Max Well-Being: a modular platform for the gamification of rehabilitation.

This study proposes a modular platform to improve the adoption of gamification in conventional physical rehabilitation programs. The effectiveness of rehabilitation is correlated to a patient's adherence to the program. This adherence can be diminished due to factors such as motivation, feedback, and isolation. Gamification is a means of adding game-like elements to a traditionally non-game activity. This has been shown to be effective in providing a more engaging experience and improving adherence. The platform is made of three main parts; a central hardware hub, various wired and wireless sensors, and a software program with a stream-lined user interface. The software interface and hardware peripherals were all designed to be simple to use by either a medical specialist or an end-user patient without the need for technical training. A usability study was performed using a group of university students and a group of medical specialists. Using the System Usability Scale, the system received an average score of 69.25 ± 20.14 and 72.5 ± 17.16 by the students and medical specialists, respectively. We also present a framework that attempts to assist in selecting commercial games that are viable for physical rehabilitation.

Teleoperated Probe Manipulator for Prone-Position Echocardiography Examination.

Echocardiography probe manipulation is a strenuous task. During a procedure, the operator must hold the probe, extend their arm, bend their elbow, and monitor the resulting image simultaneously, which causes strain and introduces variability to the measurement. We propose a teleoperated probe manipulation robot to reduce the burden of handling the probe and minimize the infection risk during the COVID pandemic. The proposed robot utilizes prone position scanning that could enlarge the cardiac windows for easier scanning and eliminate the risk of the robot pressing down on the patient. We derived the robot's requirements based on a real clinical scenario. Initial evaluation showed that the robot could achieve the required range of motion, force, and control. The robot's functionality was tested by a non-clinician, in which the tester could obtain heart images of a volunteer in under one minute.

A Passive Three Degree of Freedom Transtibial Prosthesis With Adjustable Coronal Compliance and Independent Toe Joint.

The effects of including lateral compliance or a toe joint in transtibial prostheses have been studied independently, showing the potential to improve the gait biomechanics in terms of stability, walking speed, and metabolic cost. However, both of these features are not commonly found in commercial prostheses despite their importance in human gait. In this work, we present a multi-axis passive transtibial prosthesis with three degrees of freedom (DOF). The prosthesis includes a compliant and adjustable coronal articulation using beam springs, an independent 3D-printed flexible forefoot as a toe joint, and sagittal dorsiflexion-plantarflexion stiffness using a helicoidal spring. We mechanically characterize each degree of freedom in terms of the provided stiffness. The measured stiffness values were 3.26Nm/deg, 4.94, or 5.63 Nm/deg in the sagittal plane (with different springs), and 2.54 Nm/deg, 2.79 Nm/deg, 2.94 Nm/deg, or 3.72 Nm/deg in the coronal plane (by adjusting the mechanism). Finally, the effect of different types of infill and infill levels for the 3D printed toes were explored, showing stiffness varying from 2.05 N/mm to 350 N/mm. The obtained sagittal stiffness is beneath the ones found in able-bodied persons; in contrast, the lateral stiffness values are comparatively higher than that of the able-bodied persons. However, the current design is simple to rearrange and modify the stiffness values. Lastly, the wide range of stiffness achievable in the 3D printed toes can be useful to achieve proper torque requirements in the forefoot for a broad range of users.

Wearable Kinesthetic I/O Device for Sharing Wrist Joint Stiffness.

In this paper, we developed a wearable kinesthetic I/O system, which is able to share wrist joint stiffness by measuring and intervening in four muscle activities on the forearm simultaneously through the same electrodes. This achieves interactive peg rehabilitation by sharing muscle activities among patients and therapists. Through the performance study, it was shown that 1) applied EMS and measured wrist joint stiffness, and 2) produced wrist joint stiffness and measured EMG value has a linear correlation, which allows designing a mapping function between the measured EMG value on one person and the EMS value applied to another person. In a perceptual study, which shared the wrist stiffness between two persons, participants were able to recognize the level of their confederate's wrist joint stiffness using a 4-point Likert scale linearly. The developed system would benefit a physical therapist and a patient for sharing their wrist stiffness and grip force, which are usually difficult to be observed in a visual contact.

Design of a myoelectric 3D-printed prosthesis for a child with upper limb congenital amputation.

For an early intervention with children, a prosthetic hand that is affordable, light-weight, and easy to wear and use is vital. Commercial prosthetic hands for children are often too expensive, burdensome and difficult to use. In this research, we attempt to address these issues with a novel design for a prosthetic hand for children. The proposed prosthesis implements two important features: the use of sound biofeedback and a soft socket with in-liner electrodes. We hypothesize that these features will make the hand prosthesis easy to use, lightweight and affordable, improving the control performance and increasing the acceptance rate. Preliminary experiments showed that the proposed prosthesis can be successfully controlled by a congenital amputation.

Optimized Design of a Variable Viscosity Link for Robotic AFO.

Herein we present the development of a novel Ankle Foot Orthosis for gait support of people with foot-drop symptoms. The developed AFO uses an elastic link mechanism to brake the ankle joint during initial contact, thus mitigating foot-slap, and an integrated energy store-and-release mechanism to support toe lift in the swing phase, thus mitigating toe-drag. This paper presents improvements in the braking-holding power of the elastic link mechanism over its previous version, the torque-angle characteristics of the developed AFO with the renewed elastic link, and a pilot test with one person with foot-drop symptoms to verify the proposed functions of the developed AFO.

Feasibility of Synergy-Based Exoskeleton Robot Control in Hemiplegia.

Here, we present a study on exoskeleton robot control based on inter-limb locomotor synergies using a robot control method developed to target hemiparesis. The robot control is based on inter-limb locomotor synergies and kinesiological information from the non-paretic leg and a walking aid cane to generate motion patterns for the assisted leg. The developed synergy-based system was tested against an autonomous robot control system in five patients with hemiparesis and varying locomotor abilities. Three of the participants were able to walk using the robot. Results from these participants showed an improved spatial symmetry ratio and more consistent step length with the synergy-based method compared with that for the autonomous method, while the increase in the range of motion for the assisted joints was larger with the autonomous system. The kinematic synergy distribution of the participants walking without the robot suggests a relationship between each participant's synergy distribution and his/her ability to control the robot: participants with two independent synergies accounting for approximately 80% of the data variability were able to walk with the robot. This observation was not consistently apparent with conventional clinical measures such as the Brunnstrom stages. This paper contributes to the field of robot-assisted locomotion therapy by introducing the concept of inter-limb synergies, demonstrating performance differences between synergy-based and autonomous robot control, and investigating the range of disability in which the system is usable.

Tarsusmeter: Development of a wearable device for ankle joint impedance estimation.

We present the development and basic evaluation of a new wearable device for estimation of ankle joint impedance called Tarsusmeter. The device is intended for application with persons with locomotion disabilities to quantify the ankle joint impedance, especially in cases of spasticity where the joint's impedance is expected to differ significantly from healthy persons. The lack of a simple and light weight solution to provide objective evaluation of ankle joint impedance motivates the design criteria of this device to be as such. The target application is also to quantify variable stiffness actuator based orthosis in-vivo. Thus the form factor avoids overlap with custom shapes of such orthosis. The paper presents the mechanical design of the device, physical simulations to characterize the device-leg system, the used algorithm for impedance parameter estimation, and preliminary testing of the device.

Wearable gait measurement system with an instrumented cane for exoskeleton control.

In this research we introduce a wearable sensory system for motion intention estimation and control of exoskeleton robot. The system comprises wearable inertial motion sensors and shoe-embedded force sensors. The system utilizes an instrumented cane as a part of the interface between the user and the robot. The cane reflects the motion of upper limbs, and is used in terms of human inter-limb synergies. The developed control system provides assisted motion in coherence with the motion of other unassisted limbs. The system utilizes the instrumented cane together with body worn sensors, and provides assistance for start, stop and continuous walking. We verified the function of the proposed method and the developed wearable system through gait trials on treadmill and on ground. The achievement contributes to finding an intuitive and feasible interface between human and robot through wearable gait sensors for practical use of assistive technology. It also contributes to the technology for cognitively assisted locomotion, which helps the locomotion of physically challenged people.