A remote-controlled automatic chest compression device capable of moving compression position during CPR: A pilot study in a mannequin and a swine model of cardiac arrest.

BACKGROUND: Recently, we developed a chest compression device that can move the chest compression position without interruption during CPR and be remotely controlled to minimize rescuer exposure to infectious diseases. The purpose of this study was to compare its performance with conventional mechanical CPR device in a mannequin and a swine model of cardiac arrest. MATERIALS AND METHODS: A prototype of a remote-controlled automatic chest compression device (ROSCER) that can change the chest compression position without interruption during CPR was developed, and its performance was compared with LUCAS 3 in a mannequin and a swine model of cardiac arrest. In a swine model of cardiac arrest, 16 male pigs were randomly assigned into the two groups, ROSCER CPR (n = 8) and LUCAS 3 CPR (n = 8), respectively. During 5 minutes of CPR, hemodynamic parameters including aortic pressure, right atrial pressure, coronary perfusion pressure, common carotid blood flow, and end-tidal carbon dioxide partial pressure were measured. RESULTS: In the compression performance test using a mannequin, compression depth, compression time, decompression time, and plateau time were almost equal between ROSCER and LUCAS 3. In a swine model of cardiac arrest, coronary perfusion pressure showed no difference between the two groups (p = 0.409). Systolic aortic pressure and carotid blood flow were higher in the LUCAS 3 group than in the ROSCER group during 5 minutes of CPR (p < 0.001, p = 0.008, respectively). End-tidal CO2 level of the ROSCER group was initially lower than that of the LUCAS 3 group, but was higher over time (p = 0.022). A Kaplan-Meier survival analysis for ROSC also showed no difference between the two groups (p = 0.46). CONCLUSION: The prototype of a remote-controlled automated chest compression device can move the chest compression position without interruption during CPR. In a mannequin and a swine model of cardiac arrest, the device showed no inferior performance to a conventional mechanical CPR device.

Advanced Compliant Anti-Gravity Robot System for Lumbar Stabilization Exercise Using Series Elastic Actuator.

Background: The lumbar stabilization exercise is one of the most recommended treatments in medical professionals for patients suffering from low back pain. However, because lumbar stabilization exercise is calisthenics, it is challenging to perform because of the body load of the elderly, disabled, and patients that lack muscle strength. Additionally, it interferes with the effect of exercise because it can strain parts of the body. Methods: To overcome them, a compliant anti-gravity rehabilitation proto-type device using the Series Elastic Actuator (SEA) was developed previously to provide quantitative assist force to the person, producing similar exercise effects with calisthenics. From an exercise experiment with 20 participants, it caused discomfort to participants during exercise owing to the non-ergonomic design of the previous device. Different muscle activation tendencies were observed between calisthenics and exercise using the device. For advanced technical solutions to clinical needs, which is exercise using the rehabilitation robot to produce a similar effect to calisthenics, the mechanical design of the rehabilitation robot was improved based on the previous device after receiving feedback from clinical trials and static analysis. For the safety of exercise using the robot, a cascade PID-PI controller was used to reduce the influence of friction and disturbance due to the external movement. Results: Surface electromyography(sEMG) signal from lumbar muscles showed desired monotonic reduction ratio and higher similarity results compared to the previous device, which proved the exercise effectiveness using the robot. Conclusion: The proposed robot is considered as a solution to a clinical need of lumbar rehabilitation for the elderly, disabled, and patients.