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sábado, 31 de enero de 2009

Rehabilitation Robots: Novedades en diciembre 2008.

Estas son algunas de las novedades sobre rehabilitación asistida por robots que ha salido en los últimos meses y están indexadas en Pub Med.
La primara es un artículo en el Journal of Rehabilitation Research and Development sobre el uso combinado de electroestimulación funcional con electrodos intramusculares y Lokomat.
Podeís acceder al artículo original aquí.

1: J Rehabil Res Dev. 2008;45(7):997-1006.

Feasibility of combining gait robot and multichannel functional electrical stimulation with intramuscular electrodes.

McCabe JP, Dohring ME, Marsolais EB, Rogers J, Burdsall R, Roenigk K, Pundik S, Daly JJ.

Cognitive and Motor Learning Laboratory, Louis Stokes Cleveland VA Medical Center, 10701 East Blvd, 151-W, Cleveland, OH 44106. JessicaPMcCabe@hotmail.com.

After stroke rehabilitation, many survivors of stroke exhibit persistent gait deficits. In previous work, we demonstrated significant gains in gait kinematics for survivors of chronic stroke using multichannel functional electrical stimulation with intramuscular electrodes (FES-IM). For this study, we tested the feasibility of combining FES-IM and gait robot technologies for treating persistent gait deficits after stroke. Six subjects, >/= 6 months after stroke, received 30-minute intervention sessions of combined FES-IM and gait robotics 4 days a week for 12 weeks. Feasibility was assessed according to three factors: (1) performance of the interface of the two technologies during intervention sessions, (2) clinicians' success in using two technologies simultaneously, and (3) subject satisfaction. FES-IM system hardware and software design features combined with the gait robot technology proved feasible to use. Each technology alone provided unique advantages and disadvantages of gait practice characteristics. Because of the unique advantages and disadvantages of each technology, gait deficits need to be accurately identified and a judicious treatment plan properly targeted before FES-IM, a gait robot, or both combined are selected.

PMID: 19165689 [PubMed - in process]

La revista Journal of Rehabilitation Research and Development donde ha sido publicado pertenede al United States Department of Veterans Affairs.


Otras artículos interesantes vienen del congreso

IEEE Engineering in Medicine and Biology Society

August 20-24, 2008

"Personalized Healthcare through Technology"

Vancouver Convention & Exhibition Centre
Vancouver, British Columbia, Canada

En concreto de la mesa número 6 de este congreso:

06. Neural Engineering; Neuromuscular Systems; Rehabilitation Engineering
Chair:Robert Butera (Georgia Institute of Technology, Atlanta, GA, USA)
Co-Chair: Jose Carmena (University of California, Berkeley, CA, USA)
Co-Chair: Dominique Durand (Case Western Reserve University, Cleveland, OH, USA)

Chair: Robert Kearney (McGill University, Montreal, QC, Canada)
Co-Chair: Eric Perreault (Northwestern University, Evanston, IL, USA)
Co-Chair: Richard Jones (University of Otago, Christchurch, New Zealand)

Entre los presentes en la mesa hay que destacar a Jose M. Carmena, que es español y estudió en la Universidad Politecnica de Valencia. Es ahora uno de los mejores investigadores españoles o valencianos.
Trabaja en el Brain-Machine Interface Systems Laboratory en la Universidad ee California, Berkeley.

En 2008 asistí a una presentación suya en el primer seminario RETADIM sobre Brain-Machine Interfaces. (RETADIM: Red Española de Tecnologías de Apoyo a la Discapacidad y Mayores)

Aquí Michelle J Johnson, que firma el artículo siguiente. Trabaja en el
Department of Physical Medicine And Rehabilitation del Medical College of Wisconsin. En Milwaukee. En concreto en el
Rehabilitation Robotic Research Desing Lab del que es directora.
Desde allí desarrola varios proyectos, entre ellos TheraDrive y ADLER.

No se trata de algo lejano, Michelle estuvo en España el año pasado y fué muy fácil hablar con ella y
compartir una pizza en la terraza de la piscina del hotel del congreso. Cuando pedí que nos hicieran
una foto ya le dije: "Es para que al enseñarla la gente vea que esto es algo totalmente real y cercano y
no algo salido de la Guerra de las Galaxias"

Conf Proc IEEE Eng Med Biol Soc. 2008;1:4511-4.

A mobile robot therapist for under-supervised training with robot/computer assisted motivating systems.

Shakya Y, Johnson MJ.

Dept. of Biomedical Engineering, Marquette University, Milwaukee, WI 53233, USA.

Robot assisted therapy is a new and promising area in stroke rehabilitation and has shown to be effective in reducing motor impairment, but is a costly solution for home rehabilitation. High medical costs could be reduced if we could improve rehabilitation exercise in unsupervised environments such as the home. Hence, there is an augmented need for a cost effective rehabilitation system that can be used outside the clinic. This paper presents the design concept for an autonomous robotic assistant that is low-cost and effective in engaging the users while assisting them with therapy in any under-supervised area. We investigated how the robot assistant can support TheraDrive, our low-cost therapy system. We present the design methods and a case study demonstrating the arm and video collection system.

PMID: 19163718 [PubMed - as supplied by publisher]
ADLER: Robot para entrenar Actividades de la Vida Diaria. (Activities of Dayly Living)

3: Conf Proc IEEE Eng Med Biol Soc. 2008;1:4310-3.

Design framework for a simple robotic ankle evaluation and rehabilitation device.

Syrseloudis CE, Emiris IZ, Maganaris CN, Lilas TE.

Department of Informatics and Telecommunications, National University of Athens, GREECE.

This paper juxtaposes simple yet sufficiently general robotic mechanisms for ankle function evaluation, measurement and physiotherapy. For the choice, design and operation of the mechanism, a kinematics model of foot is adopted from biomechanics, based on the hypothesis that foot kinematics are similar to a 2R serial robot. We undertake experiments, using a 3D scanner and an inertial sensor in order to fully specify the design framework by studying a larger sample of healthy subjects. Our experimental analysis confirms and enhances the 2R foot model, and leads us to the choice of the specific mechanism. We compute the required workspace and thus address the issues required for a complete and efficient design. The robot must be capable to perform several multi-axis motions and sustain a significant range of forces and torques. We compare mechanisms based on serial and parallel robots, and choose a parallel tripod with an extra rotation axis for its simplicity, accuracy and generality.

PMID: 19163666 [PubMed - as supplied by publisher]

4: Conf Proc IEEE Eng Med Biol Soc. 2008;1:4290-3.

Design and implementation of visual-haptic assistive control system for virtual rehabilitation exercise and teleoperation manipulation.

Veras EJ, De Laurentis KJ, Dubey R.

This paper describes the design and implementation of a control system that integrates visual and haptic information to give assistive force feedback through a haptic controller (Omni Phantom) to the user. A sensor-based assistive function and velocity scaling program provides force feedback that helps the user complete trajectory following exercises for rehabilitation purposes. This system also incorporates a PUMA robot for teleoperation, which implements a camera and a laser range finder, controlled in real time by a PC, were implemented into the system to help the user to define the intended path to the selected target. The real-time force feedback from the remote robot to the haptic controller is made possible by using effective multithreading programming strategies in the control system design and by novel sensor integration. The sensor-based assistant function concept applied to teleoperation as well as shared control enhances the motion range and manipulation capabilities of the users executing rehabilitation exercises such as trajectory following along a sensor-based defined path. The system is modularly designed to allow for integration of different master devices and sensors. Furthermore, because this real-time system is versatile the haptic component can be used separately from the telerobotic component; in other words, one can use the haptic device for rehabilitation purposes for cases in which assistance is needed to perform tasks (e.g., stroke rehab) and also for teleoperation with force feedback and sensor assistance in either supervisory or automatic modes.

PMID: 19163661 [PubMed - as supplied by publisher]

5: Conf Proc IEEE Eng Med Biol Soc. 2008;1:4282-5.

Development of virtual reality exercise of hand motion assist robot for rehabilitation therapy by patient self-motion control.

Ueki S, Nishimoto Y, Abe M, Kawasaki H, Ito S, Ishigure Y, Mizumoto J, Ojika T.

Faculty of Engineering Gifu University, Yanagido, 1-1, Japan.

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.

PMID: 19163659 [PubMed - as supplied by publisher]

6: Conf Proc IEEE Eng Med Biol Soc. 2008;1:4262-5.

Measurement of reaching movement with 6-DOF upper rehabilitation system "Robotherapist".

Kikuchi T, Oda K, Isozumi S, Ohyama Y, Shichi N, Furusho J.

Osaka University, 2-1 Yamadaoka, Suita, Japan.

In recent years, the needs for rehabilitation support systems are increasing, which use robot technology and virtual reality technology. Applying these technologies make efficient rehabilitation possible. We have developed 6-degrees-of-freedom (DOF) upper rehabilitation support system to evaluate synergy pattern of stroke survivors and to train stroke survivors, named "Robotherapist". When stroke survivors who can move plural joints only along a certain constant pattern called synergy pattern do reaching movement, some of them cannot keep their posture of the arm normal, but can move their hand along the aim orbit. In this study, we experiment on a measurement of reaching movement with our system and make a model of movement peculiar to stroke survivors and a model of movement of healthy people. Additionally, we propose application software for reaching training with this model. In this paper, we report measurement of reaching movement and propose application software for reaching training with our system.

PMID: 19163654 [PubMed - as supplied by publisher]

7: Conf Proc IEEE Eng Med Biol Soc. 2008;1:4258-61.

Supervisory controller design for a robot-assisted reach-to-grasp rehabilitation task.

Wang F, Sarkar N.

Department of Mechanical Engineering, Vanderbilt University, Nashville, TN, 37235, USA.

The goal of this project is to develop a high-level controller to provide reference trajectories automatically to the low-level controller of a rehabilitation robotic device in reach-to-grasp task. The high-level controller, which is the supervisory controller, is an event driven, asynchronous discrete event system (DES), described by a finite automaton. Extensive simulations are performed using the supervisory controller for a reach-to-grasp rehabilitation task. The results demonstrate the feasibility and convenience of the proposed supervisory controller.

PMID: 19163653 [PubMed - as supplied by publisher]

8: Conf Proc IEEE Eng Med Biol Soc. 2008;1:4190-3.

Modeling and evaluation of human motor skills in a virtual tennis task.

Tanaka Y, Ishii M, Tsuji T, Imamura N.

Graduate School of Engineering, Hiroshima University, Higashi-hiroshima, Japan.

The present paper develops a virtual tennis system using robotic devices for the rehabilitation of upper arm movements, and discusses an evaluation method of human motor skills for natural stroke in the dynamic task. In the training, a trainee manipulates the handle of an impedance-controlled robot to hit a ball by a racket toward the center of a circular target on the wall with considerations of motion smoothness and timing. A reference hand motion for the target task is clarified through a set of training experiments with 6 health volunteers and computationally expressed in the framework of a minimum jerk model. The designed index based on the reference model will be effective to quantitatively evaluate the recovery of motor skills for natural stroke in the virtual tennis task.

PMID: 19163636 [PubMed - as supplied by publisher]

9: Conf Proc IEEE Eng Med Biol Soc. 2008;1:3558-61.

Altered multijoint reflex coordination is indicative of motor impairment level following stroke.

Trumbower RD, Ravichandran VJ, Krutky MA, Perreault EJ.

Sensory Motor Performance Program at The Rehabilitation Institute of Chicago, IL 60611, USA.

Following stroke, individuals often are unable to activate their elbow and shoulder muscles independently. There is growing evidence that altered reflex pathways may contribute to these abnormal patterns of activation or muscle synergies. Most studies investigating reflex function following stroke have examined only individual joints at rest. Thus, the purpose of this study was to quantify multijoint reflex contributions to the stereotyped muscle synergies commonly observed following stroke. We hypothesized that the patterns of reflex coordination mirror the abnormal muscle coactivity patterns previously reported for voluntary activation. 10 chronic stroke and 8 age-matched control subjects participated. Reflexes were elicited by perturbing the arm with a 3 degree of freedom robot while subjects exerted voluntary forces at the elbow and shoulder. The force conditions tested were selected to assess the influence of gravity and the influence of joint torque generation without gravity on reflex coordination. Reflex magnitude was quantified by the average rectified electromyogram, recorded from 8 muscles that span the elbow and shoulder. Patterns of reflex coordination were quantified using independent components analysis. Results show significant reflex coupling between elbow flexor and shoulder abductor-extensor muscles in stroke patients during isolated elbow and shoulder torque generation and during active arm support against gravity. Identified patterns of stretch reflex coordination were consistent with the stereotyped voluntary flexion synergy, suggesting reflex pathways contribute to abnormal muscle coordination following stroke.

PMID: 19163477 [PubMed - as supplied by publisher]

10: Conf Proc IEEE Eng Med Biol Soc. 2008;1:3467-70.

RUPERT closed loop control design.

Balasubramanian S, Wei R, He J.

Harrington Department of Bioengineering, Arizona State University, Tempe, 85287, USA.

Rehabilitation robotics is an active area of research in the field of stroke rehabilitation. There is significant potential for improving the current physical rehabilitation methods after stroke through the use of robotic devices. RUPERT is a wearable robotic exoskeleton powered by pneumatic muscle actuators. An adaptive robot control strategy combining a PID-based feedback controller and an Iterative Learning Controller (ILC) is proposed for performing passive reaching tasks. Additionally, a fuzzy rule-base for estimating the learning rate for the ILC is also proposed. The proposed control scheme has the ability to adapt to different subject for performing different reaching tasks. The preliminary results from two able-bodied subjects demonstrate that the proposed controller can provide consistent performance for different subjects performing different reaching tasks.

PMID: 19163455 [PubMed - as supplied by publisher]

youtube: Rupert

Más robots crazy en Arizona

11: Conf Proc IEEE Eng Med Biol Soc. 2008;1:1977-80.

Assessment of walking performance in robot-assisted gait training: A novel approach based on empirical data.

Banz R, Riener R, Lunenburger L, Bolliger M.

Balgrist University Hospital, Spinal Cord Injury Research, Zurich, Switzerland.

Motivation and voluntary drive of patients can be improved by applying biofeedback during robot-assisted rehabilitation trainings. Biofeedback systems were traditionally based on theoretical assumptions. In this paper, we present a novel approach to calculate biofeedback during robot-assisted gait training. Our method was based on empirical data that were obtained from healthy subjects when simulating distinctive degrees of walking performance during robot-assisted gait training. This empirical data-based biofeedback (EDBF) method was evaluated with 18 subjects without gait disorders. A higher correlation between the subjects' walking performance and biofeedback values was found for the EDBF method compared to a theory-based biofeedback approach.

PMID: 19163079 [PubMed - as supplied by publisher]
Tambíen he hecho otras entradas sobre el trabajo de Robert Riener en Hocoma con Armin. Lokomat y dentro del proyecto europeo MIMICS (Multimodal Immersive Motion rehabilitation with Interactive Cognitive Systems).

12: Conf Proc IEEE Eng Med Biol Soc. 2008;1:1961-4.

Muscle coordination in healthy subjects during floor walking and stair climbing in robot assisted gait training.

Hussein S, Schmidt H, Volkmar M, Werner C, Helmich I, Piorko F, Kruger J, Hesse S.

Rehabilitation Robotics Group (IPK/TU Berlin), Faculty of Mechanical Engineering, Technical University of of Berlin 10587, Germany.

The aim of gait rehabilitation is a restoration of an independent gait and improvement of daily life walking functions. Therefore the specific patterns, that are to be relearned, must be practiced to stimulate the learning process of the central nervous system (CNS). The Walking Simulator HapticWalker allows for the training of arbitrary gait trajectories of daily life. To evaluate the quality of the training a total of 9 subjects were investigated during free floor walking and stair climbing and during the same tasks in two different training modes on the HapticWalker: 1) with and 2) without vertical center of mass (CoM) motion. Electromyograms (EMG) of 8 gait relevant muscles were measured and muscle activation was compared for the various training modes. Besides the muscle activation as an indicator for the quality of rehabilitation training the study investigates if a cancellation of the vertical CoM movement by adaption of the footplate trajectory is feasible i.e. the muscle activation patterns for the two training modes on the HapticWalker agree. Results show no significant differences in activation timing between the training modes. This indicates the feasibility of using a passive patient suspension and emulate the vertical CoM motion by trajectory adaption of the footplates. The muscle activation timing during HapticWalker training shows important characteristics observed in physiological free walking though a few differences can still remain.

PMID: 19163075 [PubMed - as supplied by publisher]
Haptic Walker.

Ya había hecho otra entrada sobre Haptic Walker y Schmidt H, y esta publicación ampía un poco la información de aquella entrada.

Autor: Samuel Franco Domínguez
e-mail: rehabilitacion2.0@gmail.com

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