assistance Progression Initiative) Trial: - A Novel Robotics Delivery Approach in Stroke Rehabilitation

    Science.gov (United States)

    Wolf, Steven L.; Sahu, Komal; Bay, R. Curtis; Buchanan, Sharon; Reiss, Aimee; Linder, Susan; Rosenfeldt, Anson; Alberts, Jay

    2015-01-01

    Background Geographical location, socioeconomic status and logistics surrounding transportation impede access of post-stroke individuals to comprehensive rehabilitative services. Robotic therapy may enhance telerehabilitation by delivering consistent and state-of-the art therapy while allowing for the remote monitoring and adjusting therapy for underserved populations. The Hand Mentor Pro (HMP), was incorporated within a home exercise program (HEP) to improve upper extremity functional capabilities post-stroke. Objective To determine the efficacy of a home-based telemonitored robotic-assisted therapy as part of a HEP compared with a dose-matched HEP-only intervention among individuals less than 6 months post-stroke and characterized as underserved. Methods In this prospective, single-blinded, multisite, randomized controlled trial, 99 hemiparetic participants with limited access to upper extremity rehabilitation were randomized to the: 1) experimental group which received combined HEP and HMP for 3 hrs/day x 5 days x 8 weeks; or 2) control group which received HEP only at an identical dosage. Weekly communication between the supervising therapist and participant promoted compliance and progression of the HEP and HMP prescription. The Action Research Arm Test and Wolf Motor Function Test along with the Fugl Meyer Assessment (upper extremity) were primary and secondary outcome measures respectively, undertaken before and after the interventions. Results Both groups demonstrated improvement across all upper extremity outcomes. Conclusions Robotic+HEP and HEP only were both effectively delivered remotely. There was no difference between groups in change in motor function over time, additional research is necessary to determine appropriate dosage of HMP and HEP. PMID:25782693

  6. The HAAPI (Home Arm Assistance Progression Initiative) Trial: A Novel Robotics Delivery Approach in Stroke Rehabilitation.

    Science.gov (United States)

    Wolf, Steven L; Sahu, Komal; Bay, R Curtis; Buchanan, Sharon; Reiss, Aimee; Linder, Susan; Rosenfeldt, Anson; Alberts, Jay

    2015-01-01

    Geographical location, socioeconomic status, and logistics surrounding transportation impede access of poststroke individuals to comprehensive rehabilitative services. Robotic therapy may enhance telerehabilitation by delivering consistent and state-of-the art therapy while allowing remote monitoring and adjusting therapy for underserved populations. The Hand Mentor Pro (HMP) was incorporated within a home exercise program (HEP) to improve upper-extremity (UE) functional capabilities poststroke. To determine the efficacy of a home-based telemonitored robotic-assisted therapy as part of a HEP compared with a dose-matched HEP-only intervention among individuals less than 6 months poststroke and characterized as underserved. In this prospective, single-blinded, multisite, randomized controlled trial, 99 hemiparetic participants with limited access to UE rehabilitation were randomized to either (1) the experimental group, which received combined HEP and HMP for 3 h/d ×5 days ×8 weeks, or (2) the control group, which received HEP only at an identical dosage. Weekly communication between the supervising therapist and participant promoted compliance and progression of the HEP and HMP prescription. The Action Research Arm Test and Wolf Motor Function Test along with the Fugl-Meyer Assessment (UE) were primary and secondary outcome measures, respectively, undertaken before and after the interventions. Both groups demonstrated improvement across all UE outcomes. Robotic + HEP and HEP only were both effectively delivered remotely. There was no difference between groups in change in motor function over time. Additional research is necessary to determine the appropriate dosage of HMP and HEP. © The Author(s) 2015.

  7. Quantifying Age-Related Differences in Human Reaching while Interacting with a Rehabilitation Robotic Device

    Directory of Open Access Journals (Sweden)

    Vivek Yadav

    2010-01-01

    Full Text Available New movement assessment and data analysis methods are developed to quantify human arm motion patterns during physical interaction with robotic devices for rehabilitation. These methods provide metrics for future use in diagnosis, assessment and rehabilitation of subjects with affected arm movements. Specifically, the current study uses existing pattern recognition methods to evaluate the effect of age on performance of a specific motion, reaching to a target by moving the end-effector of a robot (an X-Y table. Differences in the arm motion patterns of younger and older subjects are evaluated using two measures: the principal component analysis similarity factor (SPCA to compare path shape and the number of Fourier modes representing 98% of the path ‘energy’ to compare the smoothness of movement, a particularly important variable for assessment of pathologic movement. Both measures are less sensitive to noise than others previously reported in the literature and preserve information that is often lost through other analysis techniques. Data from the SPCA analysis indicate that age is a significant factor affecting the shapes of target reaching paths, followed by reaching movement type (crossing body midline/not crossing and reaching side (left/right; hand dominance and trial repetition are not significant factors. Data from the Fourier-based analysis likewise indicate that age is a significant factor affecting smoothness of movement, and movements become smoother with increasing trial number in both younger and older subjects, although more rapidly so in younger subjects. These results using the proposed data analysis methods confirm current practice that age-matched subjects should be used for comparison to quantify recovery of arm movement during rehabilitation. The results also highlight the advantages that these methods offer relative to other reported measures.

  8. A post-stroke rehabilitation system integrating robotics, VR and high-resolution EEG imaging.

    Science.gov (United States)

    Steinisch, Martin; Tana, Maria Gabriella; Comani, Silvia

    2013-09-01

    We propose a system for the neuro-motor rehabilitation of upper limbs in stroke survivors. The system is composed of a passive robotic device (Trackhold) for kinematic tracking and gravity compensation, five dedicated virtual reality (VR) applications for training of distinct movement patterns, and high-resolution EEG for synchronous monitoring of cortical activity. In contrast to active devices, the Trackhold omits actuators for increased patient safety and acceptance levels, and for reduced complexity and costs. VR applications present all relevant information for task execution as easy-to-understand graphics that do not need any written or verbal instructions. High-resolution electroencephalography (HR-EEG) is synchronized with kinematic data acquisition, allowing for the epoching of EEG signals on the basis of movement-related temporal events. Two healthy volunteers participated in a feasibility study and performed a protocol suggested for the rehabilitation of post-stroke patients. Kinematic data were analyzed by means of in-house code. Open source packages (EEGLAB, SPM, and GMAC) and in-house code were used to process the neurological data. Results from kinematic and EEG data analysis are in line with knowledge from currently available literature and theoretical predictions, and demonstrate the feasibility and potential usefulness of the proposed rehabilitation system to monitor neuro-motor recovery.

  9. Clinical effectiveness of combined virtual reality and robot assisted fine hand motion rehabilitation in subacute stroke patients.

    Science.gov (United States)

    Huang, Xianwei; Naghdy, Fazel; Naghdy, Golshah; Du, Haiping

    2017-07-01

    Robot-assisted therapy is regarded as an effective and reliable method for the delivery of highly repetitive rehabilitation training in restoring motor skills after a stroke. This study focuses on the rehabilitation of fine hand motion skills due to their vital role in performing delicate activities of daily living (ADL) tasks. The proposed rehabilitation system combines an adaptive assist-as-needed (AAN) control algorithm and a Virtual Reality (VR) based rehabilitation gaming system (RGS). The developed system is described and its effectiveness is validated through clinical trials on a group of eight subacute stroke patients for a period of six weeks. The impact of the training is verified through standard clinical evaluation methods and measuring key kinematic parameters. A comparison of the pre- and post-training results indicates that the method proposed in this study can improve fine hand motion rehabilitation training effectiveness.

  10. Stroke Rehabilitation in Frail Elderly with the Robotic Training Device ACRE: A Randomized Controlled Trial and Cost-Effectiveness Study

    NARCIS (Netherlands)

    Schoone, M.; Dusseldorp, E.; Akker-van Marle, M.E. van den; Doornebosch, A.J.; Bal, R.; Meems, A.; Oderwald, M.P.; Balen, R. van

    2011-01-01

    The ACRE (ACtive REhabilitation) robotic device is developed to enhance therapeutic treatment of upper limbs after stroke. The aim of this study is to assess effects and costs of ACRE training for frail elderly patients and to establish if ACRE can be a valuable addition to standard therapy in nursi

  11. Donkey-assisted rehabilitation program for children: a pilot study.

    Science.gov (United States)

    De Rose, Paola; Cannas, Elisabetta; Reinger Cantiello, Patrizia

    2011-01-01

    Bonding with animals grants access to the sphere of affectivity and facilitates therapeutic engagement. The methodological approach of donkey-assisted programs is based on mediation, which is characterized by multidirectional relationships (patient-donkey-therapist). The donkey is an excellent facilitator in the motivation-building process, being able to stimulate the child's development by way of active and positive forces that foster psycho-affective and psycho-cognitive development processes. Results of this study, which focused on the child's approach to the donkey, indicate that while communicating with the animal, children rely more on physical expressions than on verbal language. Donkey-assisted rehabilitative sessions can help in identifying children's strong points, on which motivation could be built.

  12. Donkey-assisted rehabilitation program for children: a pilot study

    Directory of Open Access Journals (Sweden)

    Paola De Rose

    2011-12-01

    Full Text Available Bonding with animals grants access to the sphere of affectivity and facilitates therapeutic engagement. The methodological approach of donkey-assisted programs is based on mediation, which is characterized by multidirectional relationships (patient-donkey-therapist. The donkey is an excellent facilitator in the motivation-building process, being able to stimulate the child's development by way of active and positive forces that foster psycho-affective and psycho-cognitive development processes. Results of this study, which focused on the child's approach to the donkey, indicate that while communicating with the animal, children rely more on physical expressions than on verbal language. Donkey-assisted rehabilitative sessions can help in identifying children's strong points, on which motivation could be built.

  13. Use of a robotic device for the rehabilitation of severe upper limb paresis in subacute stroke: exploration of patient/robot interactions and the motor recovery process.

    Science.gov (United States)

    Duret, Christophe; Courtial, Ophélie; Grosmaire, Anne-Gaëlle; Hutin, Emilie

    2015-01-01

    This pioneering observational study explored the interaction between subacute stroke inpatients and a rehabilitation robot during upper limb training. 25 stroke survivors (age 55 ± 17 years; time since stroke, 52 ± 21 days) with severe upper limb paresis carried out 16 sessions of robot-assisted shoulder/elbow training (InMotion 2.0, IMT, Inc., MA, USA) combined with standard therapy. The values of 3 patient/robot interaction parameters (a guidance parameter: Stiffness, a velocity-related parameter: Slottime, and Robotic Power) were compared between sessions 1 (S1), 4 (S4), 8 (S8), 12 (S12), and 16 (S16). Pre/post Fugl-Meyer Assessment (FMA) scores were compared in 18 patients. Correlations between interaction parameters and clinical and kinematic outcome measures were evaluated. Slottime decreased at S8 (P = 0.003), while Guidance decreased at S12 (P = 0.008). Robotic Power tended to decrease until S16. FMA scores improved from S1 to S16 (+49%, P = 0.002). Changes in FMA score were correlated with the Stiffness parameter (R = 0.4, P = 0.003). Slottime was correlated with movement velocity. This novel approach demonstrated that a robotic device is a useful and reliable tool for the quantification of interaction parameters. Moreover, changes in these parameters were correlated with clinical and kinematic changes. These results suggested that robot-based recordings can provide new insights into the motor recovery process.

  14. Use of a Robotic Device for the Rehabilitation of Severe Upper Limb Paresis in Subacute Stroke: Exploration of Patient/Robot Interactions and the Motor Recovery Process

    Directory of Open Access Journals (Sweden)

    Christophe Duret

    2015-01-01

    Full Text Available This pioneering observational study explored the interaction between subacute stroke inpatients and a rehabilitation robot during upper limb training. 25 stroke survivors (age 55±17 years; time since stroke, 52±21 days with severe upper limb paresis carried out 16 sessions of robot-assisted shoulder/elbow training (InMotion 2.0, IMT, Inc., MA, USA combined with standard therapy. The values of 3 patient/robot interaction parameters (a guidance parameter: Stiffness, a velocity-related parameter: Slottime, and Robotic Power were compared between sessions 1 (S1, 4 (S4, 8 (S8, 12 (S12, and 16 (S16. Pre/post Fugl-Meyer Assessment (FMA scores were compared in 18 patients. Correlations between interaction parameters and clinical and kinematic outcome measures were evaluated. Slottime decreased at S8 (P=0.003, while Guidance decreased at S12 (P=0.008. Robotic Power tended to decrease until S16. FMA scores improved from S1 to S16 (+49%, P=0.002. Changes in FMA score were correlated with the Stiffness parameter (R=0.4, P=0.003. Slottime was correlated with movement velocity. This novel approach demonstrated that a robotic device is a useful and reliable tool for the quantification of interaction parameters. Moreover, changes in these parameters were correlated with clinical and kinematic changes. These results suggested that robot-based recordings can provide new insights into the motor recovery process.

  15. Exerciser for rehabilitation of the Arm (ERA): Development and unique features of a 3D end-effector robot.

    Science.gov (United States)

    Milot, Marie-Helene; Hamel, Mathieu; Provost, Philippe-Olivier; Bernier-Ouellet, Julien; Dupuis, Maxime; Letourneau, Dominic; Briere, Simon; Michaud, Francois

    2016-08-01

    Stroke is one of the leading causes of disability worldwide. Consequently, many stroke survivors exhibit difficulties undergoing voluntary movement in their affected upper limb, compromising their functional performance and level of independence. To minimize the negative impact of stroke disabilities, exercises are recognized as a key element in post-stroke rehabilitation. In order to provide the practice of exercises in a uniform and controlled manner as well as increasing the efficiency of therapists' interventions, robotic training has been found, and continues to prove itself, as an innovative intervention for post-stroke rehabilitation. However, the complexity as well as the limited degrees of freedom and workspace of currently commercially available robots can limit their use in clinical settings. Up to now, user-friendly robots covering a sufficiently large workspace for training of the upper limb in its full range of motion are lacking. This paper presents the design and implementation of ERA, an upper-limb 3-DOF force-controlled exerciser robot, which presents a workspace covering the entire range of motion of the upper limb. The ERA robot provides 3D reaching movements in a haptic virtual environment. A description of the hardware and software components of the ERA robot is also presented along with a demonstration of its capabilities in one of the three operational modes that were developed.

  16. Functional MRI using robotic MRI compatible devices for monitoring rehabilitation from chronic stroke in the molecular medicine era (Review)

    Science.gov (United States)

    ASTRAKAS, LOUKAS G.; NAQVI, SYED HASSAN ABBAS; KATEB, BABAK; TZIKA, A. ARIA

    2012-01-01

    The number of individuals suffering from stroke is increasing daily, and its consequences are a major contributor to invalidity in today’s society. Stroke rehabilitation is relatively new, having been hampered from the longstanding view that lost functions were not recoverable. Nowadays, robotic devices, which aid by stimulating brain plasticity, can assist in restoring movement compromised by stroke-induced pathological changes in the brain which can be monitored by MRI. Multiparametric magnetic resonance imaging (MRI) of stroke patients participating in a training program with a novel Magnetic Resonance Compatible Hand-Induced Robotic Device (MR_CHIROD) could yield a promising biomarker that, ultimately, will enhance our ability to advance hand motor recovery following chronic stroke. Using state-of-the art MRI in conjunction with MR_CHIROD-assisted therapy can provide novel biomarkers for stroke patient rehabilitation extracted by a meta-analysis of data. Successful completion of such studies may provide a ground breaking method for the future evaluation of stroke rehabilitation therapies. Their results will attest to the effectiveness of using MR-compatible hand devices with MRI to provide accurate monitoring during rehabilitative therapy. Furthermore, such results may identify biomarkers of brain plasticity that can be monitored during stroke patient rehabilitation. The potential benefit for chronic stroke patients is that rehabilitation may become possible for a longer period of time after stroke than previously thought, unveiling motor skill improvements possible even after six months due to retained brain plasticity. PMID:22426741

  17. A Robot-Based Tool for Physical and Cognitive Rehabilitation of Elderly People Using Biofeedback

    Directory of Open Access Journals (Sweden)

    Leire Lopez-Samaniego

    2016-11-01

    Full Text Available This publication presents a complete description of a technological solution system for the physical and cognitive rehabilitation of elderly people through a biofeedback system, which is combined with a Lego robot. The technology used was the iOS’s (iPhone Operating System Objective-C programming language and its XCode programming environment; and SQLite in order to create the database. The biofeedback system is implemented by the use of two biosensors which are, in fact, a Microsoft band 2 in order to register the user’s heart rate and a MYO sensor to detect the user’s arm movement. Finally, the system was tested with seven elderly people from La Santa y Real Casa de la Misericordia nursing home in Bilbao. The statistical assessment has shown that the users are satisfied with the usability of the system, with a mean score of 79.29 on the System Usability Scale (SUS questionnaire.

  18. A Robot-Based Tool for Physical and Cognitive Rehabilitation of Elderly People Using Biofeedback

    Science.gov (United States)

    Lopez-Samaniego, Leire; Garcia-Zapirain, Begonya

    2016-01-01

    This publication presents a complete description of a technological solution system for the physical and cognitive rehabilitation of elderly people through a biofeedback system, which is combined with a Lego robot. The technology used was the iOS’s (iPhone Operating System) Objective-C programming language and its XCode programming environment; and SQLite in order to create the database. The biofeedback system is implemented by the use of two biosensors which are, in fact, a Microsoft band 2 in order to register the user’s heart rate and a MYO sensor to detect the user’s arm movement. Finally, the system was tested with seven elderly people from La Santa y Real Casa de la Misericordia nursing home in Bilbao. The statistical assessment has shown that the users are satisfied with the usability of the system, with a mean score of 79.29 on the System Usability Scale (SUS) questionnaire. PMID:27886146

  19. A Robot-Based Tool for Physical and Cognitive Rehabilitation of Elderly People Using Biofeedback.

    Science.gov (United States)

    Lopez-Samaniego, Leire; Garcia-Zapirain, Begonya

    2016-11-24

    This publication presents a complete description of a technological solution system for the physical and cognitive rehabilitation of elderly people through a biofeedback system, which is combined with a Lego robot. The technology used was the iOS's (iPhone Operating System) Objective-C programming language and its XCode programming environment; and SQLite in order to create the database. The biofeedback system is implemented by the use of two biosensors which are, in fact, a Microsoft band 2 in order to register the user's heart rate and a MYO sensor to detect the user's arm movement. Finally, the system was tested with seven elderly people from La Santa y Real Casa de la Misericordia nursing home in Bilbao. The statistical assessment has shown that the users are satisfied with the usability of the system, with a mean score of 79.29 on the System Usability Scale (SUS) questionnaire.

  20. Rehabilitation

    Science.gov (United States)

    ... doing things you did before. This process is rehabilitation. Rehabilitation often focuses on Physical therapy to help your ... who has had a stroke may simply want rehabilitation to be able to dress or bathe without ...

  1. PSO-SVM-Based Online Locomotion Mode Identification for Rehabilitation Robotic Exoskeletons.

    Science.gov (United States)

    Long, Yi; Du, Zhi-Jiang; Wang, Wei-Dong; Zhao, Guang-Yu; Xu, Guo-Qiang; He, Long; Mao, Xi-Wang; Dong, Wei

    2016-09-02

    Locomotion mode identification is essential for the control of a robotic rehabilitation exoskeletons. This paper proposes an online support vector machine (SVM) optimized by particle swarm optimization (PSO) to identify different locomotion modes to realize a smooth and automatic locomotion transition. A PSO algorithm is used to obtain the optimal parameters of SVM for a better overall performance. Signals measured by the foot pressure sensors integrated in the insoles of wearable shoes and the MEMS-based attitude and heading reference systems (AHRS) attached on the shoes and shanks of leg segments are fused together as the input information of SVM. Based on the chosen window whose size is 200 ms (with sampling frequency of 40 Hz), a three-layer wavelet packet analysis (WPA) is used for feature extraction, after which, the kernel principal component analysis (kPCA) is utilized to reduce the dimension of the feature set to reduce computation cost of the SVM. Since the signals are from two types of different sensors, the normalization is conducted to scale the input into the interval of [0, 1]. Five-fold cross validation is adapted to train the classifier, which prevents the classifier over-fitting. Based on the SVM model obtained offline in MATLAB, an online SVM algorithm is constructed for locomotion mode identification. Experiments are performed for different locomotion modes and experimental results show the effectiveness of the proposed algorithm with an accuracy of 96.00% ± 2.45%. To improve its accuracy, majority vote algorithm (MVA) is used for post-processing, with which the identification accuracy is better than 98.35% ± 1.65%. The proposed algorithm can be extended and employed in the field of robotic rehabilitation and assistance.

  2. PSO-SVM-Based Online Locomotion Mode Identification for Rehabilitation Robotic Exoskeletons

    Directory of Open Access Journals (Sweden)

    Yi Long

    2016-09-01

    Full Text Available Locomotion mode identification is essential for the control of a robotic rehabilitation exoskeletons. This paper proposes an online support vector machine (SVM optimized by particle swarm optimization (PSO to identify different locomotion modes to realize a smooth and automatic locomotion transition. A PSO algorithm is used to obtain the optimal parameters of SVM for a better overall performance. Signals measured by the foot pressure sensors integrated in the insoles of wearable shoes and the MEMS-based attitude and heading reference systems (AHRS attached on the shoes and shanks of leg segments are fused together as the input information of SVM. Based on the chosen window whose size is 200 ms (with sampling frequency of 40 Hz, a three-layer wavelet packet analysis (WPA is used for feature extraction, after which, the kernel principal component analysis (kPCA is utilized to reduce the dimension of the feature set to reduce computation cost of the SVM. Since the signals are from two types of different sensors, the normalization is conducted to scale the input into the interval of [0, 1]. Five-fold cross validation is adapted to train the classifier, which prevents the classifier over-fitting. Based on the SVM model obtained offline in MATLAB, an online SVM algorithm is constructed for locomotion mode identification. Experiments are performed for different locomotion modes and experimental results show the effectiveness of the proposed algorithm with an accuracy of 96.00% ± 2.45%. To improve its accuracy, majority vote algorithm (MVA is used for post-processing, with which the identification accuracy is better than 98.35% ± 1.65%. The proposed algorithm can be extended and employed in the field of robotic rehabilitation and assistance.

  3. PSO-SVM-Based Online Locomotion Mode Identification for Rehabilitation Robotic Exoskeletons

    Science.gov (United States)

    Long, Yi; Du, Zhi-Jiang; Wang, Wei-Dong; Zhao, Guang-Yu; Xu, Guo-Qiang; He, Long; Mao, Xi-Wang; Dong, Wei

    2016-01-01

    Locomotion mode identification is essential for the control of a robotic rehabilitation exoskeletons. This paper proposes an online support vector machine (SVM) optimized by particle swarm optimization (PSO) to identify different locomotion modes to realize a smooth and automatic locomotion transition. A PSO algorithm is used to obtain the optimal parameters of SVM for a better overall performance. Signals measured by the foot pressure sensors integrated in the insoles of wearable shoes and the MEMS-based attitude and heading reference systems (AHRS) attached on the shoes and shanks of leg segments are fused together as the input information of SVM. Based on the chosen window whose size is 200 ms (with sampling frequency of 40 Hz), a three-layer wavelet packet analysis (WPA) is used for feature extraction, after which, the kernel principal component analysis (kPCA) is utilized to reduce the dimension of the feature set to reduce computation cost of the SVM. Since the signals are from two types of different sensors, the normalization is conducted to scale the input into the interval of [0, 1]. Five-fold cross validation is adapted to train the classifier, which prevents the classifier over-fitting. Based on the SVM model obtained offline in MATLAB, an online SVM algorithm is constructed for locomotion mode identification. Experiments are performed for different locomotion modes and experimental results show the effectiveness of the proposed algorithm with an accuracy of 96.00% ± 2.45%. To improve its accuracy, majority vote algorithm (MVA) is used for post-processing, with which the identification accuracy is better than 98.35% ± 1.65%. The proposed algorithm can be extended and employed in the field of robotic rehabilitation and assistance. PMID:27598160

  4. Magnetic resonance-compatible robotic and mechatronics systems for image-guided interventions and rehabilitation: a review study.

    Science.gov (United States)

    Tsekos, Nikolaos V; Khanicheh, Azadeh; Christoforou, Eftychios; Mavroidis, Constantinos

    2007-01-01

    The continuous technological progress of magnetic resonance imaging (MRI), as well as its widespread clinical use as a highly sensitive tool in diagnostics and advanced brain research, has brought a high demand for the development of magnetic resonance (MR)-compatible robotic/mechatronic systems. Revolutionary robots guided by real-time three-dimensional (3-D)-MRI allow reliable and precise minimally invasive interventions with relatively short recovery times. Dedicated robotic interfaces used in conjunction with fMRI allow neuroscientists to investigate the brain mechanisms of manipulation and motor learning, as well as to improve rehabilitation therapies. This paper gives an overview of the motivation, advantages, technical challenges, and existing prototypes for MR-compatible robotic/mechatronic devices.

  5. Design and development of an upper extremity motion capture system for a rehabilitation robot.

    Science.gov (United States)

    Nanda, Pooja; Smith, Alan; Gebregiorgis, Adey; Brown, Edward E

    2009-01-01

    Human robot interaction is a new and rapidly growing field and its application in the realm of rehabilitation and physical care is a major focus area of research worldwide. This paper discusses the development and implementation of a wireless motion capture system for the human arm which can be used for physical therapy or real-time control of a robotic arm, among many other potential applications. The system is comprised of a mechanical brace with rotary potentiometers inserted at the different joints to capture position data. It also contains surface electrodes which acquire electromyographic signals through the CleveMed BioRadio device. The brace interfaces with a software subsystem which displays real time data signals. The software includes a 3D arm model which imitates the actual movement of a subject's arm under testing. This project began as part of the Rochester Institute of Technology's Undergraduate Multidisciplinary Senior Design curriculum and has been integrated into the overall research objectives of the Biomechatronic Learning Laboratory.

  6. Design and validation of a rehabilitation robotic exoskeleton for tremor assessment and suppression.

    Science.gov (United States)

    Rocon, E; Belda-Lois, J M; Ruiz, A F; Manto, M; Moreno, J C; Pons, J L

    2007-09-01

    Exoskeletons are mechatronic systems worn by a person in such a way that the physical interface permits a direct transfer of mechanical power and exchange of information. Upper limb robotic exoskeletons may be helpful for people with disabilities and/or limb weakness or injury. Tremor is the most common movement disorder in neurological practice. In addition to medication, rehabilitation programs, and deep brain stimulation, biomechanical loading has appeared as a potential tremor suppression alternative. This paper introduces the robotic exoskeleton called WOTAS (wearable orthosis for tremor assessment and suppression) that provides a means of testing and validating nongrounded control strategies for orthotic tremor suppression. This paper describes in detail the general concept for WOTAS, outlining the special features of the design and selection of system components. Two control strategies developed for tremor suppression with exoskeletons are described. These two strategies are based on biomechanical loading and notch filtering the tremor through the application of internal forces. Results from experiments using these two strategies on patients with tremor are summarized. Finally, results from clinical trials are presented, which indicate the feasibility of ambulatory mechanical suppression of tremor.

  7. A pilot randomized trial of two cognitive rehabilitation interventions for mild cognitive impairment: caregiver outcomes.

    Science.gov (United States)

    Cuc, Andrea V; Locke, Dona E C; Duncan, Noah; Fields, Julie A; Snyder, Charlene Hoffman; Hanna, Sherrie; Lunde, Angela; Smith, Glenn E; Chandler, Melanie

    2017-02-24

    This study aims to provide effect size estimates of the impact of two cognitive rehabilitation interventions provided to patients with mild cognitive impairment: computerized brain fitness exercise and memory support system on support partners' outcomes of depression, anxiety, quality of life, and partner burden. A randomized controlled pilot trial was performed. At 6 months, the partners from both treatment groups showed stable to improved depression scores, while partners in an untreated control group showed worsening depression over 6 months. There were no statistically significant differences on anxiety, quality of life, or burden outcomes in this small pilot trial; however, effect sizes were moderate, suggesting that the sample sizes in this pilot study were not adequate to detect statistical significance. Either form of cognitive rehabilitation may help partners' mood, compared with providing no treatment. However, effect size estimates related to other partner outcomes (i.e., burden, quality of life, and anxiety) suggest that follow-up efficacy trials will need sample sizes of at least 30-100 people per group to accurately determine significance. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

  8. Hiding robot inertia using resonance.

    Science.gov (United States)

    Vallery, Heike; Duschau-Wicke, Alexander; Riener, Robert

    2010-01-01

    To enable compliant training modes with a rehabilitation robot, an important prerequisite is that any undesired human-robot interaction forces caused by robot dynamics must be avoided, either by an appropriate mechanical design or by compensating control strategies. Our recently proposed control scheme of "Generalized Elasticities" employs potential fields to compensate for robot dynamics, including inertia, beyond what can be done using closed-loop force control. In this paper, we give a simple mechanical equivalent using the example of the gait rehabilitation robot Lokomat. The robot consists of an exoskeleton that is attached to a frame around the patient's pelvis. This frame is suspended by a springloaded parallelogram structure. The mechanism allows vertical displacement while providing almost constant robot gravity compensation. However, inertia of the device when the patient's pelvis moves up and down remains a source of large interaction forces, which are reflected in increased ground reaction forces. Here, we investigate an alternative suspension: To hide not only gravity, but also robot inertia during vertical pelvis motion, we suspend the robot frame by a stiff linear spring that allows the robot to oscillate vertically at an eigenfrequency close to the natural gait frequency. This mechanism reduces human-robot interaction forces, which is demonstrated in pilot experimental results.

  9. Robotic resistance treadmill training improves locomotor function in human spinal cord injury: a pilot study.

    Science.gov (United States)

    Wu, Ming; Landry, Jill M; Schmit, Brian D; Hornby, T George; Yen, Sheng-Che

    2012-05-01

    To determine whether cable-driven robotic resistance treadmill training can improve locomotor function in humans with incomplete spinal cord injury (SCI). Repeated assessment of the same patients with crossover design. Research units of rehabilitation hospitals in Chicago. Patients with chronic incomplete SCI (N=10) were recruited to participate in this study. Subjects were randomly assigned to 1 of 2 groups. One group received 4 weeks of assistance training followed by 4 weeks of resistance training, while the other group received 4 weeks of resistance training followed by 4 weeks of assistance training. Locomotor training was provided by using a cable-driven robotic locomotor training system, which is highly backdrivable and compliant, allowing patients the freedom to voluntarily move their legs in a natural gait pattern during body weight supported treadmill training (BWSTT), while providing controlled assistance/resistance forces to the leg during the swing phase of gait. Primary outcome measures were evaluated for each participant before training and after 4 and 8 weeks of training. Primary measures were self-selected and fast overground walking velocity and 6-minute walking distance. Secondary measures included clinical assessments of balance, muscle tone, and strength. A significant improvement in walking speed and balance in humans with SCI was observed after robotic treadmill training using the cable-driven robotic locomotor trainer. There was no significant difference in walking functional gains after resistance versus assistance training, although resistance training was more effective for higher functioning patients. Cable-driven robotic resistance training may be used as an adjunct to BWSTT for improving overground walking function in humans with incomplete SCI, particularly for those patients with relatively high function. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  10. Effects of robotic-aided rehabilitation on recovery of upper extremity function in chronic stroke: a single case study.

    Science.gov (United States)

    Flinn, Nancy A; Smith, Jennifer L; Tripp, Christopher J; White, Matthew W

    2009-01-01

    The objective of the study was to examine the results of robotic therapy in a single client. A 48-year-old female client 15 months post-stroke, with right hemiparesis, received robotic therapy as an outpatient in a large Midwestern rehabilitation hospital. Robotic therapy was provided three times a week for 6 weeks. Robotic therapy consisted of goal-directed, robotic-aided reaching tasks to exercise the hemiparetic shoulder and elbow. No other therapeutic intervention for the affected upper extremity was provided during the study or 3 months follow-up period. The outcome measures included the Fugl-Meyer, graded Wolf motor function test (GWMFT), motor activity log, active range of motion and Canadian occupational performance measure. The participant made gains in active movement; performance; and satisfaction of functional tasks, GWMFT and functional use. Limitations involved in this study relate to the generalizability of the sample size, effect of medications, expense of robotic technologies and the impact of aphasia. Future research should incorporate functional use training along with robotic therapy.

  11. HandTutor™ enhanced hand rehabilitation after stroke--a pilot study.

    Science.gov (United States)

    Carmeli, Eli; Peleg, Sara; Bartur, Gadi; Elbo, Enbal; Vatine, Jean-Jacques

    2011-12-01

    This study assessed the potential therapeutic benefi t of using HandTutor™ in combination with traditional rehabilitation in a post-stroke sub-acute population. The study compares an experimental group receiving traditional therapy combined with HandTutorTM treatment, against a control group receiving only traditional therapy. An assessor-blinded, randomized controlled pilot trial, was conducted in the Reuth rehabilitation unit in Israel. Thirty-one stroke patients in the sub-acute phase, were randomly assigned to one of the two groups (experimental or control) in sets of three. The experimental group (n = 16) underwent a hand rehabilitation programme using the HandTutorTM combined with traditional therapy. The control group (n = 15) received only traditional therapy. The treatment schedules for both groups were of similar duration and frequency. Improvements were evaluated using three indicators: 1) The Brunnström-Fugl-Meyer (FM) test, 2) the Box and Blocks (B&B) test and 3) improvement parameters as determined by the HandTutorTM software. Following 15 consecutive treatment sessions, a signifi cant improvement was observed within the experimental group (95% confi dence intervals) compared with the control group: B&B p = 0.015; FM p = 0.041, HandTutor™ performance accuracy on x axis and performance accuracy on y axis p occupational therapy and physiotherapy during post stroke hand function rehabilitation.

  12. Assistive Technology Based on Robotics and Rise in China

    Institute of Scientific and Technical Information of China (English)

    ZHANG Xiaoyu; WANG Kaixuan

    2013-01-01

    The concept of assistive technology based on robotics,rehabilitation robot and intelligent assistive devices.Domestic intelligence assistive devices include intelligent prosthetics,intelligent orthotics,intelligent walker,assistive devices for smart home environment control,intelligent life assistive devices; Domestic intelligent rehabilitation robot include upper limb rehabilitation robot,hand rehabilitation robot,lower limb rehabilitation robot,robotic smart wheelchair,intelligent nursing bed,daily care robot,the development trend of intelligent assistive devices and rehabilitation robot.

  13. HRAF PILOT- Prototype Facility for Verification & Validation of Robotics & Autonomy

    Science.gov (United States)

    Ward, R.; Reed, S.; Monchieri, E.; Martelli, A.; Biggio, A.; Schroeven-Deceuninck, H.

    2014-08-01

    The development of complex autonomous landed robotic systems will be critical for future planetary exploration missions. Such missions will encounter dynamically changing environments with high levels of uncertainty and will require the use of specialist test facilities including mock planetary surfaces, simulated software environments and field trials. However these same facilities can also have practical applications for terrestrial users in fields such as agriculture, automotive, first response, mining, oil and gas exploration [1].This paper presents the progress of the project to develop a Core Infrastruture Protoype of HRAF conducted on behalf of the European Space Agency (ESA) by a consortium composed of SCISYS, Astrium UK, Thales Alenia Space, Joanneum Research and the Virtutal Engineering Centre.

  14. An Evaluation of the Design and Usability of a Novel Robotic Bilateral Arm Rehabilitation Device for Patients with Stroke

    Directory of Open Access Journals (Sweden)

    Yu-Cheng Pei

    2017-07-01

    Full Text Available Study designCase series.Evidence levelIV (case series.IntroductionRobot-assisted therapy for upper limb rehabilitation is an emerging research topic and its design process must integrate engineering, neurological pathophysiology, and clinical needs.Purpose of the studyThis study developed/evaluated the usefulness of a novel rehabilitation device, the MirrorPath, designed for the upper limb rehabilitation of patients with hemiplegic stroke.MethodsThe process follows Tseng’s methodology for innovative product design and development, namely two stages, device development and usability assessment. During the development process, the design was guided by patients’ rehabilitation needs as defined by patients and their therapists. The design applied synchronic movement of the bilateral upper limbs, an approach that is compatible with the bilateral movement therapy and proprioceptive neuromuscular facilitation theories. MirrorPath consists of a robotic device that guides upper limb movement linked to a control module containing software controlling the robotic movement.ResultsFive healthy subjects were recruited in the pretest, and 4 patients, 4 caregivers, and 4 therapists were recruited in the formal test for usability. All recruited subjects were allocated to the test group, completed the evaluation, and their data were all analyzed. The total system usability scale score obtained from the patients, caregivers, and therapists was 71.8 ± 11.9, indicating a high level of usability and product acceptance.Discussion and conclusionFollowing a standard development process, we could yield a design that meets clinical needs. This low-cost device provides a feasible platform for carrying out robot-assisted bilateral movement therapy of patients with hemiplegic stroke.Clinical Trial Registrationidentifier NCT02698605.

  15. Functional impacts of exoskeleton-based rehabilitation in chronic stroke: multi-joint versus single-joint robotic training.

    Science.gov (United States)

    Grimaldi, Giuliana; Manto, Mario

    2013-12-19

    Stroke is a major cause of disability in the world. The activities of upper limb segments are often compromised following a stroke, impairing most daily tasks. Robotic training is now considered amongst the rehabilitation methods applied to promote functional recovery. However, the implementation of robotic devices remains a major challenge for the bioengineering and clinical community. Latest exoskeletons with multiple degrees of freedom (DOF) may become particularly attractive, because of their low apparent inertia, the multiple actuators generating large torques, and the fact that patients can move the arm in the normal wide workspace. A recent study published in JNER by Milot and colleagues underlines that training with a 6-DOF exoskeleton impacts positively on motor function in patients being in stable phase of recovery after a stroke. Also, multi-joint robotic training was not found to be superior to single-joint robotic training. Although it is often considered that rehabilitation should start from simple movements to complex functional movements as the recovery evolves, this study challenges this widespread notion whose scientific basis has remained uncertain.

  16. Conflicting results of robot-assisted versus usual gait training during postacute rehabilitation of stroke patients: a randomized clinical trial

    Science.gov (United States)

    Taveggia, Giovanni; Borboni, Alberto; Mulé, Chiara; Negrini, Stefano

    2016-01-01

    Robot gait training has the potential to increase the effectiveness of walking therapy. Clinical outcomes after robotic training are often not superior to conventional therapy. We evaluated the effectiveness of a robot training compared with a usual gait training physiotherapy during a standardized rehabilitation protocol in inpatient participants with poststroke hemiparesis. This was a randomized double-blind clinical trial in a postacute physical and rehabilitation medicine hospital. Twenty-eight patients, 39.3% women (72±6 years), with hemiparesis (Bobath approach were assigned randomly to an experimental or a control intervention of robot gait training to improve walking (five sessions a week for 5 weeks). Outcome measures included the 6-min walk test, the 10 m walk test, Functional Independence Measure, SF-36 physical functioning and the Tinetti scale. Outcomes were collected at baseline, immediately following the intervention period and 3 months following the end of the intervention. The experimental group showed a significant increase in functional independence and gait speed (10 m walk test) at the end of the treatment and follow-up, higher than the minimal detectable change. The control group showed a significant increase in the gait endurance (6-min walk test) at the follow-up, higher than the minimal detectable change. Both treatments were effective in the improvement of gait performances, although the statistical analysis of functional independence showed a significant improvement in the experimental group, indicating possible advantages during generic activities of daily living compared with overground treatment. PMID:26512928

  17. Using visual feedback distortion to alter coordinated pinching patterns for robotic rehabilitation

    Directory of Open Access Journals (Sweden)

    Brewer Bambi R

    2007-05-01

    Full Text Available Abstract Background It is common for individuals with chronic disabilities to continue using the compensatory movement coordination due to entrenched habits, increased perception of task difficulty, or personality variables such as low self-efficacy or a fear of failure. Following our previous work using feedback distortion in a virtual rehabilitation environment to increase strength and range of motion, we address the use of visual feedback distortion environment to alter movement coordination patterns. Methods Fifty-one able-bodied subjects participated in the study. During the experiment, each subject learned to move their index finger and thumb in a particular target pattern while receiving visual feedback. Visual distortion was implemented as a magnification of the error between the thumb and/or index finger position and the desired position. The error reduction profile and the effect of distortion were analyzed by comparing the mean total absolute error and a normalized error that measured performance improvement for each subject as a proportion of the baseline error. Results The results of the study showed that (1 different coordination pattern could be trained with visual feedback and have the new pattern transferred to trials without visual feedback, (2 distorting individual finger at a time allowed different error reduction profile from the controls, and (3 overall learning was not sped up by distorting individual fingers. Conclusion It is important that robotic rehabilitation incorporates multi-limb or finger coordination tasks that are important for activities of daily life in the near future. This study marks the first investigation on multi-finger coordination tasks under visual feedback manipulation.

  18. Predicting clinically significant changes in motor and functional outcomes after robot-assisted stroke rehabilitation.

    Science.gov (United States)

    Hsieh, Yu-wei; Lin, Keh-chung; Wu, Ching-yi; Lien, Hen-yu; Chen, Jean-lon; Chen, Chih-chi; Chang, Wei-han

    2014-02-01

    To investigate the predictors of minimal clinically important changes on outcome measures after robot-assisted therapy (RT). Observational cohort study. Outpatient rehabilitation clinics. A cohort of outpatients with stroke (N=55). Patients with stroke received RT for 90 to 105min/d, 5d/wk, for 4 weeks. Outcome measures, including the Fugl-Meyer Assessment (FMA) and Motor Activity Log (MAL), were measured before and after the intervention. Potential predictors include age, sex, side of lesion, time since stroke onset, finger extension, Box and Block Test (BBT) score, and FMA distal score. Statistical analysis showed that the BBT score (odds ratio[OR]=1.06; P=.04) was a significant predictor of clinically important changes in the FMA. Being a woman (OR=3.9; P=.05) and BBT score (OR=1.07; P=.02) were the 2 significant predictors of clinically significant changes in the MAL amount of use subscale. The BBT score was the significant predictor of an increased probability of achieving clinically important changes in the MAL quality of movement subscale (OR=1.07; P=.02). The R(2) values for the 3 logistic regression models were low (.114-.272). The results revealed that patients with stroke who had greater manual dexterity measured by the BBT appear to have a higher probability of achieving clinically significant motor and functional outcomes after RT. Further studies are needed to evaluate other potential predictors to improve the models and validate the findings. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  19. Using visual feedback distortion to alter coordinated pinching patterns for robotic rehabilitation

    Science.gov (United States)

    Matsuoka, Yoky; Brewer, Bambi R; Klatzky, Roberta L

    2007-01-01

    Background It is common for individuals with chronic disabilities to continue using the compensatory movement coordination due to entrenched habits, increased perception of task difficulty, or personality variables such as low self-efficacy or a fear of failure. Following our previous work using feedback distortion in a virtual rehabilitation environment to increase strength and range of motion, we address the use of visual feedback distortion environment to alter movement coordination patterns. Methods Fifty-one able-bodied subjects participated in the study. During the experiment, each subject learned to move their index finger and thumb in a particular target pattern while receiving visual feedback. Visual distortion was implemented as a magnification of the error between the thumb and/or index finger position and the desired position. The error reduction profile and the effect of distortion were analyzed by comparing the mean total absolute error and a normalized error that measured performance improvement for each subject as a proportion of the baseline error. Results The results of the study showed that (1) different coordination pattern could be trained with visual feedback and have the new pattern transferred to trials without visual feedback, (2) distorting individual finger at a time allowed different error reduction profile from the controls, and (3) overall learning was not sped up by distorting individual fingers. Conclusion It is important that robotic rehabilitation incorporates multi-limb or finger coordination tasks that are important for activities of daily life in the near future. This study marks the first investigation on multi-finger coordination tasks under visual feedback manipulation. PMID:17537239

  20. Effects of robot-driven gait orthosis treadmill training on the autonomic response in rehabilitation-responsive stroke and cervical spondylotic myelopathy patients.

    Science.gov (United States)

    Magagnin, Valentina; Bo, Ivano; Turiel, Maurizio; Fornari, Maurizio; Caiani, Enrico G; Porta, Alberto

    2010-06-01

    Body weight supported treadmill training (BWSTT) assisted with a robotic-driven gait orthosis is utilized in rehabilitation of individuals with lost motor skills. A typical rehabilitation session included: sitting, standing, suspension, robotic-assisted walking at 1.5 and 2.5km/h, respectively with 50% body weight support and recovery. While the effects of robotic-assisted BWSTT on motor performances were deeply studied, the influences on the cardiovascular control are still unknown. The aim of the study was to evaluate in stroke (ST) and cervical spondylotic myelopathy (CSM) patients: (1) the autonomic response during a traditional robotic-assisted BWSTT session of motor rehabilitation; (2) the effects of 30 daily sessions of BWSTT on cardiovascular regulation. The autonomic response was assessed through symbolic analysis of short-term heart rate variability in 11 pathologic subjects (5 ST and 6 CSM patients) whose motor skills were improved as a result of the rehabilitation therapy. Results showed variable individual responses to the rehabilitation session in ST patients at the beginning of the therapy. At the end of the rehabilitation process, the responses of ST patients were less variable and more similar to those previously observed in healthy subjects. CSM patients exhibited an exaggerated vagal response to the fastest walking phase during the first rehabilitative session. This abnormal response was limited after the last rehabilitative session. We conclude that robotic-assisted BWSTT is helpful in restoring cardiovascular control in rehabilitation-responsive ST patients and limiting vagal responses in rehabilitation-responsive CSM patients.

  1. Hybrid Force Control Based on ICMAC for an Astronaut Rehabilitative Training Robot

    Directory of Open Access Journals (Sweden)

    Lixun Zhang

    2012-08-01

    Full Text Available A novel Astronaut Rehabilitative Training Robot (ART based on a cable‐driven mechanism is represented in this paper. ART, a typical passive force servo system, can help astronauts to bench press in a microgravity environment. The purpose of this paper is to design controllers to eliminate the surplus force caused by an astronaut’s active movements. Based on the dynamics modelling of the cable‐driven unit, a hybrid force controller based on improved credit assignment CMAC (ICMAC is presented. A planning method for the cable tension is proposed so that the dynamic load produced by the ART can realistically simulate the gravity and inertial force of the barbell in a gravity environment. Finally, MATLAB simulation results of the man‐machine cooperation system are provided in order to verify the effectiveness of the proposed control strategy. The simulation results show that the hybrid control method based on the structure invariance principle can inhibit the surplus force and that ICMAC can improve the dynamic performance of the passive force servo system. Furthermore, the hybrid force controller based on ICMAC can ensure the stability of the system.

  2. Estimation of Human Arm Joints Using Two Wireless Sensors in Robotic Rehabilitation Tasks.

    Science.gov (United States)

    Bertomeu-Motos, Arturo; Lledó, Luis D; Díez, Jorge A; Catalan, Jose M; Ezquerro, Santiago; Badesa, Francisco J; Garcia-Aracil, Nicolas

    2015-12-04

    This paper presents a novel kinematic reconstruction of the human arm chain with five degrees of freedom and the estimation of the shoulder location during rehabilitation therapy assisted by end-effector robotic devices. This algorithm is based on the pseudoinverse of the Jacobian through the acceleration of the upper arm, measured using an accelerometer, and the orientation of the shoulder, estimated with a magnetic angular rate and gravity (MARG) device. The results show a high accuracy in terms of arm joints and shoulder movement with respect to the real arm measured through an optoelectronic system. Furthermore, the range of motion (ROM) of 50 healthy subjects is studied from two different trials, one trying to avoid shoulder movements and the second one forcing them. Moreover, the shoulder movement in the second trial is also estimated accurately. Besides the fact that the posture of the patient can be corrected during the exercise, the therapist could use the presented algorithm as an objective assessment tool. In conclusion, the joints' estimation enables a better adjustment of the therapy, taking into account the needs of the patient, and consequently, the arm motion improves faster.

  3. Estimation of Human Arm Joints Using Two Wireless Sensors in Robotic Rehabilitation Tasks

    Directory of Open Access Journals (Sweden)

    Arturo Bertomeu-Motos

    2015-12-01

    Full Text Available This paper presents a novel kinematic reconstruction of the human arm chain with five degrees of freedom and the estimation of the shoulder location during rehabilitation therapy assisted by end-effector robotic devices. This algorithm is based on the pseudoinverse of the Jacobian through the acceleration of the upper arm, measured using an accelerometer, and the orientation of the shoulder, estimated with a magnetic angular rate and gravity (MARG device. The results show a high accuracy in terms of arm joints and shoulder movement with respect to the real arm measured through an optoelectronic system. Furthermore, the range of motion (ROM of 50 healthy subjects is studied from two different trials, one trying to avoid shoulder movements and the second one forcing them. Moreover, the shoulder movement in the second trial is also estimated accurately. Besides the fact that the posture of the patient can be corrected during the exercise, the therapist could use the presented algorithm as an objective assessment tool. In conclusion, the joints’ estimation enables a better adjustment of the therapy, taking into account the needs of the patient, and consequently, the arm motion improves faster.

  4. Robotics

    Science.gov (United States)

    Popov, E. P.; Iurevich, E. I.

    The history and the current status of robotics are reviewed, as are the design, operation, and principal applications of industrial robots. Attention is given to programmable robots, robots with adaptive control and elements of artificial intelligence, and remotely controlled robots. The applications of robots discussed include mechanical engineering, cargo handling during transportation and storage, mining, and metallurgy. The future prospects of robotics are briefly outlined.

  5. Development and feasibility study of a sensory-enhanced robot-aided motor training in stroke rehabilitation.

    Science.gov (United States)

    Liu, W; Mukherjee, M; Tsaur, Y; Kim, S H; Liu, H; Natarajan, P; Agah, A

    2009-01-01

    Functional impairment of the upper limb is a major challenge faced by many stroke survivors. The present study aimed at developing a novel sensory-enhanced robot-aided motor training program and testing its feasibility in stroke rehabilitation. A specially designed robot handle was developed as an attachment to the Inmotion2 robotic system. This handle provided sensory stimulation through pins connected to small servo motors inside the handle. Vibration of the pins was activated during motor training once pressure on the handle reached a certain threshold indicating an active motion of the study subject. Nine chronic stroke survivors were randomly assigned to either a sensory-enhanced robot-aided motor training group (SERMT) or robot-aided motor training only group (RMT). All participants underwent a 6-week motor training program, performing target reaching movements with the specialized handle with or without vibration stimulation during training. Motor Status (MS) scores were measured for functional outcome prior to and after training. The results showed significant improvement in the total MS scores after training in both experimental groups. However, MS sub-scores for the shoulder/elbow and the wrist/hand increased significantly only in the SERMT group (p<0.05). Future studies are required to confirm these preliminary findings.

  6. Motor imagery, P300 and error-related EEG-based robot arm movement control for rehabilitation purpose.

    Science.gov (United States)

    Bhattacharyya, Saugat; Konar, Amit; Tibarewala, D N

    2014-12-01

    The paper proposes a novel approach toward EEG-driven position control of a robot arm by utilizing motor imagery, P300 and error-related potentials (ErRP) to align the robot arm with desired target position. In the proposed scheme, the users generate motor imagery signals to control the motion of the robot arm. The P300 waveforms are detected when the user intends to stop the motion of the robot on reaching the goal position. The error potentials are employed as feedback response by the user. On detection of error the control system performs the necessary corrections on the robot arm. Here, an AdaBoost-Support Vector Machine (SVM) classifier is used to decode the 4-class motor imagery and an SVM is used to decode the presence of P300 and ErRP waveforms. The average steady-state error, peak overshoot and settling time obtained for our proposed approach is 0.045, 2.8% and 44 s, respectively, and the average rate of reaching the target is 95%. The results obtained for the proposed control scheme make it suitable for designs of prosthetics in rehabilitative applications.

  7. Use of the robot assisted gait therapy in rehabilitation of patients with stroke and spinal cord injury.

    Science.gov (United States)

    Sale, P; Franceschini, M; Waldner, A; Hesse, S

    2012-03-01

    Difficulty in walking is a major feature of neurological disease, and loss of mobility is the activity of daily living on which patients place the greatest value. The impact on patients is enormous, with negative ramifications on their participation in social, vocational, and recreational activities. In current clinical practice the gait restoration with robotic device is an integral part of rehabilitation program. Robot therapy involves the use of a robot exoskeleton device or end-effector device to help the patient retrain motor coordination by performing well-focused and carefully directed repetitive practice. The exoskeleton, as an assistive device, is also an external structural mechanism with joints and links corresponding to those of the human body. These robots use joint trajectories of the entire gait cycle and offer a uniform (more or less) stiff control along this trajectory. In this field the new powered exoskeleton ReWalk (Argo Medical Technologies Ltd) was developed to have an alternative mobility solution to the wheelchair and rehabilitation treatment for individuals with severe walking impairments, enabling them to stand, walk, ascend/descent stairs and more. The end-effector-based robot is a device with footplates placed on a double crank and rocker gear system. Alternatives to powered exoskeletons are devices that use movable footplates to which the patient's feet are attached. All devices include some form of body weight support. Prominent goals in the field include: developing implementable technologies that can be easily used by patients, therapists, and clinicians; enhancing the efficacy of clinician's therapies and increasing the ease of activities in the daily lives of patients.

  8. Efficacy of Feedback-Controlled Robotics-Assisted Treadmill Exercise to Improve Cardiovascular Fitness Early After Stroke: A Randomized Controlled Pilot Trial.

    Science.gov (United States)

    Stoller, Oliver; de Bruin, Eling D; Schindelholz, Matthias; Schuster-Amft, Corina; de Bie, Rob A; Hunt, Kenneth J

    2015-07-01

    Cardiovascular fitness is greatly reduced after stroke. Although individuals with mild to moderate impairments benefit from conventional cardiovascular exercise interventions, there is a lack of effective approaches for persons with severely impaired physical function. This randomized controlled pilot trial investigated efficacy and feasibility of feedback-controlled robotics-assisted treadmill exercise (FC-RATE) for cardiovascular rehabilitation in persons with severe impairments early after stroke. Twenty individuals (age 61 ± 11 years; 52 ± 31 days poststroke) with severe motor limitations (Functional Ambulation Classification 0-2) were recruited for FC-RATE or conventional robotics-assisted treadmill exercise (RATE) (4 weeks, 3 × 30-minute sessions/wk). Outcome measures focused on peak cardiopulmonary performance parameters, training intensity, and feasibility, with examiners blinded to allocation. All 14 allocated participants (70% of recruited) completed the intervention (7/group, withdrawals unrelated to intervention), without serious adverse events occurring. Cardiovascular fitness increased significantly in both groups, with peak oxygen uptake increasing from 14.6 to 17.7 mL · kg · min (+17.8%) after 4 weeks (45.8%-55.7% of predicted maximal aerobic capacity; time effect P = 0.01; no group-time interaction). Training intensity (% heart rate reserve) was significantly higher for FC-RATE (40% ± 3%) than for conventional RATE (14% ± 2%) (P = 0.001). Substantive overall increases in the main cardiopulmonary performance parameters were observed, but there were no significant between-group differences when comparing FC-RATE and conventional RATE. Feedback-controlled robotics-assisted treadmill exercise significantly increased exercise intensity, but recommended intensity levels for cardiovascular training were not consistently achieved. Future research should focus on appropriate algorithms within advanced robotic systems to promote optimal cardiovascular

  9. Pilot project in developing community rehabilitation service for migrant workers suffering from pneumoconiosis in Mainland China.

    Science.gov (United States)

    Lo, H Y L K; Luo, X Y; Lau, C M J; Wong, K Y L

    2008-01-01

    Pneumoconiosis is one of the major occupational health problems in China and increasing numbers of migrant workers suffered from this occupational disease after working in a dusty environment for few years. These migrant workers panicked after being diagnosed as suffering from pneumoconiosis and facing physiological disturbances including progressive dyspnea, respiratory failure or complications like silico-tuberculosis after their return to their rural village. This article reviews the preliminary results of a community rehabilitation pilot project conducted in a rural village in Guizhou, one of the provinces in southwest China. It shares the joint effort of professionals from Guangdong Province and Hong Kong SAR on supporting the migrant workers to manage and cope with this occupational disease. Finally, strategies including early intervention were suggested to help migrant workers to manage the disease. Most importantly, occupational health promotion and prevention were urged as the measures of utmost importance in reducing the risk for migrant workers suffering from pneumoconiosis.

  10. Yoga in stroke rehabilitation: a systematic review and results of a pilot study.

    Science.gov (United States)

    Lynton, Holly; Kligler, Benjamin; Shiflett, Samuel

    2007-01-01

    This article presents a systematic review of the literature pertaining to the use of yoga in stroke rehabilitation. In addition, we present the results of a small pilot study designed to explore the hypothesis that a Kundalini yoga practice of 12 weeks would lead to an improvement in aphasia as well as in fine motor coordination in stroke patients. The 3 participants attended yoga classes twice a week for 12 weeks, before and after which they were tested on the O'Connor Tweezer Dexterity test, a timed test where the participant places pins in a Peg-Board with tweezers, and the Boston Aphasia Exam for speech. All 3 participants showed improvement on both measures. The small sample size makes it impossible to draw definite conclusions, but the positive trends in this study suggest that further research should be done to examine the effects of Kundalini yoga on specific illnesses or medical conditions.

  11. A patient-specific EMG-driven neuromuscular model for the potential use of human-inspired gait rehabilitation robots.

    Science.gov (United States)

    Ma, Ye; Xie, Shengquan; Zhang, Yanxin

    2016-03-01

    A patient-specific electromyography (EMG)-driven neuromuscular model (PENm) is developed for the potential use of human-inspired gait rehabilitation robots. The PENm is modified based on the current EMG-driven models by decreasing the calculation time and ensuring good prediction accuracy. To ensure the calculation efficiency, the PENm is simplified into two EMG channels around one joint with minimal physiological parameters. In addition, a dynamic computation model is developed to achieve real-time calculation. To ensure the calculation accuracy, patient-specific muscle kinematics information, such as the musculotendon lengths and the muscle moment arms during the entire gait cycle, are employed based on the patient-specific musculoskeletal model. Moreover, an improved force-length-velocity relationship is implemented to generate accurate muscle forces. Gait analysis data including kinematics, ground reaction forces, and raw EMG signals from six adolescents at three different speeds were used to evaluate the PENm. The simulation results show that the PENm has the potential to predict accurate joint moment in real-time. The design of advanced human-robot interaction control strategies and human-inspired gait rehabilitation robots can benefit from the application of the human internal state provided by the PENm.

  12. Literature Review on the Effects of tDCS Coupled with Robotic Therapy in Post Stroke Upper Limb Rehabilitation

    Directory of Open Access Journals (Sweden)

    Davide Simonetti

    2017-05-01

    Full Text Available Today neurological diseases such as stroke represent one of the leading cause of long-term disability. Many research efforts have been focused on designing new and effective rehabilitation strategies. In particular, robotic treatment for upper limb stroke rehabilitation has received significant attention due to its ability to provide high-intensity and repetitive movement therapy with less effort than traditional methods. In addition, the development of non-invasive brain stimulation techniques such as transcranial Direct Current Stimulation (tDCS has also demonstrated the capability of modulating brain excitability thus increasing motor performance. The combination of these two methods is expected to enhance functional and motor recovery after stroke; to this purpose, the current trends in this research field are presented and discussed through an in-depth analysis of the state-of-the-art. The heterogeneity and the restricted number of collected studies make difficult to perform a systematic review. However, the literature analysis of the published data seems to demonstrate that the association of tDCS with robotic training has the same clinical gain derived from robotic therapy alone. Future studies should investigate combined approach tailored to the individual patient's characteristics, critically evaluating the brain areas to be targeted and the induced functional changes.

  13. Literature Review on the Effects of tDCS Coupled with Robotic Therapy in Post Stroke Upper Limb Rehabilitation

    Science.gov (United States)

    Simonetti, Davide; Zollo, Loredana; Milighetti, Stefano; Miccinilli, Sandra; Bravi, Marco; Ranieri, Federico; Magrone, Giovanni; Guglielmelli, Eugenio; Di Lazzaro, Vincenzo; Sterzi, Silvia

    2017-01-01

    Today neurological diseases such as stroke represent one of the leading cause of long-term disability. Many research efforts have been focused on designing new and effective rehabilitation strategies. In particular, robotic treatment for upper limb stroke rehabilitation has received significant attention due to its ability to provide high-intensity and repetitive movement therapy with less effort than traditional methods. In addition, the development of non-invasive brain stimulation techniques such as transcranial Direct Current Stimulation (tDCS) has also demonstrated the capability of modulating brain excitability thus increasing motor performance. The combination of these two methods is expected to enhance functional and motor recovery after stroke; to this purpose, the current trends in this research field are presented and discussed through an in-depth analysis of the state-of-the-art. The heterogeneity and the restricted number of collected studies make difficult to perform a systematic review. However, the literature analysis of the published data seems to demonstrate that the association of tDCS with robotic training has the same clinical gain derived from robotic therapy alone. Future studies should investigate combined approach tailored to the individual patient's characteristics, critically evaluating the brain areas to be targeted and the induced functional changes. PMID:28588467

  14. Controlling a Rehabilitation Robot with Brain-Machine Interface: An approach based on Independent Component Analysis and Multiple Kernel Learning

    Directory of Open Access Journals (Sweden)

    Yi-Hung Liu

    2013-03-01

    Full Text Available Patients suffering from severe motor disabilities usually require assistance from other people when doing rehabilitation exercises, which causes the rehabilitation process to be time-consuming and inconvenient. Therefore, we propose an automatic feature extraction method for a brain-machine interface that allows patients to control a robot using their own brain waves. A brain–machine interface (BMI based on the P300 event-related potential (ERP, called Brain Controlled Rehabilitation System (BCRS, was developed to detect the intentions of patients. Using the BCRS, patients can communicate with the robot through their brain waves. However, deciding how to obtain an automatically extracted, useful EEG signal is a difficult and important problem for BMI research. In this paper, Independent Component Analysis – Multiple Kernel Learning (ICA-MKL is used to directly extract a useful signal and build the classification mode for BCRS. The results reveal that this method is useful for automatically extracting the P300 signal and the accuracy is better than MKL. In additional, the same method can be extended into any motor imaginary area and the accuracy of ICA-MKL for brain imaginary data is also good to removing eye-blink artifacts and the accuracy performance is also good.

  15. Development of a social skills assessment screening scale for psychiatric rehabilitation settings: A pilot study

    Directory of Open Access Journals (Sweden)

    Poornima Bhola

    2016-01-01

    Full Text Available Context: Deficits in social skills may present in a range of psychiatric disorders, particularly in the more serious and persistent conditions, and have an influence on functioning across various domains. Aims: This pilot study aimed at developing a brief measure, for structured evaluation and screening for social skills deficits, which can be easily integrated into routine clinical practice. Settings and Design: The sample consisted of 380 inpatients and their accompanying caregivers, referred to Psychiatric Rehabilitation Services at a tertiary care government psychiatric hospital. Materials and Methods: The evaluation included an Inpatient intake Proforma and the 20-item Social Skills Assessment Screening Scale (SSASS. Disability was assessed using the Indian Disability Evaluation and Assessment Scale (IDEAS for a subset of 94 inpatients. Statistical Analysis Used: The analysis included means and standard deviations, frequency and percentages, Cronbach's alpha to assess internal consistency, t-tests to assess differences in social skills deficits between select subgroups, and correlation between SSASS and IDEAS scores. Results: The results indicated the profile of social skills deficits assessed among the inpatients with varied psychiatric diagnoses. The “psychosis” group exhibited significantly higher deficits than the “mood disorder” group. Results indicated high internal consistency of the SSASS and adequate criterion validity demonstrated by correlations with select IDEAS domains. Modifications were made to the SSASS following the pilot study. Conclusions: The SSASS has potential value as a measure for screening and individualised intervention plans for social skills training in mental health and rehabilitation settings. The implications for future work on the psychometric properties and clinical applications are discussed.

  16. Cognitive rehabilitation system for children with autism spectrum disorder using serious games: A pilot study.

    Science.gov (United States)

    Aresti-Bartolome, Nuria; Garcia-Zapirain, Begonya

    2015-01-01

    This paper studies and assesses how rehabilitation activities and supervised computer games incorporated into a system aimed at people diagnosed with Autism Spectrum Disorder (ASD) can be used to work on the areas affected by ASD at any time and in any place. This research specifically assesses the areas that affect communication and interaction between people with ASD and professionals. In order to do this, a group of 20 children diagnosed with ASD of between 3 and 8 years old (clinical group) was used, together with a group of 20 children of between 3 and 8 years old with a neurotypical development, which served as a control group. During the tests, response time and visual interaction with the session leader were evaluated. Despite the fact that the clinical group spent more time (M = 21.08 sec) than the control group (M = 4.52) to interact leader, eye contact predominated in the interaction. As a result of the pilot study, the system obtained could help in cognitive rehabilitation.

  17. Virtual reality for upper extremity rehabilitation in early stroke: a pilot randomized controlled trial.

    Science.gov (United States)

    Yin, Chan Wai; Sien, Ng Yee; Ying, Low Ai; Chung, Stephanie Fook-Chong Man; Tan May Leng, Dawn

    2014-11-01

    To investigate the effect of virtual reality (VR) rehabilitation on upper extremity motor performance of patients with early stroke. Pilot randomized controlled trial. Rehabilitation wards. Twenty three adults with stroke (mean age (SD) = 58.35 (13.45) years and mean time since stroke (SD) = 16.30 (7.44) days). Participants were randomly assigned to VR group (n=11) or control group (n=12). VR group received nine 30 minutes upper extremity VR therapy in standing (five weekdays in two weeks) plus conventional therapy, which included physical and occupational therapy. Control group received only conventional therapy, which was comparable to total training time received by VR group (mean training hours (SD):VR = 17.07 (2.86); control = 15.50 (2.79)). The main outcome measure was the Fugl-Meyer Assessment (FMA). Secondary outcomes included Action Research Arm Test, Motor Activity Log and Functional Independence Measure. Results were taken at baseline, post intervention and 1-month post intervention. Participants' feedback and adverse effects were recorded. All participants improved in FMA scores (mean change (SD) = 11.65 (8.56), Ptherapy alone, this study demonstrates the feasibility of VR training in early stroke. © The Author(s) 2014.

  18. An integrated gait rehabilitation training based on Functional Electrical Stimulation cycling and overground robotic exoskeleton in complete spinal cord injury patients: Preliminary results.

    Science.gov (United States)

    Mazzoleni, S; Battini, E; Rustici, A; Stampacchia, G

    2017-07-01

    The aim of this study is to investigate the effects of an integrated gait rehabilitation training based on Functional Electrical Stimulation (FES)-cycling and overground robotic exoskeleton in a group of seven complete spinal cord injury patients on spasticity and patient-robot interaction. They underwent a robot-assisted rehabilitation training based on two phases: n=20 sessions of FES-cycling followed by n= 20 sessions of robot-assisted gait training based on an overground robotic exoskeleton. The following clinical outcome measures were used: Modified Ashworth Scale (MAS), Numerical Rating Scale (NRS) on spasticity, Penn Spasm Frequency Scale (PSFS), Spinal Cord Independence Measure Scale (SCIM), NRS on pain and International Spinal Cord Injury Pain Data Set (ISCI). Clinical outcome measures were assessed before (T0) after (T1) the FES-cycling training and after (T2) the powered overground gait training. The ability to walk when using exoskeleton was assessed by means of 10 Meter Walk Test (10MWT), 6 Minute Walk Test (6MWT), Timed Up and Go test (TUG), standing time, walking time and number of steps. Statistically significant changes were found on the MAS score, NRS-spasticity, 6MWT, TUG, standing time and number of steps. The preliminary results of this study show that an integrated gait rehabilitation training based on FES-cycling and overground robotic exoskeleton in complete SCI patients can provide a significant reduction of spasticity and improvements in terms of patient-robot interaction.

  19. Pilot study of a targeted dance class for physical rehabilitation in children with cerebral palsy

    Directory of Open Access Journals (Sweden)

    Citlali López-Ortiz

    2016-09-01

    Full Text Available Introduction: This pilot study evaluates the effects of a targeted dance class utilizing classical ballet principles for rehabilitation of children with cerebral palsy on balance and upper extremity control. Methods: Twelve children with cerebral palsy (ages 7–15 years with Gross Motor Function Classification scores II–IV participated in this study and were assigned to either a control group or targeted dance class group. Targeted dance class group participated in 1-h classes three times per week in a 4-week period. The Pediatric Balance Scale and the Quality of Upper Extremity Skills Test were administered before, after, and 1 month after the targeted dance class. Results: Improvements in the Pediatric Balance Scale were present in the targeted dance class group in before versus after and before versus 1 month follow-up comparisons (p-value = 0.0088 and p-value = 0.019, respectively. The Pediatric Balance Scale changes were not significant in the control group. The Quality of Upper Extremity Skills Test did not reach statistical differences in either group. Conclusion: Classical ballet as an art form involves physical training, musical accompaniment, social interactions, and emotional expression that could serve as adjunct to traditional physical therapy. This pilot study demonstrated improvements in balance control. A larger study with a more homogeneous sample is warranted.

  20. Pilot study of a targeted dance class for physical rehabilitation in children with cerebral palsy

    Science.gov (United States)

    López-Ortiz, Citlali; Egan, Tara; Gaebler-Spira, Deborah J

    2016-01-01

    Introduction: This pilot study evaluates the effects of a targeted dance class utilizing classical ballet principles for rehabilitation of children with cerebral palsy on balance and upper extremity control. Methods: Twelve children with cerebral palsy (ages 7–15 years) with Gross Motor Function Classification scores II–IV participated in this study and were assigned to either a control group or targeted dance class group. Targeted dance class group participated in 1-h classes three times per week in a 4-week period. The Pediatric Balance Scale and the Quality of Upper Extremity Skills Test were administered before, after, and 1 month after the targeted dance class. Results: Improvements in the Pediatric Balance Scale were present in the targeted dance class group in before versus after and before versus 1 month follow-up comparisons (p-value = 0.0088 and p-value = 0.019, respectively). The Pediatric Balance Scale changes were not significant in the control group. The Quality of Upper Extremity Skills Test did not reach statistical differences in either group. Conclusion: Classical ballet as an art form involves physical training, musical accompaniment, social interactions, and emotional expression that could serve as adjunct to traditional physical therapy. This pilot study demonstrated improvements in balance control. A larger study with a more homogeneous sample is warranted. PMID:27721977

  1. Robotics and virtual reality: the development of a life-sized 3-D system for the rehabilitation of motor function.

    Science.gov (United States)

    Patton, J L; Dawe, G; Scharver, C; Mussa-Ivaldi, F A; Kenyon, R

    2004-01-01

    We have been developing and combining state-of-art devices that allow humans to visualize and feel synthetic objects superimposed on the real world. This effort stems from the need of platform for extending experiments on motor control and learning to realistic human motor tasks and environments, not currently represented in the practice of research. This paper's goal is to outline our motivations, progress, and objectives. Because the system is a general tool, we also hope to motivate researchers in related fields to join in. The platform under development, an augmented reality system combined with a haptic-interface robot, will be a new tool for contributing to the scientific knowledge base in the area of human movement control and rehabilitation robotics. Because this is a prototype, the system will also guide new methods by probing the levels of quality necessary for future design cycles and related technology. Inevitably, it should also lead the way to commercialization of such systems.

  2. Robotics, stem cells, and brain-computer interfaces in rehabilitation and recovery from stroke: updates and advances.

    Science.gov (United States)

    Boninger, Michael L; Wechsler, Lawrence R; Stein, Joel

    2014-11-01

    The aim of this study was to describe the current state and latest advances in robotics, stem cells, and brain-computer interfaces in rehabilitation and recovery for stroke. The authors of this summary recently reviewed this work as part of a national presentation. The article represents the information included in each area. Each area has seen great advances and challenges as products move to market and experiments are ongoing. Robotics, stem cells, and brain-computer interfaces all have tremendous potential to reduce disability and lead to better outcomes for patients with stroke. Continued research and investment will be needed as the field moves forward. With this investment, the potential for recovery of function is likely substantial.

  3. A decision-theoretic approach in the design of an adaptive upper-limb stroke rehabilitation robot.

    Science.gov (United States)

    Huq, Rajibul; Kan, Patricia; Goetschalckx, Robby; Hébert, Debbie; Hoey, Jesse; Mihailidis, Alex

    2011-01-01

    This paper presents an automated system for a rehabilitation robotic device that guides stroke patients through an upper-limb reaching task. The system uses a partially observable Markov decision process (POMDP) as its primary engine for decision-making. The POMDP allows the system to automatically modify exercise parameters to account for the specific needs and abilities of different individuals, and to use these parameters to take appropriate decisions about stroke rehabilitation exercises. The performance of the system was evaluated through various simulations and by comparing the decisions made by the system with those of a human therapist for a single patient. In general, the simulations showed promising results and the therapist thought the system decisions were believable.

  4. Functional electrical stimulation based on a pelvis support robot for gait rehabilitation of hemiplegic patients after stroke.

    Science.gov (United States)

    Ye, Jing; Nakashima, Yasutaka; Zhang, Bo; Kobayashi, Yo; Fujie, Masakatsu G

    2014-01-01

    More and more stroke survivors are suffering from physical motor impairments. Current therapeutic interventions have various limits to the efficient recovery of normal motor function of the lower limbs. Therefore, we propose a novel gait rehabilitation system for hemiplegic patients after stroke. It integrates functional electrical stimulation (FES) with a pelvis-supporting robotic system. A corresponding relationship between the gait phase and the active lateral movement of the pelvis is first constructed from experiments on simulated hemiplegic patients. By estimating the gait phase from the lateral motion of the pelvis based on this relationship, the timing of FES sent to the muscles of the lower limbs can be automatically determined during a gait cycle. After experiments on simulated hemiplegic stroke survivors with the FES control algorithm, the proposed algorithm and the gait rehabilitation system are verified to be feasible and promising.

  5. Stroke Rehabilitation in Frail Elderly with the Robotic Training Device ACRE: A Randomized Controlled Trial and Cost-Effectiveness Study

    Directory of Open Access Journals (Sweden)

    M. Schoone

    2011-01-01

    Full Text Available The ACRE (ACtive REhabilitation robotic device is developed to enhance therapeutic treatment of upper limbs after stroke. The aim of this study is to assess effects and costs of ACRE training for frail elderly patients and to establish if ACRE can be a valuable addition to standard therapy in nursing home rehabilitation. The study was designed as randomized controlled trial, one group receiving therapy as usual and the other receiving additional ACRE training. Changes in motor abilities, stroke impact, quality of life and emotional well-being were assessed. In total, 24 patients were included. In this small number no significant effects of the ACRE training were found. A large number of 136 patients were excluded. Main reasons for exclusion were lack of physiological or cognitive abilities. Further improvement of the ACRE can best be focused on making the system suitable for self-training and development of training software for activities of daily living.

  6. Attitudinal Change in Elderly Citizens Toward Social Robots

    DEFF Research Database (Denmark)

    Damholdt, Malene Flensborg; Nørskov, Marco; Yamazaki, Ryuji

    2015-01-01

    and anthropomorphic thinking were undertaken to assess change. Attitudes toward robots were assessed with a new generic 35-items questionnaire (attitudes toward social robots scale: ASOR-5), offering a differentiated conceptualization of the conditions for social interaction. There was no significant difference......Attitudes toward robots influence the tendency to accept or reject robotic devices. Thus it is important to investigate whether and how attitudes toward robots can change. In this pilot study we investigate attitudinal changes in elderly citizens toward a tele-operated robot in relation to three...... parameters: (i) the information provided about robot functionality, (ii) the number of encounters, (iii) personality type. Fourteen elderly residents at a rehabilitation center participated. Pre-encounter attitudes toward robots, anthropomorphic thinking, and personality were assessed. Thereafter...

  7. tDCS and Robotics on Upper Limb Stroke Rehabilitation: Effect Modification by Stroke Duration and Type of Stroke

    OpenAIRE

    Sofia Straudi; Felipe Fregni; Carlotta Martinuzzi; Claudia Pavarelli; Stefano Salvioli; Nino Basaglia

    2016-01-01

    Objective:. The aim of this exploratory pilot study is to test the effects of bilateral tDCS combined with upper extremity robot-assisted therapy (RAT) on stroke survivors. Methods. We enrolled 23 subjects who were allocated to 2 groups: RAT + real tDCS and RAT + sham-tDCS. Each patient underwent 10 sessions (5 sessions/week) over two weeks. Outcome measures were collected before and after treatment: (i) Fugl-Meyer Assessment-Upper Extremity (FMA-UE), (ii) Box and Block Test (BBT), and (iii) ...

  8. Building Robota, a Mini-Humanoid Robot for the Rehabilitation of Children with Autism

    Science.gov (United States)

    Billard, Aude; Robins, Ben; Nadel, Jacqueline; Dautenhahn, Kerstin

    2007-01-01

    The Robota project constructs a series of multiple-degrees-of-freedom, doll-shaped humanoid robots, whose physical features resemble those of a human baby. The Robota robots have been applied as assistive technologies in behavioral studies with low-functioning children with autism. These studies investigate the potential of using an imitator robot…

  9. Building Robota, a Mini-Humanoid Robot for the Rehabilitation of Children with Autism

    Science.gov (United States)

    Billard, Aude; Robins, Ben; Nadel, Jacqueline; Dautenhahn, Kerstin

    2007-01-01

    The Robota project constructs a series of multiple-degrees-of-freedom, doll-shaped humanoid robots, whose physical features resemble those of a human baby. The Robota robots have been applied as assistive technologies in behavioral studies with low-functioning children with autism. These studies investigate the potential of using an imitator robot…

  10. Influence of complementing a robotic upper limb rehabilitation system with video games on the engagement of the participants: a study focusing on muscle activities.

    Science.gov (United States)

    Li, Chong; Rusák, Zoltán; Horváth, Imre; Ji, Linhong

    2014-12-01

    Efficacious stroke rehabilitation depends not only on patients' medical treatment but also on their motivation and engagement during rehabilitation exercises. Although traditional rehabilitation exercises are often mundane, technology-assisted upper-limb robotic training can provide engaging and task-oriented training in a natural environment. The factors that influence engagement, however, are not fully understood. This paper therefore studies the relationship between engagement and muscle activities as well as the influencing factors of engagement. To this end, an experiment was conducted using a robotic upper limb rehabilitation system with healthy individuals in three training exercises: (a) a traditional exercise, which is typically used for training the grasping function, (b) a tracking exercise, currently used in robot-assisted stroke patient rehabilitation for fine motor movement, and (c) a video game exercise, which is a proliferating approach of robot-assisted rehabilitation enabling high-level active engagement of stroke patients. These exercises differ not only in the characteristics of the motion that they use but also in their method of triggering engagement. To measure the level of engagement, we used facial expressions, motion analysis of the arm movements, and electromyography. The results show that (a) the video game exercise could engage the participants for a longer period than the other two exercises, (b) the engagement level decreased when the participants became too familiar with the exercises, and (c) analysis of normalized root mean square in electromyographic data indicated that muscle activities were more intense when the participants are engaged. This study shows that several sub-factors on engagement, such as versatility of feedback, cognitive tasks, and competitiveness, may influence engagement more than the others. To maintain a high level of engagement, the rehabilitation system needs to be adaptive, providing different exercises to

  11. Feasibility of training nurses in motivational interviewing to improve patient experience in mental health inpatient rehabilitation: a pilot study.

    Science.gov (United States)

    Bunyan, M; Crowley, J; Smedley, N; Mutti, M-F; Cashen, A; Thompson, T; Foster, J

    2017-05-01

    WHAT IS KNOWN ON THE SUBJECT?: Recently, concerns have been raised about how well United Kingdom National Health Service nurses care for their patients and their level of compassion. Motivational interviewing (MI) is an established approach to helping people make positive behaviour changes, through directive, person-centred counselling within a collaborative relationship between clinician and recipient. Based on evidence that MI may influence nursing practice positively, an investigation into the feasibility of training nurses on mental health inpatient rehabilitation wards ('rehabilitation') in MI to improve patient experience was reported. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: This pilot study demonstrates that training rehabilitation nurses in MI is feasible and provides preliminary evidence suggesting that a larger study to examine efficacy is warranted, including a calculation of sample size required to draw robust statistical conclusions. Nurses evaluated the training as highly relevant to their work. Patients responded well to interviews and focus groups with support from experts-by-experience; they were generally fairly satisfied with the rehabilitation ward and slight improvements in their experience were found following MI training for nurses but not at 6-month follow-up. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Rehabilitation nurses may face conflicting demands between ensuring patients with severe difficulties meet their basic needs and working with them to develop greater independence. Qualitative findings question whether nurse-patient interactions are fully valued as nursing interventions in inpatient rehabilitation. Learning MI might be a useful way of helping nurses think in detail about their interactions with patients and how to improve communications with their patients. The principles of MI should be incorporated into pre-registration training. Introduction There is limited research addressing the experiences of patients in inpatient

  12. A cable-driven wrist robotic rehabilitator using a novel torque-field controller for human motion training

    Science.gov (United States)

    Chen, Weihai; Cui, Xiang; Zhang, Jianbin; Wang, Jianhua

    2015-06-01

    Rehabilitation technologies have great potentials in assisted motion training for stroke patients. Considering that wrist motion plays an important role in arm dexterous manipulation of activities of daily living, this paper focuses on developing a cable-driven wrist robotic rehabilitator (CDWRR) for motion training or assistance to subjects with motor disabilities. The CDWRR utilizes the wrist skeletal joints and arm segments as the supporting structure and takes advantage of cable-driven parallel design to build the system, which brings the properties of flexibility, low-cost, and low-weight. The controller of the CDWRR is designed typically based on a virtual torque-field, which is to plan "assist-as-needed" torques for the spherical motion of wrist responding to the orientation deviation in wrist motion training. The torque-field controller can be customized to different levels of rehabilitation training requirements by tuning the field parameters. Additionally, a rapidly convergent parameter self-identification algorithm is developed to obtain the uncertain parameters automatically for the floating wearable structure of the CDWRR. Finally, experiments on a healthy subject are carried out to demonstrate the performance of the controller and the feasibility of the CDWRR on wrist motion training or assistance.

  13. Virtual reality in the rehabilitation of the arm after hemiplegic stroke: a randomized controlled pilot study.

    Science.gov (United States)

    Crosbie, J H; Lennon, S; McGoldrick, M C; McNeill, M D J; McDonough, S M

    2012-09-01

    To assess the feasibility of a trial to investigate the effectiveness of virtual reality-mediated therapy compared to conventional physiotherapy in the motor rehabilitation of the arm following stroke, and to provide data for a power analysis to determine numbers for a future main trial. Pilot randomized controlled trial. Clinical research facility. Eighteen people with a first stroke, 10 males and 8 females, 7 right and 2 left side most affected. Mean time since stroke 10.8 months. Participants were randomized to a virtual reality group or a conventional arm therapy group for nine sessions over three weeks. The upper limb Motricity Index and the Action Research Arm Test were completed at baseline, post intervention and six weeks follow-up. Outcome data were obtained from 95% of participants at the end of treatment and at follow-up: one participant withdrew. Compliance was high; only two people reported side-effects from virtual reality exposure. Both groups demonstrated small (7-8 points on upper limb Motricity Index and 4 points on the Action Research Arm Test), but non-significant, changes to their arm impairment and activity levels. A randomized controlled trial of virtual reality-mediated therapy comparable to conventional therapy would be feasible, with some suggested improvements in recruitment and outcome measures. Seventy-eight participants (39 per group) would be required for a main trial.

  14. Relationship between clinical assessments of function and measurements from an upper-limb robotic rehabilitation device in cervical spinal cord injury.

    Science.gov (United States)

    Zariffa, José; Kapadia, Naaz; Kramer, John L K; Taylor, Philippa; Alizadeh-Meghrazi, Milad; Zivanovic, Vera; Albisser, Urs; Willms, Rhonda; Townson, Andrea; Curt, Armin; Popovic, Milos R; Steeves, John D

    2012-05-01

    Upper limb robotic rehabilitation devices can collect quantitative data about the user's movements. Identifying relationships between robotic sensor data and manual clinical assessment scores would enable more precise tracking of the time course of recovery after injury and reduce the need for time-consuming manual assessments by skilled personnel. This study used measurements from robotic rehabilitation sessions to predict clinical scores in a traumatic cervical spinal cord injury (SCI) population. A retrospective analysis was conducted on data collected from subjects using the Armeo Spring (Hocoma, AG) in three rehabilitation centers. Fourteen predictive variables were explored, relating to range-of-motion, movement smoothness, and grip ability. Regression models using up to four predictors were developed to describe the following clinical scores: the GRASSP (consisting of four sub-scores), the ARAT, and the SCIM. The resulting adjusted R(2) value was highest for the GRASSP "Quantitative Prehension" component (0.78), and lowest for the GRASSP "Sensibility" component (0.54). In contrast to comparable studies in stroke survivors, movement smoothness was least beneficial for predicting clinical scores in SCI. Prediction of upper-limb clinical scores in SCI is feasible using measurements from a robotic rehabilitation device, without the need for dedicated assessment procedures.

  15. Robotic assistance for performing vocational rehabilitation activities using BaxBot.

    Science.gov (United States)

    Ashley, Kyle; Alqasemi, Redwan; Dubey, Rajiv

    2017-07-01

    Activities of Daily Living (ADL's) refer to tasks that people do on a daily basis, such as self-feeding, cleaning the house, or bathing. These activities often require a degree of functional mobility that may be outside the ability of a person suffering from cognitive or physical impairment. This work describes methods of performing ADL's with a mobile robotic system. We examined the needs of potential users and caregivers through surveys to determine the most needed applications for robotic assistance. Using this information, we extended the functionality of our BaxBot mobile robotic system to provide meaningful, autonomous assistance in performing three specific ADL's with minimal user interaction.

  16. Efficacy of rehabilitation robotics for walking training in neurological disorders: A review

    OpenAIRE

    Candace Tefertiller, PT, DPT, ATP, NCS; Beth Pharo, PT; Nicholas Evans, MHSc; Patricia Winchester, PT, PhD

    2011-01-01

    Robotic technologies are becoming more prevalent for treating neurological conditions in clinical settings. We conducted a literature search of original articles to identify all studies that examined the use of robotic devices for restoring walking function in adults with neurological disorders. We evaluated and rated each study using either the Physiotherapy Evidence Database scale for randomized controlled trials (RCTs) or the Downs and Black scale for non-RCTs. We reviewed 30 articles (14 ...

  17. Improving the transparency of a rehabilitation robot by exploiting the cyclic behaviour of walking.

    Science.gov (United States)

    van Dijk, W; van der Kooij, H; Koopman, B; van Asseldonk, E H F; van der Kooij, H

    2013-06-01

    To promote active participation of neurological patients during robotic gait training, controllers, such as "assist as needed" or "cooperative control", are suggested. Apart from providing support, these controllers also require that the robot should be capable of resembling natural, unsupported, walking. This means that they should have a transparent mode, where the interaction forces between the human and the robot are minimal. Traditional feedback-control algorithms do not exploit the cyclic nature of walking to improve the transparency of the robot. The purpose of this study was to improve the transparent mode of robotic devices, by developing two controllers that use the rhythmic behavior of gait. Both controllers use adaptive frequency oscillators and kernel-based non-linear filters. Kernelbased non-linear filters can be used to estimate signals and their time derivatives, as a function of the gait phase. The first controller learns the motor angle, associated with a certain joint angle pattern, and acts as a feed-forward controller to improve the torque tracking (including the zero-torque mode). The second controller learns the state of the mechanical system and compensates for the dynamical effects (e.g. the acceleration of robot masses). Both controllers have been tested separately and in combination on a small subject population. Using the feedforward controller resulted in an improved torque tracking of at least 52 percent at the hip joint, and 61 percent at the knee joint. When both controllers were active simultaneously, the interaction power between the robot and the human leg was reduced by at least 40 percent at the thigh, and 43 percent at the shank. These results indicate that: if a robotic task is cyclic, the torque tracking and transparency can be improved by exploiting the predictions of adaptive frequency oscillator and kernel-based nonlinear filters.

  18. The effects of electromechanical wrist robot assistive system with neuromuscular electrical stimulation for stroke rehabilitation.

    Science.gov (United States)

    Hu, X L; Tong, K Y; Li, R; Xue, J J; Ho, S K; Chen, P

    2012-06-01

    An electromyography (EMG)-driven electromechanical robot system integrated with neuromuscular electrical stimulation (NMES) was developed for wrist training after stroke. The performance of the system in assisting wrist flexion/extension tracking was evaluated on five chronic stroke subjects, when the system provided five different schemes with or without NMES and robot assistance. The tracking performances were measured by range of motion (ROM) of the wrist and root mean squared error (RMSE). The performance is better when both NMES and robot assisted in the tracking than those with either NMES or robot only (Pmotor functions in the hand, wrist and elbow functions after the training, as indicated by the clinical scores of Fugl-Meyer Assessment, Action Research Arm Test, Wolf Motor Function Test; and also showed reduced spasticity in the wrist and the elbow as measured by the Modified Ashworth Score of each subject. After the training, the co-contractions were reduced between the flexor carpi radialis and extensor carpi radialis, and between the biceps brachii and triceps brachii. Assistance from the robot helped improve the movement accuracy; and the NMES helped increase the muscle activation for the wrist joint and suppress the excessive muscular activities from the elbow joint. The NMES-robot assisted wrist training could improve the hand, wrist, and elbow functions.

  19. 一种气动驱动新型上肢康复机器人%A Novel upper limb rehabilitation robot by pneumatic actuators

    Institute of Scientific and Technical Information of China (English)

    王生泽; 金韬

    2011-01-01

    The clinical rehabilitative medicine theory and the clinical recovery experience conducts are unified,researched into the upper limb rehabilitation robot's program and designed a rehabilitation training upper limb rehabilitation of pneumatic flexible robot which is applied to patients with hemiplegia.Then the security and the flexibility of pneumatic technology is applied into the fleld of rehabilitation.And showed an effort to effectively implement the limbs from completely passive to passive to active mainly dominated gradually to the finally rehabilitation of the training process to completely take the initiative training appropriate mode.%结合临床康复医学理论及临床康复经验对上肢康复机器人方案进行研究,设计了一种应用于偏瘫患者康复训练的气动式上肢康复柔性机器人,进而将气动技术的安全性、柔顺性应用到康复领域中来,有效地实现了患肢由完全被动到以被动为主逐渐到以主动为主,最后康复到完全主动训练过程的适宜模式.

  20. Rehabilitering

    DEFF Research Database (Denmark)

    Stokholm, Gitte; Jensen, Liselotte; Petersen, Charlotte

    Fokus på forståelse af rehabilitering som tværfaglig tilgang indrettet på borgerens præmisser. Der diskuteres faldgrupper og fortolkningsspørgsmål, der opstår, når man gerne vil handle politisk korrekt og lade de personer, det drejer sig om, komme til orde og få indflydelse. Emner er handicappoli...

  1. Effects of a robot-assisted training of grasp and pronation/supination in chronic stroke: a pilot study

    Directory of Open Access Journals (Sweden)

    Lambercy Olivier

    2011-11-01

    Full Text Available Abstract Background Rehabilitation of hand function is challenging, and only few studies have investigated robot-assisted rehabilitation focusing on distal joints of the upper limb. This paper investigates the feasibility of using the HapticKnob, a table-top end-effector device, for robot-assisted rehabilitation of grasping and forearm pronation/supination, two important functions for activities of daily living involving the hand, and which are often impaired in chronic stroke patients. It evaluates the effectiveness of this device for improving hand function and the transfer of improvement to arm function. Methods A single group of fifteen chronic stroke patients with impaired arm and hand functions (Fugl-Meyer motor assessment scale (FM 10-45/66 participated in a 6-week 3-hours/week rehabilitation program with the HapticKnob. Outcome measures consisted primarily of the FM and Motricity Index (MI and their respective subsections related to distal and proximal arm function, and were assessed at the beginning, end of treatment and in a 6-weeks follow-up. Results Thirteen subjects successfully completed robot-assisted therapy, with significantly improved hand and arm motor functions, demonstrated by an average 3.00 points increase on the FM and 4.55 on the MI at the completion of the therapy (4.85 FM and 6.84 MI six weeks post-therapy. Improvements were observed both in distal and proximal components of the clinical scales at the completion of the study (2.00 FM wrist/hand, 2.55 FM shoulder/elbow, 2.23 MI hand and 4.23 MI shoulder/elbow. In addition, improvements in hand function were observed, as measured by the Motor Assessment Scale, grip force, and a decrease in arm muscle spasticity. These results were confirmed by motion data collected by the robot. Conclusions The results of this study show the feasibility of this robot-assisted therapy with patients presenting a large range of impairment levels. A significant homogeneous improvement in

  2. Therapeutic Robotics: A Technology Push: Stroke rehabilitation is being aided by robots that guide movement of shoulders and elbows, wrists, hands, arms and ankles to significantly improve recovery of patients.

    Science.gov (United States)

    Krebs, Hermano Igo; Hogan, Neville

    2006-09-01

    In this paper, we present a retrospective and chronological review of our efforts to revolutionize the way physical medicine is practiced by developing and deploying therapeutic robots. We present a sample of our clinical results with well over 300 stroke patients, both inpatients and outpatients, proving that movement therapy has a measurable and significant impact on recovery following brain injury. Bolstered by this result, we embarked on a two-pronged approach: 1) to determine what constitutes best therapy practice and 2) to develop additional therapeutic robots. We review our robots developed over the past 15 years and their unique characteristics. All are configured both to deliver reproducible therapy but also to measure outcomes with minimal encumbrance, thus providing critical measurement tools to help unravel the key question posed under the first prong: what constitutes "best practice"? We believe that a "gym" of robots like these will become a central feature of physical medicine and the rehabilitation clinic within the next ten years.

  3. Cardiac rehabilitation program in patients with Chagas heart failure: a single-arm pilot study

    Directory of Open Access Journals (Sweden)

    Mauro Felippe Felix Mediano

    2016-06-01

    Full Text Available Abstract: INTRODUCTION: The benefit of a cardiac rehabilitation (CR program for patients with Chagas heart failure (CHF remains unclear. Therefore, we aimed to investigate the effects of CR for CHF patients. METHODS: A single-arm pilot study, including 12 patients with CHF, was performed. Patients participated in an 8-month physical exercise intervention, comprising aerobic, strength, and stretching exercises (3 times per week, 60 minutes per session. Nutritional and pharmaceutical counseling were also performed. Functional capacity (cardiopulmonary exercise test, muscle respiratory strength (manovacuometry, and body composition (anthropometry and skinfolds were evaluated at baseline, and after 4 and 8 months of intervention. Cardiac function (echocardiography, biomarkers (lipid profile, glucose, and glycated hemoglobin and quality of life (Minnesota Living with Heart Failure Questionnaire were assessed at baseline and at the end of the intervention. RESULTS: Seven of 12 patients included in the study completed the 8-month follow-up period. Only 2 moderate adverse events occurred during the exercise training. Functional capacity improved after 4 months of CR, while left ventricular ejection fraction (LVEF and respiratory strength improved after 8 months. Patients with right ventricular (RV dysfunction at baseline exhibited an improvement in functional capacity after 4 months, and improvements in left ventricular (LV diastolic pressure, respiratory strength, and quality of life at the end of follow-up. Conversely, those with normal baseline RV function demonstrated LVEF increases that were not observed in patients with RV dysfunction. CONCLUSIONS: CR was feasible, safe, and has important clinical benefits for patients with CHF, specifically for cardiac function and muscle respiratory strength.

  4. Utilization of the internet to deliver cardiac rehabilitation at a distance: a pilot study.

    Science.gov (United States)

    Zutz, Amber; Ignaszewski, Andrew; Bates, Joanna; Lear, Scott A

    2007-06-01

    Less than 25% of eligible patients attend cardiac rehabilitation programs (CRP), with geographical proximity being a predominant barrier. Therefore, we undertook a pilot study to assess the feasibility and safety of using the Internet as a medium for delivery of an interactive "virtual" CRP (vCRP) to patients at a distance. Fifteen patients on the waiting list for a local hospital-based CRP were randomized to either an Internet-based vCRP or observational control. The vCRP consisted of on-line intake forms, one-on-one chat sessions with a nurse, dietitian, and exercise specialist, downloadable exercise heart rate monitoring, education and data monitoring of blood pressure, weight, and glucose. Participants were assessed for exercise capacity, risk factors, and lifestyle behaviors at baseline and at 12 weeks. Those in the vCRP logged onto the Internet-based CRP an average of 4.2 times per week. There were no adverse events in the vCRP participants. The vCRP group significantly improved their HDL-C, triglycerides, total cholesterol:HDL-C ratio, exercise capacity as assessed in metabolic equivalents, weekly physical activity, and exercise specific self-efficacy (p < 0.05). There were no significant improvements in the control group. Improvements in the vCRP group were similar to historical controls in a standard CRP. Feedback from exit interviews of the vCRP participants was unanimously positive. This Internet-based CRP resulted in clinically significant improvements in risk factors and exercise capacity similar to that of a standard CRP. The high user acceptance indicated that this program may have the potential to effectively manage patients who do not have access to traditional hospital-based CRP.

  5. [Robotics].

    Science.gov (United States)

    Bier, J

    2000-05-01

    Content of this paper is the current state of the art of robots in surgery and the ongoing work on the field of surgical robotics at the Clinic for Maxillofacial Surgery at the Charité. Robots in surgery allows the surgeon to transform the accuracy of the imaging systems directly during the intervention and to plan an intervention beforehand. In this paper firstly the state of the art is described. Subsequently the scientific work at the clinic is described in detail. The paper closes with a outlook for future applications of robotics systems in maxillofacial surgery.

  6. Rehabilitation Evaluation Methodology of upper Limb Rehabilitation Robot based on AHP-fuzzy Comprehensive Evaluation%基于AHP-模糊综合评判的上肢康复机器人康复评价方法

    Institute of Scientific and Technical Information of China (English)

    王建辉; 张程; 纪雯; 顾德英

    2012-01-01

    Along with the research of 5-DOF wearable upper limb rehabilitation robots, a rehabilitation evaluation methodology was provided based on AHP-fuzzy comprehensive, the AHP hierarchical multiple index rehabilitation evaluation model in accordance was established with the rehabilitation medicine knowledge, and evaluation index with proper AHP-fuzzy synthetic relationshipcalculate operator is composed. Tested by a serious of experiments, this evaluation methodology has scientifically feasibility and provides a brand new concept for realizing the rehabilitation evaluation function for 5-DOF upper limb robot.%以5-DOF穿戴式上肢康复机器人为平台,提出了一种基于AHP-模糊综合评判的康复评价方法,依据康复医学知识建立了AHP递阶康复评价模型,选取适当的AHP-模糊关系合成算子逐阶求取康复评价指标.通过实例验证了该评价方法具有一定的科学性及充分的可行性,为实现5-DOF上肢康复机器人的康复评价功能提出了一种新思路.

  7. Robotic psychophysics system for assessment, diagnosis and rehabilitation of the neurological causes of falls in the elderly.

    Science.gov (United States)

    Lin, Chin-Hsuan; Faisal, A Aldo

    2015-08-01

    Falls are the leading causes of unintentional injuries in the elderly and thus a pose a major hazard to our ageing society. We present the FOHEPO (FOot HEight POsitioning) system to measure, diagnose and eventually rehabilitate ageing-related neurological causes of falls. We hypothesise that both perceptual and motor variability is likely to increase with age and may lead to imprecise perception and movements causing trip overs, the major triggers of falls. Our robotic experimental system automatically measures and tracks different sources of noise in the nervous system: visual perception noise of obstacle height, proprioceptive noise of localising raising one's foot to a desired height, noise in the visual feedback of the foot movements. We developed age-appropriate psychophysical measurement protocols shorter than standard protocols for perceptual and motor accuracy. These quantify individual subjects perceptual and movement accuracy thresholds through their psychometric curves. Therefore, these platform measurements will enable us to estimate fall probabilities quantitatively, i.e. the chance that a foot will clip an obstacle because subjects did not add a sufficient safety factor when clearing it. Potentially, we can use our FOHEPO system in a game-ified setting to rehabilitate elderly users to move with larger safety factors so as to reduce their risks of trip-over.

  8. Sequential combination of robot-assisted therapy and constraint-induced therapy in stroke rehabilitation: a randomized controlled trial.

    Science.gov (United States)

    Hsieh, Yu-Wei; Lin, Keh-Chung; Horng, Yi-Shiung; Wu, Ching-Yi; Wu, Tai-Chieh; Ku, Fang-Ling

    2014-05-01

    Robot-assisted therapy (RT) and constraint-induced therapy (CIT) both show great promise to improve stroke rehabilitation outcomes. Although the respective treatment efficacy of RT and CIT has been validated, the additive effects of RT combined with CIT remain unknown. This study investigated the treatment effects of RT in sequential combination with a distributed form of CIT (RT + dCIT) compared with RT and conventional rehabilitation (CR). Forty-eight patients with stroke were enrolled and randomized to receive one of the three interventions for 4 weeks. Primary outcomes assessed the changes of motor impairment and motor function on the Fugl-Meyer Assessment (FMA) and Wolf Motor Function Test (WMFT). Secondary outcomes, including the Motor Activity Log (MAL) and accelerometers, examined functional performance during daily activities. The three treatment groups improved significantly on most primary and secondary outcomes over time. The combined RT + dCIT group exhibited significantly greater improvement on the FMA and functional ability subscale of the WMFT than the RT and CR groups. The improvements on the MAL and accelerometers were not significantly different among the three groups. RT in sequential combination with CIT led to additive effects on participants' motor ability and functional ability to perform motor tasks after stroke, which support that combined therapy can be an effective means to intensify outcomes. Further research investigating the potential long-term effects of combination therapy, especially on real-life performance, would be valuable.

  9. A Damper Driven Robotic End-Point Manipulator for Functional Rehabilitation Exercises After Stroke

    NARCIS (Netherlands)

    Westerveld, Ard; Aalderink, Benno; Aalderink, B.J.; Hagedoorn, W.; Buijze, M.; Schouten, Alfred Christiaan; van der Kooij, Herman

    2014-01-01

    Stroke survivors may benefit from robotic assistance for relearning of functional movements. Current assistive devices are either passive, limited to only two dimensions or very powerful. However, for reach training, weight compensation and a little assistance with limited power is sufficient. We

  10. tDCS and Robotics on Upper Limb Stroke Rehabilitation: Effect Modification by Stroke Duration and Type of Stroke

    Directory of Open Access Journals (Sweden)

    Sofia Straudi

    2016-01-01

    Full Text Available Objective. The aim of this exploratory pilot study is to test the effects of bilateral tDCS combined with upper extremity robot-assisted therapy (RAT on stroke survivors. Methods. We enrolled 23 subjects who were allocated to 2 groups: RAT + real tDCS and RAT + sham-tDCS. Each patient underwent 10 sessions (5 sessions/week over two weeks. Outcome measures were collected before and after treatment: (i Fugl-Meyer Assessment-Upper Extremity (FMA-UE, (ii Box and Block Test (BBT, and (iii Motor Activity Log (MAL. Results. Both groups reported a significant improvement in FMA-UE score after treatment (p<0.01. No significant between-groups differences were found in motor function. However, when the analysis was adjusted for stroke type and duration, a significant interaction effect (p<0.05 was detected, showing that stroke duration (acute versus chronic and type (cortical versus subcortical modify the effect of tDCS and robotics on motor function. Patients with chronic and subcortical stroke benefited more from the treatments than patients with acute and cortical stroke, who presented very small changes. Conclusion. The additional use of bilateral tDCS to RAT seems to have a significant beneficial effect depending on the duration and type of stroke. These results should be verified by additional confirmatory studies.

  11. tDCS and Robotics on Upper Limb Stroke Rehabilitation: Effect Modification by Stroke Duration and Type of Stroke.

    Science.gov (United States)

    Straudi, Sofia; Fregni, Felipe; Martinuzzi, Carlotta; Pavarelli, Claudia; Salvioli, Stefano; Basaglia, Nino

    2016-01-01

    Objective. The aim of this exploratory pilot study is to test the effects of bilateral tDCS combined with upper extremity robot-assisted therapy (RAT) on stroke survivors. Methods. We enrolled 23 subjects who were allocated to 2 groups: RAT + real tDCS and RAT + sham-tDCS. Each patient underwent 10 sessions (5 sessions/week) over two weeks. Outcome measures were collected before and after treatment: (i) Fugl-Meyer Assessment-Upper Extremity (FMA-UE), (ii) Box and Block Test (BBT), and (iii) Motor Activity Log (MAL). Results. Both groups reported a significant improvement in FMA-UE score after treatment (p stroke type and duration, a significant interaction effect (p stroke duration (acute versus chronic) and type (cortical versus subcortical) modify the effect of tDCS and robotics on motor function. Patients with chronic and subcortical stroke benefited more from the treatments than patients with acute and cortical stroke, who presented very small changes. Conclusion. The additional use of bilateral tDCS to RAT seems to have a significant beneficial effect depending on the duration and type of stroke. These results should be verified by additional confirmatory studies.

  12. Rehabilitering

    DEFF Research Database (Denmark)

    Caswell, Dorte; Høybye-Mortensen, Matilde; Dall, Tanja

    2013-01-01

    Rehabilitering som både begreb og indsats har været genstand for stigende fokus i de seneste år, på både politisk, organisatorisk og praksis-niveau. Fra januar 2013 træder en større reform af førtidspension og fleksjob i kraft, og med reformen etableres ’rehabilitering’ som både mål og middel i...... beskæftigelsesindsatsen. Med dette temanummer af Social Politik ønsker vi at sætte fokus på rehabiliteringsbegrebets udbredelse og udfyldelse, og de konsekvenser de aktuelle social- og beskæftigelsespolitiske tendenser kan have for den konkrete rehabiliteringsindsats i praksis....

  13. Exercise-based rehabilitation after hospital discharge for survivors of critical illness with intensive care unit–acquired weakness: A pilot feasibility trial ☆ ☆☆

    OpenAIRE

    Connolly, Bronwen; Thompson, April; Douiri, Abdel; Moxham, John; Hart, Nicholas

    2015-01-01

    Purpose The aim of this study was to investigate feasibility of exercise-based rehabilitation delivered after hospital discharge in patients with intensive care unit–acquired weakness (ICU-AW). Materials and methods Twenty adult patients, mechanically ventilated for more than 48 hours, with ICU-AW diagnosis at ICU discharge were included in a pilot feasibility randomized controlled trial receiving a 16-session exercise-based rehabilitation program. Twenty-one patients without ICU-AW participa...

  14. Exercise-based rehabilitation after hospital discharge for survivors of critical illness with intensive care unit–acquired weakness: A pilot feasibility trial ☆ ☆☆

    OpenAIRE

    Connolly, Bronwen; Thompson, April; Douiri, Abdel; Moxham, John; Hart, Nicholas

    2015-01-01

    Purpose The aim of this study was to investigate feasibility of exercise-based rehabilitation delivered after hospital discharge in patients with intensive care unit–acquired weakness (ICU-AW). Materials and methods Twenty adult patients, mechanically ventilated for more than 48 hours, with ICU-AW diagnosis at ICU discharge were included in a pilot feasibility randomized controlled trial receiving a 16-session exercise-based rehabilitation program. Twenty-one patients without ICU-AW participa...

  15. Pilot study on effectiveness of simulation for surgical robot design using manipulability.

    Science.gov (United States)

    Kawamura, Kazuya; Seno, Hiroto; Kobayashi, Yo; Fujie, Masakatsu G

    2011-01-01

    Medical technology has advanced with the introduction of robot technology, which facilitates some traditional medical treatments that previously were very difficult. However, at present, surgical robots are used in limited medical domains because these robots are designed using only data obtained from adult patients and are not suitable for targets having different properties, such as children. Therefore, surgical robots are required to perform specific functions for each clinical case. In addition, the robots must exhibit sufficiently high movability and operability for each case. In the present study, we focused on evaluation of the mechanism and configuration of a surgical robot by a simulation based on movability and operability during an operation. We previously proposed the development of a simulator system that reproduces the conditions of a robot and a target in a virtual patient body to evaluate the operability of the surgeon during an operation. In the present paper, we describe a simple experiment to verify the condition of the surgical assisting robot during an operation. In this experiment, the operation imitating suturing motion was carried out in a virtual workspace, and the surgical robot was evaluated based on manipulability as an indicator of movability. As the result, it was confirmed that the robot was controlled with low manipulability of the left side manipulator during the suturing. This simulation system can verify the less movable condition of a robot before developing an actual robot. Our results show the effectiveness of this proposed simulation system.

  16. A Pilot Project of Early Integrated Traumatic Brain Injury Rehabilitation in Singapore

    Directory of Open Access Journals (Sweden)

    Siew Kwaon Lui

    2014-01-01

    Full Text Available Objective. Document acute neurosurgical and rehabilitation parameters of patients of all traumatic brain injury (TBI severities and determine whether early screening along with very early integrated TBI rehabilitation changes functional outcomes. Methods. Prospective study involving all patients with TBI admitted to a neurosurgical department of a tertiary hospital. They were assessed within 72 hours of admission by the rehabilitation team and received twice weekly rehabilitation reviews. Patients with further rehabilitation needs were then transferred to the attached acute inpatient TBI rehabilitation unit (TREATS and their functional outcomes were compared against a historical group of patients. Demographic variables, acute neurosurgical characteristics, medical complications, and rehabilitation outcomes were recorded. Results. There were 298 patients screened with an average age of 61.8±19.1 years. The most common etiology was falls (77.5%. Most patients were discharged home directly (67.4% and 22.8% of patients were in TREATS. The TREATS group functionally improved (P<0.001. Regression analysis showed by the intervention of TREATS, that there was a statistically significant FIM functional gain of 18.445 points (95% CI −30.388 to −0.6502, P=0.03. Conclusion. Our study demonstrated important epidemiological data on an unselected cohort of patients with TBI in Singapore and functional improvement in patients who further received inpatient rehabilitation.

  17. Combining a hybrid robotic system with a bain-machine interface for the rehabilitation of reaching movements: A case study with a stroke patient.

    Science.gov (United States)

    Resquin, F; Ibañez, J; Gonzalez-Vargas, J; Brunetti, F; Dimbwadyo, I; Alves, S; Carrasco, L; Torres, L; Pons, Jose Luis

    2016-08-01

    Reaching and grasping are two of the most affected functions after stroke. Hybrid rehabilitation systems combining Functional Electrical Stimulation with Robotic devices have been proposed in the literature to improve rehabilitation outcomes. In this work, we present the combined use of a hybrid robotic system with an EEG-based Brain-Machine Interface to detect the user's movement intentions to trigger the assistance. The platform has been tested in a single session with a stroke patient. The results show how the patient could successfully interact with the BMI and command the assistance of the hybrid system with low latencies. Also, the Feedback Error Learning controller implemented in this system could adjust the required FES intensity to perform the task.

  18. A 3-DOF parallel robot with spherical motion for the rehabilitation and evaluation of balance performance.

    Science.gov (United States)

    Patanè, Fabrizio; Cappa, Paolo

    2011-04-01

    In this paper a novel electrically actuated parallel robot with three degrees-of-freedom (3 DOF) for dynamic postural studies is presented. The design has been described, the solution to the inverse kinematics has been found, and a numerical solution for the direct kinematics has been proposed. The workspace of the implemented robot is characterized by an angular range of motion of about ±10° for roll and pitch when yaw is in the range ±15°. The robot was constructed and the orientation accuracy was tested by means of an optoelectronic system and by imposing a sinusoidal input, with a frequency of 1 Hz and amplitude of 10°, along the three axes, in sequence. The collected data indicated a phase delay of 1° and an amplitude error of 0.5%-1.5%; similar values were observed for cross-axis sensitivity errors. We also conducted a clinical application on a group of normal subjects, who were standing in equilibrium on the robot base with eyes open (EO) and eyes closed (EC), which was rotated with a tri-axial sinusoidal trajectory with a frequency of 0.5 Hz and amplitude 5° for roll and pitch and 10° for the yaw. The postural configuration of the subjects was recorded with an optoelectronic system. However, due to the mainly technical nature of this paper, only initial validation outcomes are reported here. The clinical application showed that only the tilt and displacement on the sagittal pane of head, trunk, and pelvis in the trials conducted with eyes closed were affected by drift and that the reduction of the yaw rotation and of the mediolateral translation was not a controlled parameter, as happened, instead, for the other anatomical directions.

  19. Fine finger motor skill training with exoskeleton robotic hand in chronic stroke: stroke rehabilitation.

    Science.gov (United States)

    Ockenfeld, Corinna; Tong, Raymond K Y; Susanto, Evan A; Ho, Sze-Kit; Hu, Xiao-ling

    2013-06-01

    Background and Purpose. Stroke survivors often show a limited recovery in the hand function to perform delicate motions, such as full hand grasping, finger pinching and individual finger movement. The purpose of this study is to describe the implementation of an exoskeleton robotic hand together with fine finger motor skill training on 2 chronic stroke patients. Case Descriptions. Two post-stroke patients participated in a 20-session training program by integrating 10 minutes physical therapy, 20 minutes robotic hand training and 15 minutes functional training tasks with delicate objects(card, pen and coin). These two patients (A and B) had cerebrovascular accident at 6 months and 11 months respectively when enrolled in this study. Outcomes. The results showed that both patients had improvements in Fugl-Meyer assessment (FM), Action Research Arm Test (ARAT). Patients had better isolation of the individual finger flexion and extension based on the reduced muscle co-contraction from the electromyographic(EMG) signals and finger extension force after 20 sessions of training. Discussion. This preliminary study showed that by focusing on the fine finger motor skills together with the exoskeleton robotic hand, it could improve the motor recovery of the upper extremity in the fingers and hand function, which were showed in the ARAT. Future randomized controlled trials are needed to evaluate the clinical effectiveness.

  20. Virtual reality and robotics for stroke rehabilitation: where do we go from here?

    Science.gov (United States)

    Wade, Eric; Winstein, Carolee J

    2011-01-01

    Promoting functional recovery after stroke requires collaborative and innovative approaches to neurorehabilitation research. Task-oriented training (TOT) approaches that include challenging, adaptable, and meaningful activities have led to successful outcomes in several large-scale multisite definitive trials. This, along with recent technological advances of virtual reality and robotics, provides a fertile environment for furthering clinical research in neurorehabilitation. Both virtual reality and robotics make use of multimodal sensory interfaces to affect human behavior. In the therapeutic setting, these systems can be used to quantitatively monitor, manipulate, and augment the users' interaction with their environment, with the goal of promoting functional recovery. This article describes recent advances in virtual reality and robotics and the synergy with best clinical practice. Additionally, we describe the promise shown for automated assessments and in-home activity-based interventions. Finally, we propose a broader approach to ensuring that technology-based assessment and intervention complement evidence-based practice and maintain a patient-centered perspective.

  1. Design of a robotic device for assessment and rehabilitation of hand sensory function.

    Science.gov (United States)

    Lambercy, Olivier; Robles, Alejandro Juárez; Kim, Yeongmi; Gassert, Roger

    2011-01-01

    This paper presents the design and implementation of the Robotic Sensory Trainer, a robotic interface for assessment and therapy of hand sensory function. The device can provide three types of well controlled stimuli: (i) angular displacement at the metacarpophalangeal (MCP) joint using a remote-center-of-motion double-parallelogram structure, (ii) vibration stimuli at the fingertip, proximal phalange and palm, and (iii) pressure at the fingertip, while recording position, interaction force and feedback from the user over a touch screen. These stimuli offer a novel platform to investigate sensory perception in healthy subjects and patients with sensory impairments, with the potential to assess deficits and actively train detection of specific sensory cues in a standardized manner. A preliminary study with eight healthy subjects demonstrates the feasibility of using the Robotic Sensory Trainer to assess the sensory perception threshold in MCP angular position. An average just noticeable difference (JND) in the MCP joint angle of 2.46° (14.47%) was found, which is in agreement with previous perception studies. © 2011 IEEE

  2. Interdisciplinary collaboration experiences in creating an everyday rehabilitation model: a pilot study

    Directory of Open Access Journals (Sweden)

    Moe A

    2016-04-01

    Full Text Available Aud Moe,1,2 Hildfrid V Brataas1,2 1Faculty of Health Science, Nord University, Steinkjer, Nord-Trøndelag, 2Center of Care Research, Mid-Norway, Steinkjer, Nord-Trøndelag, Norway Background: When functional impairment occurs, assistance to achieve self-help can lead to qualitatively more active everyday life for recipients and better use of community resources. Home-based everyday rehabilitation is a new interdisciplinary service for people living at home. Rehabilitation involves meeting the need for interprofessional services, interdisciplinary collaboration, and coordination of services. Everyday rehabilitation is a service that requires close interdisciplinary cooperation. The purpose of this study was to gain knowledge about employees' experiences with establishing a new multidisciplinary team and developing a team-based work model. Method: The study had a qualitative design using two focus group interviews with a newly established rehabilitation team. The sample consisted of an occupational therapist, two care workers with further education in rehabilitation, a nurse, a physiotherapist, and a project leader. Data were analyzed by thematic content analysis. Results: The data highlight three phases: a planning phase (ten meetings over half a year, a startup phase of trials of interdisciplinary everyday rehabilitation in practice (2 months, and a third period specifying and implementing an everyday rehabilitation model (6 months. During these phases, three themes emerged: 1 team creation and design of the service, 2 targeted practical trials, and 3 equality of team members and combining interdisciplinary methods. Conclusion: The team provided information about three processes: developing work routines and a revised team-based flow chart, developing team cooperation with integrated trans- and interdisciplinary collaboration, and working with external exchange. There is more need for secure network solutions. Keywords: everyday rehabilitation

  3. Potential of a suite of robot/computer-assisted motivating systems for personalized, home-based, stroke rehabilitation

    Directory of Open Access Journals (Sweden)

    Feng Xin

    2007-03-01

    Full Text Available Abstract Background There is a need to improve semi-autonomous stroke therapy in home environments often characterized by low supervision of clinical experts and low extrinsic motivation. Our distributed device approach to this problem consists of an integrated suite of low-cost robotic/computer-assistive technologies driven by a novel universal access software framework called UniTherapy. Our design strategy for personalizing the therapy, providing extrinsic motivation and outcome assessment is presented and evaluated. Methods Three studies were conducted to evaluate the potential of the suite. A conventional force-reflecting joystick, a modified joystick therapy platform (TheraJoy, and a steering wheel platform (TheraDrive were tested separately with the UniTherapy software. Stroke subjects with hemiparesis and able-bodied subjects completed tracking activities with the devices in different positions. We quantify motor performance across subject groups and across device platforms and muscle activation across devices at two positions in the arm workspace. Results Trends in the assessment metrics were consistent across devices with able-bodied and high functioning strokes subjects being significantly more accurate and quicker in their motor performance than low functioning subjects. Muscle activation patterns were different for shoulder and elbow across different devices and locations. Conclusion The Robot/CAMR suite has potential for stroke rehabilitation. By manipulating hardware and software variables, we can create personalized therapy environments that engage patients, address their therapy need, and track their progress. A larger longitudinal study is still needed to evaluate these systems in under-supervised environments such as the home.

  4. Potential of a suite of robot/computer-assisted motivating systems for personalized, home-based, stroke rehabilitation

    Science.gov (United States)

    Johnson, Michelle J; Feng, Xin; Johnson, Laura M; Winters, Jack M

    2007-01-01

    Background There is a need to improve semi-autonomous stroke therapy in home environments often characterized by low supervision of clinical experts and low extrinsic motivation. Our distributed device approach to this problem consists of an integrated suite of low-cost robotic/computer-assistive technologies driven by a novel universal access software framework called UniTherapy. Our design strategy for personalizing the therapy, providing extrinsic motivation and outcome assessment is presented and evaluated. Methods Three studies were conducted to evaluate the potential of the suite. A conventional force-reflecting joystick, a modified joystick therapy platform (TheraJoy), and a steering wheel platform (TheraDrive) were tested separately with the UniTherapy software. Stroke subjects with hemiparesis and able-bodied subjects completed tracking activities with the devices in different positions. We quantify motor performance across subject groups and across device platforms and muscle activation across devices at two positions in the arm workspace. Results Trends in the assessment metrics were consistent across devices with able-bodied and high functioning strokes subjects being significantly more accurate and quicker in their motor performance than low functioning subjects. Muscle activation patterns were different for shoulder and elbow across different devices and locations. Conclusion The Robot/CAMR suite has potential for stroke rehabilitation. By manipulating hardware and software variables, we can create personalized therapy environments that engage patients, address their therapy need, and track their progress. A larger longitudinal study is still needed to evaluate these systems in under-supervised environments such as the home. PMID:17331243

  5. Dose-response relationship of robot-assisted stroke motor rehabilitation: the impact of initial motor status.

    Science.gov (United States)

    Hsieh, Yu-wei; Wu, Ching-yi; Lin, Keh-chung; Yao, Grace; Wu, Kuen-yuh; Chang, Ya-ju

    2012-10-01

    The increasing availability of robot-assisted therapy (RT), which provides quantifiable, reproducible, interactive, and intensive practice, holds promise for stroke rehabilitation, but data on its dose-response relation are scanty. This study used 2 different intensities of RT to examine the treatment effects of RT and the effect on outcomes of the severity of initial motor deficits. Fifty-four patients with stroke were randomized to a 4-week intervention of higher-intensity RT, lower-intensity RT, or control treatment. The primary outcome, the Fugl-Meyer Assessment, was administered at baseline, midterm, and posttreatment. Secondary outcomes included the Medical Research Council scale, the Motor Activity Log, and the physical domains of the Stroke Impact Scale. The higher-intensity RT group showed significantly greater improvements on the Fugl-Meyer Assessment than the lower-intensity RT and control treatment groups at midterm (P=0.003 and P=0.02) and at posttreatment (P=0.04 and P=0.02). Within-group gains on the secondary outcomes were significant, but the differences among the 3 groups did not reach significance. Recovery rates of the higher-intensity RT group were higher than those of the lower-intensity RT group, particularly on the Fugl-Meyer Assessment. Scatterplots with curve fitting showed that patients with moderate motor deficits gained more improvements than those with severe or mild deficits after the higher-intensity RT. This study demonstrated the higher treatment intensity provided by RT was associated with better motor outcome for patients with stroke, which may shape further stroke rehabilitation. Clinical Trial Registration- URL: http://clinicaltrials.gov. Unique identifier: NCT00917605.

  6. Design on the Control System of a Gait Rehabilitation Training Robot based on Brain-Computer Interface and Virtual Reality Technology

    Directory of Open Access Journals (Sweden)

    Hui Wang

    2012-10-01

    Full Text Available In this paper a control system of a gait rehabilitation training robot based on Brain-Computer Interface (BCI and virtual reality technology is proposed, which makes the patients’ rehabilitation training process more interesting. A technique for measuring the mental states of the human and associated applications based on normal brain signals are examined and evaluated firstly. Secondly, the virtual game starts with the information from the BCI and then it runs in the form of a thread, with the singleton design pattern as the main mode. Thirdly, through the synergistic cooperation with the main software, the virtual game can achieve quick and effective access to blood oxygen, heart rate and other physiological information of the patients. At the same time, by means of the hardware control system, the start‐up of the gait rehabilitation training robot could be controlled accurately and effectively. Therefore, the plantar pressure information and the velocity information, together with the physiological information of the patients, would be properly reflected in the game lastly and the physical condition of the patients participating in rehabilitation training would also be reflected to a great extent.

  7. Design on the Control System of a Gait Rehabilitation Training Robot Based on Brain-Computer Interface and Virtual Reality Technology

    Directory of Open Access Journals (Sweden)

    Hui Wang

    2012-10-01

    Full Text Available In this paper a control system of a gait rehabilitation training robot based on Brain-Computer Interface (BCI and virtual reality technology is proposed, which makes the patients' rehabilitation training process more interesting. A technique for measuring the mental states of the human and associated applications based on normal brain signals are examined and evaluated firstly. Secondly, the virtual game starts with the information from the BCI and then it runs in the form of a thread, with the singleton design pattern as the main mode. Thirdly, through the synergistic cooperation with the main software, the virtual game can achieve quick and effective access to blood oxygen, heart rate and other physiological information of the patients. At the same time, by means of the hardware control system, the start-up of the gait rehabilitation training robot could be controlled accurately and effectively. Therefore, the plantar pressure information and the velocity information, together with the physiological information of the patients, would be properly reflected in the game lastly and the physical condition of the patients participating in rehabilitation training would also be reflected to a great extent.

  8. Feasibility of virtual therapy in rehabilitation of Parkinson's disease patients: pilot study

    OpenAIRE

    Loureiro,Ana Paula Cunha; Ribas,Cristiane Gonçalves; Zotz,Talita Gianello Gnoato; Chen,Rebeca; Ribas,Flávia

    2012-01-01

    INTRODUCTION: Among Parkinson's disease (PD) motor disabilities, postural and balance alterations are important parameters to physical therapists who need to choose specific, targeted therapies for their patients. Among many therapy options, virtual therapy is studied as to whether it can be a viable rehabilitation method. OBJECTIVE: To verify the applicability of virtual rehabilitation in PD patients for the improvement of their balance and quality of life. MATERIAL AND METHODS: Six voluntee...

  9. Rehabilitation of Children with Hemiparesis: A Pilot Study on the Use of Virtual Reality

    Directory of Open Access Journals (Sweden)

    Ivana Olivieri

    2013-01-01

    Full Text Available Background. A wide range of treatments have been used to improve upper arm motor performances in children with congenital hemiplegia. Recent findings are suggesting that virtual reality based intervention could be a promising tool also in pediatric rehabilitation. Methods. Six patients with congenital hemiplegia (age: 4–16 years were recruited among those treated in the Child Neuropsychiatry and Rehabilitation Unit of the IRCCS “Santa Maria Nascente” (Milan, Italy, for a preliminary investigation about using nonimmersive virtual reality for upper limb rehabilitation. Ten sessions using VRRS system (Khymeia, Padova, Italy were weekly administered as a part of the rehabilitative treatment. Melbourne Assessment of Unilateral Limb Movement, Ashworth Scale, and Arm’s PROM were selected as main outcome measures. At the end of treatment, participants filled in an ad hoc satisfaction questionnaire. Results. All subjects completed the proposed treatment, and they also gave a positive judgment regarding this rehabilitative method. Melbourne score increased in all patients. Conclusion. Our findings seem to support the evidence that VR treatment could be a promising and engaging tool for pediatric rehabilitation. However, the limited size of the population and the small number of sessions require further investigations and RCTs to confirm our positive results.

  10. Robotic exoskeleton with an assist-as-needed control strategy for gait rehabilitation after stroke

    OpenAIRE

    Bortole, Magdo

    2014-01-01

    Stroke is a loss of brain function caused by a disturbance on the blood supply to the brain. The main consequence of a stroke is a serious long-term disability, and it affects millions of people around the world every year. Motor recovery after stroke is primarily based on physical therapy and the most common rehabilitation method focuses on the task specific approach. Gait is one of the most important daily life activity affected in stroke victims, leading to poor ambulatory activity. Theref...

  11. Clonally related methicillin-resistant Staphylococcus aureus isolated from short-finned pilot whales (Globicephala macrorhynchus), human volunteers, and a bayfront cetacean rehabilitation facility

    Science.gov (United States)

    In May of 2011 a live mass stranding of 26 short-finned pilot whales (Globicephala macrorhynchus) occurred in the lower Florida Keys. Five surviving whales were transferred from the original stranding site to a nearby marine mammal rehabilitation facility where they were constantly attended to by a ...

  12. Robots

    Institute of Scientific and Technical Information of China (English)

    驷萍

    1997-01-01

    一篇介绍机器人的文章写得如此耐读,如此清新! 首先.我们弄清了robot一词的来历: It was used first in 1920 in a play by Czcchoslovak writer Karel Capek.The wordrobot comes from the Czech word for slave. 上句提供了一个时间:1920。文章接着便抓住这个时间做文章: 且The word robot.and robots themselves are less than 100 years old.But humanshave been dreaming of real and imaginary copies of themselves for thousands of years. 文章就这样写出了波澜,1920年和 thousands of years自然而然构成了强烈对比。1954年和1960s是两个谈及机器人时不得不一提的时间: In 1954,the world’s first robot was produced in the United States. During the 1960s,the first industrial robots appeared beside human workers infactories.下面这句让我们体味到 the Czech word for slave中的 slave不仅言之有理,而且影视和小说里的机器人“造反”,进而 killed the humans who made them的情节也“事出有因”: What do today’s robots do?Robots do work.Work that human consideruninteresting or dangerous.…do many jobs that people consider tiring. 本文将机器人的“功过”放在一起写,笔

  13. Motion Tracking and Identification of Unrestraint Gait Rehabilitation by Use of Elderly Support Robot

    Science.gov (United States)

    Nokata, Makoto; Hirai, Wataru; Itatani, Ryosuke

    This paper presents a robotic training system that can exercise the user without bodily restraint, neither markers nor sensors are attached to the trainee. We developed the robot system that has a total of four mounted components: a laser sensor, a camera, a cushion, and an electric motor. This paper have showed the method used for determining whether the trainee was bending forward or backward while walking, and the extent of the tilt, using the recorded image of the back of the trainee's head. A characteristic of our software algorithms has been that the image was divided into 9 quadrants, and each quadrant undergoes Hough transformation. We have verified experimentally that by using our algorithms for the four patterns of forward, backward, diagonally, and crouching, the tilt of the trainee's body have been accurately determined. We created a flowchart for determining the direction of movement according to experimental results. By adjusting the values used to make the distinction according to the position and the angle of the camera, and the width of the back of the trainee's head, we were able to accurately determine the walking condition of the trainee, and achieve early detection of the start of a fall.

  14. 新型卧式下肢康复训练机器人机械系统设计%New horizontal lower limb rehabilitative robot

    Institute of Scientific and Technical Information of China (English)

    方涛涛; 韩建海; 王会良; 尤爱民

    2013-01-01

    Objective: To deve10p a kind of robot which was geared to the needs of bedridden stroke patients as well as weak for walking patients and help them to accomplish rehabilitation daily training of their 10wer limbs in bed. Method: On the basis of having analyzed multiple rehabilitation models, a kind of new horizontal 10wer limbs rehabilitative robot had been designed. The mechanical leg had four degrees of freedom and the composition of control system was studied in detail. The experimental prototype was performed. Result: After pattern repeated tests,the fol10wing points could be authenticated:The robot moved stably and singularity-free. Healthy person felt comfortable during experience in the robot. The joint angle was consistent with being expected. So the structure could well meet the demand of variety rehabilitation modes. Conclusion: The horizontal 10wer limb rehabilitation structure is feasible, and is helpful to do early rehabilitation exercise and reduce the work of physical therapists.%目的:面向长期卧床的脑卒中偏瘫患者和下肢行走功能虚弱的患者,研究一种卧式下肢康复训练机器人,帮助他们在床上完成下肢的日常康复训练.方法:在对多种康复训练模式进行分析的基础上,本文设计了一种新型卧式四自由度下肢康复训练机器人.本文详细叙述了四自由度机械腿的机械结构设计和控制系统的构成,并制作出了实验样机.结果:经过多模式重复实验,机器人动作平稳,正常人上机体验,下肢感觉舒适,关节活动角度与设定角度一致,能够很好地满足多种康复训练模式的要求满足人体关节运动需求.结论:该卧式康复结构具有可行性,有助于脑卒中患者做下肢早期的康复训练,可以减轻康复治疗师的工作负担.

  15. 基于力反馈的上肢康复机器人%Rehabilitation robot based on force feedback

    Institute of Scientific and Technical Information of China (English)

    李世远; 李双鲲; 高翔; 蔡杰

    2015-01-01

    For the patients with hemiplegia caused by cerebral apoplexy, this paper presents a new upper limb rehabilitation robot system based on Virtual Reality Technology. The system is mainly form of an upper limb exoskeleton device, PHANTOM, the motor controller and workstation. Patients wearing upper limb exoskeleton mechanism, installed in the patients with side, in the move of the exoskeleton that help patients do exercise. In the process of moving the exoskeleton, through the force feedback mechanism will feedback the force to the PHANTOM, then feedback to the doctor.%针对脑中风引起的偏瘫患者,提出了一种新的基于虚拟现实技术上的上肢康复机器人系统。该系统主要由上肢外骨骼装置,触觉装置,电机控制器和工作站组成。患者穿戴上肢外骨骼机构,安装在患者患侧,通过电机带动外骨骼运动从而使患者患侧运动。在外骨骼运动过程中,通过力反馈机构将患者受力或施力反馈到三维触觉操作器,进而反馈给对其辅助治疗的医生。

  16. Early individualised manipulative rehabilitation following lumbar open laser microdiscectomy improves early post-operative functional disability: A randomized, controlled pilot study.

    Science.gov (United States)

    Kim, Byungho J; Ahn, Junghoon; Cho, Heecheol; Kim, Dongyun; Kim, Taeyeong; Yoon, Bumchul

    2016-01-01

    Lumbar open laser microdiscectomy has been shown to be an effective intervention and safe approach for lumbar disc prolapse. However early post-operative physical disability affecting daily activities have been sporadically reported. To evaluate the feasibility of using early individualised manipulative rehabilitation to improve early post-operative functional disability following lumbar discectomy. Randomised controlled pilot trial. Setting at a major metropolitan spine surgery hospital. Twenty-one patients aged 25-69 years who underwent lumbar microdiscectomy were randomised to either the manipulative rehabilitation treatment group or the active control group. Rehabilitation was initiated 2-3 weeks after surgery, twice a week for 4 weeks. Each session was for 30 minutes. Primary outcomes were the Roland-Morris disability questionnaire and the visual analogue pain scale. Outcome measures were assessed at baseline and post-intervention. Early post-operative physical disability was improved with a 55% reduction by early individualised manipulative rehabilitation, compared to that of control care with a 5% increase. Early post-operative residual leg pain decreased with rehabilitation (55%) and control care (9%). This pilot study supports the feasibility of a future definitive randomised control trial and indicates this type of rehabilitation may be an important option for post-operative management after spinal surgery.

  17. Robotic training and kinematic analysis of arm and hand after incomplete spinal cord injury: a case study.

    Science.gov (United States)

    Kadivar, Z; Sullivan, J L; Eng, D P; Pehlivan, A U; O'Malley, M K; Yozbatiran, N; Francisco, G E

    2011-01-01

    Regaining upper extremity function is the primary concern of persons with tetraplegia caused by spinal cord injury (SCI). Robotic rehabilitation has been inadequately tested and underutilized in rehabilitation of the upper extremity in the SCI population. Given the acceptance of robotic training in stroke rehabilitation and SCI gait training, coupled with recent evidence that the spinal cord, like the brain, demonstrates plasticity that can be catalyzed by repetitive movement training such as that available with robotic devices, it is probable that robotic upper-extremity training of persons with SCI could be clinically beneficial. The primary goal of this pilot study was to test the feasibility of using a novel robotic device for the upper extremity (RiceWrist) and to evaluate robotic rehabilitation using the RiceWrist in a tetraplegic person with incomplete SCI. A 24-year-old male with incomplete SCI participated in 10 sessions of robot-assisted therapy involving intensive upper limb training. The subject successfully completed all training sessions and showed improvements in movement smoothness, as well as in the hand function. Results from this study provide valuable information for further developments of robotic devices for upper limb rehabilitation in persons with SCI. © 2011 IEEE

  18. Using a robot to personalise health education for children with diabetes type 1: a pilot study

    NARCIS (Netherlands)

    Blanson Henkemans, O.A.; Bierman, B.P.B.; Janssen, J.; Neerincx, M.A.; Looije, R.; Bosch, H. van der; Giessen, J.A.M. van der

    2013-01-01

    Objective Assess the effects of personalised robot behaviours on the enjoyment and motivation of children (8–12) with diabetes, and on their acquisition of health knowledge, in educational play. Methods Children (N = 5) played diabetes quizzes against a personal or neutral robot on three occasions:

  19. Using a robot to personalise health education for children with diabetes type 1: a pilot study

    NARCIS (Netherlands)

    Blanson Henkemans, O.A.; Bierman, B.P.B.; Janssen, J.; Neerincx, M.A.; Looije, R.; Bosch, H. van der; Giessen, J.A.M. van der

    2013-01-01

    Objective Assess the effects of personalised robot behaviours on the enjoyment and motivation of children (8–12) with diabetes, and on their acquisition of health knowledge, in educational play. Methods Children (N = 5) played diabetes quizzes against a personal or neutral robot on three occasions:

  20. Pilot study of design method for surgical robot using workspace reproduction system.

    Science.gov (United States)

    Seno, Hiroto; Kawamura, Kazuya; Kobayashi, Yo; Fujie, Masakatsu G

    2011-01-01

    Recent development methods for surgical robots have an inherent problem. The user-friendliness of operating robot cannot be revealed until completion of the robot. To assist the design of a surgical robot that is user-friendly in terms of surgeon's operation, we propose a system that considers the operation manner of surgeon during the design phase of the robot. This system includes the following functionality: 1) a master manipulator that measures the operation manner of the surgeon (operator), and 2) a slave simulator in which the mechanical parameters can be configured freely. The operator can use the master manipulator to operate the slave simulator. Using this system, we investigate the necessity of considering the operator's manner when developing a surgical robot. In the experiment, we used three instruments with mechanisms that differed with respect to the length between bending joints and measured the trajectory of each instrument tip position during the surgical task. The results show that there are differences in the trajectories of each mechanism. Based on the results, changes in the mechanism of the surgical robot influenced the operator's manner. Therefore, when designing the mechanism for a surgical robot, there is a need to consider how this influences the operator's manner.

  1. Health-related quality of life following robotic surgery: a pilot study.

    Science.gov (United States)

    Lau, Susie; Aubin, Sylvie; Rosberger, Zeev; Gourdji, Iris; How, Jeffrey; Gotlieb, Raphael; Drummond, Nancy; Eniu, Ioana; Abitbol, Jeremie; Gotlieb, Walter

    2014-12-01

    Objectifs : Déterminer, chez les femmes présentant un cancer de l’endomètre qui subissent une chirurgie assistée par robot, la relation entre l’âge, l’IMC et les aspects physiques, fonctionnels et psychosociaux de la qualité de vie liée à la santé (QdVLS), y compris la satisfaction de la patiente. Méthodes : Au cours des deux premières années du programme de chirurgie robotisée, nous avons recueilli des données de façon prospective au sujet des caractéristiques démographiques des patientes et de leurs issues chirurgicales. Dans le cadre de la première consultation postopératoire (de 21 à 28 jours à la suite de la chirurgie), toutes les participantes ont rempli un questionnaire sur la QdVLS. Nous avons examiné l’association entre l’IMC, l’âge et les différents aspects de la QdVLS au moyen du test de chi carré et d’une analyse de variance. Résultats : Chez 109 participantes, 41 étaient âgées de 70 ans ou plus et 51 présentaient un IMC de 30 kg/m(2) ou plus. À la suite de la chirurgie, la durée moyenne (±σ) de l’hospitalisation était de 1,9 ±1,5 jour; de plus, le degré de douleur signalé atteignait son apogée au deuxième jour suivant l’opération (score moyen de 3,4 ± 2,1 sur une échelle de sept points). De surcroît, les deux tiers des femmes n’ont signalé aucune douleur au cours de la première consultation postopératoire et seulement 18,2 % des femmes âgées de 70 ans ou plus ont eu recours à des narcotiques (quels qu’ils soient) aux fins de la maîtrise de la douleur. Ces résultats ont indiqué que la chirurgie n’avait exercé que peu d’influence sur la QdVLS; les femmes reprenaient leurs activités habituelles dans un délai moyen de 11 jours à la suite de la chirurgie. Enfin, le score moyen accordé par les participantes en matière de satisfaction a été de 6,7 sur une échelle de sept points. Conclusion : Cette étude pilote a démontré les avantages, en matière de Qd

  2. Attitudinal Change in Elderly Citizens Toward Social Robots: The Role of Personality Traits and Beliefs About Robot Functionality.

    Science.gov (United States)

    Damholdt, Malene F; Nørskov, Marco; Yamazaki, Ryuji; Hakli, Raul; Hansen, Catharina Vesterager; Vestergaard, Christina; Seibt, Johanna

    2015-01-01

    Attitudes toward robots influence the tendency to accept or reject robotic devices. Thus it is important to investigate whether and how attitudes toward robots can change. In this pilot study we investigate attitudinal changes in elderly citizens toward a tele-operated robot in relation to three parameters: (i) the information provided about robot functionality, (ii) the number of encounters, (iii) personality type. Fourteen elderly residents at a rehabilitation center participated. Pre-encounter attitudes toward robots, anthropomorphic thinking, and personality were assessed. Thereafter the participants interacted with a tele-operated robot (Telenoid) during their lunch (c. 30 min.) for up to 3 days. Half of the participants were informed that the robot was tele-operated (IC) whilst the other half were naïve to its functioning (UC). Post-encounter assessments of attitudes toward robots and anthropomorphic thinking were undertaken to assess change. Attitudes toward robots were assessed with a new generic 35-items questionnaire (attitudes toward social robots scale: ASOR-5), offering a differentiated conceptualization of the conditions for social interaction. There was no significant difference between the IC and UC groups in attitude change toward robots though trends were observed. Personality was correlated with some tendencies for attitude changes; Extraversion correlated with positive attitude changes to intimate-personal relatedness with the robot (r = 0.619) and to psychological relatedness (r = 0.581) whilst Neuroticism correlated negatively (r = -0.582) with mental relatedness with the robot. The results tentatively suggest that neither information about functionality nor direct repeated encounters are pivotal in changing attitudes toward robots in elderly citizens. This may reflect a cognitive congruence bias where the robot is experienced in congruence with initial attitudes, or it may support action-based explanations of cognitive dissonance reductions

  3. Attitudinal change in elderly citizens towards social robots: the role of personality traits and beliefs about robot functionality.

    Directory of Open Access Journals (Sweden)

    Malene Flensborg Damholdt

    2015-11-01

    Full Text Available Attitudes towards robots influence the tendency to accept or reject robotic devices. Thus it is important to investigate whether and how attitudes towards robots can change. In this pilot study we investigate attitudinal changes in elderly citizens toward a tele-operated robot in relation to three parameters: (i the information provided about robot functionality, (ii the number of encounters, (iii personality type. Fourteen elderly residents at a rehabilitation centre participated. Pre-encounter attitudes towards robots, anthropomorphic thinking, and personality were assessed. Thereafter the participants interacted with a tele-operated robot (Telenoid during their lunch (c. 30 min. for up to three days. Half of the participants were informed that the robot was tele-operated (IC whilst the other half were naïve to its functioning (UC. Post-encounter assessments of attitudes towards robots and anthropomorphic thinking were undertaken to assess change. Attitudes towards robots were assessed with a new generic 35-item questionnaire (Attitudes towards social robots scale: ASOR-5, offering a differentiated conceptualization of the conditions for social interaction.There was no significant difference between the IC and UC groups in attitude change towards robots though trends were observed. Personality was correlated with some tendencies for attitude changes; Extraversion correlated with positive attitude changes to intimate-personal relatedness with the robot (r=.619 and to psychological relatedness (r=.581 whilst Neuroticism correlated negatively (r=-.582 with mental relatedness with the robot. The results tentatively suggest that neither information about functionality nor direct repeated encounters are pivotal in changing attitudes towards robots in elderly citizens. This may reflect a cognitive congruence bias where the robot is experienced in congruence with initial attitudes, or it may support action-based explanations of cognitive dissonance

  4. Hybrid gait training with an overground robot for people with incomplete spinal cord injury: a pilot study

    Directory of Open Access Journals (Sweden)

    Antonio J del-Ama

    2014-05-01

    Full Text Available Locomotor training has proved to provide beneficial effect in terms of mobility in incomplete paraplegic patients. Neuroprosthetic technology can contribute to increase the efficacy of a training paradigm in the promotion of a locomotor pattern. Robotic exoskeletons can be used to manage the unavoidable loss of performance of artificially-driven muscles. Hybrid exoskeletons blend complementary robotic and neuro-prosthetic technologies. The aim of this pilot study was to determine the effects of hybrid gait training in three case studies with persons with incomplete spinal cord injury in terms of locomotion performance during assisted gait, patient-robot adaptations, impact on ambulation and assessment of lower limb muscle strength and spasticity. Participants with incomplete Spinal Cord Injury (SCI received interventions with a hybrid bilateral exoskeleton for 4 days. Assessment of gait function revealed that patients improved the 6 minutes and 10 meters walking tests after the intervention, and further improvements were observed one week after the intervention. Muscle examination revealed improvements in knee and hip sagittal muscle balance scores and decreased score in ankle extensor balance. It is concluded that improvements in biomechanical function of the knee joint after the tested overground hybrid gait trainer are coherent with improvements in gait performance.

  5. Self-awareness rehabilitation after Traumatic Brain Injury: A pilot study to compare two group therapies.

    Science.gov (United States)

    Rigon, Jessica; Burro, Roberto; Guariglia, Cecilia; Maini, Manuela; Marin, Dario; Ciurli, Paola; Bivona, Umberto; Formisano, Rita

    2017-01-01

    Deficits of self-awareness (SA) are very common after severe acquired brain injury (sABI), especially in traumatic brain injury (TBI), playing an important role in the efficacy of the rehabilitation process. This pilot study provides information regarding two structured group therapies for disorders of SA. Nine patients with severe TBI were consecutively recruited and randomly assigned to one SA group therapy programme, according either to the model proposed by Ben-Yishay & Lakin (1989) (B&L Group), or by Sohlberg & Mateer (1989) (S&M Group). Neuropsychological tests and self-awareness questionnaires were administered before and after a 10 weeks group therapy. Results showed that both SA and neuropsychological functioning significantly improved in both groups. It is important to investigate and treat self-awareness, also to improve the outcome of neuropsychological disorders. The two group therapies proposed seem to be specific for impulsivity and emotional dyscontrol and for cognitive disorders.

  6. The New Jersey Institute of Technology Robot-Assisted Virtual Rehabilitation (NJIT-RAVR system for children with cerebral palsy: a feasibility study

    Directory of Open Access Journals (Sweden)

    Kelly Donna

    2009-11-01

    Full Text Available Abstract Background We hypothesize that the integration of virtual reality (VR with robot assisted rehabilitation could be successful if applied to children with hemiparetic CP. The combined benefits of increased attention provided by VR and the larger training stimulus afforded by adaptive robotics may increase the beneficial effects of these two approaches synergistically. This paper will describe the NJIT-RAVR system, which combines adaptive robotics with complex VR simulations for the rehabilitation of upper extremity impairments and function in children with CP and examine the feasibility of this system in the context of a two subject training study. Methods The NJIT-RAVR system consists of the Haptic Master, a 6 degrees of freedom, admittance controlled robot and a suite of rehabilitation simulations that provide adaptive algorithms for the Haptic Master, allowing the user to interact with rich virtual environments. Two children, a ten year old boy and a seven year old girl, both with spastic hemiplegia secondary to Cerebral Palsy were recruited from the outpatient center of a comprehensive pediatric rehabilitation facility. Subjects performed a battery of clinical testing and kinematic measurements of reaching collected by the NJIT-RAVR system. Subjects trained with the NJIT-RAVR System for one hour, 3 days a week for three weeks. The subjects played a combination of four or five simulations depending on their therapeutic goals, tolerances and preferences. Games were modified to increase difficulty in order to challenge the subjects as their performance improved. The testing battery was repeated following the training period. Results Both participants completed 9 hours of training in 3 weeks. No untoward events occurred and no adverse responses to treatment or complaints of cyber sickness were reported. One participant showed improvements in overall performance on the functional aspects of the testing battery. The second subject made

  7. The New Jersey Institute of Technology Robot-Assisted Virtual Rehabilitation (NJIT-RAVR) system for children with cerebral palsy: a feasibility study.

    Science.gov (United States)

    Qiu, Qinyin; Ramirez, Diego A; Saleh, Soha; Fluet, Gerard G; Parikh, Heta D; Kelly, Donna; Adamovich, Sergei V

    2009-11-16

    We hypothesize that the integration of virtual reality (VR) with robot assisted rehabilitation could be successful if applied to children with hemiparetic CP. The combined benefits of increased attention provided by VR and the larger training stimulus afforded by adaptive robotics may increase the beneficial effects of these two approaches synergistically. This paper will describe the NJIT-RAVR system, which combines adaptive robotics with complex VR simulations for the rehabilitation of upper extremity impairments and function in children with CP and examine the feasibility of this system in the context of a two subject training study. The NJIT-RAVR system consists of the Haptic Master, a 6 degrees of freedom, admittance controlled robot and a suite of rehabilitation simulations that provide adaptive algorithms for the Haptic Master, allowing the user to interact with rich virtual environments. Two children, a ten year old boy and a seven year old girl, both with spastic hemiplegia secondary to Cerebral Palsy were recruited from the outpatient center of a comprehensive pediatric rehabilitation facility. Subjects performed a battery of clinical testing and kinematic measurements of reaching collected by the NJIT-RAVR system. Subjects trained with the NJIT-RAVR System for one hour, 3 days a week for three weeks. The subjects played a combination of four or five simulations depending on their therapeutic goals, tolerances and preferences. Games were modified to increase difficulty in order to challenge the subjects as their performance improved. The testing battery was repeated following the training period. Both participants completed 9 hours of training in 3 weeks. No untoward events occurred and no adverse responses to treatment or complaints of cyber sickness were reported. One participant showed improvements in overall performance on the functional aspects of the testing battery. The second subject made improvements in upper extremity active range of motion and

  8. Validation of a mechanism to balance exercise difficulty in robot-assisted upper-extremity rehabilitation after stroke

    Directory of Open Access Journals (Sweden)

    Zimmerli Lukas

    2012-02-01

    Full Text Available Abstract Background The motivation of patients during robot-assisted rehabilitation after neurological disorders that lead to impairments of motor functions is of great importance. Due to the increasing number of patients, increasing medical costs and limited therapeutic resources, clinicians in the future may want patients to practice their movements at home or with reduced supervision during their stay in the clinic. Since people only engage in an activity and are motivated to practice if the outcome matches the effort at which they perform, an augmented feedback application for rehabilitation should take the cognitive and physical deficits of patients into account and incorporate a mechanism that is capable of balancing i.e. adjusting the difficulty of an exercise in an augmented feedback application to the patient's capabilities. Methods We propose a computational mechanism based on Fitts' Law that balances i.e. adjusts the difficulty of an exercise for upper-extremity rehabilitation. The proposed mechanism was implemented into an augmented feedback application consisting of three difficulty conditions (easy, balanced, hard. The task of the exercise was to reach random targets on the screen from a starting point within a specified time window. The available time was decreased with increasing condition difficulty. Ten subacute stroke patients were recruited to validate the mechanism through a study. Cognitive and motor functions of patients were assessed using the upper extremity section of the Fugl-Meyer Assessment, the modified Ashworth scale as well as the Addenbrookes cognitive examination-revised. Handedness of patients was obtained using the Edinburgh handedness inventory. Patients' performance during the execution of the exercises was measured twice, once for the paretic and once for the non-paretic arm. Results were compared using a two-way ANOVA. Post hoc analysis was performed using a Tukey HSD with a significance level of p Results

  9. The Feasibility and Validity of a Remote Pulse Oximetry System for Pulmonary Rehabilitation: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Jonathan Tang

    2012-01-01

    Full Text Available Pulmonary rehabilitation is an effective treatment for people with chronic obstructive pulmonary disease. However, access to these services is limited especially in rural and remote areas. Telerehabilitation has the potential to deliver pulmonary rehabilitation programs to these communities. The aim of this study was threefold: to establish the technical feasibility of transmitting real-time pulse oximetry data, determine the validity of remote measurements compared to conventional face-to-face measures, and evaluate the participants’ perception of the usability of the technology. Thirty-seven healthy individuals participated in a single remote pulmonary rehabilitation exercise session, conducted using the eHAB telerehabilitation system. Validity was assessed by comparing the participant's oxygen saturation and heart rate with the data set received at the therapist’s remote location. There was an 80% exact agreement between participant and therapist data sets. The mean absolute difference and Bland and Altman’s limits of agreement fell within the minimum clinically important difference for both oxygen saturation and heart rate values. Participants found the system easy to use and felt confident that they would be able to use it at home. Remote measurement of pulse oximetry data for a pulmonary rehabilitation exercise session was feasible and valid when compared to conventional face-to-face methods.

  10. Instilling positive beliefs about disabilities: pilot testing a novel experiential learning activity for rehabilitation students.

    Science.gov (United States)

    Silverman, Arielle M; Pitonyak, Jennifer S; Nelson, Ian K; Matsuda, Patricia N; Kartin, Deborah; Molton, Ivan R

    2017-02-25

    To develop and test a novel impairment simulation activity to teach beginning rehabilitation students how people adapt to physical impairments. Masters of Occupational Therapy students (n = 14) and Doctor of Physical Therapy students (n = 18) completed the study during the first month of their program. Students were randomized to the experimental or control learning activity. Experimental students learned to perform simple tasks while simulating paraplegia and hemiplegia. Control students viewed videos of others completing tasks with these impairments. Before and after the learning activities, all students estimated average self-perceived health, life satisfaction, and depression ratings among people with paraplegia and hemiplegia. Experimental students increased their estimates of self-perceived health, and decreased their estimates of depression rates, among people with paraplegia and hemiplegia after the learning activity. The control activity had no effect on these estimates. Impairment simulation can be an effective way to teach rehabilitation students about the adaptations that people make to physical impairments. Positive impairment simulations should allow students to experience success in completing activities of daily living with impairments. Impairment simulation is complementary to other pedagogical methods, such as simulated clinical encounters using standardized patients. Implication of Rehabilitation It is important for rehabilitation students to learn how people live well with disabilities. Impairment simulations can improve students' assessments of quality of life with disabilities. To be beneficial, impairment simulations must include guided exposure to effective methods for completing daily tasks with disabilities.

  11. Eclectic/mixed model method for upper extremity functional recovery in stroke rehabilitation: A pilot study.

    Science.gov (United States)

    Kumar, K Vijaya; Joshua, Abraham M; Kedambadi, Rakshith; Mithra, P Prasanna

    2017-01-01

    Eclectic treatment method is a flexible approach that uses techniques drawn from various schools of thought involving several treatment methods and allows the therapist to adapt to each client's individual needs. Wider application for eclectic approach is however limited in stroke rehabilitation. The objective is to find out whether eclectic approach improves upper extremity (UE) functional recovery in acute stroke rehabilitation. Twenty-five postacute unilateral supratentorial stroke subjects recruited from tertiary care hospitals recovered with Stage 2-5 in Brunnstorm stage of UE motor recovery (BRS-UE) underwent 45 min of eclectic approach for UE every day involving seven different treatment methods (5 min for each method) for 6 days consecutively. The outcome was UE subscale of the Fugl-Meyer Motor test (UE-FM), UE subscale of the Stroke Rehabilitation Assessment of Movement (UE-STREAM), Wolf Motor Function test (WMFT-FAS), and Stroke Impact Scale-16 (SIS-16) was collected at the end of the sixth session. All the participants showed significant improvement in all the outcome measures. The Stage 2 and 3 subjects showed UE-STREAM (P = 0.007) WMFT-FAS (P rehabilitation when the stroke occurs.

  12. 外骨骼康复机械手的结构设计及仿真分析%Design and Kinematical Analysis of Exoskeleton Rehabilitation Robot Hand

    Institute of Scientific and Technical Information of China (English)

    李超; 袁锐波; 丘世因; 刘永亮

    2016-01-01

    为解决中风患者传统康复训练效率低、成本高、不易在家中操作等问题,提出了外骨骼康复机械手的研究,首先建立了人手正逆运动学模型,然后以食指为例设计了外骨骼康复机械手结构,最后利用ADAMS 软件进行运功学仿真,从而验证了设计结果的正确性。为控制系统的设计和物理样机的制造提供了理论依据。%In this paper,the exoskeleton rehabilitation robot hand is studied in order to solve its prob-lems of low efficiency,high cost,difficult home use etc.in the traditional rehabilitation process.First, the kinematical model of the human hand is built;then the structure of exoskeleton rehabilitation robot hand is designed with the index finger as example;finally,the correctness of design results is verified by ADAMS kinematic analysis.This provides theoretical basis for control system design and physical proto-type manufacturing.

  13. Brief Report: A Pilot Summer Robotics Camp to Reduce Social Anxiety and Improve Social/Vocational Skills in Adolescents with ASD

    Science.gov (United States)

    Kaboski, Juhi R.; Diehl, Joshua John; Beriont, Jane; Crowell, Charles R.; Villano, Michael; Wier, Kristin; Tang, Karen

    2015-01-01

    This pilot study evaluated a novel intervention designed to reduce social anxiety and improve social/vocational skills for adolescents with autism spectrum disorder (ASD). The intervention utilized a shared interest in robotics among participants to facilitate natural social interaction between individuals with ASD and typically developing (TD)…

  14. Brief Report: A Pilot Summer Robotics Camp to Reduce Social Anxiety and Improve Social/Vocational Skills in Adolescents with ASD

    Science.gov (United States)

    Kaboski, Juhi R.; Diehl, Joshua John; Beriont, Jane; Crowell, Charles R.; Villano, Michael; Wier, Kristin; Tang, Karen

    2015-01-01

    This pilot study evaluated a novel intervention designed to reduce social anxiety and improve social/vocational skills for adolescents with autism spectrum disorder (ASD). The intervention utilized a shared interest in robotics among participants to facilitate natural social interaction between individuals with ASD and typically developing (TD)…

  15. Cognitive rehabilitation training in patients with brain tumor-related epilepsy and cognitive deficits: a pilot study.

    Science.gov (United States)

    Maschio, Marta; Dinapoli, Loredana; Fabi, Alessandra; Giannarelli, Diana; Cantelmi, Tonino

    2015-11-01

    The aim of this pilot observational study was to evaluate effect of cognitive rehabilitation training (RehabTr) on cognitive performances in patients with brain tumor-related epilepsy (BTRE) and cognitive disturbances. Medical inclusion criteria: patients (M/F) ≥ 18 years ≤ 75 with symptomatic seizures due to primary brain tumors or brain metastases in stable treatment with antiepileptic drugs; previous surgical resection or biopsy; >70 Karnofsky Performance Status; stable oncological disease. Eligible patients recruited from 100 consecutive patients with BTRE at first visit to our Center from 2011 to 2012. All recruited patients were administered battery of neuropsychological tests exploring various cognitive domains. Patients considered to have a neuropsychological deficit were those with at least one test score for a given domain indicative of impairment. Thirty patients out of 100 showed cognitive deficits, and were offered participation in RehabTr, of which 16 accepted (5 low grade glioma, 4 high grade glioma, 2 glioblastoma, 2 meningioma and 3 metastases) and 14 declined for various reasons. The RehabTr consisted of one weekly individual session of 1 h, for a total of 10 weeks, carried out by a trained psychologist. The functions trained were: memory, attention, visuo-spatial functions, language and reasoning by means of Training NeuroPsicologico (TNP(®)) software. To evaluate the effect of the RehabTr, the same battery of tests was administered directly after cognitive rehabilitation (T1), and at six-month follow-up (T2). Statistical analysis with Student T test for paired data showed that short-term verbal memory, episodic memory, fluency and long term visuo-spatial memory improved immediately after the T1 and remained stable at T2. At final follow-up all patients showed an improvement in at least one domain that had been lower than normal at baseline. Our results demonstrated a positive effect of rehabilitative training at different times, and, for

  16. Design of remote rehabilitation training robotic system for fingers%手指远程康复训练机器人系统设计

    Institute of Scientific and Technical Information of China (English)

    易荣武; 王爱民

    2016-01-01

    It has gained the attention of researchers both at home and abroad to use remote rehabilitation robotic technology for stroke patients’ rehabilitation treatment ,and that has become a hotspot in research of rehabilitation .For the need of medical rehabilitation for the stroke and hands injured patients , a one‐to‐many remote hand function rehabilitation training robotic system based on the typical model of C/S is designed .It allowed doctors to remote control the machine via AV and evaluate according to the training parameters , thus make more scientific and reasonable rehabilitation training plan to help the stroke patients or hand disabled persons at home or community hospital .It has been proved that the system has a promoting effect on hand function recovery , and it can assist doctors in the rehabilitation training .%将远程康复机器人技术运用到脑卒中患者的康复治疗中,已经得到国内外研究人员的重视,并且已经成为康复领域研究的热点。针对手指受伤或脑卒中患者手指康复医疗的迫切需要,设计了一套基于典型的客户端/服务器(C/S)模式的手指远程康复训练机器人系统,使得医生可以通过音视频远程监控康复训练机构,并根据训练参数做出评估,从而制定出更加科学合理的康复训练计划,有助于在家中或社区医院的脑卒中病人或手指伤残人员的康复训练。临床实践证明,该康复训练系统对偏瘫患者手指功能的康复有促进作用,能够辅助医生对病人进行有效的康复医疗训练。

  17. Development of a Wearable and Portable Rehabilitation Exoskeleton Robot%可穿戴便携式康复外骨骼机器人的开发

    Institute of Scientific and Technical Information of China (English)

    叶雯珺; 李智军

    2013-01-01

    Robot-assisted rehabilitation which promises to redefine clinical strategies has drawn more and more attention for stroke therapy recently. Compared with classic rehabilitation limited to subjective observation of therapists on patients, the treatment by robotic devices can be more precise to improve the rehabilitation effects. In this paper, a wearable and portable rehabilitation robot with upper limbs of 5 degrees of freedom (DOFs) and upper limbs of 4 DOFs was introduced. The surface electromyographic (sEMG) signals were used to drive all the DOFs of both limbs to aid the training of prosthetic limbs. All data during the rehabilitation, including the sEMG signals and joint motions, can be collected for the purposes of both online analysis and offline storage.%  近年来,康复机器人辅助中风病人的康复治疗吸引了越来越多的关注。相对于传统的由康复师进行的中风治疗,康复机器人进行的治疗更为精确,且不受康复师主观因素的影响,能够显著提高康复治疗的效果。本文介绍了一个拥有5自由度上肢与4自由度下肢的可穿戴便携式康复外骨骼机器人。机器人的所有自由度都由患者的肌电信号驱动,帮助患者进行失能肢体的康复训练。该机器人可穿戴和便携的特性为患者行走功能的康复提供了新的手段。康复过程中,患者的所有康复运动数据(包括患者的表面肌电信号数据和每个关节的运动数据)都可以被采集,便于在线分析和离线记录。

  18. Social Interaction Test between a Rat and a Robot: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Rusalky del Angel Ortiz

    2016-01-01

    Full Text Available The social interaction test is based on spontaneous behaviour observed between pairs of animals, usually rodents. Commonly, the behaviour of one of the members in the dyad is related to the behaviour of its partner; therefore, making accurate predictions about behaviour is difficult, and the behaviour of the dyad cannot be controlled. In the present study, we programmed an e-puck robot with simple behavioural patterns, such as moving around a cage and following and approaching a rat. The results were analysed by comparing behaviour that was displayed by two groups of experimental rats towards different types of partners: (i in the first group of experimental rats, they interacted with another group of rats and (ii in the second group of experimental rats, they interacted with the e-puck robot. Our aim was to study the behaviour of experimental rats in the social interaction test when the interaction partner is a pre-programmed robot, in order to find out whether a rat is able to display social interaction activities in that context. Those activities were evaluated by a structured scheme of possible behaviours, quantified in categories according to currently well-accepted nomenclature and definitions. In order to achieve this goal, we compared the social and nonsocial behaviour displayed by the experimental rat in rat-rat and rat-robot interactions (such as approaching and following behaviour. We observed predominantly nonsocial behaviours, such as exploring the cage, when the experimental rats confronted either another rat or the robot. The experimental rats displayed similar periods of approaching, sniffing and crawling (social behaviour, exploring, being quiet, self-grooming and evading (nonsocial behaviour in encountering both the rat and the robot. However, in the presence of the robot, the experimental rats displayed long periods of time spent in following, in contrast to short periods of immobility. In the present study, we explored a

  19. A pilot study of surgical training using a virtual robotic surgery simulator.

    Science.gov (United States)

    Tergas, Ana I; Sheth, Sangini B; Green, Isabel C; Giuntoli, Robert L; Winder, Abigail D; Fader, Amanda N

    2013-01-01

    Our objectives were to compare the utility of learning a suturing task on the virtual reality da Vinci Skills Simulator versus the da Vinci Surgical System dry laboratory platform and to assess user satisfaction among novice robotic surgeons. Medical trainees were enrolled prospectively; one group trained on the virtual reality simulator, and the other group trained on the da Vinci dry laboratory platform. Trainees received pretesting and post-testing on the dry laboratory platform. Participants then completed an anonymous online user experience and satisfaction survey. We enrolled 20 participants. Mean pretest completion times did not significantly differ between the 2 groups. Training with either platform was associated with a similar decrease in mean time to completion (simulator platform group, 64.9 seconds [P = .04]; dry laboratory platform group, 63.9 seconds [P virtual reality platform. The majority found the training "definitely useful" in improving robotic surgical skills (mean, 4.6) and would attend future training sessions (mean, 4.5). Training on the virtual reality robotic simulator or the dry laboratory robotic surgery platform resulted in significant improvements in time to completion and economy of motion for novice robotic surgeons. Although there was a perception that both simulators improved performance, there was a preference for the virtual reality simulator. Benefits unique to the simulator platform include autonomy of use, computerized performance feedback, and ease of setup. These features may facilitate more efficient and sophisticated simulation training above that of the conventional dry laboratory platform, without loss of efficacy.

  20. Exploring the effect of companion robots on emotional expression in older adults with dementia: a pilot randomized controlled trial.

    Science.gov (United States)

    Moyle, Wendy; Cooke, Marie; Beattie, Elizabeth; Jones, Cindy; Klein, Barbara; Cook, Glenda; Gray, Chrystal

    2013-05-01

    This pilot study aimed to compare the effect of companion robots (PARO) to participation in an interactive reading group on emotions in people living with moderate to severe dementia in a residential care setting. A randomized crossover design, with PARO and reading control groups, was used. Eighteen residents with mid- to late-stage dementia from one aged care facility in Queensland, Australia, were recruited. Participants were assessed three times using the Quality of Life in Alzheimer's Disease, Rating Anxiety in Dementia, Apathy Evaluation, Geriatric Depression, and Revised Algase Wandering Scales. PARO had a moderate to large positive influence on participants' quality of life compared to the reading group. The PARO intervention group had higher pleasure scores when compared to the reading group. Findings suggest PARO may be useful as a treatment option for people with dementia; however, the need for a larger trial was identified.

  1. [Masturbation device (EGG) as a new penile rehabilitation tool: a pilot study].

    Science.gov (United States)

    Sato, Yoshikazu; Tanda, Hitoshi; Nakajima, Hisao; Nitta, Toshikazu; Akagashi, Keigo; Hanzawa, Tatsuo; Tobe, Musashi; Haga, Kazunori; Uchida, Kosuke; Honma, Ichiya

    2013-05-01

    Erectile dysfunction following radical prostatectomy (RP) is still a significant burden as a post-operative morbidity, despite advances in nerve-sparing techniques and penile (erectile function) rehabilitation (PR) programs. We assessed the effects of stimulation with the masturbation device "EGG" on enhancement of erectile response along with administration of phospho diesterase type 5 inhibitor. We also studied the change of self-esteem and motivation for continuation of PR after stimulation with EGG. Eight nonresponders for PDE5-I who underwent retropubic RP were enrolled. Patients' median age was 71.5 years old. No patients received adjuvant therapy for prostate cancer. The patients' erectile response in the penile rehabilitation session (masturbation) with PDE5-I+manual stimulation and PDE5-I+stimulation with EGG were evaluated by erection hardness score (EHS). Changes of self-esteem and motivation for penile rehabilitation were assessed by the self-esteem subscale of the Self-Esteem and Relationship (SEAR) questionnaire and one original question, respectively. PDE5-I + stimulation with EGG significantly enhanced EHS compared to PDE5-I+manual stimulation in the eight patients (p=0.027). Transformed score of self-esteem subscale score of SEAR questionnaire was significantly increased in the PR session with EGG compared to the PR session with manual stimulation (p=0.043). Six patients who showed a better erectile response with EGG retained motivation for continuation of PR. PDE5-I+stimulation with EGG improved the erectile response in post-RP patients. EGG as a masturbation device may have a potential for contribution to successful PR.

  2. Modular Ankle Robotics Training in Early Sub-Acute Stroke: A Randomized Controlled Pilot Study

    Science.gov (United States)

    Forrester, Larry W.; Roy, Anindo; Krywonis, Amanda; Kehs, Glenn; Krebs, Hermano Igo; Macko, Richard F.

    2014-01-01

    Background Modular lower extremity (LE) robotics may offer a valuable avenue for restoring neuromotor control after hemiparetic stroke. Prior studies show that visually-guided and visually-evoked practice with an ankle robot (anklebot) improves paretic ankle motor control that translates into improved overground walking. Objective Assess the feasibility and efficacy of daily anklebot training during early sub-acute hospitalization post-stroke. Methods Thirty-four inpatients from a stroke unit were randomly assigned to anklebot (N=18) or passive manual stretching (N=16) treatments. All suffered a first stroke with residual hemiparesis (ankle manual muscle test grade 1/5 to 4/5), and at least trace muscle activation in plantar- or dorsiflexion. Anklebot training employed an “assist-as-needed” approach during > 200 volitional targeted paretic ankle movements, with difficulty adjusted to active range of motion and success rate. Stretching included >200 daily mobilizations in these same ranges. All sessions lasted 1 hour and assessments were not blinded. Results Both groups walked faster at discharge, however the robot group improved more in percent change of temporal symmetry (p=0.032) and also of step length symmetry (p=0.038), with longer nonparetic step lengths in the robot (133%) vs. stretching (31%) groups. Paretic ankle control improved in the robot group, with increased peak (p≤ 0.001) and mean (p≤ 0.01) angular speeds, and increased movement smoothness (p≤ 0.01). There were no adverse events. Conclusion Though limited by small sample size and restricted entry criteria, our findings suggest that modular lower extremity robotics during early sub-acute hospitalization is well tolerated and improves ankle motor control and gait patterning. PMID:24515923

  3. Modular ankle robotics training in early subacute stroke: a randomized controlled pilot study.

    Science.gov (United States)

    Forrester, Larry W; Roy, Anindo; Krywonis, Amanda; Kehs, Glenn; Krebs, Hermano Igo; Macko, Richard F

    2014-09-01

    BACKGROUND. Modular lower extremity robotics may offer a valuable avenue for restoring neuromotor control after hemiparetic stroke. Prior studies show that visually guided and visually evoked practice with an ankle robot (anklebot) improves paretic ankle motor control that translates into improved overground walking. To assess the feasibility and efficacy of daily anklebot training during early subacute hospitalization poststroke. Thirty-four inpatients from a stroke unit were randomly assigned to anklebot (n = 18) or passive manual stretching (n = 16) treatments. All suffered a first stroke with residual hemiparesis (ankle manual muscle test grade 1/5 to 4/5), and at least trace muscle activation in plantar- or dorsiflexion. Anklebot training employed an "assist-as-needed" approach during >200 volitional targeted paretic ankle movements, with difficulty adjusted to active range of motion and success rate. Stretching included >200 daily mobilizations in these same ranges. All sessions lasted 1 hour and assessments were not blinded. Both groups walked faster at discharge; however, the robot group improved more in percentage change of temporal symmetry (P = .032) and also of step length symmetry (P = .038), with longer nonparetic step lengths in the robot (133%) versus stretching (31%) groups. Paretic ankle control improved in the robot group, with increased peak (P ≤ .001) and mean (P ≤ .01) angular speeds, and increased movement smoothness (P ≤ .01). There were no adverse events. Though limited by small sample size and restricted entry criteria, our findings suggest that modular lower extremity robotics during early subacute hospitalization is well tolerated and improves ankle motor control and gait patterning. © The Author(s) 2014.

  4. Design of a Rehabilitation Robot for Human Lower Limb Training%人体下肢运动康复训练机器人的设计

    Institute of Scientific and Technical Information of China (English)

    张立娟; 姜世公; 崔登祺; 吕蕴琦; 刘羽白; 高学山; 赵军; 张通

    2015-01-01

    According to the demand of rehabilitation training for the elderly or hemiplegia patients and the lack of intelligent training rehabilitation equipment, after analyzing the gait of patients, a new intelligent rehabilitation robot for the human lower limb movement is designed. This control system took the main chip as core, and integrate several tension sensors, CAN bus, and servo motor, etc. Through the human-computer interaction system, help the old man or hemiplegia patients automatically go forward, turn around, and prevent speeding, falling and other functions in real time. The kinematics analysis was carried out on the studied system, and the law of motion was described in details, and then, the rehabilitation robot prototype was tested. The experiment results indicated that the system has simple operation, high reliability and strong practicability. At the same time of helping patients with early rehabilitation, it also has an important significance for the development of rehabilitation equipment.%针对当今社会老人以及偏瘫患者的康复训练需求和智能化训练康复设备的不足,分析了偏瘫患者的步态,设计了一种辅助患者行走及康复的下肢康复训练机器人.控制系统以主芯片为核心,集成了多个传感器、CAN总线和伺服电机等,通过人机交互系统能实时地实现自动向前、左右转弯、防超速、防摔倒等功能,通过对移动系统进行运动学分析,获得了运动规律,并进行康复训练机器人样机实验.实验结果表明:该系统操作简单,可靠性高、实用性强,在帮助患者快速康复的同时,也可为康复设备的开发起到指导意义.

  5. Effectiveness of training community-based rehabilitation workers on multiple disabilities: A pilot study

    Directory of Open Access Journals (Sweden)

    Vijay Samuel V Raj

    2015-01-01

    Full Text Available Context: Community-based rehabilitation (CBR as a developmental strategy addresses the needs of people with disabilities and their family. CBR personals at remote rural play an important role in early detection and prevention of disabilities. The identification with proper guidance can help to overcome the scarcity in early detection. An effective training for rehabilitation workers should contain training program emphasis on multiple disabilities. Aims: The aim of this study was to assess the effectiveness of training CBR personal with relation to knowledge on multiple disabilities. Settings and Design: An experimental design of 12 month's intervention confined to Chamarajanagar district. Subjects and Methods: A total of 20 subjects of trained CBR personals with the age group of 20–45 years were included in this study. The initial baseline evaluation was performed with a pretest questionnaire to assess their knowledge. The training with practical exposure on multiple disabilities was carried out at an interval of 3 months. The posttest at 12 months was analyzed. Statistical Analysis Used: SPSS version 16 for Windows was used for analysis. The results were statistically analyzed using paired test, Chi-square test, and ANOVA for between and within the groups. Results: The results showed significance on effectiveness of training. There was an improvement in outcome measures reflecting on identification and management of disabilities. Conclusions: The knowledge regarding early identification of disabilities plays an important role. Implementation of training methods on a regular interval and as a part in continuing education plays an important source for better outcome.

  6. Rehabilitation of stroke patients using Yamamoto New Scalp Acupuncture: a pilot study.

    Science.gov (United States)

    Hegyi, Gabriella; Szigeti, Gyula P

    2012-10-01

    The aim of this study was to investigate whether acupuncture, especially Yamamoto's New Scalp Acupuncture (YNSA), is of value in additional to standard poststroke motor rehabilitation. A prospective, assessor-blinded randomized control trial was carried out in an inpatient stroke rehabilitation unit with day hospital service. After inclusion, patients were stratified into control group and acupuncture group, randomly. The Barthel Index, the Rivermead Scale Index, and the Visual Analogue Scale were used to follow the efficacy of treatment. In the acupuncture group, all the sensory, motor, and functional scores improved significantly during the examination period until 2 years after injury. The Barthel Index is increased from 4±2 to 95±4 in the acupuncture group. This index also increased in the control group (from 4±2 to 75±4), but the changes were significantly less than in the acupuncture group. A significant spontaneous recovery during the 2-year follow-up was found, but the YNSA treatment facilitated the functional recovery. Improved moving function and more flexible joints and ligaments were observed in comparison to the patients' condition prior to treatment. The data suggest that the YNSA is a useful method to treat stroke patients and enhance their quality of life.

  7. A pilot study of rhythm and timing training as a supplement to occupational therapy in stroke rehabilitation.

    Science.gov (United States)

    Hill, Valerie; Dunn, Leah; Dunning, Kari; Page, Stephen J

    2011-01-01

    Stroke is the leading cause of disability. A need exists for an effective intervention to enhance upper extremity (UE) motor abilities and activities of daily living (ADL) performance. The objectives of this pilot study were to (1) determine the feasibility of adding Interactive Metronome (IM) to an occupational therapy (OT) program; and (2) determine changes in UE impairments, function, quality of life, and perceived physical performance ability and satisfaction using a combined IM + OT regimen compared with OT alone for adults with chronic stroke. This pilot study (n=10) used a 2-group (OT or IM+OT) pretest-posttest design. The intervention involved 60 minutes of IM + OT or OT alone, 3 days a week for 10 weeks. Outcome measures included the UE Fugl-Meyer (impairment), the Arm Motor Ability Test (function), the Box and Block Test (function), Stroke Impact Scale (quality of life), and the Canadian Occupational Performance Measure (perceived performance ability and satisfaction). It was feasible to add IM to OT. The IM+OT group demonstrated decreased impairment and increased quality of life. However, the OT-alone group demonstrated greater gains in function, perceived physical performance ability, and satisfaction. These findings suggest that rhythm and timing training using the IM is a feasible intervention to consider as part of therapy treatment. However, IM may fit best for prefunctional treatment, as it seemed to primarily decrease impairment. It may also serve as a supplement before or after treatment in order to maximize rehabilitation potential. Clinical implications and suggestions for future studies are provided.

  8. A proof of concept study investigating the feasibility of combining iPAM robot assisted rehabilitation with functional electrical stimulation to deliver whole arm exercise in stroke survivors.

    Science.gov (United States)

    O'Connor, Rory J; Jackson, Andrew; Makower, Sophie G; Cozens, Alastair; Levesley, Martin

    2014-01-01

    Rehabilitation robots can provide exercise for stroke survivors with weakness at the shoulder and elbow, but most do not facilitate hand movements. The aim was to combine robotics and functional electrical stimulation to facilitate exercise in stroke survivors with upper limb impairment. iPAM Mk II was used to assist active reaching in combination with an Odstock Pace stimulator to assist hand opening. The ABILHAND, Action Research Arm Test (ARAT) and the Stroke Impact Scale (SIS) were recorded at baseline and completion. Nine participants (eight males and one female; mean age = 58 years) were recruited; mean time since stroke was 16 months (range = 6-64). The ABILHAND at baseline was -2.73, improving to -1.45 at follow-up (p = 0.038). The ARAT changed from 4.1 to 2.6 (p = 0.180), and the SIS from 49 to 60 (p = 0.019). This study demonstrates that it is possible to combine two technologies in stroke rehabilitation.

  9. Pilot Study of Person Robot Interaction in a Public Transit Space

    DEFF Research Database (Denmark)

    Svenstrup, Mikael; Bak, Thomas; Maler, Ouri

    2009-01-01

    This paper describes a study of the effect of a human interactive robot placed in an urban transit space. The underlying hypothesis is that it is possible to create interesting new living spaces and induce value in terms of experiences, information or economics, by putting socially interactive...

  10. Pilot study of a cell phone-based exercise persistence intervention post-rehabilitation for COPD

    Directory of Open Access Journals (Sweden)

    Huong Q Nguyen

    2009-08-01

    Full Text Available Huong Q Nguyen1, Dawn P Gill1, Seth Wolpin1, Bonnie G Steele2, Joshua O Benditt11University of Washington, seattle, WA, USA; 2VA Puget Sound Health Care System, Seattle, WA, USAObjective: To determine the feasibility and efficacy of a six-month, cell phone-based exercise persistence intervention for patients with chronic obstructive pulmonary disease (COPD following pulmonary rehabilitation.Methods: Participants who completed a two-week run-in were randomly assigned to either MOBILE-Coached (n = 9 or MOBILE-Self-Monitored (n = 8. All participants met with a nurse to develop an individualized exercise plan, were issued a pedometer and exercise booklet, and instructed to continue to log their daily exercise and symptoms. MOBILE-Coached also received weekly reinforcement text messages on their cell phones; reports of worsening symptoms were automatically flagged for follow-up. Usability and satisfaction were assessed. Participants completed incremental cycle and six minute walk (6MW tests, wore an activity monitor for 14 days, and reported their health-related quality of life (HRQL at baseline, three, and six months.Results: The sample had a mean age of 68 ± 11 and forced expiratory volume in one second (FEV1 of 40 ± 18% predicted. Participants reported that logging their exercise and symptoms was easy and that keeping track of their exercise helped them remain active. There were no differences between groups over time in maximal workload, 6MW distance, or HRQL (p > 0.05; however, MOBILE-Self-Monitored increased total steps/day whereas MOBILE-Coached logged fewer steps over six months (p = 0.04.Conclusions: We showed that it is feasible to deliver a cell phone-based exercise persistence intervention to patients with COPD post-rehabilitation and that the addition of coaching appeared to be no better than self-monitoring. The latter finding needs to be interpreted with caution since this was a purely exploratory study.Trial registration: Clinical

  11. A controlled pilot trial of two commercial video games for rehabilitation of arm function after stroke.

    Science.gov (United States)

    Chen, Mei-Hsiang; Huang, Lan-Ling; Lee, Chang-Franw; Hsieh, Ching-Lin; Lin, Yu-Chao; Liu, Hsiuchih; Chen, Ming-I; Lu, Wen-Shian

    2015-07-01

    To investigate the acceptability and potential efficacy of two commercial video games for improving upper extremity function after stroke in order to inform future sample size and study design. A controlled clinical trial design using sequential allocation into groups. A clinical occupational therapy department. Twenty-four first-stroke patients. Patients were assigned to one of three groups: conventional group, Wii group, and XaviX group. In addition to regular one-hour conventional rehabilitation, each group received an additional half-hour of upper extremity exercises via conventional devices, Wii games, or XaviX games, for eight weeks. The Fugl-Meyer Assessment of motor function, Box and Block Test of Manual Dexterity, Functional Independence Measure, and upper extremity range of motion were used at baseline and postintervention. Also, a questionnaire was used to assess motivation and enjoyment. The effect size of differences in change scores between the Wii and conventional groups ranged from 0.71 (SD 0.59) to 0.28 (SD 0.58), on the Fugl-Meyer Assessment of motor function (d = 0.74) was larger than that between the XaviX and conventional groups, ranged from 0.44 (SD 0.49) to 0.28 (SD 0.58) (d = 0.30). Patient enjoyment was significantly greater in the video game groups (Wii mean 4.25, SD 0.89; XaviX mean 4.38, SD 0.52) than in the conventional group (mean 2.25, SD 0.89, F = 18.55, p rehabilitation. A sample size of 72 patients (24 per group) would be appropriate for a full study. © The Author(s) 2014.

  12. Robotics

    Science.gov (United States)

    Rothschild, Lynn J.

    2012-01-01

    Earth's upper atmosphere is an extreme environment: dry, cold, and irradiated. It is unknown whether our aerobiosphere is limited to the transport of life, or there exist organisms that grow and reproduce while airborne (aerophiles); the microenvironments of suspended particles may harbor life at otherwise uninhabited altitudes[2]. The existence of aerophiles would significantly expand the range of planets considered candidates for life by, for example, including the cooler clouds of a hot Venus-like planet. The X project is an effort to engineer a robotic exploration and biosampling payload for a comprehensive survey of Earth's aerobiology. While many one-shot samples have been retrieved from above 15 km, their results are primarily qualitative; variations in method confound comparisons, leaving such major gaps in our knowledge of aerobiology as quantification of populations at different strata and relative species counts[1]. These challenges and X's preliminary solutions are explicated below. X's primary balloon payload is undergoing a series of calibrations before beginning flights in Spring 2012. A suborbital launch is currently planned for Summer 2012. A series of ground samples taken in Winter 2011 is being used to establish baseline counts and identify likely background contaminants.

  13. Summary of rehabilitation robot for upper limbs and evaluation methods for stroke patients%脑卒中患者上肢康复机器人及评价方法综述

    Institute of Scientific and Technical Information of China (English)

    王丽; 张秀峰; 马岩; 杨荣

    2015-01-01

    The application of robotic technology for upper limb rehabilitation training is an important means for treatment of stroke patients� The paper analyzes the theoretical basis of robot⁃assisted rehabilitation training based on the central nervous system with high plasticity� According to the significance and social needs of rehabilitation robot, the paper summarizes five kinds of rehabilitation robot for upper limbs ’ research progress and achievements, including rehabilitation robot for upper limbs, rehabilitation robot for upper limbs integrating FES, rehabilitation robot for upper limbs based on virtual reality technology, rehabilitation robot for upper limbs based on sEMG and rehabilitation robot for upper limbs based on BCI� In order to improve the function of the rehabilitation robot and realize the quantitative assessment of the upper limb movement in patients with stroke, this article also analyzes several kinds of clinical evaluation methods commonly used� They are Brunnstrom evaluation method, Fugl⁃Meyer evaluation method, Ueda, Bin evaluation method and Bobath evaluation method� Finally, the development trend of rehabilitation robot for upper limbs in mechanical design, control strategy and evaluation methods are analyzed.%利用机器人技术进行上肢康复训练是脑卒中患者进行康复治疗的重要手段之一。本文根据中枢神经系统具有高度的可塑性,分析了机器人辅助康复训练的理论依据。并且依据康复机器人的社会需求和研究意义,归纳总结了5种上肢康复机器人的研究进展和研究成果,其中包括上肢康复机器人、功能性电刺激辅助上肢康复机器人、基于虚拟现实技术的上肢康复机器人、基于sEMG的上肢康复训练机器人、基于BCI上肢康复训练机器人。为完善康复机器人的功能,实现对脑卒中患者上肢运动功能的量化评估,本文还分析了目前临床上常用的几种评价

  14. Interprofessional education: a pilot study of rehabilitation sciences students participating in interdisciplinary international service-learning.

    Science.gov (United States)

    Pechak, Celia; Gonzalez, Eugenia; Summers, Connie; Capshaw, Stephanie

    2013-01-01

    Various models of interprofessional education, including service-learning, are used to teach students how to be effective members of healthcare teams. The purpose of this study was to examine pilot data related to the impact of an elective one-credit global health course with an international service-learning experience (ISL) on the student participants. An interdisciplinary team of 3 faculty accompanied 4 students representing occupational therapy, physical therapy, and speech-language pathology programs for an 8-day ISL experience. Students responded to faculty-developed reflection questions pre-travel, during travel, and 2-weeks and 4-months post travel. Content analysis was used to analyze themes that emerged from the students' written reflections. Three major themes emerged: collaboration, satisfaction, and self-discovery. The most prominent theme was related to interprofessional collaboration.

  15. Outcomes from a pilot study using computer-based rehabilitative tools in a military population.

    Science.gov (United States)

    Sullivan, Katherine W; Quinn, Julia E; Pramuka, Michael; Sharkey, Laura A; French, Louis M

    2012-01-01

    Novel therapeutic approaches and outcome data are needed for cognitive rehabilitation for patients with a traumatic brain injury; computer-based programs may play a critical role in filling existing knowledge gaps. Brain-fitness computer programs can complement existing therapies, maximize neuroplasticity, provide treatment beyond the clinic, and deliver objective efficacy data. However, these approaches have not been extensively studied in the military and traumatic brain injury population. Walter Reed National Military Medical Center established its Brain Fitness Center (BFC) in 2008 as an adjunct to traditional cognitive therapies for wounded warriors. The BFC offers commercially available "brain-training" products for military Service Members to use in a supportive, structured environment. Over 250 Service Members have utilized this therapeutic intervention. Each patient receives subjective assessments pre and post BFC participation including the Mayo-Portland Adaptability Inventory-4 (MPAI-4), the Neurobehavioral Symptom Inventory (NBSI), and the Satisfaction with Life Scale (SWLS). A review of the first 29 BFC participants, who finished initial and repeat measures, was completed to determine the effectiveness of the BFC program. Two of the three questionnaires of self-reported symptom change completed before and after participation in the BFC revealed a statistically significant reduction in symptom severity based on MPAI and NBSI total scores (p < .05). There were no significant differences in the SWLS score. Despite the typical limitations of a retrospective chart review, such as variation in treatment procedures, preliminary results reveal a trend towards improved self-reported cognitive and functional symptoms.

  16. An EMG-driven exoskeleton hand robotic training device on chronic stroke subjects: task training system for stroke rehabilitation.

    Science.gov (United States)

    Ho, N S K; Tong, K Y; Hu, X L; Fung, K L; Wei, X J; Rong, W; Susanto, E A

    2011-01-01

    An exoskeleton hand robotic training device is specially designed for persons after stroke to provide training on their impaired hand by using an exoskeleton robotic hand which is actively driven by their own muscle signals. It detects the stroke person's intention using his/her surface electromyography (EMG) signals from the hemiplegic side and assists in hand opening or hand closing functional tasks. The robotic system is made up of an embedded controller and a robotic hand module which can be adjusted to fit for different finger length. Eight chronic stroke subjects had been recruited to evaluate the effects of this device. The preliminary results showed significant improvement in hand functions (ARAT) and upper limb functions (FMA) after 20 sessions of robot-assisted hand functions task training. With the use of this light and portable robotic device, stroke patients can now practice more easily for the opening and closing of their hands at their own will, and handle functional daily living tasks at ease. A video is included together with this paper to give a demonstration of the hand robotic system on chronic stroke subjects and it will be presented in the conference.

  17. Active Theater as a Complementary Therapy for Parkinson's Disease Rehabilitation: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Nicola Modugno

    2010-01-01

    Full Text Available Most medical treatments of Parkinson's disease (PD are aimed at the reduction of motor symptoms. However, even when motor improvements are evident, patients often report a deterioration of their daily lives. Thus, to achieve a global improvement in personal well-being, not only drugs, but also complementary therapies, such as physical exercise, occupational and speech therapy, and active music therapy, have been used. We hypothesized that theater could reduce clinical disability and improve the quality of life of PD patients (primary end points more efficiently than other complementary therapies because (1 in order to impersonate a character, patients are forced to regain the control of their bodies; and (2 while being part of a group, patients have a high degree of social interaction. The need to regain the control of their bodies and their social functioning is very likely to deeply motivate patients. To assess this hypothesis, we ran a randomized, controlled, and single-blinded study that lasted 3 years, on 20 subjects affected by a moderate form of idiopathic PD, in stable treatment with L-dopa and L-dopa agonists, and without severe sensory deficits. Ten patients were randomly assigned to an active theater program (in which patients were required to participate, while the others underwent physiotherapy (control group, the most common nonpharmacological treatment for PD rehabilitation. Patients of both groups were evaluated at the beginning of each year, using five clinical rating scales (Unified ParkinsonParkinson'ss Disease Rating Scale [UPDRS], Schwab and England Scale, ParkinsonParkinson'ss Disease Quality of Life [PDQ39] Scale, Epworth Sleepiness Scale, and Hamilton Depression Rating Scale. The theater patients showed progressive improvements and, at the end of the third year, they showed significant improvements in all clinical scales. Conversely, the control patients did not exhibit significant ameliorations with time. Thus, the

  18. Active theater as a complementary therapy for Parkinson's disease rehabilitation: a pilot study.

    Science.gov (United States)

    Modugno, Nicola; Iaconelli, Sara; Fiorlli, Mariagrazia; Lena, Francesco; Kusch, Imogen; Mirabella, Giovanni

    2010-11-16

    Most medical treatments of Parkinson's disease (PD) are aimed at the reduction of motor symptoms. However, even when motor improvements are evident, patients often report a deterioration of their daily lives. Thus, to achieve a global improvement in personal well-being, not only drugs, but also complementary therapies, such as physical exercise, occupational and speech therapy, and active music therapy, have been used. We hypothesized that theater could reduce clinical disability and improve the quality of life of PD patients (primary end points) more efficiently than other complementary therapies because (1) in order to impersonate a character, patients are forced to regain the control of their bodies; and (2) while being part of a group, patients have a high degree of social interaction. The need to regain the control of their bodies and their social functioning is very likely to deeply motivate patients. To assess this hypothesis, we ran a randomized, controlled, and single-blinded study that lasted 3 years, on 20 subjects affected by a moderate form of idiopathic PD, in stable treatment with L-dopa and L-dopa agonists, and without severe sensory deficits. Ten patients were randomly assigned to an active theater program (in which patients were required to participate), while the others underwent physiotherapy (control group), the most common nonpharmacological treatment for PD rehabilitation. Patients of both groups were evaluated at the beginning of each year, using five clinical rating scales (Unified Parkinson's Disease Rating Scale [UPDRS], Schwab and England Scale, Parkinson's Disease Quality of Life [PDQ39] Scale, Epworth Sleepiness Scale, and Hamilton Depression Rating Scale). The theater patients showed progressive improvements and, at the end of the third year, they showed significant improvements in all clinical scales. Conversely, the control patients did not exhibit significant ameliorations with time. Thus, the present study provides the first

  19. NEUROLOGIC MUSIC THERAPY TRAINING FOR MOBILITY AND STABILITY REHABILITATION WITH PARKINSON’S DISEASE – A PILOT STUDY.

    Directory of Open Access Journals (Sweden)

    Anna A. Bukowska

    2016-01-01

    Full Text Available Idiopathic Parkinson’s Disease (PD is a progressive condition with gait disturbance and balance disorder as the main symptoms. Previous research studies focused on the application of Rhythmic Auditory Stimulation (RAS in PD gait rehabilitation. The key hypothesis of this pilot study, however, assumes the major role of the combination of all three Neurologic Music Therapy (NMT sensorimotor techniques in improving spatio-temporal gait parameters, and postural stability in the course of PD. The 55 PD-diagnosed subjects invited to the study were divided into two groups: 30 in the experimental and 25 in the control group. Inclusion criteria included Hoehn & Yahr stage 2 or 3, the ability to walk independently without any aid and stable pharmacological treatment for the duration of the experiment. In order to evaluate the efficacy of the chosen therapy procedure the following measures were applied: Optoelectrical 3D Movement Analysis System BTS Smart for gait, and Computerized Dynamic Posturography CQ Stab for stability and balance . All measures were conducted both before and after the therapy cycle. The subjects from the experimental group attended music therapy sessions 4 times a week for 4 weeks. Therapeutic Instrumental Music Performance (TIMP, Pattern Sensory Enhancement (PSE and Rhythmic Auditory Stimulation (RAS were used in every 45-minute session for practicing daily life activities, balance, pre-gait and gait pattern. Percussion instruments, the metronome and rhythmic music were the basis for each session. The subjects from the control group were asked to stay active and perform daily life activities between the measures. The research showed that the combination of the three NMT sensorimotor techniques can be used to improve gait and other rhythmical activities in PD rehabilitation.The results demonstrated significant improvement in the majority of the spatiotemporal gait parameters in the experimental group in comparison to the control

  20. Exercise Training in Treatment and Rehabilitation of Hip Osteoarthritis: A 12-Week Pilot Trial

    Directory of Open Access Journals (Sweden)

    Kirsti Uusi-Rasi

    2017-01-01

    Full Text Available Introduction. Osteoarthritis (OA of the hip is one of the major causes of pain and disability in the older population. Although exercise is an effective treatment for knee OA, there is lack of evidence regarding hip OA. The aim of this trial was to test the safety and feasibility of a specifically designed exercise program in relieving hip pain and improving function in hip OA participants and to evaluate various methods to measure changes in their physical functioning. Materials and Methods. 13 women aged ≥ 65 years with hip OA were recruited in this 12-week pilot study. Results. Pain declined significantly over 30% from baseline, and joint function and health-related quality of life improved slightly. Objective assessment of physical functioning showed statistically significant improvement in the maximal isometric leg extensor strength by 20% and in the hip extension range of motion by 30%. Conclusions. The exercise program was found to be safe and feasible. The present evidence indicates that the exercise program is effective in the short term. However, adequate powered RCTs are needed to determine effects of long-term exercise therapy on pain and progression of hip OA.

  1. Exercise Training in Treatment and Rehabilitation of Hip Osteoarthritis: A 12-Week Pilot Trial.

    Science.gov (United States)

    Uusi-Rasi, Kirsti; Patil, Radhika; Karinkanta, Saija; Tokola, Kari; Kannus, Pekka; Sievänen, Harri

    2017-01-01

    Introduction. Osteoarthritis (OA) of the hip is one of the major causes of pain and disability in the older population. Although exercise is an effective treatment for knee OA, there is lack of evidence regarding hip OA. The aim of this trial was to test the safety and feasibility of a specifically designed exercise program in relieving hip pain and improving function in hip OA participants and to evaluate various methods to measure changes in their physical functioning. Materials and Methods. 13 women aged ≥ 65 years with hip OA were recruited in this 12-week pilot study. Results. Pain declined significantly over 30% from baseline, and joint function and health-related quality of life improved slightly. Objective assessment of physical functioning showed statistically significant improvement in the maximal isometric leg extensor strength by 20% and in the hip extension range of motion by 30%. Conclusions. The exercise program was found to be safe and feasible. The present evidence indicates that the exercise program is effective in the short term. However, adequate powered RCTs are needed to determine effects of long-term exercise therapy on pain and progression of hip OA.

  2. Home-based Computer Assisted Arm Rehabilitation (hCAAR) robotic device for upper limb exercise after stroke: results of a feasibility study in home setting.

    Science.gov (United States)

    Sivan, Manoj; Gallagher, Justin; Makower, Sophie; Keeling, David; Bhakta, Bipin; O'Connor, Rory J; Levesley, Martin

    2014-12-12

    Home-based robotic technologies may offer the possibility of self-directed upper limb exercise after stroke as a means of increasing the intensity of rehabilitation treatment. The current literature has a paucity of robotic devices that have been tested in a home environment. The aim of this research project was to evaluate a robotic device Home-based Computer Assisted Arm Rehabilitation (hCAAR) that can be used independently at home by stroke survivors with upper limb weakness. hCAAR device comprises of a joystick handle moved by the weak upper limb to perform tasks on the computer screen. The device provides assistance to the movements depending on users ability. Nineteen participants (stroke survivors with upper limb weakness) were recruited. Outcome measures performed at baseline (A0), at end of 8-weeks of hCAAR use (A1) and 1 month after end of hCAAR use (A2) were: Optotrak kinematic variables, Fugl Meyer Upper Extremity motor subscale (FM-UE), Action Research Arm Test (ARAT), Medical Research Council (MRC) and Modified Ashworth Scale (MAS), Chedoke Arm and Hand Activity Inventory (CAHAI) and ABILHAND. Two participants were unable to use hCAAR: one due to severe paresis and the other due to personal problems. The remaining 17 participants were able to use the device independently in their home setting. No serious adverse events were reported. The median usage time was 433 minutes (IQR 250 - 791 min). A statistically significant improvement was observed in the kinematic and clinical outcomes at A1. The median gain in the scores at A1 were by: movement time 19%, path length 15% and jerk 19%, FM-UE 1 point, total MAS 1.5 point, total MRC 2 points, ARAT 3 points, CAHAI 5.5 points and ABILHAND 3 points. Three participants showed clinically significant improvement in all the clinical outcomes. The hCAAR feasibility study is the first clinical study of its kind reported in the current literature; in this study, 17 participants used the robotic device independently

  3. Locomotor training through a 3D cable-driven robotic system for walking function in children with cerebral palsy: a pilot study.

    Science.gov (United States)

    Wu, Ming; Kim, Janis; Arora, Pooja; Gaebler-Spira, Deborah J; Zhang, Yunhui

    2014-01-01

    Locomotor training using treadmill has been shown to elicit significant improvements in locomotor ability for some children with cerebral palsy (CP), the functional gains are relatively small and it requires greater involvement from a physical therapist. Current robotic gait training systems are effective in reducing the strenuous work of a physical therapist during locomotor training, but are less effective in improving locomotor function in some children with CP due to the limitations of the systems. Thus, a 3D cable-driven robotic gait training system was developed and tested in five children with CP through a 6 week of long-term gait training. Results indicated that both overground walking speed and 6 minute walking distance improved after robot assisted treadmill training through the cable-driven robotic system, and partially retained at 8 weeks after the end of training. Results from this pilot study indicated that it seems feasible to conduct locomotor training in children with CP through the 3D cable-driven robotic system.

  4. Evaluating the interactive web-based program, activate your heart, for cardiac rehabilitation patients: a pilot study.

    Science.gov (United States)

    Brough, Christopher; Boyce, Sally; Houchen-Wolloff, Linzy; Sewell, Louise; Singh, Sally

    2014-10-29

    Conventional cardiac rehabilitation (CR) programs are traditionally based on time-constrained, structured, group-based programs, usually set in hospitals or leisure centers. Uptake for CR remains poor, despite the ongoing evidence demonstrating its benefits. Additional alternative forms of CR are needed. An Internet-based approach may offer an alternative mode of delivering CR that may improve overall uptake. Activate Your Heart (AYH) is a Web-based CR program that has been designed to support individuals with coronary heart disease (CHD). The aim of this pilot study was to observe the outcome for participants following the AYH program. We conducted a prospective observational trial, recruiting low-risk patients with CHD. Measures of exercise, exercise capacity, using the Incremental Shuttle Walk Test (ISWT), dietary habits, and psychosocial well-being were conducted by a CR specialist at baseline and at 8 weeks following the Web-based intervention. We recruited 41 participants; 33 completed the program. We documented significant improvements in the ISWT distance (mean change 49.69 meters, SD 68.8, PLife (QOL) (mean change 0.28, SD 0.4, P<.001). Dietary habits improved with an increased proportion of patients consuming at least 5 portions of fruit and vegetables per day, (22 [71%] to 29 [94%] P=.01) and an increased proportion of patients consuming at least 2 portions of oily fish per week (14 [45%] to 21 [68%], P=.01). We did not detect changes in anxiety and depression scores or exercise behavior. We observed important improvements in exercise capacity, QOL, and dietary habits in a group of participants following a Web-based CR program. The program may offer an alternative approach to CR. A mobile version has been developed and we need to conduct further trials to establish its value compared to supervised CR.

  5. Upper extremity proprioception in healthy aging and stroke populations, and the effects of therapist- and robot-based rehabilitation therapies on proprioceptive function

    Directory of Open Access Journals (Sweden)

    Charmayne Mary Lee Hughes

    2015-03-01

    Full Text Available The world’s population is aging, with the number of people ages 65 or older expected to surpass 1.5 billion people, or 16% of the global total. As people age, there are notable declines in proprioception due to changes in the central and peripheral nervous systems. Moreover, the risk of stroke increases with age, with approximately two-thirds of stroke-related hospitalizations occurring in people over the age of 65. In this literature review we first summarize behavioral studies investigating proprioceptive deficits in normally aging older adults and stroke patients, and discuss the differences in proprioceptive function between these populations. We then provide a state of the art review the literature regarding therapist- and robot-based rehabilitation of the upper extremity proprioceptive dysfunction in stroke populations and discuss avenues of future research.

  6. Upper extremity proprioception in healthy aging and stroke populations, and the effects of therapist- and robot-based rehabilitation therapies on proprioceptive function.

    Science.gov (United States)

    Hughes, Charmayne Mary Lee; Tommasino, Paolo; Budhota, Aamani; Campolo, Domenico

    2015-01-01

    The world's population is aging, with the number of people ages 65 or older expected to surpass 1.5 billion people, or 16% of the global total. As people age, there are notable declines in proprioception due to changes in the central and peripheral nervous systems. Moreover, the risk of stroke increases with age, with approximately two-thirds of stroke-related hospitalizations occurring in people over the age of 65. In this literature review, we first summarize behavioral studies investigating proprioceptive deficits in normally aging older adults and stroke patients, and discuss the differences in proprioceptive function between these populations. We then provide a state of the art review the literature regarding therapist- and robot-based rehabilitation of the upper extremity proprioceptive dysfunction in stroke populations and discuss avenues of future research.

  7. Upper Extremity Proprioception in Healthy Aging and Stroke Populations, and the Effects of Therapist- and Robot-Based Rehabilitation Therapies on Proprioceptive Function

    Science.gov (United States)

    Hughes, Charmayne Mary Lee; Tommasino, Paolo; Budhota, Aamani; Campolo, Domenico

    2015-01-01

    The world’s population is aging, with the number of people ages 65 or older expected to surpass 1.5 billion people, or 16% of the global total. As people age, there are notable declines in proprioception due to changes in the central and peripheral nervous systems. Moreover, the risk of stroke increases with age, with approximately two-thirds of stroke-related hospitalizations occurring in people over the age of 65. In this literature review, we first summarize behavioral studies investigating proprioceptive deficits in normally aging older adults and stroke patients, and discuss the differences in proprioceptive function between these populations. We then provide a state of the art review the literature regarding therapist- and robot-based rehabilitation of the upper extremity proprioceptive dysfunction in stroke populations and discuss avenues of future research. PMID:25784872

  8. Exercise-based rehabilitation after hospital discharge for survivors of critical illness with intensive care unit-acquired weakness: A pilot feasibility trial.

    Science.gov (United States)

    Connolly, Bronwen; Thompson, April; Douiri, Abdel; Moxham, John; Hart, Nicholas

    2015-06-01

    The aim of this study was to investigate feasibility of exercise-based rehabilitation delivered after hospital discharge in patients with intensive care unit-acquired weakness (ICU-AW). Twenty adult patients, mechanically ventilated for more than 48 hours, with ICU-AW diagnosis at ICU discharge were included in a pilot feasibility randomized controlled trial receiving a 16-session exercise-based rehabilitation program. Twenty-one patients without ICU-AW participated in a nested observational cohort study. Feasibility, clinical, and patient-centered outcomes were measured at hospital discharge and at 3 months. Intervention feasibility was demonstrated by high adherence and patient acceptability, and absence of adverse events, but this must be offset by the low proportion of enrolment for those screened. The study was underpowered to detect effectiveness of the intervention. The use of manual muscle testing for the diagnosis of ICU-AW lacked robustness as an eligibility criterion and lacked discrimination for identifying rehabilitation requirements. Process evaluation of the trial identified methodological factors, categorized by "population," "intervention," "control group," and "outcome." Important data detailing the design, conduct, and implementation of a multicenter randomized controlled trial of exercise-based rehabilitation for survivors of critical illness after hospital discharge have been reported. Clinical Trials Identifier NCT00976807. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  9. Analysis and Research on Comfort of Rehabilitation Robot Flexible Joints%康复机器人柔性关节舒适性分析与研究

    Institute of Scientific and Technical Information of China (English)

    刘莹; 张小栋

    2015-01-01

    The comfort of the rehabilitation robot flexible joints is essential to ensure the safe and stable operation of human-machine interaction, in this paper, analysis and research on the comfort design for rehabilitation robot flexible joint has carried out. The design principles of mechanical structure and requirements of the flexible joint are analyzed, and the man-machine contact pressure points are chosen from the perspective of physiology, and from the point of bionics to establish the exoskele-tons of flexible joint activities, at the same time comparative analysis is mainly focused on the exoskeleton of flexible joints drive systems, thus to form a set of perfect bionic design principle of flexible joint, and to lay a foundation for designing the flexible joints that are lightly and ingeniously structured, easy to wear, and smooth operated.%康复机器人柔性关节的舒适性对保障人机接触的安全稳定运行至关重要,针对康复机器人柔性关节舒适性设计进行了分析与研究。从拟人化的角度分析了柔性关节的机械结构设计原理与要求,从生理学角度选择人机压力接触承受点,从仿生学角度建立了外骨骼柔性关节活动范围,同时重点对比分析了外骨骼柔性关节驱动系统,形成了一套完善的柔性关节仿生设计原则,为设计结构轻巧、穿戴方便、操作柔顺的柔性关节奠定了基础。

  10. Combined transcranial direct current stimulation and robot-assisted arm training in subacute stroke patients: a pilot study.

    Science.gov (United States)

    Hesse, S; Werner, C; Schonhardt, E M; Bardeleben, A; Jenrich, W; Kirker, S G B

    2007-01-01

    Preliminary reports suggest that central stimulation may enhance the effect of conventional physical therapies after stroke. This pilot study examines the safety and methodology of using transcranial direct stimulation (tDCS) with robot-assisted arm training (AT), to inform planning a larger randomised controlled trial. Ten patients, after an ischaemic stroke 4-8 weeks before study onset, no history of epilepsy, participated. Eight had a cortical lesion and 2 had subcortical lesions: all had severe arm paresis and, co-incidentally, 5 had severe aphasia. Over six weeks, they received thirty 20 min-sessions of AT. During the first 7 minutes, 1.5mA of tDCS was applied, with the anode over the lesioned hemisphere and the cathode above the contralateral orbit. Arm and language impairment were assessed with the Fugl-Meyer motor score (FM, full range 0-66) and the Aachener Aphasie Test. No major side effects occurred. Arm function of three patients (two with a subcortical lesion) improved significantly, with FM scores increasing from 6 to 28, 10 to 49 and 11 to 48. In the remaining seven patients, all with cortical lesions, arm function changed little, FM scores did not increase more than 5 points. Unexpectedly, aphasia improved in 4 patients. These procedures are safe, and easy to use in a clinical setting. In future studies, patients should be stratified by degree of arm weakness and lesion site, also the unexpected aphasia improvement warrants following-up.

  11. Effects of intensive arm training with the rehabilitation robot ARMin II in chronic stroke patients: four single-cases

    Directory of Open Access Journals (Sweden)

    Nef Tobias

    2009-12-01

    Full Text Available Abstract Background Robot-assisted therapy offers a promising approach to neurorehabilitation, particularly for severely to moderately impaired stroke patients. The objective of this study was to investigate the effects of intensive arm training on motor performance in four chronic stroke patients using the robot ARMin II. Methods ARMin II is an exoskeleton robot with six degrees of freedom (DOF moving shoulder, elbow and wrist joints. Four volunteers with chronic (≥ 12 months post-stroke left side hemi-paresis and different levels of motor severity were enrolled in the study. They received robot-assisted therapy over a period of eight weeks, three to four therapy sessions per week, each session of one hour. Patients 1 and 4 had four one-hour training sessions per week and patients 2 and 3 had three one-hour training sessions per week. Primary outcome variable was the Fugl-Meyer Score of the upper extremity Assessment (FMA, secondary outcomes were the Wolf Motor Function Test (WMFT, the Catherine Bergego Scale (CBS, the Maximal Voluntary Torques (MVTs and a questionnaire about ADL-tasks, progress, changes, motivation etc. Results Three out of four patients showed significant improvements (p Conclusion Data clearly indicate that intensive arm therapy with the robot ARMin II can significantly improve motor function of the paretic arm in some stroke patients, even those in a chronic state. The findings of the study provide a basis for a subsequent controlled randomized clinical trial.

  12. 一种基于sEMG评估上肢康复机器人有效性的方法%The Method of Evaluation on Upper-Limbs Rehabilitation Exoskeletal Robot Based on sEMG

    Institute of Scientific and Technical Information of China (English)

    王源; 于海龙; Suzuki Hiroyuki; 谢叻; Yu Wenwei; 李海丽

    2013-01-01

    将表面肌电信号(sEMG)运用到上肢康复机器人的有效性评估方面,提供一种方便有效的针对外骨骼康复机器人的训练效果评估方法,有利于针对不同机械结构的外骨骼机器人采用不同的康复医疗方案.利用肌电信号时域分析的积分机电值iEMG和均方根值RMS等肌电信号特征,并结合对肌电图的分析设计出针对六自由度上肢外骨骼机器人的对应训练方案,并对该套机器人系统进行科学的有效性评估.%This paper uses sEMG as a convenient and effective method to the effectiveness evaluation of Upper-Limbs rehabilitation exoskeletal robot. This method is beneficial to the different mechanical structure rehabilitation robot and can gain targeted medical treatment. Meanwhile, this is also can evaluate the effectiveness of the exosekeletal robot itself. This paper takes advantages of iEMG, RMS, and the electromyography to design a training plan for the 6-DOF robot and also have a scientific evaluation of the Upper-Limb rehabilitation system.

  13. A combined robotic and cognitive training for locomotor rehabilitation: Evidences of cerebral functional reorganization in two chronic traumatic brain injured patients

    Directory of Open Access Journals (Sweden)

    Katiuscia eSacco

    2011-11-01

    Full Text Available It has been demonstrated that automated locomotor training can improve walking capabilities in spinal cord-injured subjects but its effectiveness on brain damaged patients has not been well established. A possible explanation of the discordant results on the efficacy of robotic training in patients with cerebral lesions could be that these patients, besides stimulation of physiological motor patterns through passive leg movements, also need to train the cognitive aspects of motor control. Indeed, another way to stimulate cerebral motor areas in paretic patients is to use the cognitive function of motor imagery. A promising possibility is thus to combine sensorimotor training with the use of motor imagery. The aim of this paper is to assess changes in brain activations after a combined sensorimotor and cognitive training for gait rehabilitation. The protocol consisted of the integrated use of a robotic gait orthosis prototype with locomotor imagery tasks. Assessment was conducted on two patients with chronic traumatic brain injury and major gait impairments, using functional magnetic resonance imaging. Physiatric functional scales were used to assess clinical outcomes. Results showed greater activation post-training in the sensorimotor and supplementary motor cortices, as well as enhanced functional connectivity within the motor network. Improvements in balance and, to a lesser extent, in gait outcomes were also found.

  14. Training modalities in robot-mediated upper limb rehabilitation in stroke: a framework for classification based on a systematic review

    Science.gov (United States)

    2014-01-01

    Robot-mediated post-stroke therapy for the upper-extremity dates back to the 1990s. Since then, a number of robotic devices have become commercially available. There is clear evidence that robotic interventions improve upper limb motor scores and strength, but these improvements are often not transferred to performance of activities of daily living. We wish to better understand why. Our systematic review of 74 papers focuses on the targeted stage of recovery, the part of the limb trained, the different modalities used, and the effectiveness of each. The review shows that most of the studies so far focus on training of the proximal arm for chronic stroke patients. About the training modalities, studies typically refer to active, active-assisted and passive interaction. Robot-therapy in active assisted mode was associated with consistent improvements in arm function. More specifically, the use of HRI features stressing active contribution by the patient, such as EMG-modulated forces or a pushing force in combination with spring-damper guidance, may be beneficial. Our work also highlights that current literature frequently lacks information regarding the mechanism about the physical human-robot interaction (HRI). It is often unclear how the different modalities are implemented by different research groups (using different robots and platforms). In order to have a better and more reliable evidence of usefulness for these technologies, it is recommended that the HRI is better described and documented so that work of various teams can be considered in the same group and categories, allowing to infer for more suitable approaches. We propose a framework for categorisation of HRI modalities and features that will allow comparing their therapeutic benefits. PMID:25012864

  15. FY1995 development of rehabilitation system for promoting social integration of people with disabilities. Development of a robotic orthosis assisting motion capabilities; 1995 nendo shogaino aru hito no shakai shinshutsu wo sokushinsuru rehabilitation system no kaihatsu. Rehabilitation kino wo yusuru doryoku sogu no kaihatsu

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-03-01

    People with slight disabilities on motion. capability can be active in daily life using properly designed motion-assisting devices. Using these device in various cases would help the disabled participate in production activities, and would promote social integration of the disabled as rehabilitation in a broad sense. This research aims at developing such a device capable to help human motion by forearm based on technology and science in robotics. Two different methods are discussed in this research in order to develop robotic orthosis with good performance for assisting human motion by forearm. The first method is constructing a robotic orthosis with electronic motors and force sensors to produce a desired mechanical impedance. This orthosis was carefully designed such that mechanical safety for human is realized. The validity of the mechanism is illustrated by several experiments. The second method is constructing a low cost robotic orthosis with pneumatic actuators. A new type of pneumatic actuator is developed to realize this orthosis. Experimental results show that physical therapy can be performed effectively using this orthosis operated by direct teaching. (NEDO)

  16. Feasibility of using a humanoid robot to elicit communicational response in children with mild autism

    Science.gov (United States)

    Malik, Norjasween Abdul; Shamsuddin, Syamimi; Yussof, Hanafiah; Azfar Miskam, Mohd; Che Hamid, Aminullah

    2013-12-01

    Research evidences are accumulating with regards to the potential use of robots for the rehabilitation of children with autism. The purpose of this paper is to elaborate on the results of communicational response in two children with autism during interaction with the humanoid robot NAO. Both autistic subjects in this study have been diagnosed with mild autism. Following the outcome from our first pilot study; the aim of this current experiment is to explore the application of NAO robot to engage with a child and further teach about emotions through a game-centered and song-based approach. The experiment procedure involved interaction between humanoid robot NAO with each child through a series of four different modules. The observation items are based on ten items selected and referenced to GARS-2 (Gilliam Autism Rating Scale-second edition) and also input from clinicians and therapists. The results clearly indicated that both of the children showed optimistic response through the interaction. Negative responses such as feeling scared or shying away from the robot were not detected. Two-way communication between the child and robot in real time significantly gives positive impact in the responses towards the robot. To conclude, it is feasible to include robot-based interaction specifically to elicit communicational response as a part of the rehabilitation intervention of children with autism.

  17. Dynamics analysis and application of the rehabilitation power assist robot for the leg%下肢助力机器人动力学分析与应用

    Institute of Scientific and Technical Information of China (English)

    陈峰; 汤敏; 马卫国; 刘羡飞

    2011-01-01

    背景:2005年成功研制出下肢康复机器人系统,该机器人通过中心控制系统和步态、姿态控制系统互相协调,带动下肢各种运动,从而达到恢复下肢功能的目的.目的:对下肢康复助力机器人做动力学分析.方法:该系统为一个复杂的动力系统,由多个关节和多个连杆组成,具有多个输入和多个输出,分析其运动和作用力之间的关系.通过运动信息感知网,实现机器人系统主动为使用者提供完成髋关节屈/伸、旋内/旋外及外展/内收功能恢复动作的助力支持.结果与结论:利用动力学方程完成人-机混合系统的控制.减小人体感受的运动强度,使练习者能充分完成功能恢复动作,随着康复者下肢力量的加强和动作的熟练程度的提高,通过改变系统控制参数,系统会逐步减少对其助力支持,直到康复.%BACKGROUND: In 2005, the successful production of lower extremity rehabilitation robot system can co-promote the delivery of leg movement through the central control system as well as the gait and attitude control system so as to restore lower limb function.OBJECTIVE: To perform the mechanical analysis of the rehabilitation power assist robot.METHODS: Power assist exoskeleton is a complicated dynamical system composed of many joints and links, and it is a MIMO.Power assist robot dynamics is about the movement-force relationship, and its results of simulation are used to optimize the system. Through motion information perception, the rehabilitation power assist robot provides power for wearer hip joint to acco m plish motion of flexion/extension , abd uction/adduction and internal rotation/external rotation . RESU LTS AND CONCLUSION : The dynamical equation is used to realize the hybrid control. The practitioner can fully completed functional recovery action, with promotion of practicer limb strength and action proficiency, the system gradually reduces the power support until the recovery.

  18. 下肢康复机器人及其交互控制方法%Lower Limb Rehabilitation Robots and Interactive Control Methods

    Institute of Scientific and Technical Information of China (English)

    胡进; 侯增广; 陈翼雄; 张峰; 王卫群

    2014-01-01

    瘫痪病人的数量与日俱增,其康复训练通常是一个长期的过程。相对于传统的理疗,使用机器人辅助康复训练能够提高效率,降低成本,减少理疗师的人员和体力消耗,因此节省了康复医疗资源,并且可以完成更加多样的主被动训练策略,从而提高了康复效果。根据患者进行康复运动时的身体姿态,下肢康复机器人可分以下4类:坐卧式机器人、直立式机器人、辅助起立式机器人和多体位式机器人,坐卧式又细分为末端式和外骨骼式,直立式进一步划分为悬吊减重(Suspending body weight support, sBWS)式步态训练机器人和独立可穿戴式机器人。由于下肢康复机器人是与运动功能受损的患肢相互作用,为了给患者创造一个安全、舒适、自然的训练环境,机器人和患者之间的交互控制不可或缺。根据获取运动意图时所使用的传感器信号,交互控制可以基本分为两类:1)基于力信号的交互控制;2)基于生物医学信号的交互控制。在基于力信号的交互控制中,力位混合控制和阻抗控制是最为常用的两种方法;而在基于生物医学信号的交互控制中,表面肌电(Surface electromyogram, sEMG)和脑电(Electroencephalogram, EEG)最常被用于运动意图的推断。%The number of paralytic sufferers is currently growing huge and the rehabilitation for them is usually a long-time process. Compared to the traditional physiotherapy, rehabilitation with the assistance of robots can reduce the cost and time, and less labor intensity is required. Moreover, various training strategies are provided by robots, so that rehabilitation effect can be improved. Lower limb rehabilitation robots are categorized into horizontal exercisers, vertical locomotors, sit-to-stand aids and multi-orientation hybrids, according to the posture of patient during therapy. Horizontal exercisers are subcategorized into end effectors and exoskeletons, and

  19. Feasibility of a Psychosocial Rehabilitation Intervention to Enhance the Involvement of Relatives in Cancer Rehabilitation: Pilot Study for a Randomized Controlled Trial

    DEFF Research Database (Denmark)

    Ledderer, Loni; la Cour, Karen; Mogensen, Ole

    2013-01-01

    Background Cancer often affects the quality of life and well-being of patients as well as their relatives. Previous studies have suggested that relatives should be involved in psychosocial rehabilitation to address the needs for an interpersonal relationship with others in the disease trajectory...

  20. Advances in rehabilitation medicine.

    Science.gov (United States)

    Ng, Yee Sien; Chew, Effie; Samuel, Geoffrey S; Tan, Yeow Leng; Kong, Keng He

    2013-10-01

    Rehabilitation medicine is the medical specialty that integrates rehabilitation as its core therapeutic modality in disability management. More than a billion people worldwide are disabled, and the World Health Organization has developed the International Classification of Functioning, Disability and Health as a framework through which disability is addressed. Herein, we explore paradigm shifts in neurorehabilitation, with a focus on restoration, and provide overviews on developments in neuropharmacology, rehabilitation robotics, virtual reality, constraint-induced therapy and brain stimulation. We also discuss important issues in rehabilitation systems of care, including integrated care pathways, very early rehabilitation, early supported discharge and telerehabilitation. Finally, we highlight major new fields of rehabilitation such as spasticity management, frailty and geriatric rehabilitation, intensive care and cancer rehabilitation.

  1. A Pilot Study for Retrospective Evaluation of Cured-in-Place Pipe (CIPP) Rehabilitation of Municipal Gravity Sewers

    Science.gov (United States)

    Pipe rehabilitation and trenchless pipe replacement technologies have seen a steadily increasing use over the past 30 to 40 years. Despite the massive public investment in the rehabilitation of the US water and wastewater infrastructure, there has been little formal and quantita...

  2. Postoperative transcutaneous oxygen measurement in the prediction of delayed wound healing and prosthetic fitting among amputees during rehabilitation. A pilot study.

    Science.gov (United States)

    Yablon, S A; Novick, E S; Jain, S S; Inhoffer, M; Graves, D E

    1995-01-01

    Postoperative assessment of amputation wound healing remains largely subjective in nature, being based on the physician's clinical judgement. These considerations significantly impact on the rehabilitation course, as premature prosthetic fitting may result in wound breakdown. Alternatively, delayed healing may result in prolonged hospital length of stay. Few attempts have been made to correlate objective parameters of limb perfusion with amputation wound healing or prosthetic fitting outcome during the rehabilitation phase of treatment. A pilot study was conducted, in which the transcutaneous oxygen monitor, a noninvasive device measuring transcutaneous partial pressure of oxygen (tcpO2), was applied to the stumps of 11 consecutive above-or below-knee amputees admitted for rehabilitation after amputation. All patients were tested within 1 wk of admission and 45 days of amputation. The treatment team was blinded as to the test results. A direct correlation was observed between wound healing outcome and tcpO2 results (Fisher's exact test [FET], P = 0.03), and no patient with a tcpO2 of rpbi], = -0.835; P = 0.01), delayed prosthetic fitting (rpbi = 0.742; p = 0.01), and poorer wound healing at admission (rpbi = 0.932; P = 0.001). Postoperative tcpO2 measurement may have use in objectively identifying patients at greater risk of delayed wound healing and prosthetic fitting, although further study is warranted.

  3. Investigation of robotic-assisted tilt-table therapy for early-stage spinal cord injury rehabilitation.

    Science.gov (United States)

    Craven, Colm T D; Gollee, Henrik; Coupaud, Sylvie; Purcell, Mariel A; Allan, David B

    2013-01-01

    Damage to the spinal cord compromises motor function and sensation below the level of injury, resulting in paralysis and progressive secondary health complications. Inactivity and reduced energy requirements result in reduced cardiopulmonary fitness and an increased risk of coronary heart disease and cardiovascular complications. These risks may be minimized through regular physical activity. It is proposed that such activity should begin at the earliest possible time point after injury, before extensive neuromuscular degeneration has occurred. Robotic-assisted tilt-table therapy may be used during early-stage spinal cord injury (SCI) to facilitate stepping training, before orthostatic stability has been achieved. This study investigates whether such a stimulus may be used to maintain pulmonary and coronary health by describing the acute responses of patients with early-stage (<1 yr) motor-complete SCI (cSCI) and motor-incomplete SCI (iSCI) to passive, active, and electrically stimulated robotic-assisted stepping. Active participation was found to elicit an increased response from iSCI patients. The addition of electrical stimulation did not consistently elicit further increases. Extensive muscle atrophy was found to have occurred in those patients with cSCI, thereby limiting the potential effectiveness of electrical stimulation. Active participation in robotic-assisted tilt-table therapy may be used to improve cardiopulmonary fitness in iSCI patients if implemented as part of a regular training program.

  4. Development of virtual reality exercise of hand motion assist robot for rehabilitation therapy by patient self-motion control.

    Science.gov (United States)

    Ueki, Satoshi; Nishimoto, Yutaka; Abe, Motoyuki; Kawasaki, Haruhisa; Ito, Satoshi; Ishigure, Yasuhiko; Mizumoto, Jun; Ojika, Takeo

    2008-01-01

    This paper presents a virtual reality-enhanced hand rehabilitation support system with a symmetric master-slave motion assistant for independent rehabilitation therapies. Our aim is to provide fine motion exercise for a hand and fingers, which allows the impaired hand of a patient to be driven by his or her healthy hand on the opposite side. Since most disabilities caused by cerebral vascular accidents or bone fractures are hemiplegic, we adopted a symmetric master-slave motion assistant system in which the impaired hand is driven by the healthy hand on the opposite side. A VR environment displaying an effective exercise was created in consideration of system's characteristic. To verify the effectiveness of this system, a clinical test was executed by applying to six patients.

  5. Medical robotics.

    Science.gov (United States)

    Ferrigno, Giancarlo; Baroni, Guido; Casolo, Federico; De Momi, Elena; Gini, Giuseppina; Matteucci, Matteo; Pedrocchi, Alessandra

    2011-01-01

    Information and communication technology (ICT) and mechatronics play a basic role in medical robotics and computer-aided therapy. In the last three decades, in fact, ICT technology has strongly entered the health-care field, bringing in new techniques to support therapy and rehabilitation. In this frame, medical robotics is an expansion of the service and professional robotics as well as other technologies, as surgical navigation has been introduced especially in minimally invasive surgery. Localization systems also provide treatments in radiotherapy and radiosurgery with high precision. Virtual or augmented reality plays a role for both surgical training and planning and for safe rehabilitation in the first stage of the recovery from neurological diseases. Also, in the chronic phase of motor diseases, robotics helps with special assistive devices and prostheses. Although, in the past, the actual need and advantage of navigation, localization, and robotics in surgery and therapy has been in doubt, today, the availability of better hardware (e.g., microrobots) and more sophisticated algorithms(e.g., machine learning and other cognitive approaches)has largely increased the field of applications of these technologies,making it more likely that, in the near future, their presence will be dramatically increased, taking advantage of the generational change of the end users and the increasing request of quality in health-care delivery and management.

  6. Motivational and Behavioral Activation as an Adjunct to Psychiatric Rehabilitation for Mild to Moderate Negative Symptoms in Individuals with Schizophrenia: A Proof-of-Concept Pilot Study

    Directory of Open Access Journals (Sweden)

    Kee-Hong Choi

    2016-11-01

    Full Text Available Few psychosocial approaches address the negative symptoms of schizophrenia, which shares common features with depression and anxiety. Behavioral activation (BA is effective for addressing depression and anxiety in adults with various mental disorders. Motivational Interviewing (MI has been successfully applied to address ambivalence or lack of motivation towards treatment. Motivational and behavioral activation (mBA has been developed by incorporating the core principles from BA and MI with recent findings on the negative symptoms of schizophrenia. In this study, we aimed to examine the feasibility and preliminary efficacy of mBA in a non-randomized controlled pilot study that included individuals with schizophrenia with mild to moderate negative symptoms receiving psychiatric rehabilitation. A total of 73 individuals with schizophrenia were recruited. Forty-seven of the participants who met the study inclusion and exclusion criteria were assigned to either an mBA + usual psychiatric rehabilitation group (mBA or a usual psychiatric rehabilitation only group (treatment as usual, TAU. Administering mBA to individuals with schizophrenia with mild to moderate negative symptoms was feasible in a community mental health setting. Relative to TAU, mBA was associated with large effects in reducing negative symptoms measured using the Positive and Negative Syndrome Scale (PANSS and the Brief Negative Symptom Scale (BNSS. However, after considering PANSS cognitive deficits and marital status as covariates due to significant differences in their baseline levels, the treatment effects on the BNSS were partially observed. In addition, participants in the mBA group showed improved verbal learning and memory compared with those in the TAU group. In individuals with schizophrenia receiving the usual forms of psychiatric rehabilitation in a community mental health setting, mBA appears to offer a promising adjunctive approach for addressing mild to moderate

  7. Robust Control of Six-linkage Walking Assistance Rehabilitation Robot%六连杆助行康复机器人鲁棒控制

    Institute of Scientific and Technical Information of China (English)

    张立勋; 伊蕾; 白大鹏

    2011-01-01

    为帮助老年人及偏瘫患者恢复自然步态的行走,提出了一种六连杆助行康复机器人机构模型.考虑患者体重差异及助行康复训练过程中下肢肌张力的变化,在机器人动力学分析的基础上设计了一种具有抗干扰性能的鲁棒控制器.基于李亚普诺大理论证明了该控制器可有效地抑制外界干扰信号的影响,并进行了鲁棒控制实验研究.研究结果表明,鲁棒控制器能够抑制负载突变及不确定性干扰,保证控制系统工作的稳定性,满足患者对助行训练安全性的要求.%A mechanism model of a six-linkage walking assistant rehabilitation robot is presented to help the aged and hemiplegic patients walk with natural gait. Considering the weight difference among patients and the changes in muscular tension of lower limbs during assisted-walking training, a robust controller with anti-jamming performance is designed based on the robot dynamics analysis. It is proved by Lyapunov theory that the controller can suppress the influence from external interference signals effectively. The robust control experiment results show that the controller can suppress the influence of load variations and uncertain disturbance.

  8. ArmAssist Robotic System versus Matched Conventional Therapy for Poststroke Upper Limb Rehabilitation: A Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    Tijana J. Dimkić Tomić

    2017-01-01

    Full Text Available The ArmAssist is a simple low-cost robotic system for upper limb motor training that combines known benefits of repetitive task-oriented training, greater intensity of practice, and less dependence on therapist assistance. The aim of this preliminary study was to compare the efficacy of ArmAssist (AA robotic training against matched conventional arm training in subacute stroke subjects with moderate-to-severe upper limb impairment. Twenty-six subjects were enrolled within 3 months of stroke and randomly assigned to the AA group or Control group (n=13 each. Both groups were trained 5 days per week for 3 weeks. The primary outcome measure was Fugl-Meyer Assessment-Upper Extremity (FMA-UE motor score, and the secondary outcomes were Wolf Motor Function Test-Functional Ability Scale (WMFT-FAS and Barthel index (BI. The AA group, in comparison to the Control group, showed significantly greater increases in FMA-UE score (18.0 ± 9.4 versus 7.5 ± 5.5, p=0.002 and WMFT-FAS score (14.1 ± 7.9 versus 6.7 ± 7.8, p=0.025 after 3 weeks of treatment, whereas the increase in BI was not significant (21.2 ± 24.8 versus 13.1 ± 10.7, p=0.292. There were no adverse events. We conclude that arm training using the AA robotic device is safe and able to reduce motor deficits more effectively than matched conventional arm training in subacute phase of stroke. The study has been registered at the ClinicalTrials.gov, ID: NCT02729649.

  9. Benefits of Centralized Scheduling in a Postacute Residential Rehabilitation Program for People With Acquired Brain Lesions: A Pilot Study.

    Science.gov (United States)

    Vestri, Alec; Pizzighello, Silvia; Piccoli, Sara; Martinuzzi, Andrea

    2017-04-01

    To determine whether the use of a designated staff person to coordinate and schedule therapy services in a postacute residential rehabilitation program for people with acquired brain lesions results in (1) a higher-intensity treatment and a reduced length of stay; (2) reduced rehabilitation costs; and (3) increased patient and staff satisfaction. This nonrandomized retrospective study from 2009 through 2012 uses data collected relative to 2 different methods of scheduling: (1) self-planning, in which each single team member makes appointments that are then displayed on a shared board; and (2) managed planning, in which appointments are made by a designated staff person. A residential center for people with postacute acquired brain lesions. Patients (N=20) with acquired brain lesions who had similar clinical and demographic characteristics comprised the managed planning group (n=10) and the self-planning group (n=10). Not applicable. Organizational measures (length of stay in rehabilitation, number of treatment hours, total cost of rehabilitation), clinical outcome scales (Disability Rating Scale, FIM, and Barthel Index), perceived quality of treatment by patients (questionnaire), and perceived satisfaction of team members (Job Descriptive Index). All patients improved on all clinical rating scales at the time of discharge (all effect sizes are large). In the managed planning group, the number of treatment hours increased (Cohen's d=2.15), resulting in reduced length of stay (Cohen's d=.95) and cost of rehabilitation (Cohen's d=1.22). In addition, the quality of treatment perceived by the patients and their families increased, while team member satisfaction did not change. The use of a designated staff person to manage therapy services improves efficiency and efficacy of a patient-centered health care system. The proposed scheduling system results in a remarkable cost saving for the National Health System. Copyright © 2017 American Congress of Rehabilitation

  10. Telemedicine-guided education on secondary stroke and fall prevention following inpatient rehabilitation for Texas patients with stroke and their caregivers: a feasibility pilot study.

    Science.gov (United States)

    Jhaveri, Mansi M; Benjamin-Garner, Ruby; Rianon, Nahid; Sherer, Mark; Francisco, Gerard; Vahidy, Farhaan; Kobayashi, Kayta; Gaber, Mary; Shoemake, Paige; Vu, Kim; Trevino, Alyssa; Grotta, James; Savitz, Sean

    2017-09-03

    The aftermath of stroke leaves many consequences including cognitive deficits and falls due to imbalance. Stroke survivors and families struggle to navigate the complex healthcare system with little assistance posthospital discharge, often leading to early hospital readmission and worse stroke outcomes. Telemedicine Guided Education on Secondary Stroke and Fall Prevention Following Inpatient Rehabilitation feasibility study examines whether stroke survivors and their caregivers find value in telerehabilitation (TR) home visits that provide individualised care and education by a multidisciplinary team after discharge from inpatient rehabilitation. A prospective, single arm, pilot study is designed to evaluate the feasibility of weekly TR home visits initiated postdischarge from inpatient rehabilitation. Newly diagnosed patients with stroke are recruited from a Houston-based comprehensive stroke centre inpatient rehabilitation unit, loaned an iPad with data plan and trained to use information technology security-approved videoconferencing application. After hospital discharge, six weekly TR home visits are led by rotating specialists (pharmacist, physical/occupational therapist, speech therapist, rehabilitation physician, social worker, geriatrician specialised in fracture prevention) followed by satisfaction survey on week 7. Specialists visually assess patients in real time, educate them on secondary stroke and fall prevention and suggest ways to improve function including direct medical interventions when indicated. Primary outcomes are proportion of eligible patients consenting to the study, participation rate in all six TR home visits and satisfaction score. The study started 31 December 2015 with plan to enrol up to 50 patients over 24 months. Feasibility study results will inform us as to whether a randomised controlled trial is warranted to determine efficacy of TR home visit intervention in improving stroke outcomes. Ethics approval obtained by the

  11. Memory and accurate processing brain rehabilitation for the elderly: LEGO robot and iPad case study.

    Science.gov (United States)

    Lopez-Samaniego, Leire; Garcia-Zapirain, Begonya; Mendez-Zorrilla, Amaia

    2014-01-01

    This paper presents the results of research that applies cognitive therapies associated with memory and mathematical problem-solving in elderly people. The exercises are programmed in an iPad and can be performed both from the Tablet and in an interactive format with a LEGO robot. The system has been tested with 2 men and 7 women over the age of 65 who have slight physical and cognitive impairment. Evaluation with the SUS resulted in a mean of 48.45 with a standard deviation of 5.82. The score of overall satisfaction was 84.37 with a standard deviation of 18.6. Interaction with the touch screen caused some usability problems due to the elderly people's visual difficulties and clicking accuracy. Future versions will include visualization with more color contrast and less use of the keyboard.

  12. Making the Case for Specialized Caseloads among Vocational Rehabilitation Counselors Working with Ex-Offenders: A Pilot Study

    Science.gov (United States)

    Bates-Maves, Julie K.; O'Sullivan, Deirdre

    2017-01-01

    Purpose: This article outlines findings from a sample of 137 vocational rehabilitation counselors regarding their stigmatizing attitudes, burnout levels, work experience, caseload composition, and working alliance with clients who have a range of disabilities and a criminal history. Method: Electronic surveys were sent to vocational rehabilitation…

  13. A Kinect-Based System for Physical Rehabilitation: A Pilot Study for Young Adults with Motor Disabilities

    Science.gov (United States)

    Chang, Yao-Jen; Chen, Shu-Fang; Huang, Jun-Da

    2011-01-01

    This study assessed the possibility of rehabilitating two young adults with motor impairments using a Kinect-based system in a public school setting. This study was carried out according to an ABAB sequence in which A represented the baseline and B represented intervention phases. Data showed that the two participants significantly increased their…

  14. Upper Limb Rehab Robot Used in Rehabilitation of Upper Limb Function of Hemiplegia Patients%上肢康复机器人应用于偏瘫患者上肢功能康复

    Institute of Scientific and Technical Information of China (English)

    邹贵娣; 欧阳冬方

    2014-01-01

    上肢康复机器人技术是一种新兴的运动神经康复治疗技术,越来越多研究证实机器人可以实现长期、稳定的重复训练,具备目标导向性和任务导向性等特点,保证了训练的强度和时间,弥补了传统康复训练方法的不足。偏瘫患者上肢功能康复应用上肢康复机器人取得良好效果。%Upper limb rehab robot technology is developed in recent years as a new motor nerve rehabilitation technology. It is more and more con-firmed by foreign researchs that the robot can finish the long-term and stable repetitive training , it is charactered of target oriented and task oriented, and so on, which ensures the training intensity and time, making up for the deficiency of the traditional rehabilitation training methods. It has achieved good rehabilitation results by applying in the upper limb function rehab in patients with hemiplegia.

  15. Brain-Computer Interface-based robotic end effector system for wrist and hand rehabilitation: results of a three-armed randomized controlled trial for chronic stroke

    Directory of Open Access Journals (Sweden)

    Kai Keng eAng

    2014-07-01

    Full Text Available The objective of this study was to investigate the efficacy of an Electroencephalography (EEG-based Motor Imagery (MI Brain-Computer Interface (BCI coupled with a Haptic Knob (HK robot for arm rehabilitation in stroke patients. In this three-arm, single-blind, randomized controlled trial; 21 chronic hemiplegic stroke patients (Fugl-Meyer Motor Assessment (FMMA score 10-50, recruited after pre-screening for MI BCI ability, were randomly allocated to BCI-HK, HK or Standard Arm Therapy (SAT groups. All groups received 18 sessions of intervention over 6 weeks, 3 sessions per week, 90 minutes per session. The BCI-HK group received 1 hour of BCI coupled with HK intervention, and the HK group received 1 hour of HK intervention per session. Both BCI-HK and HK groups received 120 trials of robot-assisted hand grasping and knob manipulation followed by 30 minutes of therapist-assisted arm mobilization. The SAT group received 1.5 hours of therapist-assisted arm mobilization and forearm pronation-supination movements incorporating wrist control and grasp-release functions. In all, 14 males, 7 females, mean age 54.2 years, mean stroke duration 385.1 days, with baseline FMMA score 27.0 were recruited. The primary outcome measure was upper-extremity FMMA scores measured mid-intervention at week 3, end-intervention at week 6, and follow-up at weeks 12 and 24. Seven, 8 and 7 subjects underwent BCI-HK, HK and SAT interventions respectively. FMMA score improved in all groups, but no intergroup differences were found at any time points. Significantly larger motor gains were observed in the BCI-HK group compared to the SAT group at weeks 3, 12 and 24, but motor gains in the HK group did not differ from the SAT group at any time point. In conclusion, BCI-HK is effective, safe, and may have the potential for enhancing motor recovery in chronic stroke when combined with therapist-assisted arm mobilization.

  16. Brain-computer interface-based robotic end effector system for wrist and hand rehabilitation: results of a three-armed randomized controlled trial for chronic stroke.

    Science.gov (United States)

    Ang, Kai Keng; Guan, Cuntai; Phua, Kok Soon; Wang, Chuanchu; Zhou, Longjiang; Tang, Ka Yin; Ephraim Joseph, Gopal J; Kuah, Christopher Wee Keong; Chua, Karen Sui Geok

    2014-01-01

    The objective of this study was to investigate the efficacy of an Electroencephalography (EEG)-based Motor Imagery (MI) Brain-Computer Interface (BCI) coupled with a Haptic Knob (HK) robot for arm rehabilitation in stroke patients. In this three-arm, single-blind, randomized controlled trial; 21 chronic hemiplegic stroke patients (Fugl-Meyer Motor Assessment (FMMA) score 10-50), recruited after pre-screening for MI BCI ability, were randomly allocated to BCI-HK, HK or Standard Arm Therapy (SAT) groups. All groups received 18 sessions of intervention over 6 weeks, 3 sessions per week, 90 min per session. The BCI-HK group received 1 h of BCI coupled with HK intervention, and the HK group received 1 h of HK intervention per session. Both BCI-HK and HK groups received 120 trials of robot-assisted hand grasping and knob manipulation followed by 30 min of therapist-assisted arm mobilization. The SAT group received 1.5 h of therapist-assisted arm mobilization and forearm pronation-supination movements incorporating wrist control and grasp-release functions. In all, 14 males, 7 females, mean age 54.2 years, mean stroke duration 385.1 days, with baseline FMMA score 27.0 were recruited. The primary outcome measure was upper extremity FMMA scores measured mid-intervention at week 3, end-intervention at week 6, and follow-up at weeks 12 and 24. Seven, 8 and 7 subjects underwent BCI-HK, HK and SAT interventions respectively. FMMA score improved in all groups, but no intergroup differences were found at any time points. Significantly larger motor gains were observed in the BCI-HK group compared to the SAT group at weeks 3, 12, and 24, but motor gains in the HK group did not differ from the SAT group at any time point. In conclusion, BCI-HK is effective, safe, and may have the potential for enhancing motor recovery in chronic stroke when combined with therapist-assisted arm mobilization.

  17. Adaptive Hierarchical Control for the Muscle Strength Training of Stroke Survivors in Robot-aided Upper-limb Rehabilitation

    Directory of Open Access Journals (Sweden)

    Guozheng Xu

    2012-10-01

    Full Text Available Muscle strength training for stroke patients is of vital importance for helping survivors to progressively restore muscle strength and improve the performance of their activities in daily living (ADL. An adaptive hierarchical therapy control framework which integrates the patient’s real biomechanical state estimation with task‐performance quantitative evaluation is proposed. Firstly, a high‐level progressive resistive supervisory controller is designed to determine the resistive force base for each training session based on the patient’s online task‐performance evaluation. Then, a low‐level adaptive resistive force triggered controller is presented to further regulate the interactive resistive force corresponding to the patient’s real‐time biomechanical state ‐ characterized by the patient’s bio‐damping and bio‐stiffness in the course of one training session, so that the patient is challenged in a moderate but engaging and motivating way. Finally, a therapeutic robot system using a Barrett WAMTM compliant manipulator is set up. We recruited eighteen inpatient and outpatient stroke participants who were randomly allocated in experimental (robot‐aided and control (conventional physical therapy groups and enrolled for sixteen weeks of progressive resistance training. The preliminary results show that the proposed therapy control strategies can enhance the recovery of strength and motor control ability.

  18. 77 FR 21547 - Proposed Priorities; Disability and Rehabilitation Research Projects and Centers Program

    Science.gov (United States)

    2012-04-10

    ...). Currently, therapy robots are found only in large medical and rehabilitation centers. There is a need to... to such therapy outside of large rehabilitation centers. Therapy robots can help extend the therapist... products that expand the use of therapy robots beyond large rehabilitation centers and into more community...

  19. Neuropsychological rehabilitation of memory deficits and activities of daily living in patients with Alzheimer's disease: a pilot study

    Directory of Open Access Journals (Sweden)

    Ávila R.

    2004-01-01

    Full Text Available Patients with Alzheimer's disease (AD gradually lose their cognitive competence, particularly memory, and the ability to perform daily life tasks. Neuropsychological rehabilitation is used to improve cognitive functions by facilitating memory performance through the use of external aids and internal strategies. The effect of neuropsychological rehabilitation through memory training - motor movements, verbal association, and categorization - and activities of daily living (ADL training was tested in a sample of 5 elderly out-patients (mean age: 77.4 ± 2.88 years, with mild AD (Mini-Mental State Examination score: 22.20 ± 2.17 and their caregivers. All patients had been taking rivastigmine (6-12 mg/day for at least 3 months before being assigned to the rehabilitation sessions, and they continued to take the medication during the whole program. Just before and after the 14-week neuropsychological rehabilitation program all patients were assessed by interviewers that did not participate in the cognitive training, using the Mini-Mental State Examination, Montgomery-Alsberg Depression Rating Scale, Hamilton Anxiety Scale, Interview to Determine Deterioration in Functioning in Dementia, Functional Test, Memory Questionnaire of Daily Living for patient and caregiver, Quality of Life Questionnaire for patient and caregiver, and a neuropsychological battery. The results showed a statistically significant improvement in ADL measured by Functional Test (P = 0.04, and only a small improvement in memory and psychiatric symptoms. Our results support the view that weekly stimulation of memory and training of ADL is believed to be of great value in AD treatment, not only delaying the progress of the disease, but also improving some cognitive functions and ADL, even though AD is a progressively degenerative disease.

  20. Neurocognitive robot-assisted therapy of hand function.

    Science.gov (United States)

    Metzger, Jean-Claude; Lambercy, Olivier; Califfi, Antonella; Conti, Fabio M; Gassert, Roger

    2014-01-01

    Neurocognitive therapy, according to the Perfetti method, proposes exercises that challenge motor, sensory as well as cognitive functions of neurologically impaired patients. At the level of the hand, neurocognitive exercises typically involve haptic exploration and interaction with objects of various shapes and mechanical properties. Haptic devices are thus an ideal support to provide neurocognitive exercises under well-controlled and reproducible conditions, and to objectively assess patient performance. Here we present three neurocognitive robot-assisted exercises which were implemented on the ReHapticKnob, a high-fidelity two-degrees-of-freedom hand rehabilitation robot. The exercises were evaluated for feasibility and acceptance in a pilot study on five patients suffering from different neurological disorders. Results showed that all patients were able to take part in the neurocognitive robot-assisted therapy, and that the proposed therapy was well accepted by patients, as assessed through subjective questionnaires. Force/torque and position measurements provided insights on the motor strategy employed by the patients during the exploration of virtual object properties, and served as objective assessment of task performance. The fusion of the neurocognitive therapy concept with robot-assisted rehabilitation enriches therapeutic approaches through the focus on haptics, and could provide novel insights on sensorimotor impairment and recovery.

  1. Recovery of Proprioception in the Upper Extremity by Robotic Mirror Therapy: a Clinical Pilot Study for Proof of Concept.

    Science.gov (United States)

    Nam, Hyung Seok; Koh, Sukgyu; Beom, Jaewon; Kim, Yoon Jae; Park, Jang Woo; Koh, Eun Sil; Chung, Sun Gun; Kim, Sungwan

    2017-10-01

    A novel robotic mirror therapy system was recently developed to provide proprioceptive stimulus to the hemiplegic arm during a mirror therapy. Validation of the robotic mirror therapy system was performed to confirm its synchronicity prior to the clinical study. The mean error angle range between the intact arm and the robot was 1.97 to 4.59 degrees. A 56-year-old male who had right middle cerebral artery infarction 11 months ago received the robotic mirror therapy for ten 30-minute sessions during 2 weeks. Clinical evaluation and functional magnetic resonance imaging (fMRI) studies were performed before and after the intervention. At the follow-up evaluation, the thumb finding test score improved from 2 to 1 for eye level and from 3 to 1 for overhead level. The Albert's test score on the left side improved from 6 to 11. Improvements were sustained at 2-month follow-up. The fMRI during the passive motion revealed a considerable increase in brain activity at the lower part of the right superior parietal lobule, suggesting the possibility of proprioception enhancement. The robotic mirror therapy system may serve as a useful treatment method for patients with supratentorial stroke to facilitate recovery of proprioceptive deficit and hemineglect. © 2017 The Korean Academy of Medical Sciences.

  2. Gait Planning and Simulation of Wearable Lower Limbs Rehabilitation Exoskeleton Robot%可穿戴式下肢康复外骨骼机器人步态规划及仿真

    Institute of Scientific and Technical Information of China (English)

    谢海胜; 陈岱民

    2013-01-01

    通过分析人的下肢各关节的特征及自由度,设计可穿戴式下肢康复外骨骼机器人结构,利用CAD软件solidworks进行三维建模。为了实现可穿戴式下肢康复外骨骼机器人稳定行走功能,本文运用零力矩点( ZMP)判断依据进行步态规划。在机器人进行步态规划时采用三次样条插值法得到可穿戴式下肢康复外骨骼机器人各关节的平滑运动轨迹,同时,摆动腿在运动过程中脚底与地面始终平行。最后在ADAMS软件中建立可穿戴式下肢康复外骨骼机器人的虚拟样机进行运动学仿真。%Through analyzing the characteristics and freedom of human lower extremity joints, this paper designs a structure of the wearable lower limbs rehabilitation exoskeleton robot and builds a three-dimensional modeling by solidworks software of CAD. In order to realize the function of the stable walking for the wearable lower limbs rehabilitation exoskeleton robot,it uses the principle of ZMP to plan gait. In the process of planning gait,it gets the smooth trajectory of every joint by cubic spline interpolation, keeping the foot of swinging legs parallel to the ground. Finally, it establishes a virtual prototype of the wearable lower limb rehabilitation exoskeleton robot and makes a simulation in ADAMS software.

  3. How could robotic training and botolinum toxin be combined in chronic post stroke upper limb spasticity? A pilot study.

    Science.gov (United States)

    Pennati, G V; Da Re, C; Messineo, I; Bonaiuti, D

    2015-08-01

    Spasticity has a role of primary importance in functional motor recovery of upper limb after a stroke. The widespread intervention is the botulinum toxin neurolysis, however robotic training could have a role as useful addition to this conventional therapy. The aim of this study was to verify how the combination of a short robotic training and chemical neurolysis reduces spasticity and improves function in chronic post-stroke patients. Prospective single blind randomized controlled clinical trial. Post-stroke outpatients. Fifteen chronic post-stroke outpatients with severe upper limb spastic paresis. Two experimental groups underwent ten sessions of robotic training, alone (Group A) or with Botulinum toxin neurolysis (Group B). Evaluation of motor function with Fugl Meyer Upper Limb Assessment Scale (FMA) and Box & Block Test (B&B), disability with Functional Indipendence Measure (FIM), spasticity with Modified Ashworth Scale (MAS), and the Quality of Life (Euro-Qol) and muscular recruitment pattern with dynamic surface electromyography were carried out before and after the interventions. Both groups showed improvement in FMA (Group A 8.25 and Group B 5.29). Higher improvement in B&B was detected in the group A (2.62 versus 0,14 in Group B). MAS was improved more in the Group B (-0,86 versus -0,14 in Group A). In both groups, sEMG showed a reduction of co-contractions and an increase of agonist muscles recruitment during the reaching movement and the robotic exercises. The demonstrated improvement in motor function and in muscular activation pattern suggests how a short robotic training could be effective in chronic post-stroke spasticity of upper limb and in less severe spasticity the only robotic treatment could be effective. With the limits of small sample, the results showed some equivalence between these two approaches with respect to motor recovery and spasticity reduction suggesting that the cost effectiveness of each treatment may have an important role in

  4. Optimized Physical Design and Simulation of a Lower limb Exoskeletons’ Rehabilitation Robot%一种下肢外骨骼康复机器人优化的结构设计与控制仿真分析

    Institute of Scientific and Technical Information of China (English)

    张玉叶; 张小栋; 江城; 王贺; 石强勇

    2015-01-01

    Nowadays,more and more stroke pa-tients lead to the strenuous rehabilitation training tasks of therapists and the incomplete rehabilita-tion evaluation system.Aiming at such situations our team design a n exoskeleton rehabilitation ro-bot.According to the dynamic characters of the robot we analyzed the lower limb rehabilitation strategy and the corresponding control strategy.A control method was therefore proposed and ana-lyzed via simulation.The simulation results show that the proposed control method has obvious ad-vantages in tracking precision and speed.%越来越多的脑卒中患者使得理疗师的康复训练工作繁重且康复效果评估体系不完整,针对此现状,设计出一款优化的外骨骼康复机器人模型。介绍了该机器人优化的结构设计,并对其进行了相对应的控制策略分析,进而提出一种控制方法并进行了仿真分析。仿真实验研究表明,所提出的控制策略在跟踪精度和速度上都具有明显的优势。

  5. 欠驱动式外骨骼手指康复机器人的设计和仿真%The design and simulation of the underactuation exoskeleton finger rehabilitation robot

    Institute of Scientific and Technical Information of China (English)

    张帆; 郭书祥; 魏巍

    2015-01-01

    In this paper, a novel exoskeleton finger rehabilitation robot system based on EEG signals is proposed, and the system consists of an exoskeleton finger robot, one EEG system, one human-computer interaction system, one motor control unit, some sensors and a workstation. Patients produce the EEG signals by the visual stimulation, and after the workstation collects and analyzes these signals, it is sent to the motor control unit to drive the robot motion that is fixed on the patient's finger to assist patient in finishing the rehabilitation tralning. The finger robot malnly adopts the underactuation method, and it can achieve the flexion and extension motion of three joints through the synchronous toothed belt transmission mechanism driven by the motor fixed on the back of the hand. Meanwhile, the paper adopts the UG software to design the robot and ADAMS software to the kinematic simulation. According to the robot trajectory and the movement parameters curve of the robot end-effecter, it shows that the exoskeleton finger robot motion is smooth without the motion dead point, and robot can satisfy movement requirements of the human finger, and accord with design characteristic of the ergonomic, which means that it has the ability to assist patients to implement the repeatability rehabilitation tralning.%本文提出一种新的基于脑电信号控制的外骨骼手指康复机器人系统,该系统主要由外骨骼手指康复机器人、脑电信号系统(EEG)、肌电信号系统(EMG)、人机交互系统、电机控制单元、相关传感器和工作站组成。患者通过外界的视觉刺激产生脑电信号,工作站经过对这些信号采集和处理后传递给电机控制单元控制,并驱动电机实现穿戴在患者手上的外骨骼手指机器人运动,辅助其完成康复训练。该机器人主要采用欠驱动的方式,由安装在手背处的电机带动同步齿形带传动机构实现机器的三个关节的弯曲和伸

  6. 康复机器人训练对脑卒中偏瘫患者上肢功能的影响%Effect of rehabilitation robot on upper extremity function of hemiplegic patients

    Institute of Scientific and Technical Information of China (English)

    龙耀斌

    2012-01-01

    Objective: To observe the effect of the upper limb rehabilitation robot combined with conventional rehabilitation on upper extremity function of hemiplegic patients. Methods: 80 cases of hemiplegic upper limb dysfunction were divided into two groups. Both groups were given normal limb function training, at the same time the treatment group was given the upper iitnb rehabilitation robot training. Modified ashworth scale (MAS) score, simplified Fugl-Meyer upper limb motor function (FMA) score and the modified Barthel index (MBI) were compared before and after the treatment. Results: After 1 month of treatment, MAS scores in two groups were decreased as compared with those before treatment (F<0. 05), and those in treatment group was reduced as compared with control group (P<0. 05). FMA and ADL in two groups after treatment were improved as compared with those before treatment(Prehabilitation robot training with conventional rehabilitation can not only effectively improve the upper limb function of hemiplegic patients, but also can promote the recovery of activities of daily living.%目的:探讨上肢康复机器人训练结合常规康复治疗对脑卒中偏瘫患者上肢功能的影响.方法:80例脑梗死患者随机分为2组,均接受基础药物治疗和常规康复治疗;观察组增加上肢康复机器人训练.治疗前后分别进行上肢肌张力改良Ashworth量表(MAS)评分、上肢运动功能(FMA)评分及改良Barthel指数(MBI)评定.结果:治疗1个月后,2组患者上肢MAS评分均较治疗前明显下降(P<0.05),且观察组更低于对照组(P<0.05);FMA及改良Barthel指数(MBI)评分均较治疗前明显提高(P<0.05),且观察组较对照组更加显著(P<0.05).结论:上肢康复机器人训练结合常规康复治疗不仅能改善脑梗死患者上肢功能,而且能促进日常生活活动能力的恢复.

  7. Combining levodopa and virtual reality-based therapy for the rehabilitation of upper limb after acute stroke: pilot study part II.

    Science.gov (United States)

    Samuel, Geoffrey Sithamparapillai; Oey, Nicodemus Eldrick; Choo, Min; Ju, Han; Chan, Wai Yin; Kok, Stanley; Ge, Yu; Van Dongen, Antonius M; Ng, Yee Sien

    2016-06-17

    This study aimed to evaluate the safety and efficacy of a combination of levodopa and virtual reality (VR)-based therapy for the enhancement of upper limb recovery following acute stroke. This was a pilot single-blinded case series of acute stroke patients with upper extremity hemiparesis randomised to standard care with concomitant administration of either levodopa alone (conventional therapy or control group) or combination therapy consisting of VR-based motivational visuomotor feedback training coupled with levodopa neuromodulation (combination therapy or VR group). Main clinical outcome measures were the Fugl-Meyer-Upper Extremity (FM-UE) assessment and Action Research Arm Test (ARAT). Kinematic measurements of the affected upper limb movement were evaluated as a secondary measure of improvement. Of 42 patients screened, four were enrolled in the VR group and four in the control group, from which two patients dropped out during the trial. Patients receiving combination therapy had clinically significant improvements in FM-UE assessment scores of 16.5 points compared to a 3.0-points improvement among control patients. Similarly, ARAT scores of VR group patients improved by 15.3 points compared to a 10.0-points improvement in the control group. Corresponding improvements were noted in kinematic measures, including hand-path ratio, demonstrating improved quality of upper limb movement in the VR group. Our results suggest that VR-based therapy and pharmacotherapy may be combined for acute stroke rehabilitation. The bedside acquisition of kinematic measurements allows for an accurate assessment of the quality of limb movement, offering a sensitive clinical tool for quantifying motor recovery during the rehabilitation process after acute stroke.

  8. Effectiveness of subperiosteal bone anchor (Onplant) placement in the anterior highly atrophic maxilla for cross-arch prosthetic rehabilitation: Results from a pilot study.

    Science.gov (United States)

    Heuberer, Simone; Ulm, Christian; Zauza, Konstantin; Zechner, Werner; Watzek, Georg; Dvorak, Gabriella

    The present prospective pilot study aimed to evaluate the feasibility of Onplants (Onplant Orthodontic System) off label use in the highly atrophic edentulous maxillae of adult patients to avoid bone grafting and conventional dental or zygomatic implants. Two Onplants were placed subperiosteally in the anterior part of the hard palate in five adult patients presenting a highly atrophic edentulous maxilla, class V or VI, according to Cawood and Howell. After a healing period of 4 months the prosthetic procedures were started. Outcome measures were the survival rate of the Onplant system, complication rate and OHRQoL using a OHIP-G questionnaire at three different stages: before and after the Onplant placement and at the end of treatment. Unexpectedly, the present study had to be discontinued due to the early loss of all 10 Onplants at the time of prosthetic loading. In total, 16 patients were meant to participate, but the study was stopped after complete failures of the first five patients. While all inserted Onplants became unstable, no other complications like penetration of the nasal cavity, infections or fractures of the abutment screw were observed. The patient satisfaction and the oral health-related quality of life declined with the number of surgical interventions and finally with the Onplant failure. The anterior part of the adult hard palate apparently did not present adequate bone regenerative capacity to support Onplant-prosthetic rehabilitation. Off-label Onplant-supported prostheses are contraindicated for permanent maxillary rehabilitation in edentulous adult patients. Conflict-of-interest statement: The original manufacturer provided the materials free of charge in this investigator-sponsored research (code: 2011-1027). The authors declare no conflicts of interest in relation to this study.

  9. A pilot study on the effects of a team building process on the perception of work environment in an integrative hospital for neurological rehabilitation.

    Science.gov (United States)

    Ostermann, Thomas; Bertram, Mathias; Büssing, Arndt

    2010-03-09

    Neurological rehabilitation is one of the most care-intensive challenges in the health care system requiring specialist therapeutic and nursing knowledge. In this descriptive pilot study, we investigated the effects of a team building process on perceived work environment, self-ascribed professional competence, life satisfaction, and client satisfaction in an anthroposophic specialized hospital for neurological rehabilitation. The team-building process consisted of didactic instruction and training in problem-solving, teambuilding and constructive conflict resolution. Seventy seven staff members and 44 patients' relatives were asked to complete a survey that included the Work Environment Scale (WES-10), a Life Satisfaction Scale (BMLSS), the Conviction of Therapeutic Competency (CTC) scale and the Client Satisfaction Questionnaire (CSQ-8). To evaluate the outcome of the team building process, we analyzed changes over time in the WES-10 subscales. Additionally the interrelationship between the WES-10 subscales with other subscales and with sociodemographic parameters like age, gender was calculated by means of a bivariate correlation analysis. The team building process had a significant positive effect on perceived work environment in only one area. There was a significant improvement in the ward staffs' perception of their ability to constructively resolve conflicts 3 years after inception of the team building process than there was before inception. However, even in a unit that utilized holistic treatment and nursing in the care of severely disable patients, such care necessitating a very heavy workload, the measurements on the Self Realization, Life Satisfaction and Conviction of Therapeutic Competency scales remained high and unchanged over the three year time period of the study. Strategic interventions might be an option to improve interpersonal relationships and finally quality of patient care.

  10. Android Robot-Mediated Mock Job Interview Sessions for Young Adults with Autism Spectrum Disorder: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Hirokazu Kumazaki

    2017-09-01

    Full Text Available The feasibility and preliminary efficacy of an android robot-mediated mock job interview training in terms of both bolstering self-confidence and reducing biological levels of stress in comparison to a psycho-educational approach human interview was assessed in a randomized study. Young adults (ages 18–25 years with autism spectrum disorder (ASD were randomized to participate either in a mock job interview training with our android robot system (n = 7 or a self-paced review of materials about job-interviewing skills (n = 8. Baseline and outcome measurements of self-reported performance/efficacy and salivary cortisol were obtained after a mock job interview with a human interviewer. After training sessions, individuals with ASD participating in the android robot-mediated sessions reported marginally improved self-confidence and demonstrated significantly lower levels of salivary cortisol as compared to the control condition. These results provide preliminary support for the feasibility and efficacy of android robot-mediated learning.

  11. Android Robot-Mediated Mock Job Interview Sessions for Young Adults with Autism Spectrum Disorder: A Pilot Study

    Science.gov (United States)

    Kumazaki, Hirokazu; Warren, Zachary; Corbett, Blythe A.; Yoshikawa, Yuichiro; Matsumoto, Yoshio; Higashida, Haruhiro; Yuhi, Teruko; Ikeda, Takashi; Ishiguro, Hiroshi; Kikuchi, Mitsuru

    2017-01-01

    The feasibility and preliminary efficacy of an android robot-mediated mock job interview training in terms of both bolstering self-confidence and reducing biological levels of stress in comparison to a psycho-educational approach human interview was assessed in a randomized study. Young adults (ages 18–25 years) with autism spectrum disorder (ASD) were randomized to participate either in a mock job interview training with our android robot system (n = 7) or a self-paced review of materials about job-interviewing skills (n = 8). Baseline and outcome measurements of self-reported performance/efficacy and salivary cortisol were obtained after a mock job interview with a human interviewer. After training sessions, individuals with ASD participating in the android robot-mediated sessions reported marginally improved self-confidence and demonstrated significantly lower levels of salivary cortisol as compared to the control condition. These results provide preliminary support for the feasibility and efficacy of android robot-mediated learning. PMID:28955254

  12. Android Robot-Mediated Mock Job Interview Sessions for Young Adults with Autism Spectrum Disorder: A Pilot Study.

    Science.gov (United States)

    Kumazaki, Hirokazu; Warren, Zachary; Corbett, Blythe A; Yoshikawa, Yuichiro; Matsumoto, Yoshio; Higashida, Haruhiro; Yuhi, Teruko; Ikeda, Takashi; Ishiguro, Hiroshi; Kikuchi, Mitsuru

    2017-01-01

    The feasibility and preliminary efficacy of an android robot-mediated mock job interview training in terms of both bolstering self-confidence and reducing biological levels of stress in comparison to a psycho-educational approach human interview was assessed in a randomized study. Young adults (ages 18-25 years) with autism spectrum disorder (ASD) were randomized to participate either in a mock job interview training with our android robot system (n = 7) or a self-paced review of materials about job-interviewing skills (n = 8). Baseline and outcome measurements of self-reported performance/efficacy and salivary cortisol were obtained after a mock job interview with a human interviewer. After training sessions, individuals with ASD participating in the android robot-mediated sessions reported marginally improved self-confidence and demonstrated significantly lower levels of salivary cortisol as compared to the control condition. These results provide preliminary support for the feasibility and efficacy of android robot-mediated learning.

  13. Low-vision rehabilitation by means of MP-1 biofeedback examination in patients with different macular diseases: a pilot study.

    Science.gov (United States)

    Vingolo, Enzo M; Salvatore, Serena; Cavarretta, Sonia

    2009-06-01

    Macular disease is one of the main causes of visual impairment. We studied the efficacy of low-vision rehabilitation by means of MP-1 biofeedback examination in patients with different macular disease. Five patients were enrolled (3 female and 2 male, mean age 53.8 years) and a total of 9 eyes was examined: 2 eyes with vitelliform dystrophy, 1 with a post-traumatic macular scar, 2 with Stargardt disease, 2 with myopic macular degeneration, 2 with cone dystrophy. All the patients underwent the following tests: visual acuity, reading speed, fixation test, MP-1 microperimetry. Low-vision rehabilitation, which lasted 10 weeks, consisted of 10 training sessions of 10 min for each eye, performed once a week using the MP-1 biofeedback examination. Statistical analysis was performed using Student's t-test. p values less than 0.05 were considered statistically significant. After training all patients displayed an improvement in visual acuity, fixation behaviour, retinal sensitivity and reading speed. Fixation behaviour within the 2 degrees diameter circle improved and was statistically significant for reading speed (p = 0.01). Reading speed improved from a mean value of 64.3 to 92 words/min. Our results show that audio feedback can, by increasing attentional modulation, help the brain to fix the final preferred retinal locus. Audio feedback facilitates stimuli transmission between intraretinal neurons as well as between the retina and brain, which is where the highest level of stimuli processing occurs, thereby probably supporting a "remapping phenomenon".

  14. Pilot study: Computer-based virtual anatomical interactivity for rehabilitation of individuals with chronic acquired brain injury.

    Science.gov (United States)

    Simmons, C Douglas; Arthanat, Sajay; Macri, Vincent J

    2014-01-01

    Deficiencies in upper-limb motor function and executive functioning can compromise an affected individual's ability to complete everyday activities. Impaired motor and executive functioning therefore pose a risk to increasing numbers of veterans who have been diagnosed with acquired brain injury. This article reports on changes in upper-limb motor function and executive functioning of 12 adult participants with chronic acquired brain injury using a novel, computer-based, motor and cognitive rehabilitation program called PreMotor Exercise Games (PEGs). Manual muscle, goniometric range of motion, and dynamometer assessments were used to determine motor functioning while the Executive Function Performance Test measured cognitive functioning. A three-level repeated measures design was conducted to determine changes pre- and postintervention. Participants demonstrated significant improvement in shoulder (p = 0.01) and wrist (p = 0.01) range of motion and clinically relevant improvement for elbow range of motion. Participants demonstrated clinically relevant improvement in shoulder, elbow, and wrist strength. Finally, participants demonstrated significant improvement in executive functioning (p rehabilitation and warrants further study.

  15. Rehabilitation and multiple sclerosis

    DEFF Research Database (Denmark)

    Dalgas, Ulrik

    2011-01-01

    In a chronic and disabling disease like multiple sclerosis, rehabilitation becomes of major importance in the preservation of physical, psychological and social functioning. Approximately 80% of patients have multiple sclerosis for more than 35 years and most will develop disability at some point...... of their lives, emphasising the importance of rehabilitation in order to maintain quality of life. An important aspect of multiple sclerosis rehabilitation is the preservation of physical functioning. Hot topics in the rehabilitation of physical function include (1) exercise therapy, (2) robot-assisted training...... and (3) pharmacological interventions. Exercise therapy has for many years been a controversial issue in multiple sclerosis rehabilitation and the advice generally given to patients was not to participate in physical exercise, since it was thought to lead to a worsening of symptoms or fatigue. However...

  16. The MOTIV-HEART Study: A Prospective, Randomized, Single-Blind Pilot Study of Brief Strategic Therapy and Motivational Interviewing among Cardiac Rehabilitation Patients

    Science.gov (United States)

    Pietrabissa, Giada; Manzoni, Gian Mauro; Rossi, Alessandro; Castelnuovo, Gianluca

    2017-01-01

    Background: Psychological distress, biomedical parameters, and unhealthy lifestyles contribute to a poorer prognosis for cardiac disease. Public health's challenge is to motivate patients to utilize self-care. Objective: This prospective, randomized, single-blind pilot study aimed at testing the incremental efficacy of Brief Strategic Therapy (BST) combined with Motivational Interviewing (MI) in improving selected biomedical and psychological outcomes over and beyond those of the stand-alone BST in a residential Cardiac Rehabilitation (CR) program. Method: Fourty-two inpatients (17 females), enrolled in a 1-month CR program, were randomly allocated into two conditions: (a) Three sessions of BST and (b) Three sessions of BST plus MI. Data were collected at baseline, discharge, and after 3 months through phone interviews. Results: At discharge, no significant between-group difference was found in any outcome variable. Changes from pre- to post-treatment within each condition showed significant improvements only in the BST group, where the level of external regulation diminished, and both the participants' self-regulation (Relative Autonomous Motivation Index, RAI) and willingness to change improved. At the 3-month follow-up, within-group analyses on responders (BST = 9; BST + MI = 11) showed a statistically significant improvement in the level of systolic blood pressure in both groups. Discussion: Findings showed no evidence of the incremental efficacy of combining BST and MI over and beyond BST alone on either selected biomedical or psychological outcomes among CR patients. Conclusions: Ends and limitations from the present pilot study should be considered and addressed in future investigations. PMID:28223950

  17. Clonally related methicillin-resistant Staphylococcus aureus isolated from short-finned pilot whales (Globicephala macrorhynchus), human volunteers, and a bayfront cetacean rehabilitation facility.

    Science.gov (United States)

    Hower, Suzanne; Phillips, Matthew C; Brodsky, Micah; Dameron, Adrienne; Tamargo, Manuel A; Salazar, Norma C; Jackson, Charlene R; Barrett, John B; Davidson, Maureen; Davis, Johnnie; Mukherjee, Sampa; Ewing, Ruth Y; Gidley, Maribeth L; Sinigalliano, Christopher D; Johns, Lisa; Johnson, Frank E; Adebanjo, Olufunmilola; Plano, Lisa R W

    2013-05-01

    In May of 2011, a live mass stranding of 26 short-finned pilot whales (Globicephala macrorhynchus) occurred in the lower Florida Keys. Five surviving whales were transferred from the original stranding site to a nearby marine mammal rehabilitation facility where they were constantly attended to by a team of volunteers. Bacteria cultured during the routine clinical care of the whales and necropsy of a deceased whale included methicillin-sensitive and methicillin-resistant Staphylococcus aureus (MSSA and MRSA). In order to investigate potential sources or reservoirs of MSSA and MRSA, samples were obtained from human volunteers, whales, seawater, and sand from multiple sites at the facility, nearby recreational beaches, and a canal. Samples were collected on 3 days. The second collection day was 2 weeks after the first, and the third collection day was 2 months after the last animal was removed from the facility. MRSA and MSSA were isolated on each day from the facility when animals and volunteers were present. MSSA was found at an adjacent beach on all three collection days. Isolates were characterized by utilizing a combination of quantitative real-time PCR to determine the presence of mecA and genes associated with virulence, staphylococcal protein A typing, staphylococcal cassette chromosome mec typing, multilocus sequence typing, and pulsed field gel electrophoresis (PFGE). Using these methods, clonally related MRSA were isolated from multiple environmental locations as well as from humans and animals. Non-identical but genetically similar MSSA and MRSA were also identified from distinct sources within this sample pool. PFGE indicated that the majority of MRSA isolates were clonally related to the prototype human strain USA300. These studies support the notion that S. aureus may be shed into an environment by humans or pilot whales and subsequently colonize or infect exposed new hosts.

  18. Effects of Assist-As-Needed Upper Extremity Robotic Therapy after Incomplete Spinal Cord Injury: A Parallel-Group Controlled Trial

    Directory of Open Access Journals (Sweden)

    John Michael Frullo

    2017-06-01

    Full Text Available BackgroundRobotic rehabilitation of the upper limb following neurological injury has been supported through several large clinical studies for individuals with chronic stroke. The application of robotic rehabilitation to the treatment of other neurological injuries is less developed, despite indications that strategies successful for restoration of motor capability following stroke may benefit individuals with incomplete spinal cord injury (SCI as well. Although recent studies suggest that robot-aided rehabilitation might be beneficial after incomplete SCI, it is still unclear what type of robot-aided intervention contributes to motor recovery.MethodsWe developed a novel assist-as-needed (AAN robotic controller to adjust challenge and robotic assistance continuously during rehabilitation therapy delivered via an upper extremity exoskeleton, the MAHI Exo-II, to train independent elbow and wrist joint movements. We further enrolled seventeen patients with incomplete spinal cord injury (AIS C and D levels in a parallel-group balanced controlled trial to test the efficacy of the AAN controller, compared to a subject-triggered (ST controller that does not adjust assistance or challenge levels continuously during therapy. The conducted study is a stage two, development-of-concept pilot study.ResultsWe validated the AAN controller in its capability of modulating assistance and challenge during therapy via analysis of longitudinal robotic metrics. For the selected primary outcome measure, the pre–post difference in ARAT score, no statistically significant change was measured in either group of subjects. Ancillary analysis of secondary outcome measures obtained via robotic testing indicates gradual improvement in movement quality during the therapy program in both groups, with the AAN controller affording greater increases in movement quality over the ST controller.ConclusionThe present study demonstrates feasibility of subject-adaptive robotic therapy

  19. Toward a P300 based Brain-Computer Interface for aphasia rehabilitation after stroke: Presentation of theoretical considerations and a pilot feasibility study

    Directory of Open Access Journals (Sweden)

    Sonja C Kleih

    2016-11-01

    Full Text Available People with post-stroke motor aphasia know what they would like to say but cannot express it through motor pathways due to disruption of cortical circuits. We present a theoretical background for our hypothesized connection between attention and aphasia rehabilitation and suggest why in this context, Brain-Computer Interfaces (BCI use might be beneficial for patients diagnosed with aphasia. Not only could BCI technology provide a communication tool, it might support neuronal plasticity by activating language circuits and thereby boost aphasia recovery. However, stroke may lead to heterogeneous symptoms that might hinder BCI use which is why the feasibility of this approach needed to be investigated first. In this pilot study, we included five participants diagnosed with post-stroke aphasia. Four participants were initially unable to use the visual P300 speller paradigm. By adjusting the paradigm to their needs, all participants could successfully learn to use the speller for communication with accuracies up to 100%. We describe necessary adjustments to the paradigm and present future steps to further investigate the here presented approach.

  20. Toward a P300 Based Brain-Computer Interface for Aphasia Rehabilitation after Stroke: Presentation of Theoretical Considerations and a Pilot Feasibility Study

    Science.gov (United States)

    Kleih, Sonja C.; Gottschalt, Lea; Teichlein, Eva; Weilbach, Franz X.

    2016-01-01

    People with post-stroke motor aphasia know what they would like to say but cannot express it through motor pathways due to disruption of cortical circuits. We present a theoretical background for our hypothesized connection between attention and aphasia rehabilitation and suggest why in this context, Brain-Computer Interface (BCI) use might be beneficial for patients diagnosed with aphasia. Not only could BCI technology provide a communication tool, it might support neuronal plasticity by activating language circuits and thereby boost aphasia recovery. However, stroke may lead to heterogeneous symptoms that might hinder BCI use, which is why the feasibility of this approach needs to be investigated first. In this pilot study, we included five participants diagnosed with post-stroke aphasia. Four participants were initially unable to use the visual P300 speller paradigm. By adjusting the paradigm to their needs, participants could successfully learn to use the speller for communication with accuracies up to 100%. We describe necessary adjustments to the paradigm and present future steps to investigate further this approach. PMID:27891083

  1. 上肢康复机器人在脑卒中单侧空间忽略康复中的作用%Effect of Upper Limb Rehabilitation Robot Training on Unilateral Spatial Neglect in Stroke Patients

    Institute of Scientific and Technical Information of China (English)

    梁天佳; 吴小平; 莫明玉

    2012-01-01

    Objective To observe the effect of upper limb rehabilitation robot training on unilateral spatial neglect (USN) in stoke patients. Methods 30 stroke patients with USN were divided into control group (n=1 5) and observation group (n=5). Both 2 groups received routine rehabilitation and USN comprehensive training after vital signs were stable. The observation group received upper limb rehabilitation robot training additionally. Fugl-Meyer Assessment (FMA), Modified Barthel Index (MB1) and U SN were assessed before and 8 weeks after treatment. Results The scores ofFMA and MBI and USN status were significantly improved (P<0.01), and they were better in the observation group than in the control group fi'<0.01). Conclusion Upper limb rehabilitation robot training can improve USN patients' upper limb motor function and activities of daily living, and improve the degree of USN.%目的 观察上肢康复机器人对脑卒中偏瘫患者单侧空间忽略的治疗效果.方法 脑卒中单侧空间忽略(USN)患者分为对照组(n=15)和观察组(n=15),对照组在生命体征稳定后进行常规康复治疗及USN 综合训练,观察组在接受上述治疗同时进行上肢康复机器人训练,治疗前和治疗8 周后进行简式Fugl-Meyer 运动功能量表(FMA)、改良Barthel 指数(MBI)、USN评定.结果 治疗后两组FMA、MBI、USN评定均有明显好转(P<0.01),且观察组3 项指标均明显优于对照组(P<0.01).结论 上肢康复机器人训练可有效提高USN患者上肢运动功能及日常生活活动能力,改善USN程度.

  2. Robot training of upper limb in multiple sclerosis: comparing protocols with or without manipulative task components.

    Science.gov (United States)

    Carpinella, Ilaria; Cattaneo, Davide; Bertoni, Rita; Ferrarin, Maurizio

    2012-05-01

    In this pilot study, we compared two protocols for robot-based rehabilitation of upper limb in multiple sclerosis (MS): a protocol involving reaching tasks (RT) requiring arm transport only and a protocol requiring both objects' reaching and manipulation (RMT). Twenty-two MS subjects were assigned to RT or RMT group. Both protocols consisted of eight sessions. During RT training, subjects moved the handle of a planar robotic manipulandum toward circular targets displayed on a screen. RMT protocol required patients to reach and manipulate real objects, by moving the robotic arm equipped with a handle which left the hand free for distal tasks. In both trainings, the robot generated resistive and perturbing forces. Subjects were evaluated with clinical and instrumental tests. The results confirmed that MS patients maintained the ability to adapt to the robot-generated forces and that the rate of motor learning increased across sessions. Robot-therapy significantly reduced arm tremor and improved arm kinematics and functional ability. Compared to RT, RMT protocol induced a significantly larger improvement in movements involving grasp (improvement in Grasp ARAT sub-score: RMT 77.4%, RT 29.5%, p=0.035) but not precision grip. Future studies are needed to evaluate if longer trainings and the use of robotic handles would significantly improve also fine manipulation.

  3. Evaluation of a temporary prosthetic insert in the rehabilitation of elderly ischaemic below-knee amputees: a pilot study.

    Science.gov (United States)

    Hallam, F M; Jull, G A

    1988-01-01

    The physiotherapy management of elderly, ischaemic below knee amputees is often compromised by delayed and/or complicated wound healing. Such patients are often unable to ambulate on a prosthesis for prolonged periods. Problems concommitant with immobilization such as weakness, contractures, and decreased morale tend to arise. This pilot study investigated the efficacy of incorporating a shaped Dunlopillo insert into a temporary prosthetic socket to allow the at risk group to ambulate as soon as the sutures were removed regardless of the state of wound healing. Two parameters were evaluated, namely wound healing and stump maturation. A total of eighteen subjects were observed in a control and an experimental group. Both wound healing (p < 0.05) and stump maturation (p < 0.05) were significantly enhanced by the inclusion of a Dunlopillo insert.

  4. Distinctive Steady-State Heart Rate and Blood Pressure Responses to Passive Robotic Leg Exercise during Head-Up Tilt: A Pilot Study in Neurological Patients

    Directory of Open Access Journals (Sweden)

    Amirehsan Sarabadani Tafreshi

    2017-06-01

    Full Text Available Introduction: Robot-assisted tilt table therapy was proposed for early rehabilitation and mobilization of patients after diseases such as stroke. A robot-assisted tilt table with integrated passive robotic leg exercise (PE mechanism has the potential to prevent orthostatic hypotension usually provoked by verticalization. In a previous study with rather young healthy subjects [average age: 25.1 ± 2.6 years (standard deviation], we found that PE effect on the cardiovascular system depends on the verticalization angle of the robot-assisted tilt table. In the current study, we investigated in an older population of neurological patients (a whether they show the same PE effects as younger healthy population on the cardiovascular system at different tilt angles, (b whether changing the PE frequency (i.e., stepping speed influences the PE effect on the cardiovascular system, (c whether PE could prevent orthostatic hypotension, and finally, (d whether PE effect is consistent from day to day.Methods: Heart rate (HR, and systolic and diastolic blood pressures (sBP, dBP in response to PE at two different tilt angles (α = 20°, 60° with three different PE frequencies (i.e., 0, 24, and 48 steps per minute of 10 neurological patients [average age: 68.4 ± 13.5 years (standard deviation] were measured on 2 consecutive days. Linear mixed models were used to develop statistical models and analyze the repeated measurements.Results: The models show that: PE significantly increased sBP and dBP but had no significant effect on HR. (a Similar to healthy subjects the effect of PE on sBP was dependent on the tilt angle with higher tilt angles resulting in a higher increase. Head-up tilting alone significantly increased HR and dBP but resulted in a non-significant drop in sBP. PE, in general, had a more additive effect on increasing BP. (b The effect of PE was not influenced by its speed. (c Neither during head-up tilt alone nor in combination with PE did

  5. Cognitive Symptom Management and Rehabilitation Therapy (CogSMART) for veterans with traumatic brain injury: pilot randomized controlled trial.

    Science.gov (United States)

    Twamley, Elizabeth W; Jak, Amy J; Delis, Dean C; Bondi, Mark W; Lohr, James B

    2014-01-01

    Traumatic brain injury (TBI) can result in cognitive impairments and persistent postconcussive symptoms that limit functional recovery, including return to work. We evaluated a 12 wk compensatory cognitive training intervention (Cognitive Symptom Management and Rehabilitation Therapy [CogSMART]) in the context of supported employment for Veterans with mild to moderate TBI. Participants were randomly assigned to receive 12 wk of supported employment plus CogSMART or enhanced supported employment that controlled for therapist attention (control). CogSMART sessions were delivered by the employment specialist and included psychoeducation regarding TBI; strategies to improve sleep, fatigue, headaches, and tension; and compensatory cognitive strategies in the domains of prospective memory, attention, learning and memory, and executive functioning. Compared with controls, those assigned to supported employment plus CogSMART demonstrated significant reductions in postconcussive symptoms (Cohen d = 0.97) and improvements in prospective memory functioning (Cohen d = 0.72). Effect sizes favoring CogSMART for posttraumatic stress disorder symptom severity, depressive symptom severity, and attainment of competitive work within 14 wk were in the small to medium range (Cohen d = 0.35-0.49). Those who received CogSMART rated the intervention highly. Results suggest that adding CogSMART to supported employment may improve postconcussive symptoms and prospective memory. These effects, as well as smaller effects on psychiatric symptoms and ability to return to work, warrant replication in a larger trial.

  6. Paralysis: Rehabilitation

    Science.gov (United States)

    ... Forum About Us Donate Living with Paralysis > Rehabilitation Rehabilitation Rehabilitation and exercise are key to enhancing your health and quality of life. Find a rehabilitation center near you and become familiar with different ...

  7. Calculation of jacobin matrix of a 5-DOF upper limb re-habilitation robot based on screw theory%基于旋量理论的5-DOF上肢康复机器人雅克比矩阵求解

    Institute of Scientific and Technical Information of China (English)

    兰陟; 李振亮; 李亚

    2011-01-01

    For a novel 5-DOF upper limb rehabilitation robot presented in this paper, the characteristics of the rehabilitation robot's Jacobin matrix of the robot was calculated by applying screw theory as the tool, and the kinematics simulation analysis was carried out by applying ADAMS.Under conditions that the velocity of each joint has been given, the velocity of robot end effector was determined.Finally, the correctness of jacobin matrix solution is verified by comparing the simulation results with the calculated velocity of the end effector, offering a basis for the actual velocity control of the rehabilitation robot.%提出一种新型5自由度上肢康复机器人,以旋量理论为工具推导出了该机器人的雅克比矩阵.并应用AD-AMS对其进行了运动学仿真分析,在给定各关节速度的条件下,确定了末端执行器速度.最后把用雅克比矩阵求得的末端执行器的速度与仿真结果对比,验证了雅克比矩阵求解的正确性.为实际的康复机器人的速度控制提供了依据.

  8. The relationship between pain catastrophizing, kinesiophobia and subjective knee function during rehabilitation following anterior cruciate ligament reconstruction and meniscectomy: A pilot study

    Directory of Open Access Journals (Sweden)

    Ana Tichonova

    2016-01-01

    Conclusions: Pain catastrophizing and kinesiophobia decreased during rehabilitation. A higher pain catastrophizing level correlated with a greater level of knee pain during activities, more difficulties experienced during daily activities before and after rehabilitation. A high level of kinesiophobia correlated with more difficulties experienced in daily activities and poorer knee-related quality of life before and after rehabilitation.

  9. Exploratorium: Robots.

    Science.gov (United States)

    Brand, Judith, Ed.

    2002-01-01

    This issue of Exploratorium Magazine focuses on the topic robotics. It explains how to make a vibrating robotic bug and features articles on robots. Contents include: (1) "Where Robot Mice and Robot Men Run Round in Robot Towns" (Ray Bradbury); (2) "Robots at Work" (Jake Widman); (3) "Make a Vibrating Robotic Bug" (Modesto Tamez); (4) "The Robot…

  10. An Innovative Serious Game for the Detection and Rehabilitation of Oral-Facial Malfunction in Children: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Nuria Máximo-Bocanegra

    2017-01-01

    Full Text Available We present SONRIE, a serious game based on virtual reality and comprising four games which act as tests where children must perform gestures in order to progress through several screens (raising eyebrows, kissing, blowing, and smiling. The aims of this pilot study were to evaluate the overall acceptance of the game and the capacity for detecting anomalies in motor execution and, lastly, to establish motor control benchmarks in orofacial muscles. For this purpose, tests were performed in school settings with 96 typically developing children aged between five and seven years. Regarding the different games, in the kissing game, children were able to execute the correct movement at six years of age and a precise movement at the age of seven years. Blowing actions required more maturity, starting from the age of five and achievable by the age of six years. The smiling game was performed correctly among all ages evaluated. The percentage of children who mastered this gesture with both precision and speed was progressively greater reaching more than 75% of values above 100 for children aged seven years. SONRIE was accepted enthusiastically among the population under study. In the future, SONRIE could be used as a tool for detecting difficulties regarding self-control and for influencing performance and the ability to produce fine-tuned facial movements.

  11. Changes in postural strategy during exercise against perturbation using the balance exercise assist robot: a pilot study

    Science.gov (United States)

    Itoh, Norihide; Tanabe, Shigeo; Hirano, Satoshi; Saitoh, Eiichi; Kawabata, Jumpei; Imoto, Daisuke; Mikami, Yasuo; Kubo, Toshikazu

    2017-01-01

    [Purpose] To clarify the changes in postural strategy by evaluating leg joint motion and muscle activity before and after continuous exercise against perturbation using the Balance Exercise Assist Robot (BEAR). [Subjects and Methods] Nine healthy subjects (male 7, female 2; mean age 23 ± 1 years) performed a postural perturbation coping exercise only. In the task, the robot leaned and moved automatically. Participants were instructed to maintain their default upright position and they performed the exercise five times in a row (1 minute/trial). Changes in total movement distance, range of motion of each joint (hip, knee, ankle), and mean activity of each muscle for the first and fifth trials were compared. [Results] The total movement distance of BEAR and range of motion in the hip decreased significantly from the first trial to the last trial. No change in muscle activity was observed in the rectus femoris, biceps femoris, tibialis anterior or gastrocnemius. [Conclusion] The results for exercise against perturbation using BEAR in this study suggest that BEAR may be a promising method to improve the ankle strategy for maintaining a standing posture. PMID:28210030

  12. Effects of Robot Assisted Gait Training in Progressive Supranuclear Palsy (PSP: a preliminary report.

    Directory of Open Access Journals (Sweden)

    Patrizio eSale

    2014-04-01

    Full Text Available Background and Purpose: Progressive supranuclear palsy (PSP is a rare neurodegenerative disease clinically characterized by prominent axial extrapyramidal motor symptoms with frequent falls. Over the last years the introduction of robotic technologies to recover lower limb function has been greatly employed in the rehabilitative practice. This observational trial is aimed at investigating the feasibility, the effectiveness and the efficacy of end-effector robot training in people with PSP.Method: Pilot observational trial.Participants: Five cognitively intact participants with PSP and gait disorders.Interventions: Patients were submitted to a rehabilitative program of robot-assisted walking sessions for 45 minutes, 5 times a week for 4 weeks.Main outcome measures: The spatiotemporal parameters at the beginning (T0 and at the end of treatment (T1 were recorded by a gait analysis laboratory.Results: Robot training was feasible, acceptable and safe and all participants completed the prescribed training sessions. All patients showed an improvement in the gait index (Mean velocity, Cadence, Step length and Step width (T0 versus T1.Conclusions: Robot training is a feasible and safe form of rehabilitation for cognitively intact people with PSP. This innovative approach can contribute to improve lower limb motor recovery. The focus on gait recovery is another quality that makes this research important for clinical practice. On the whole, the simplicity of treatment, the lack of side effects and the positive results in the patients support the recommendation to extend the trials of this treatment. Further investigation regarding the effectiveness of robot training in time is necessary.Trial registration: ClinicalTrials.gov NCT01668407.

  13. A Robot for Wrist Rehabilitation

    Science.gov (United States)

    2007-11-02

    hand. After reviewing each of these kinematic options, a cardan joint was found to be the most appropriate (see Figure 3). A mockup is shown in figure 4...motors for pronation/supination. Because the flexion/extension and abduction/adduction Fig.2. Curved Slider Fig.3. Cardan Joint Kinematics Fig.4

  14. Design of the Software of a Rehabilitative Gait Training Robotic System Based on the Virtual Reality Technology%基于虚拟现实的步态训练康复机器人系统软件设计

    Institute of Scientific and Technical Information of China (English)

    张磊杰; 刘永久; 王慧; 汪步云; 刘艳阳; 宋全军

    2012-01-01

    This paper proposes a rehabilitative gait training robotic system based on the virtual reality technology, which improves the current tedious and boring patients rehabilitative training process. Virtual game is activated by the information from the brain-computer interface and runs in the form of a thread with a singleton design pattern as the main mode. Interacting with the main software, virtual game can achieve quick and effective access operations of heart rate and other physiological information of patients, which are properly reflected in the game. Virtual game makes rehabilitation training more interesting and attractive and significantly increases patients' initiative to participate in rehabilitation training.%提出了一种基于虚拟现实的步态训练康复机器人系统,该系统解决了传统下肢康复训练单一乏味的问题.虚拟游戏以脑—机接口为启动端口,以线程方式在系统中运行,以单例设计模式为主要模式,通过与系统控制主软件协同合作,对病人的步态速度、心跳等生理信息进行快速合理有效的存取操作,并将速度等信息恰当地体现在游戏中.引入虚拟游戏后,康复训练过程更有趣味性,这也在很大程度上提高了病人进行康复训练的积极性.

  15. Voluntary driven exoskeleton as a new tool for rehabilitation in chronic spinal cord injury: a pilot study.

    Science.gov (United States)

    Aach, Mirko; Cruciger, Oliver; Sczesny-Kaiser, Matthias; Höffken, Oliver; Meindl, Renate Ch; Tegenthoff, Martin; Schwenkreis, Peter; Sankai, Yoshiyuki; Schildhauer, Thomas A

    2014-12-01

    Treadmill training after traumatic spinal cord injury (SCI) has become an established therapy to improve walking capabilities. The hybrid assistive limb (HAL) exoskeleton has been developed to support motor function and is tailored to the patients' voluntary drive. To determine whether locomotor training with the exoskeleton HAL is safe and can increase functional mobility in chronic paraplegic patients after SCI. A single case experimental A-B (pre-post) design study by repeated assessments of the same patients. The subjects performed 90 days (five times per week) of HAL exoskeleton body weight supported treadmill training with variable gait speed and body weight support. Eight patients with chronic SCI classified by the American Spinal Injury Association (ASIA) Impairment Scale (AIS) consisting of ASIA A (zones of partial preservation [ZPP] L3-S1), n=4; ASIA B (with motor ZPP L3-S1), n=1; and ASIA C/D, n=3, who received full rehabilitation in the acute and subacute phases of SCI. Functional measures included treadmill-associated walking distance, speed, and time, with additional analysis of functional improvements using the 10-m walk test (10MWT), timed-up and go test (TUG test), 6-minute walk test (6MWT), and the walking index for SCI II (WISCI II) score. Secondary physiologic measures including the AIS with the lower extremity motor score (LEMS), the spinal spasticity (Ashworth scale), and the lower extremity circumferences. Subjects performed standardized functional testing before and after the 90 days of intervention. Highly significant improvements of HAL-associated walking time, distance, and speed were noticed. Furthermore, significant improvements have been especially shown in the functional abilities without the exoskeleton for over-ground walking obtained in the 6MWT, TUG test, and the 10MWT, including an increase in the WISCI II score of three patients. Muscle strength (LEMS) increased in all patients accompanied by a gain of the lower limb

  16. Human-robot interaction strategies for walker-assisted locomotion

    CERN Document Server

    Cifuentes, Carlos A

    2016-01-01

    This book presents the development of a new multimodal human-robot interface for testing and validating control strategies applied to robotic walkers for assisting human mobility and gait rehabilitation. The aim is to achieve a closer interaction between the robotic device and the individual, empowering the rehabilitation potential of such devices in clinical applications. A new multimodal human-robot interface for testing and validating control strategies applied to robotic walkers for assisting human mobility and gait rehabilitation is presented. Trends and opportunities for future advances in the field of assistive locomotion via the development of hybrid solutions based on the combination of smart walkers and biomechatronic exoskeletons are also discussed. .

  17. New trends in medical and service robots human centered analysis, control and design

    CERN Document Server

    Chevallereau, Christine; Pisla, Doina; Bleuler, Hannes; Rodić, Aleksandar

    2016-01-01

    Medical and service robotics integrates several disciplines and technologies such as mechanisms, mechatronics, biomechanics, humanoid robotics, exoskeletons, and anthropomorphic hands. This book presents the most recent advances in medical and service robotics, with a stress on human aspects. It collects the selected peer-reviewed papers of the Fourth International Workshop on Medical and Service Robots, held in Nantes, France in 2015, covering topics on: exoskeletons, anthropomorphic hands, therapeutic robots and rehabilitation, cognitive robots, humanoid and service robots, assistive robots and elderly assistance, surgical robots, human-robot interfaces, BMI and BCI, haptic devices and design for medical and assistive robotics. This book offers a valuable addition to existing literature.

  18. Application of stepping motor controlled by LPC2132 in rehabilitation robot%基于LPC2132控制步进电机在康复机器人中的应用

    Institute of Scientific and Technical Information of China (English)

    陈贵亮; 孙立群; 刘更谦

    2013-01-01

    In order to achieve real-time follow and Constant weight loss function of the lower extremity exoskeleton rehabili-tation robot,a removable weight loss platform was set up at the top of the lower extremity exoskeleton rehabilitation robot. The controller LPC2132 is used for the closed-loop control of stepping motor. In the circuit control system,the sensor signal is got by A / D convertion module,the PWM transmitter module drives stepping motor,and the serial communication module is used to interact with the host computer. The pulse signal was simulated by Proteus. The simulation result proves that the system has stable operating state.%为了实现下肢外骨骼康复机器人的实时跟随,并且恒力减重功能。在下肢外骨骼康复机器人顶部设立可移动的减重平台。采用LPC2132控制器对步进电机进行闭环控制。电路控制系统中,采用A/D转换模块获取传感器信号,PWM发射模块驱动步进电机运动,串口通信模块与上位机进行交互。利用Proteus对脉冲信号进行仿真,通过试验证明了系统具有稳定的运行状态。

  19. Lokomat对脑梗死后偏瘫患者关节活动度及下肢运动功能的影响%Gait training after stroke using the Lokomat rehabilitation robot

    Institute of Scientific and Technical Information of China (English)

    赵雅宁; 郝正玮; 李建民

    2013-01-01

    Objective To investigate the effect of Lokomat gait training rehabilitation robot on joint motion and lower limb function in hemiplegic patients after stroke.Methods Forty hemiplegic patients after stroke were randomized equally into a robotic group and a control group (20 cases in each group).The robotic group received robotic rehabilitation therapy in addition to routine rehabilitation training,while the control group was only given instructions for routine rehabilitation training.All the patients were assessed at the beginning of the training and at the end of 4,8 and 10 weeks of treatment.The Fugl-Meyer Assessment of lower extremities (FMA),range of motion (ROM) in hip and knee,force and tone of bilateral hip/knee flexors and extensors were used to evaluate stepping function before training,and after 4,8 and 10 weeks of treatment.Results There was no significant difference between the 2 groups with regard to FMA scores,the ROM in hip and knee,as well as force and tone of bilateral hip/ knee flexors and extensors (P > 0.05).After treatment,the robotic group was significantly improved with all the evaluation indexes when compared to its baseline values (P < 0.05).It was also shown that the robotic group improved to a significantly greater extent than the control group (P < 0.05).Pearson's correlation analysis demonstrated a positive relationship between the ROM of knee or hip and lower limb function (P < 0.05).Conclusions The Lokomat gait training rehabilitation robot can improve the lower extremities functions,as indicated by increase of ROM and muscle strength as well as decrease in muscle spasticity in hemiplegic patients after stroke.%目的 探讨Lokomat下肢康复训练机器人对脑梗死偏瘫患者关节活动度和下肢运动功能的相关性.方法 将下肢功能偏瘫的患者40例随机分为对照组(20例)和机器人组(20例).对照组给予康复指导,自行训练;机器人组给予下肢康复机器人运动训练,每次30 min

  20. Robotic therapy provides a stimulus for upper limb motor recovery after stroke that is complementary to and distinct from conventional therapy.

    Science.gov (United States)

    Brokaw, Elizabeth B; Nichols, Diane; Holley, Rahsaan J; Lum, Peter S

    2014-05-01

    Individuals with chronic stroke often have long-lasting upper extremity impairments that impede function during activities of daily living. Rehabilitation robotics have shown promise in improving arm function, but current systems do not allow realistic training of activities of daily living. We have incorporated the ARMin III and HandSOME device into a novel robotic therapy modality that provides functional training of reach and grasp tasks. To compare the effects of equal doses of robotic and conventional therapy in individuals with chronic stroke. Subjects were randomized to 12 hours of robotic or conventional therapy and then crossed over to the other therapy type after a 1-month washout period. Twelve moderate to severely impaired individuals with chronic stroke were enrolled, and 10 completed the study. Across the 3-month study period, subjects showed significant improvements in the Fugl-Meyer (P = .013) and Box and Blocks tests (P = .028). The robotic intervention produced significantly greater improvements in the Action Research Arm Test than conventional therapy (P = .033). Gains in the Box and Blocks test from conventional therapy were larger than from robotic therapy in subjects who received conventional therapy after robotic therapy (P = .044). Data suggest that robotic therapy can elicit improvements in arm function that are distinct from conventional therapy and supplements conventional methods to improve outcomes. Results from this pilot study should be confirmed in a larger study.

  1. 下肢康复机器人系统中的跑步机速度跟随自适应控制方法%An adaptive speed control method for running machine in lower extremity rehabilitation robot system

    Institute of Scientific and Technical Information of China (English)

    崔文琪; 李峰

    2013-01-01

    Study a kind of suitable for lower limb rehabilitation robot running machine speed adaptive control method .According to the human body in the sagittal plane walking direction hip fixed on the characteristics of the robot system ,adopt pull pressure sensor to detect human movement trend ,in the speed controller based on nonlinear gain automatic setting velocity transformation quantity.According to this principle ,design a set of force measuring device ,through the physical prototype verify its feasibility . The experimental results show that this control method can meet the running machine speed with adaptive requirements .%研究了一种适用于下肢康复机器人的跑步机速度自适应控制方法。根据人体在矢状面行走方向上髋关节固定于机器人系统的特点,采用拉压力传感器来检测人体运动趋势,在速度控制器中利用非线性增益自动设置速度变换量。根据这一原理,设计了一套力测量装置,通过实物样机验证其可行性。实验结果表明,该控制方法可以满足跑步机速度跟随自适应的要求。

  2. Robot-assisted gait training for stroke patients: current state of the art and perspectives of robotics

    Science.gov (United States)

    Morone, Giovanni; Paolucci, Stefano; Cherubini, Andrea; De Angelis, Domenico; Venturiero, Vincenzo; Coiro, Paola; Iosa, Marco

    2017-01-01

    In this review, we give a brief outline of robot-mediated gait training for stroke patients, as an important emerging field in rehabilitation. Technological innovations are allowing rehabilitation to move toward more integrated processes, with improved efficiency and less long-term impairments. In particular, robot-mediated neurorehabilitation is a rapidly advancing field, which uses robotic systems to define new methods for treating neurological injuries, especially stroke. The use of robots in gait training can enhance rehabilitation, but it needs to be used according to well-defined neuroscientific principles. The field of robot-mediated neurorehabilitation brings challenges to both bioengineering and clinical practice. This article reviews the state of the art (including commercially available systems) and perspectives of robotics in poststroke rehabilitation for walking recovery. A critical revision, including the problems at stake regarding robotic clinical use, is also presented. PMID:28553117

  3. Non-invasive brain stimulation and robot-assisted gait training after incomplete spinal cord injury: A randomized pilot study.

    Science.gov (United States)

    Raithatha, Ravi; Carrico, Cheryl; Powell, Elizabeth Salmon; Westgate, Philip M; Chelette Ii, Kenneth C; Lee, Kara; Dunsmore, Laura; Salles, Sara; Sawaki, Lumy

    2016-01-01

    Locomotor training with a robot-assisted gait orthosis (LT-RGO) and transcranial direct current stimulation (tDCS) are interventions that can significantly enhance motor performance after spinal cord injury (SCI). No studies have investigated whether combining these interventions enhances lower extremity motor function following SCI. Determine whether active tDCS paired with LT-RGO improves lower extremity motor function more than a sham condition, in subjects with motor incomplete SCI. Fifteen adults with SCI received 36 sessions of either active (n = 9) or sham (n = 6) tDCS (20 minutes) preceding LT-RGO (1 hour). Outcome measures included manual muscle testing (MMT; primary outcome measure); 6-Minute Walk Test (6MinWT); 10-Meter Walk Test (10MWT); Timed Up and Go Test (TUG); Berg Balance Scale (BBS); and Spinal Cord Independence Measure-III (SCIM-III). MMT showed significant improvements after active tDCS, with the most pronounced improvement in the right lower extremity. 10MWT, 6MinWT, and BBS showed improvement for both groups. TUG and SCIM-III showed improvement only for the sham tDCS group. Pairing tDCS with LT-RGO can improve lower extremity motor function more than LT-RGO alone. Future research with a larger sample size is recommended to determine longer-term effects on motor function and activities of daily living.

  4. 脑神经康复机器人研究的进展与前景%A review of neuro-rehabilitation robot

    Institute of Scientific and Technical Information of China (English)

    王耀兵; 季林红; 王广志; 黄靖远

    2003-01-01

    @@ 1 脑神经康复机器人研究进展 近些年来,国外的一些偏瘫康复研究机构另辟蹊径,尝试将机电设备引入偏瘫康复训练中,相继研制出一些偏瘫康复训练设备--治疗机器人(therapy robot),也称脑神经康复机器人(neuro-rehbilitation robot),辅助患者进行肢体康复训练.

  5. Robot maps, robot moves, robot avoids

    OpenAIRE

    Farrugia, Claire

    2014-01-01

    Robotics is a cornerstone for this century’s innovations. From robot nurses to your own personal assistant, most robots need to know: ‘where is it?’ ‘Where should it go?’ And ‘how to get there?’ Without answers to these questions a robot cannot do much. http://www.um.edu.mt/think/robot-maps-robot-moves-robot-avoids/

  6. Robot maps, robot moves, robot avoids

    OpenAIRE

    Farrugia, Claire; Duca, Edward

    2014-01-01

    Robotics is a cornerstone for this century’s innovations. From robot nurses to your own personal assistant, most robots need to know: ‘where is it?’ ‘Where should it go?’ And ‘how to get there?’ Without answers to these questions a robot cannot do much. http://www.um.edu.mt/think/robot-maps-robot-moves-robot-avoids/

  7. Robot Actors, Robot Dramaturgies

    DEFF Research Database (Denmark)

    Jochum, Elizabeth

    This paper considers the use of tele-operated robots in live performance. Robots and performance have long been linked, from the working androids and automata staged in popular exhibitions during the nineteenth century and the robots featured at Cybernetic Serendipity (1968) and the World Expo...

  8. Robot Actors, Robot Dramaturgies

    DEFF Research Database (Denmark)

    Jochum, Elizabeth

    This paper considers the use of tele-operated robots in live performance. Robots and performance have long been linked, from the working androids and automata staged in popular exhibitions during the nineteenth century and the robots featured at Cybernetic Serendipity (1968) and the World Expo...

  9. The effects of a lifestyle physical activity counseling program with feedback of a pedometer during pulmonary rehabilitation in patients with COPD : A pilot study

    NARCIS (Netherlands)

    Flokstra-de Blok, Bertine; de Greef, Mathieu; ten Hacken, Nicolaas; Sprenger, S.; Postema, Klaas; Wempe, Johan

    Objective: To study the effects of a lifestyle physical activity counseling program with feedback of a pedometer during pulmonary rehabilitation. Methods: Twenty-one chronic obstructive pulmonary disease (COPD) patients were randomized to an experimental group that followed a regular rehabilitation

  10. Vocational rehabilitation services for patients with cancer: design of a feasibility study incorporating a pilot randomised controlled trial among women with breast cancer following surgery

    Directory of Open Access Journals (Sweden)

    Ayansina Dolapo

    2011-03-01

    Full Text Available Abstract Background Due to improvements in cancer survival the number of people of working age living with cancer across Europe is likely to increase. UK governments have made commitments to reduce the number of working days lost to ill-health and to improve access to vocational rehabilitation (VR services. Return to work for people with cancer has been identified as a priority. However, there are few services to support people to remain in or return to work after cancer and no associated trials to assess their impact. A pilot randomised controlled trial among women with breast cancer has been designed to assess the feasibility of a larger definitive trial of VR services for people with cancer. Methods Patients are being recruited from three clinical sites in two Scottish National Health Service (NHS Boards for 6 months. Eligible patients are all women who are: (1 aged between 18 and 65 years; (2 in paid employment or self-employed; (3 living or working in Lothian or Tayside, Scotland, UK; (4 diagnosed with an invasive breast cancer tumour; (5 treated first with surgery. Patients are randomly allocated to receive referral to a VR service or usual care, which involves no formal employment support. The primary outcome measure is self-reported sickness absence in the first 6 months following surgery. Secondary outcome measures include changes in quality of life (FACT-B, fatigue (FACIT-Fatigue and employment status between baseline and 6- and 12-months post-surgery. A post-trial evaluation will be conducted to assess the acceptability of the intervention among participants and the feasibility of a larger, more definitive, trial with patients with lung and prostate cancer. Discussion To our knowledge this is the first study to determine the feasibility of a randomised controlled trial of the effectiveness of VR services to enable people with cancer to remain in or return to employment. The study will provide evidence to assess the relevance and

  11. Observation on the Application of Lower Limb Rehabilitation Robot in Walking Disability of Stroke Patients%下肢康复机器人在脑卒中患者步行障碍中的应用观察

    Institute of Scientific and Technical Information of China (English)

    王俊; 杨振辉; 刘海兵; 唐丹

    2015-01-01

    Objective:To observe the application effect of lower limb rehabilitation robot in walking disability of stroke patients. Methods:60 cases of stroke patients were randomly divided into treatment group (30 cases) and control group (30 cases). The two groups were treated with basic reha-bilitative therapy, which including neurodevelopmental therapy, active/passive stretching、ADL training、brace、traditional Chinese medicine etc. In addition, the treatment group was treated with lower limb rehabilitation robot training, the control group was treated with traditional therapist-assist gait training. Results:There was significant difference in all outcome measurements in both two groups (P<0.05) after 8 weeks intervention, and there was significant difference in all outcome measurements except the FMA between the treatment group and the control group (P<0.01). Conclu-sions:The application of Lokomat lower limb rehabilitation robot can effectively improve the walking ability in patients with stroke.%目的:探讨Lokomat下肢康复机器人训练在脑卒中患者步行障碍中的应用效果。方法:将60例脑卒中偏瘫患者随机分为观察组(30例)和对照组(30例),均神经发育疗法、主/被动牵伸、ADL训练、必要的矫形器应用、传统中医治疗等基础康复治疗,观察组在基础治疗基础上进行30min的Lokomat下肢康复机器人辅助步行训练,治疗强度和时间为40减重支持、75%的引导力量、1.5km/h步行速度,步行30min;对照组则在基础治疗基础上进行30min以提高步行能力为目标的治疗师辅助步行训练,所有治疗均5次/周,1次/天,共45min/次,在治疗前、治疗8周后分别进行康复效果评价。结果:治疗8周后,两组患者的Fugl-Meyer评分、Berg平衡量表评分、6min步行距离、FAC评分、MAC评分均较治疗前显著改善(P<0.05),且观察组各项评定均显著优于对照组(P<0.01)。结论

  12. Robotic architectures

    CSIR Research Space (South Africa)

    Mtshali, M

    2010-01-01

    Full Text Available In the development of mobile robotic systems, a robotic architecture plays a crucial role in interconnecting all the sub-systems and controlling the system. The design of robotic architectures for mobile autonomous robots is a challenging...

  13. Robot Games for Elderly

    DEFF Research Database (Denmark)

    Hansen, Søren Tranberg

    2011-01-01

    in a number of countries is under pressure. Development of new types of technology which can secure self-sustainability and life quality for elderly has been suggested as way to diminish some of the problems caused by an ageing society. It has been shown that even a small amount of physical activity can...... spatio-temporal information about player behaviour - more specifically, I investigate three types of games each using a different control strategy. The first game is based on basic robot control which allows the robot to detect and follow a person. A field study in a rehabilitation centre and a nursing....... The robot facilitates interaction, and the study suggests that robot based games potentially can be used for training balance and orientation. The second game consists in an adaptive game algorithm which gradually adjusts the game challenge to the mobility skills of the player based on spatio...

  14. The Responsiveness and Correlation between Fugl-Meyer Assessment, Motor Status Scale, and the Action Research Arm Test in Chronic Stroke with Upper-Extremity Rehabilitation Robotic Training

    Science.gov (United States)

    Wei, Xi-Jun; Tong, Kai-yu; Hu, Xiao-ling

    2011-01-01

    Responsiveness of clinical assessments is an important element in the report of clinical effectiveness after rehabilitation. The correlation could reflect the validity of assessments as an indication of clinical performance before and after interventions. This study investigated the correlation and responsiveness of Fugl-Meyer Assessment (FMA),…

  15. The Responsiveness and Correlation between Fugl-Meyer Assessment, Motor Status Scale, and the Action Research Arm Test in Chronic Stroke with Upper-Extremity Rehabilitation Robotic Training

    Science.gov (United States)

    Wei, Xi-Jun; Tong, Kai-yu; Hu, Xiao-ling

    2011-01-01

    Responsiveness of clinical assessments is an important element in the report of clinical effectiveness after rehabilitation. The correlation could reflect the validity of assessments as an indication of clinical performance before and after interventions. This study investigated the correlation and responsiveness of Fugl-Meyer Assessment (FMA),…

  16. Effectiveness of lower limb exoskeletons rehabilitation robot in improving lower limb function of stroke patients%外骨骼康复机器人改善脑卒中偏瘫患者下肢功能的临床研究

    Institute of Scientific and Technical Information of China (English)

    冯宪煊; 白跃宏; 徐义明; 付腾飞; 张晗; 叶冬梅; 王刚

    2014-01-01

    Objective :To investigate the effectiveness of lower limb exoskeletons rehabilitation robot in improving lower limb function of stroke patients .Methods :Sixty stroke patients were randomly divided into control group and robot group with 30 cases in each group .The control group received routine rehabilitation training ,and the robot group was given lower limb exoskeletons rehabilitation robot training combined with routine rehabilitation training . All patients were assessed with Fugl-Meyer motor assessment scale ,Fugl-Meyer balance assessment scale and Hold-en's functional ambulance classification before and 60 days after training .Results:The scores of Fugl-Meyer motor assessment scale ,Fugl-Meyer balance assessment scale and Holden's functional ambulance classification in both groups showed statistically significant difference after treatment (P<0 .05) ,and the scores were greater in the robot group than in the control group (P<0 .05) .Conclusion:The lower limb exoskeletons rehabilitation robot training can improve the function of lower limb of stroke patients with hemiplegia .%目的:观察应用下肢外骨骼康复机器人康复训练对脑卒中偏瘫患者下肢功能的改善情况。方法:脑卒中偏瘫下肢运动功能障碍患者60例,分为机器人组和对照组各30例。对照组给予脑卒中常规康复治疗,机器人组在常规康复治疗的基础上,应用下肢外骨骼康复机器人进行康复训练。于训练前后通过 Fugl-Meyer运动及平衡功能评分、Holden步行功能分级对患者的下肢康复情况进行评价。结果:训练60d后,2组 Fugl-Meyer运动功能评分、Fugl-Meyer平衡功能评分、Holden步行功能分级均较治疗前明显提高(P<0.05),且机器人组提高幅度较对照组更显著(P<0.05)。结论:应用下肢外骨骼康复机器人可改善脑卒中偏瘫患者的下肢功能,值得在临床上推广应用。

  17. International Workshop and Summer School on Medical and Service Robotics

    CERN Document Server

    Bouri, Mohamed; Mondada, Francesco; Pisla, Doina; Rodic, Aleksandar; Helmer, Patrick

    2016-01-01

    Medical and Service Robotics integrate the most recent achievements in mechanics, mechatronics, computer science, haptic and teleoperation devices together with adaptive control algorithms. The book  includes topics such as surgery robotics, assist devices, rehabilitation technology, surgical instrumentation and Brain-Machine Interface (BMI) as examples for medical robotics. Autonomous cleaning, tending, logistics, surveying and rescue robots, and elderly and healthcare robots are typical examples of topics from service robotics. This is the Proceedings of the Third International Workshop on Medical and Service Robots, held in Lausanne, Switzerland in 2014. It presents an overview of current research directions and fields of interest. It is divided into three sections, namely 1) assistive and rehabilitation devices; 2) surgical robotics; and 3) educational and service robotics. Most contributions are strongly anchored on collaborations between technical and medical actors, engineers, surgeons and clinicians....

  18. Application of lower limb exoskeletons rehabilitation robots in rehabilitation treatment of activity limited knee joint%下肢外骨骼康复机器人在膝关节活动受限康复治疗中的应用

    Institute of Scientific and Technical Information of China (English)

    万大千; 徐义明; 白跃宏; 殷跃红

    2012-01-01

    背景:下肢外骨骼康复机器人以持续主被动活动联合为理论基础,通过模拟人体运动,刺激机体的自然复原力,发挥组织代偿作用.目的:动态观察并了解下肢外骨骼康复机器人在膝关节活动受限患者功能锻炼中的康复作用.方法:将20例术后早期膝关节活动受限患者随机等分为实验组与对照组,实验组采用下肢外骨骼康复机器人行肢体功能锻炼,对照组采用被动训练装置CPM机行功能锻炼,治疗间隙2组均采用心理疏导、低频脉冲电疗和红外线等物理治疗.结果与结论:治疗2个月后,实验组与对照组患者膝关节后屈、前伸活动度均较治疗前明显改善(P < 0.01),同时实验组股四头肌肌力较治疗前明显改善(P < 0.01).2个月后的后续治疗,实验组患者膝关节后屈、前伸活动度有了进一步的改善(P < 0.05),对照组上述指标无明显改善.说明早期采用下肢外骨骼康复机器人或CPM机配合心理疏导、低频脉冲电疗和红外线等治疗均能明显提高膝关节活动受限患者膝关节活动度,同时下肢外骨骼康复机器人具有恢复患者股四头肌肌力的作用.%BACKGROUND: Limb exoskeletons rehabilitation robots can stimulate the natural resilience of body through simulated human movement to achieve tissue compensation based on its theoretical basis of continued combined active and passive activities.OBJECTIVE: To dynamically observe and realize the rehabilitation effect of limb exoskeletons rehabilitation robots on functional exercise of patients with activity limited knee joint.METHODS: Twenty early postoperative patients with activity limited knee joint were divided into experiment group and control group randomly. The functional exercise with limb exoskeletons rehabilitation robots was performed in the experiment group. The control group underwent functional exercise with passive training devices CPM. Psychological guide, low-frequency pulse

  19. Three-dimensional, virtual reality vestibular rehabilitation for chronic imbalance problem caused by Ménière's disease: a pilot study().

    Science.gov (United States)

    Hsu, Su-Yi; Fang, Te-Yung; Yeh, Shih-Ching; Su, Mu-Chun; Wang, Pa-Chun; Wang, Victoria Y

    2017-08-01

    The purpose of this study was to evaluate a three-dimensional, virtual reality system for vestibular rehabilitation in patients with intractable Ménière's disease and chronic vestibular dysfunction. We included 70 patients (36 for study, 34 as control) with a chronic imbalance problem caused by uncompensated Ménière's disease. The virtual reality vestibular rehabilitation comprised four training tasks (modified Cawthorne-Cooksey exercises: eye, head, extension, and coordination exercises) performed in six training sessions (in 4 weeks). Measurements of the task scores and balance parameters obtained at the baseline and after final training sessions were compared. A significant improvement was observed in extension and coordination scores. Patients in the early stages of Ménière's disease had a significantly greater improvement in the center of gravity sway and trajectory excursion in the mediolateral direction than did patients in the late stages of Ménière's disease. Mild functional disability attributable to Ménière's disease was a predictor of improvement in the statokinesigram and maximum trajectory excursion in the anteroposterior direction after rehabilitation. The control group showed no significant improvement in almost all parameters. Virtual reality vestibular rehabilitation may be useful in patients with Ménière's disease, particular those in the early stages or having mild functional disability. Implication for rehabilitation Chronic imbalance caused by uncompensated Ménière's disease is an indication for vestibular rehabilitation. The interactive virtual reality video game, when integrated into vestibular rehabilitation exercise protocol, may assist patients who have mild disability Ménière's disease and who cannot benefit from treatment with drugs or surgery. The initial data from this study support the applicability of three-dimensional virtual reality technology in vestibular rehabilitation programs. The technology gives

  20. Robot and robot system

    Science.gov (United States)

    Behar, Alberto E. (Inventor); Marzwell, Neville I. (Inventor); Wall, Jonathan N. (Inventor); Poole, Michael D. (Inventor)

    2011-01-01

    A robot and robot system that are capable of functioning in a zero-gravity environment are provided. The robot can include a body having a longitudinal axis and having a control unit and a power source. The robot can include a first leg pair including a first leg and a second leg. Each leg of the first leg pair can be pivotally attached to the body and constrained to pivot in a first leg pair plane that is substantially perpendicular to the longitudinal axis of the body.

  1. The effects of embodied rhythm and robotic interventions on the spontaneous and responsive verbal communication skills of children with Autism Spectrum Disorder (ASD): A further outcome of a pilot randomized controlled trial.

    Science.gov (United States)

    Srinivasan, Sudha M; Eigsti, Inge-Marie; Gifford, Timothy; Bhat, Anjana N

    2016-07-01

    The current manuscript is the second in a mini-series of manuscripts reporting the effects of alternative, movement-based, rhythm and robotic interventions on the social communication skills of 36 school-age children with ASD. This pilot randomized controlled trial compared the effects of 8-weeks of rhythm and robotic interventions to those of a standard-of-care, comparison intervention. The first manuscript reported intervention effects on the spontaneous and responsive social attention skills of children. In this manuscript, we report intervention effects on the spontaneous and responsive verbal communication skills of children. Communication skills were assessed within a standardized test of responsive communication during the pretest and posttest as well as using training-specific measures of social verbalization during early, mid, and late training sessions. The rhythm and comparison groups improved on the standardized test in the posttest compared to the pretest. The rhythm and robot groups increased levels of social verbalization across training sessions. Movement-based and stationary contexts afforded different types and amounts of communication in children with ASD. Overall, movement-based interventions are a promising tool to enhance verbal and non-verbal communication skills in children with ASD.

  2. Lateral balance control for robotic gait training

    NARCIS (Netherlands)

    Koopman, B.; Meuleman, J.H.; Asseldonk, van E.H.F.; Kooij, van der H.

    2013-01-01

    For the rehabilitation of neurological patients robot-aided gait training is increasingly being used. Lack of balance training in these robotic gait trainers might contribute to the fact that they do not live up to the expectations. Therefore, in this study we developed and evaluated an algorithm to

  3. A pilot survey on the quality of life in respiratory rehabilitation carried out in COPD patients with severe respiratory failure: preliminary data of a novel Inpatient Respiratory Rehabilitation Questionnaire (IRRQ

    Directory of Open Access Journals (Sweden)

    Pasqua Franco

    2012-11-01

    Full Text Available Abstract Background Measuring the state of health is a method for quantifying the impact of an illness on the day-to-day life, health and wellbeing of a patient, providing a quantitative measure of an individual’s quality of life (QoL. QoL expresses patient point of view by a subjective dimension and can express the results of medical intervention. Pulmonary rehabilitation is an essential component in the management of COPD patients, and measuring QoL has become a central focus in the study of this disease. Although nowadays several questionnaires for measuring the QoL in COPD patients are available, there are no questionnaires specifically developed for evaluating QoL in COPD patients undergoing respiratory rehabilitation. The aim of this study was to develop a novel questionnaire for the QoL quantification in COPD patients undergoing in-patient pulmonary rehabilitation program. Methods The questionnaire, administered to COPD patients undergoing long-term oxygen therapy into a respiratory rehabilitation ward, was developed by a simple and graphic layout to be administered to elderly patients. It included one form for admission and another for discharge. It included only tips related to the subjective components of QoL that would be relevant for patient, although likely not strictly related to the respiratory function. A descriptive analysis was performed for the socio-demographic characteristics and both the non-parametric Wilcoxon T-test and the Cronbach’s alpha index were calculated for evaluating the sensitivity of the questionnaire to the effects of respiratory rehabilitation and for identifying its consistency. Results The physical and psychological condition of the 34 COPD patients improved after the rehabilitative treatment and this finding was detected by the questionnaire (overall improvement: 14.2±2.5%, as confirmed by the non-parametric Wilcoxon test (p Conclusions This proposed questionnaire represents a substantial innovation

  4. 助行康复机器人助力行走控制研究%Research on force control of power-assisted walking training by walking assistance rehabilitation robot

    Institute of Scientific and Technical Information of China (English)

    伊蕾; 张立勋; 于彦春

    2014-01-01

    针对一种助行康复机器人助力行走训练策略,进行了机器人助力控制研究。考虑使用者差异及机器人系统误差等干扰,建立了人机系统动力学模型及机器人助力控制模型。通过分析系统特性设计了前馈‐反馈复合控制器,为解决扰动力导致的移动单元转弯及推力突变问题,设计了模糊制器调整期望推力实现人机系统协调运动,利用M atlab软件对助力行走过程进行了控制仿真分析。研究结果表明:助力控制系统能够抑制干扰的影响,对人体提供期望推力,满足使用者对助力行走训练安全性和稳定性的要求。%Power‐assisted control of walking assistance rehabilitation robot was studied for power‐as‐sisted walking training strategy .Dynamic model of man‐machine system and power‐assisted control model both were established considering of users differences ,robot system error and other uncertain‐ties .Feedforward and feedback controller was designed according to the analysis of the system′s char‐acteristics .Fuzzy controller w as designed for phenomenon of the mobile platform turn and thrust mu‐tation which were caused by interference .The fuzzy controller could realize the coordinated control of the robot .The control simulation analysis of power‐assisted walking was carried out by using Matlab software .Research results show that the control system can suppress the interference influence to provide the desired thrust and help person to achieve a continuous and steady walking .

  5. Robotics and other devices in the treatment of patients recovering from stroke.

    Science.gov (United States)

    Volpe, Bruce T; Ferraro, Mark; Lynch, Daniel; Christos, Paul; Krol, Jennifer; Trudell, Christine; Krebs, Hermano I; Hogan, Neville

    2005-11-01

    Stroke is the leading cause of permanent disability in the United States despite advances in prevention and novel interventional treatments. Randomized controlled studies have demonstrated the effectiveness of specialized post-stroke rehabilitation units, but administrative orders have severely limited the length of stay, so novel approaches to the treatment of recovery need to be tested in outpatients. Although the mechanisms of stroke recovery depend on multiple factors, a number of techniques that concentrate on enhanced exercise of the paralyzed limb have demonstrated effectiveness in reducing the motor impairment. For example, interactive robotic devices are new tools for therapists to deliver enhanced sensorimotor training for the paralyzed upper limb, which can potentially improve patient outcome and increase patient productivity. New data support the idea that for some post-stroke patients and for some aspects of training-induced recovery, timing of the training may be less important than the quality and intensity of the training. The positive outcome that resulted in the interactive robotic trials contrasts with the failure to find a beneficial result in trials that used a noninteractive device that delivered continuous passive motion only. New pilot data from novel devices to move the wrist demonstrate benefit and suggest that successive improvement of the function of the arm progressing to the distal muscles may eventually lead to significant disability reduction. These data from robotic trials continue to contribute to the emerging scientific basis of neuro-rehabilitation.

  6. Stroke rehabilitation: recent advances and future therapies.

    Science.gov (United States)

    Brewer, L; Horgan, F; Hickey, A; Williams, D

    2013-01-01

    Despite advances in the acute management of stroke, a large proportion of stroke patients are left with significant impairments. Over the coming decades the prevalence of stroke-related disability is expected to increase worldwide and this will impact greatly on families, healthcare systems and economies. Effective neuro-rehabilitation is a key factor in reducing disability after stroke. In this review, we discuss the effects of stroke, principles of stroke rehabilitative care and predictors of recovery. We also discuss novel therapies in stroke rehabilitation, including non-invasive brain stimulation, robotics and pharmacological augmentation. Many trials are currently underway, which, in time, may impact on future rehabilitative practice.

  7. Stroke rehabilitation: recent advances and future therapies.

    LENUS (Irish Health Repository)

    Brewer, L

    2012-09-27

    Despite advances in the acute management of stroke, a large proportion of stroke patients are left with significant impairments. Over the coming decades the prevalence of stroke-related disability is expected to increase worldwide and this will impact greatly on families, healthcare systems and economies. Effective neuro-rehabilitation is a key factor in reducing disability after stroke. In this review, we discuss the effects of stroke, principles of stroke rehabilitative care and predictors of recovery. We also discuss novel therapies in stroke rehabilitation, including non-invasive brain stimulation, robotics and pharmacological augmentation. Many trials are currently underway, which, in time, may impact on future rehabilitative practice.

  8. Evaluation of gender differences for gait in normal elder by the gait rehabilitation robots%步态康复机器人评价正常老年人步态的性别差异

    Institute of Scientific and Technical Information of China (English)

    丁敏; 吴庆文; 刘保国; 杨晓刚; 杨海平

    2012-01-01

    背景:在国内采用步态康复机器人对正常老年人的步态进行评定的研究较少,且无明确结论.目的:采用步态康复机器人对正常老年人的肌力、关节活动度、痉挛状态等指标进行评定,了解老年人步态的特点.方法:选取健康老年人30名,男15名,女15名,年龄(62.40±1.58)岁.利用步态康复机器人的评估工具L-FORCE,L-STIFF和 L-ROM测试受试者的肌力、痉挛状态和关节活动度.结果与结论:老年人L-FORCE测试结果显示,双侧髋屈肌力和双侧膝屈伸肌力在健康老年人不同性别间差异有显著性意义(P 0.05).提示老年男性下肢肌力大于女性;老年男性L-STIFF测试结果高于老年女性,提示治疗师在对患者进行L-STIFF评价时要考虑性别因素;健康老年人关节活动度不存在性别差异.%BACKGROUND: In China, there are few studies on the evaluation of gait in normal elder by using gait rehabilitation robot, but nodefinitive conclusion is drawn.OBJECTIVE: To evaluate the indicators of the muscle force, range of motion (ROM), spasticity and so on by using the gaitrehabilitation robot, so that to understand the feature of the gait in the elder people.METHODS: A total of 30 healthy elder people were selected with the age of (62.40±1.58) years old including 15 males and 15females. The muscle force, spasticity and ROM of all the people were tested with the assessment tools of L-FORCE, L-STIFFand L-ROM in the gait rehabilitation robot.RESULTS AND CONCLUSION: Results of L-FORCE of the elder subjects were indicated that the bilateral hip flexor forces andbilateral knee flexor and extensor forces were different in different genders, which showed significant difference (P 0.05). It is indicated that the value of L-FORCE andL-STIFF of healthy elder people are higher in the male than those of in the female. The therapists should consider gender factorsin the evaluation of patients with L-STIFF and there is no difference of L-ROM in

  9. Efficiency of an Active Rehabilitation Intervention in a Slow-to-Recover Paediatric Population following Mild Traumatic Brain Injury: A Pilot Study

    Science.gov (United States)

    Imhoff, Sarah; Carrier-Toutant, Frédérike; Boulard, Geneviève

    2016-01-01

    Objective. The aim of this study was to identify whether the addition of an individualised Active Rehabilitation Intervention to standard care influences recovery of young patients who are slow-to-recover following a mTBI. Methods. Fifteen participants aged 15 ± 2 years received standard care and an individualised Active Rehabilitation Intervention which included (1) low- to high-intensity aerobic training; (2) sport-specific coordination exercises; and (3) therapeutic balance exercises. The following criteria were used to measure the resolution of signs and symptoms of mTBI: (1) absence of postconcussion symptoms for more than 7 consecutive days; (2) cognitive function corresponding to normative data; and (3) absence of deficits in coordination and balance. Results. The Active Rehabilitation Intervention lasted 49 ± 17 days. The duration of the intervention was correlated with self-reported participation (x-=84.64±19.63%, r = −0.792, p postconcussion symptom inventory (PCSI) score went from a total of 36.85 ± 23.21 points to 4.31 ± 5.04 points after the intervention (Z = −3.18, p = 0.001). Conclusion. A progressive submaximal Active Rehabilitation Intervention may represent an important asset in the recovery of young patients who are slow-to-recover following a mTBI. PMID:28078321

  10. Efficiency of an Active Rehabilitation Intervention in a Slow-to-Recover Paediatric Population following Mild Traumatic Brain Injury: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Sarah Imhoff

    2016-01-01

    Full Text Available Objective. The aim of this study was to identify whether the addition of an individualised Active Rehabilitation Intervention to standard care influences recovery of young patients who are slow-to-recover following a mTBI. Methods. Fifteen participants aged 15±2 years received standard care and an individualised Active Rehabilitation Intervention which included (1 low- to high-intensity aerobic training; (2 sport-specific coordination exercises; and (3 therapeutic balance exercises. The following criteria were used to measure the resolution of signs and symptoms of mTBI: (1 absence of postconcussion symptoms for more than 7 consecutive days; (2 cognitive function corresponding to normative data; and (3 absence of deficits in coordination and balance. Results. The Active Rehabilitation Intervention lasted 49±17 days. The duration of the intervention was correlated with self-reported participation (x-=84.64±19.63%, r=-0.792, p<0.001. The average postconcussion symptom inventory (PCSI score went from a total of 36.85±23.21 points to 4.31±5.04 points after the intervention (Z=-3.18, p=0.001. Conclusion. A progressive submaximal Active Rehabilitation Intervention may represent an important asset in the recovery of young patients who are slow-to-recover following a mTBI.

  11. Rehabilitation Engineering: What is Rehabilitation Engineering?

    Science.gov (United States)

    ... Parents/Teachers Resource Links for Students Glossary Rehabilitation Engineering What is rehabilitation engineering? How can future rehabilitation ... the area of rehabilitation engineering? What is rehabilitation engineering? Powered prosthetic leg. Source : M. Goldfarb, Vanderbilt U. ...

  12. 机器手辅助卒中偏瘫患者上肢运动功能康复的初步应用%Preliminary application of hand robot assisted rehabilitation of upper-limb motor function in patients with stroke and hemiplegia

    Institute of Scientific and Technical Information of China (English)

    刘霖; 朱琳; 单桂香; 阎澍妤; 曹磊; 刘秀贞; 宋为群

    2015-01-01

    目的:探讨康复机器手对卒中慢性期偏瘫患者上肢运动功能的作用。方法回顾性分析15例卒中偏瘫患者进行一般康复治疗或康复机器手治疗的效果。一般康复组患者(7例)在康复医学门诊接受为期4周,3次/周,30 min/次的一般性康复训练,同时还进行5次/周,1 h/次的家庭康复训练;机器手康复组(8例)接受与一般康复组相同时长的一般性康复训练,同时进行5次/周,1 h/次的机器手辅助训练。对两组患者分别在治疗前和治疗后进行改良Ashworth评分(MAS)、Wolf运动功能评价(WMFT)及Fugl-Meyer上肢运动功能评价(FMA-UE)。结果经过4周的治疗后,与治疗前相比,机器手康复组的 MAS评分明显降低,WMFT中的“时间”明显缩短,“功能评分”明显提升;FMA-UE中,“上肢功能”评分明显提高,“手”评分明显提高;FMA总分明显提高,康复前后分别为(40±14)、(47±14)分;治疗前后差异均有统计学意义(均P<0.05)。一般康复组各项指标差异均无统计学意义(均P>0.05)。两组进行4周康复后的效果比较,FMA-UE中“手”项目评分及WMFT中“治疗效应”机器手康复组优于一般康复组(均P<0.05)。结论康复机器手可有效降低患者上肢的痉挛,对手部运动功能的恢复有明显效果,但对腕部的运动康复作用不明显。%Objective Toinvestigatetheeffectofrehabilitationrobothandontheupperlimbmotor functioninpatientswithstrokeandhemiplegia.Methods Theeffectsoftraditionalrehabilitation therapy or robot rehabilitation treatment of 15 stroke patients with hemiplegia were analyzed retrospectively. There were 4 females and 11 males. According to the group order,they were divided into either a robot rehabilitation group (n=8 )or a general rehabilitation group (n =7 ). The patients of the general rehabilitation group received general

  13. [Application of advanced engineering technologies to medical and rehabilitation fields].

    Science.gov (United States)

    Fujie, Masakatsu

    2012-07-01

    The words "Japan syndrome" can now be heard increasingly through the media. Facing the approach of an elderly-dominated society, Robot Technology(RT)is expected to play an important role in Japan's medical, rehabilitation, and daily support fields. The industrial robot, which has already spread through the world with a great success in certain isolated environments by doing the work which is specialized for the thing with the hard known characteristic. By comparison, in the medical and rehabilitation fields, environments always change intricately, and individual characteristics differ from person to person. Fur