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1.
Sensors (Basel) ; 21(4)2021 Feb 19.
Artigo em Inglês | MEDLINE | ID: mdl-33669615

RESUMO

Measurement of interaction forces distributed across the attachment interface in wearable devices is critical for understanding ergonomic physical human-robot interaction (pHRI). The main challenges in sensorization of pHRI interfaces are (i) capturing the fine nature of force transmission from compliant human tissue onto rigid surfaces in the wearable device and (ii) utilizing a low-cost and easily implementable design that can be adapted for a variety of human interfaces. This paper addresses both challenges and presents a modular sensing panel that uses force-sensing resistors (FSRs) combined with robust electrical and mechanical integration principles that result in a reliable solution for distributed load measurement. The design is demonstrated through an upper-arm cuff, which uses 24 sensing panels, in conjunction with the Harmony exoskeleton. Validation of the design with controlled loading of the sensorized cuff proves the viability of FSRs in an interface sensing solution. Preliminary experiments with a human subject highlight the value of distributed interface force measurement in recognizing the factors that influence ergonomic pHRI and elucidating their effects. The modular design and low cost of the sensing panel lend themselves to extension of this approach for studying ergonomics in a variety of wearable applications with the goal of achieving safe, comfortable, and effective human-robot interaction.


Assuntos
Exoesqueleto Energizado , Robótica , Dispositivos Eletrônicos Vestíveis , Ergonomia , Humanos
2.
Medicine (Baltimore) ; 100(5): e24348, 2021 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-33592882

RESUMO

ABSTRACT: Gait automaticity is reduced in patients with Parkinson disease (PD) due to impaired habitual control. The aim of this study was to investigate the effect of robot-assisted gait training (RAGT) on gait automaticity as well as gait speed and balance in patients with PD.This study was a prospective, open-label, single-arm, pilot study. We planned to recruit 12 patients with idiopathic PD. Participants received 12 sessions of RAGT using exoskeleton-type robotic device. Sessions were 45-minute each, 3 days a week, for 4 consecutive weeks using an exoskeleton-type gait robot. The primary outcome was the percentage of dual-task interference measured by the 10-Meter Walk Test (10MWT) under single and dual-task (cognitive and physical) conditions. Secondary outcomes were the Berg Balance Scale and Korean version of the Falls Efficacy Scale-International. All measures were evaluated before treatment (T0), after treatment (T1), and 1-month post-treatment (T2).Twelve patients were enrolled and 1 dropped out. Finally, 11 patients with idiopathic PD were analyzed. The mean age of 11 patients (5 males) was 66.46 ±â€Š5.66 years, and disease duration was 112.91 ±â€Š50.19 months. The Hoehn and Yahr stages were 2.5 in 8 patients and 3 in 3 patients. Linear mixed-effect model analysis showed a significant change over time only in single-task gait speed of the 10MWT (P = .007), but not in dual-task gait speed, dual-task interferences, and Korean version of the Falls Efficacy Scale-International. Cognitive dual-task interference significantly increased (P = .026) at T1, but not at T2 (P = .203). No significant changes were observed for physical dual-task interference at T1 and T2. Single-task gait speed of the 10MWT was significantly increased at T1 (P = .041), but not at T2 (P = .445). There were no significant changes in the dual-task gait speed of 10MWT. A significant improvement was observed in Berg Balance Scale score at T1 and T2 (P = .004 and P = .024, respectively).In this pilot study, despite improvement in walking speed and balance, gait automaticity in patients with PD was not improved by RAGT using an exoskeleton-type robot. Additional therapeutic components may be needed to improve gait automaticity using RAGT in patients with PD.


Assuntos
Terapia por Exercício/instrumentação , Exoesqueleto Energizado , Transtornos Neurológicos da Marcha/terapia , Doença de Parkinson/terapia , Robótica/instrumentação , Idoso , Terapia por Exercício/métodos , Feminino , Marcha/fisiologia , Análise da Marcha , Transtornos Neurológicos da Marcha/etiologia , Transtornos Neurológicos da Marcha/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Doença de Parkinson/complicações , Doença de Parkinson/fisiopatologia , Projetos Piloto , Estudos Prospectivos , República da Coreia , Robótica/métodos , Resultado do Tratamento
3.
Sensors (Basel) ; 21(2)2021 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-33467420

RESUMO

Brain-computer interfaces (BCIs) have been proven to be useful for stroke rehabilitation, but there are a number of factors that impede the use of this technology in rehabilitation clinics and in home-use, the major factors including the usability and costs of the BCI system. The aims of this study were to develop a cheap 3D-printed wrist exoskeleton that can be controlled by a cheap open source BCI (OpenViBE), and to determine if training with such a setup could induce neural plasticity. Eleven healthy volunteers imagined wrist extensions, which were detected from single-trial electroencephalography (EEG), and in response to this, the wrist exoskeleton replicated the intended movement. Motor-evoked potentials (MEPs) elicited using transcranial magnetic stimulation were measured before, immediately after, and 30 min after BCI training with the exoskeleton. The BCI system had a true positive rate of 86 ± 12% with 1.20 ± 0.57 false detections per minute. Compared to the measurement before the BCI training, the MEPs increased by 35 ± 60% immediately after and 67 ± 60% 30 min after the BCI training. There was no association between the BCI performance and the induction of plasticity. In conclusion, it is possible to detect imaginary movements using an open-source BCI setup and control a cheap 3D-printed exoskeleton that when combined with the BCI can induce neural plasticity. These findings may promote the availability of BCI technology for rehabilitation clinics and home-use. However, the usability must be improved, and further tests are needed with stroke patients.


Assuntos
Interfaces Cérebro-Computador , Exoesqueleto Energizado , Plasticidade Neuronal , Impressão Tridimensional , Eletroencefalografia , Humanos , Punho
4.
Sensors (Basel) ; 21(2)2021 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-33467452

RESUMO

Traditional rigid exoskeletons can be challenging to the comfort of wearers and can have large pressure, which can even alter natural hand motion patterns. In this paper, we propose a low-cost soft exoskeleton glove (SExoG) system driven by surface electromyography (sEMG) signals from non-paretic hand for bilateral training. A customization method of geometrical parameters of soft actuators was presented, and their structure was redesigned. Then, the corresponding pressure values of air-pump to generate different angles of actuators were determined to support four hand motions (extension, rest, spherical grip, and fist). A two-step hybrid model combining the neural network and the state exclusion algorithm was proposed to recognize four hand motions via sEMG signals from the healthy limb. Four subjects were recruited to participate in the experiments. The experimental results show that the pressure values for the four hand motions were about -2, 0, 40, and 70 KPa, and the hybrid model can yield a mean accuracy of 98.7% across four hand motions. It can be concluded that the novel SExoG system can mirror the hand motions of non-paretic hand with good performance.


Assuntos
Eletromiografia , Exoesqueleto Energizado , Mãos , Força da Mão , Humanos , Movimento , Redes Neurais de Computação
5.
Cochrane Database Syst Rev ; 1: CD012479, 2021 01 13.
Artigo em Inglês | MEDLINE | ID: mdl-33434949

RESUMO

BACKGROUND: Various rehabilitation treatments may be offered following surgery for flexor tendon injuries of the hand. Rehabilitation often includes a combination of an exercise regimen and an orthosis, plus other rehabilitation treatments, usually delivered together. The effectiveness of these interventions remains unclear. OBJECTIVES: To assess the effects (benefits and harms) of different rehabilitation interventions after surgery for flexor tendon injuries of the hand. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials, the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register, MEDLINE, Embase, two additional databases and two international trials registries, unrestricted by language. The last date of searches was 11 August 2020. We checked the reference lists of included studies and relevant systematic reviews. SELECTION CRITERIA: We included randomised controlled trials (RCTs) and quasi-RCTs that compared any postoperative rehabilitation intervention with no intervention, control, placebo, or another postoperative rehabilitation intervention in individuals who have had surgery for flexor tendon injuries of the hand. Trials comparing different mobilisation regimens either with another mobilisation regimen or with a control were the main comparisons of interest. Our main outcomes of interest were patient-reported function, active range of motion of the fingers, and number of participants experiencing an adverse event. DATA COLLECTION AND ANALYSIS: Two review authors independently selected trials for inclusion, extracted data, assessed risk of bias and assessed the quality of the body of evidence for primary outcomes using the GRADE approach, according to standard Cochrane methodology. MAIN RESULTS: We included 16 RCTs and one quasi-RCT, with a total of 1108 participants, mainly adults. Overall, the participants were aged between 7 and 72 years, and 74% were male. Studies mainly focused on flexor tendon injuries in zone II. The 17 studies were heterogeneous with respect to the types of rehabilitation treatments provided, intensity, duration of treatment and the treatment setting. Each trial tested one of 14 comparisons, eight of which were of different exercise regimens. The other trials examined the timing of return to unrestricted functional activities after surgery (one study); the use of external devices applied to the participant to facilitate mobilisation, such as an exoskeleton (one study) or continuous passive motion device (one study); modalities such as laser therapy (two studies) or ultrasound therapy (one study); and a motor imagery treatment (one study). No trials tested different types of orthoses; different orthosis wearing regimens, including duration; different timings for commencing mobilisation; different types of scar management; or different timings for commencing strengthening. Trials were generally at high risk of bias for one or more domains, including lack of blinding, incomplete outcome data and selective outcome reporting. Data pooling was limited to tendon rupture data in a three trial comparison. We rated the evidence available for all reported outcomes of all comparisons as very low-certainty evidence, which means that we have very little confidence in the estimates of effect. We present the findings from three exercise regimen comparisons, as these are commonly used in clinical current practice. Early active flexion plus controlled passive exercise regimen versus early controlled passive exercise regimen (modified Kleinert protocol) was compared in one trial of 53 participants with mainly zone II flexor tendon repairs. There is very low-certainty evidence of no clinically important difference between the two groups in patient-rated function or active finger range of motion at 6 or 12 months follow-up. There is very low-certainty evidence of little between-group difference in adverse events: there were 15 overall. All three tendon ruptures underwent secondary surgery. An active exercise regimen versus an immobilisation regimen for three weeks was compared in one trial reporting data for 84 participants with zone II flexor tendon repairs. The trial did not report on self-rated function, on range of movement during three to six months or numbers of participants experiencing adverse events. The very low-certainty evidence for poor (under one-quarter that of normal) range of finger movement at one to three years follow-up means we are uncertain of the finding of zero cases in the active group versus seven cases in the immobilisation regimen. The same uncertainty applies to the finding of little difference between the two groups in adverse events (5 tendon ruptures in the active group versus 10 probable scar adhesion in the immobilisation group) indicated for surgery. Place and hold exercise regimen performed within an orthosis versus a controlled passive regimen using rubber band traction was compared in three heterogeneous trials, which reported data for a maximum of 194 participants, with mainly zone II flexor tendon repairs. The trials did not report on range of movement during three to six months, or numbers of participants experiencing adverse events. There was very low-certainty evidence of no difference in self-rated function using the Disability of the Arm, Shoulder and Hand (DASH) functional assessment between the two groups at six months (one trial) or at 12 months (one trial). There is very low-certainty evidence from one trial of greater active finger range of motion at 12 months after place and hold. Secondary surgery data were not available; however, all seven recorded tendon ruptures would have required surgery. All the evidence for the other five exercise comparisons as well as those of the other six comparisons made by the included studies was incomplete and, where available, of very low-certainty. AUTHORS' CONCLUSIONS: There is a lack of evidence from RCTs on most of the rehabilitation interventions used following surgery for flexor tendon injuries of the hand. The limited and very low-certainty evidence for all 14 comparisons examined in the 17 included studies means that we have very little confidence in the estimates of effect for all outcomes for which data were available for these comparisons. The dearth of evidence identified in this review points to the urgent need for sufficiently powered RCTs that examine key questions relating to the rehabilitation of these injuries. A consensus approach identifying these and establishing minimum study conduct and reporting criteria will be valuable. Our suggestions for future research are detailed in the review.


Assuntos
Traumatismos da Mão/reabilitação , Traumatismos dos Tendões/reabilitação , Adolescente , Adulto , Idoso , Viés , Criança , Terapia por Exercício/efeitos adversos , Terapia por Exercício/métodos , Exoesqueleto Energizado , Feminino , Traumatismos da Mão/cirurgia , Humanos , Imobilização , Terapia a Laser , Masculino , Pessoa de Meia-Idade , Contração Muscular/fisiologia , Cuidados Pós-Operatórios/métodos , Ensaios Clínicos Controlados Aleatórios como Assunto/estatística & dados numéricos , Amplitude de Movimento Articular , Ruptura/reabilitação , Ruptura/cirurgia , Traumatismos dos Tendões/cirurgia , Terapia por Ultrassom , Adulto Jovem
6.
Sensors (Basel) ; 21(3)2021 Jan 24.
Artigo em Inglês | MEDLINE | ID: mdl-33498956

RESUMO

For the controller of wearable lower-limb assistive devices, quantitative understanding of human locomotion serves as the basis for human motion intent recognition and joint-level motion control. Traditionally, the required gait data are obtained in gait research laboratories, utilizing marker-based optical motion capture systems. Despite the high accuracy of measurement, marker-based systems are largely limited to laboratory environments, making it nearly impossible to collect the desired gait data in real-world daily-living scenarios. To address this problem, the authors propose a novel exoskeleton-based gait data collection system, which provides the capability of conducting independent measurement of lower limb movement without the need for stationary instrumentation. The basis of the system is a lightweight exoskeleton with articulated knee and ankle joints. To minimize the interference to a wearer's natural lower-limb movement, a unique two-degrees-of-freedom joint design is incorporated, integrating a primary degree of freedom for joint motion measurement with a passive degree of freedom to allow natural joint movement and improve the comfort of use. In addition to the joint-embedded goniometers, the exoskeleton also features multiple positions for the mounting of inertia measurement units (IMUs) as well as foot-plate-embedded force sensing resistors to measure the foot plantar pressure. All sensor signals are routed to a microcontroller for data logging and storage. To validate the exoskeleton-provided joint angle measurement, a comparison study on three healthy participants was conducted, which involves locomotion experiments in various modes, including overground walking, treadmill walking, and sit-to-stand and stand-to-sit transitions. Joint angle trajectories measured with an eight-camera motion capture system served as the benchmark for comparison. Experimental results indicate that the exoskeleton-measured joint angle trajectories closely match those obtained through the optical motion capture system in all modes of locomotion (correlation coefficients of 0.97 and 0.96 for knee and ankle measurements, respectively), clearly demonstrating the accuracy and reliability of the proposed gait measurement system.


Assuntos
Exoesqueleto Energizado , Marcha , Fenômenos Biomecânicos , Coleta de Dados , Feminino , Humanos , Masculino , Reprodutibilidade dos Testes , Caminhada
7.
Neurol Neurochir Pol ; 55(1): 91-96, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33314016

RESUMO

AIM OF THE STUDY: To evaluate the effectiveness of virtual reality therapy (VRT) Armeo Spring® upper limb exoskeleton (Armeo), in early post-stroke rehabilitation with a focus on the elderly. CLINICAL RATIONALE FOR THE STUDY: Convalescence from a stroke is a complex process driven by a spontaneous recovery supported by multifactorial activation. Novel technology-based rehabilitation methods are being introduced to support brain plasticity. MATERIALS AND METHODS: Using a randomised controlled study design, participants within 30 days after stroke with arm paresis were, in addition to a daily rehabilitation programme, assigned to an intervention group (45 minutes Armeo IG n = 25; mean age 66.5 years) performing VRT, or to a conventional physiotherapy (45 minutes) control group (Armeo CG, n = 25, mean age 68.1 years). Montreal Cognitive Assessment (MoCA), Functional Independence Measure (FIM) and Fugl Mayer Assessment Upper Extremity Scale (FMA-UE) were performed before and after the three-week therapy with 12 therapeutic sessions. Results of participants < 65 and ≥ 65 years old were compared. RESULTS: Paretic upper arm function improved significantly in both the IG and CG groups, the improvement in FMA-UE was significantly higher in the IG compared to the CG (p = 0.02), and patients ≥ 65 years old presented an equal magnitude of improvement in paretic arm function compared to younger patients. CONCLUSIONS AND CLINICAL IMPLICATIONS: Early post-stroke rehabilitation strategies using, in addition to the daily rehabilitation programme, VRT with visual biofeedback is more effective on upper extremity motor performance than conventional physiotherapy, and the effectiveness does not diminish with patient age. This may be a promising addition to conventional physiotherapy in older stroke patients as well as in younger.


Assuntos
Exoesqueleto Energizado , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Realidade Virtual , Idoso , Humanos , Recuperação de Função Fisiológica , Acidente Vascular Cerebral/complicações , Resultado do Tratamento , Extremidade Superior
8.
Sensors (Basel) ; 21(1)2020 Dec 23.
Artigo em Inglês | MEDLINE | ID: mdl-33374744

RESUMO

Hand exoskeleton potential applications reach further than grasping or assistance during manipulation. In this paper, we present a preliminary study of how this technology can be applied in order to improve performance during standing to help the user to keep balance under perturbations. Non-impaired users wearing a hand exoskeleton gripping a hand rail were pushed by a cable-driven robot, so that their standing equilibrium was perturbed. The center of pressure, surface electromyography, and interaction force data were recorded in order to assess the performance of users and their postural strategy. The results showed that users could keep their balance with the same outcomes using their bare hands and the hand exoskeleton. However, when wearing the exoskeleton, a higher muscular activity was registered in hand flexor muscles. This is also supported by the grasping force, which shows that users stretched their hand more than expected when wearing the hand exoskeleton. This paper concludes that it is possible that the lack of tactile feedback could lead to over compensation in the grasping. Therefore, the next studies will aim to check whether this effect can be reversed by training users to wear the exoskeleton.


Assuntos
Exoesqueleto Energizado , Adulto , Eletromiografia , Mãos , Força da Mão , Humanos , Músculo Esquelético
9.
Sensors (Basel) ; 20(24)2020 Dec 12.
Artigo em Inglês | MEDLINE | ID: mdl-33322673

RESUMO

Lower body segment trajectory and gait phase prediction is crucial for the control of assistance-as-needed robotic devices, such as exoskeletons. In order for a powered exoskeleton with phase-based control to determine and provide proper assistance to the wearer during gait, we propose an approach to predict segment trajectories up to 200 ms ahead (angular velocity of the thigh, shank and foot segments) and five gait phases (loading response, mid-stance, terminal stance, preswing and swing), based on collected data from inertial measurement units placed on the thighs, shanks, and feet. The approach we propose is a long-short term memory (LSTM)-based network, a modified version of recurrent neural networks, which can learn order dependence in sequence prediction problems. The algorithm proposed has a weighted discount loss function that places more weight in predicting the next three to five time frames but also contributes to an overall prediction performance for up to 10 time frames. The LSTM model was designed to learn lower limb segment trajectories using training samples and was tested for generalization across participants. All predicted trajectories were strongly correlated with the measured trajectories, with correlation coefficients greater than 0.98. The proposed LSTM approach can also accurately predict the five gait phases, particularly swing phase with 95% accuracy in inter-subject implementation. The ability of the LSTM network to predict future gait trajectories and gait phases can be applied in designing exoskeleton controllers that can better compensate for system delays to smooth the transition between gait phases.


Assuntos
Exoesqueleto Energizado , Marcha , , Humanos , Extremidade Inferior , Redes Neurais de Computação
10.
Sensors (Basel) ; 20(24)2020 Dec 19.
Artigo em Inglês | MEDLINE | ID: mdl-33352714

RESUMO

This study aimed to develop an intuitive gait-related motor imagery (MI)-based hybrid brain-computer interface (BCI) controller for a lower-limb exoskeleton and investigate the feasibility of the controller under a practical scenario including stand-up, gait-forward, and sit-down. A filter bank common spatial pattern (FBCSP) and mutual information-based best individual feature (MIBIF) selection were used in the study to decode MI electroencephalogram (EEG) signals and extract a feature matrix as an input to the support vector machine (SVM) classifier. A successive eye-blink switch was sequentially combined with the EEG decoder in operating the lower-limb exoskeleton. Ten subjects demonstrated more than 80% accuracy in both offline (training) and online. All subjects successfully completed a gait task by wearing the lower-limb exoskeleton through the developed real-time BCI controller. The BCI controller achieved a time ratio of 1.45 compared with a manual smartwatch controller. The developed system can potentially be benefit people with neurological disorders who may have difficulties operating manual control.


Assuntos
Interfaces Cérebro-Computador , Eletroencefalografia , Exoesqueleto Energizado , Humanos , Imaginação , Máquina de Vetores de Suporte
11.
Artigo em Inglês | MEDLINE | ID: mdl-33379316

RESUMO

Spinal exoskeletons have been suggested as an approach for the prevention and rehabilitation of occupational low back pain (LBP). While the state-of-the-art exoskeletons were shown to substantially unload the back, user acceptance is still limited. Perceived discomfort and restriction of freedom of movement are commonly reported. In this pilot study, we explored the differences in subjective responses and user impressions to using passive spinal exoskeleton during a set of simple lifting tasks between LBP patients (n = 12) and asymptomatic individuals (n = 10). Visual analog scales (0-10) were used for all assessments. Overall, the results showed mostly similar responses or slightly more positive responses to the exoskeleton from LBP patients. Most notably, the LBP patients reported a statistically significant (p = 0.048) higher willingness to use the device daily (5.36 ± 4.05) compared to the control group (2.00 ± 1.85) and also gave the device a higher overall grade (6.58 ± 1.98 vs. 4.30 ± 2.26; p = 0.021). This study has demonstrated that individuals with current LBP responded more favorably to the use of the spinal exoskeleton for simple lifting tasks. This implies that current exoskeletons could be appropriate for LBP rehabilitation, but not preventions, as pain-free individuals are less willing to use such devices. Future studies should explore whether different exoskeleton designs could be more appropriate for people with no LBP issues.


Assuntos
Exoesqueleto Energizado , Remoção , Dor Lombar/reabilitação , Preferência do Paciente , Humanos , Projetos Piloto , Coluna Vertebral
12.
Sensors (Basel) ; 20(24)2020 Dec 16.
Artigo em Inglês | MEDLINE | ID: mdl-33339443

RESUMO

With the help of wearable robotics, the lower limb exoskeleton becomes a promising solution for spinal cord injury (SCI) patients to recover lower body locomotion ability. However, fewer exoskeleton gait planning methods can meet the needs of patient in real time, e.g., stride length or step width, etc., which may lead to human-machine incoordination, limit comfort, and increase the risk of falling. This work presents a human-exoskeleton-crutch system with the center of pressure (CoP)-based gait planning method to enable the balance control during the exoskeleton-assisted walking with crutches. The CoP generated by crutches and human-machine feet makes it possible to obtain the overall stability conditions of the system in the process of exoskeleton-assisted quasi-static walking, and therefore, to determine the next stride length and ensure the balance of the next step. Thus, the exoskeleton gait is planned with the guidance of stride length. It is worth emphasizing that the nominal reference gait is adopted as a reference to ensure that the trajectory of the swing ankle mimics the reference one well. This gait planning method enables the patient to adaptively interact with the exoskeleton gait. The online gait planning walking tests with five healthy volunteers proved the method's feasibility. Experimental results indicate that the algorithm can deal with the sensed signals and plan the landing point of the swing leg to ensure balanced and smooth walking. The results suggest that the method is an effective means to improve human-machine interaction. Additionally, it is meaningful for the further training of independent walking stability control in exoskeletons for SCI patients with less assistance of crutches.


Assuntos
Muletas , Exoesqueleto Energizado , Análise da Marcha , Extremidade Inferior , Caminhada , Humanos , Traumatismos da Medula Espinal/reabilitação
13.
Tog (A Coruña) ; 17(2): 232-237, nov. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-198821

RESUMO

OBJETIVOS: evaluar la efectividad de la combinación de la neuromodulación eléctrica espinal transcutánea asistida con exoesqueleto robótico en la recuperación de la función de la extremidad superior en personas con esclerosis múltiple. MÉTODOS: ensayo clínico aleatorizado con grupo control (doble ciego). Para la recogida de datos se emplean diversas escalas como: Nine Hole Peg Test, Functional Independence Measure o Modified Ashworth Scale entre otras. El estudio durará 18 semanas en las que se realizarán cuatro evaluaciones: inicial, continua, postratamiento y de seguimiento tras dos meses sin tratamiento. La muestra estará formada por personas diagnosticadas de esclerosis múltiple. DISCUSIÓN: se espera que la combinación de estas técnicas o abordajes mejore la funcionalidad de la extremidad superior en estas personas y consecuentemente su calidad de vida e independencia en su cotidianeidad


OBJECTIVE: Evaluate the effectiveness of combination in robotic exoskeleton-assisted transcutaneous spinal electrical neuromodulation on upper limb recovery function in people with multiple sclerosis. METHODS: Randomized clinical trial with control group (double blind). Data was collected with various scales such as: Nine Hole Peg Test, Functional Independence Measure or Modified Ashworth Scale. The study will last 18 weeks in wich 4 evaluations will be made: initial, continuous, post-treatment and follow-up after 2 months without treatment. The sample will be created on patients diagnosed multiple sclerosis. DISCUSSION: The combination of these techniques or approaches is expected to improve the functionality of upper limb on these patients and consequently their quality of life and independence in their daily life


Assuntos
Humanos , Adolescente , Adulto Jovem , Adulto , Esclerose Múltipla/reabilitação , Extremidade Superior/fisiologia , Estimulação Elétrica Nervosa Transcutânea/métodos , Robótica/métodos , Resultado do Tratamento , Exoesqueleto Energizado/tendências , Método Duplo-Cego , Esclerose Múltipla/diagnóstico , Qualidade de Vida , Estudos Longitudinais , Estudos Prospectivos
14.
Zh Nevrol Psikhiatr Im S S Korsakova ; 120(8. Vyp. 2): 73-80, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33016680

RESUMO

OBJECTIVE: To compare the efficacy of walking function recovery in patients in the early recovery period of ischemic stroke (IS) using an exoskeleton for the lower extremities and an active-passive pedal exercise bike. MATERIAL AND METHODS: An open randomized study of 47 patients in the early recovery period of IS was conducted. The rehabilitation course included exercises on an ExoAtlet exoskeleton in group 1 and exercises on a pedal simulator for active-passive training (5 days a week for 2 weeks) in group 2. Several tests were used to evaluate treatment results, including the Hauser walking index, the 10-meter walking test, the Berg balance scale, stabilometry, and biomechanics of walking. The complete training course was completed by 20 patients of group 1 and 21 of group 2. RESULTS: There was a significant increase in strength in paretic muscles, postural stability, functional level and walking speed in patients of both groups, but in patients of group 1, the dynamics of recovery was more pronounced (p<0.05). In group 1, there was a significant decrease in the level of disability and an increase in daily activity, which was higher compared to group 2. An analysis of the main indicators of the statokinesiogram showed the more pronounced positive shifts in patients of group 1, but significant differences were found only in the dynamics of the length and area of the curve in the test with eyes open. When studying the biomechanics of walking, it was found that the function of walking was changed: there was a significant decrease in the speed of movement by 2.2 times, the length of a double step by 1.6 times, and the pace of walking by 1.3 times compared to normal indicators. After the end of exercises, a significant increase in the length of the double step, speed and pace of walking as well as a decrease in the period of the locomotor cycle were found in group 1. CONCLUSION: The study revealed a positive impact of hardware rehabilitation on locomotion, both with the use of an exoskeleton and an active-passive pedal simulator. The use of an exoskeleton, have the advantages resulting in a significantly greater recovery of strength, stability, speed and symmetry of walking over the same period of training. A significant increase in postural stability in vertical position was revealed.


Assuntos
Exoesqueleto Energizado , Procedimentos Cirúrgicos Robóticos , Robótica , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Humanos , Caminhada
15.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 3848-3851, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018840

RESUMO

This work presents two brain-computer interfaces (BCIs) for shoulder pre-movement recognition using: 1) manual strategy for Electroencephalography (EEG) channels selection, and 2) subject-specific channels selection by applying non-negative factorization matrix (NMF). Besides, the proposed BCIs compute spatial features extracted from filtered EEG signals through Riemannian covariance matrices and a linear discriminant analysis (LDA) to discriminate both shoulder pre-movement and rest states. We studied on twenty-one healthy subjects different frequency ranges looking the best frequency band for shoulder pre-movement recognition. As a result, our BCI located automatically EEG channels on the contralateral moved limb, and enhancing the pre-movement recognition (ACC = 71.39 ± 12.68%, κ = 0.43 ± 0.25%). The ability of the proposed BCIs to select specific EEG locations more cortically related to the moved limb could benefit the neuro-rehabilitation process.


Assuntos
Interfaces Cérebro-Computador , Exoesqueleto Energizado , Encéfalo , Ombro , Extremidade Superior
16.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 4737-4740, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33019049

RESUMO

Spinal cord injury (SCI) limits life expectancy and causes a restriction of patient's daily activities. In the last years, robotics exoskeletons have appeared as a promising rehabilitation and assistance tool for patients with motor limitations, as people that have suffered a SCI. The usability and clinical relevance of these robotics systems could be further enhanced by brain-machine interfaces (BMIs), as they can be used to foster patients' neuroplasticity. However, there are not many studies showing the use of BMIs to control exoskeletons with patients. In this work we show a case study where one SCI patient has used a BMI based on motor imagery (MI) in order to control a lower limb exoskeleton that assists their gait.


Assuntos
Interfaces Cérebro-Computador , Exoesqueleto Energizado , Traumatismos da Medula Espinal , Marcha , Humanos , Extremidade Inferior
17.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 4867-4872, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33019080

RESUMO

We have developed HandMATE (Hand Movement Assisting Therapy Exoskeleton); a wearable motorized hand exoskeleton for home-based movement therapy following stroke. Each finger and the thumb is powered by a linear actuator which provides flexion and extension assistance. Force sensitive resistors integrated into the design measure grasp and extension initiation force. An assistive therapy mode is based on an admittance control strategy. We evaluated our control system via subject and bench testing. Errors during a grip force tracking task while using the HandMATE were minimal (<1%) and comparable to unassisted healthy hand performance. We also outline a dedicated app we have developed for optimal use of HandMATE at home. The exoskeleton communicates wirelessly with an Android tablet which features guided exercises, therapeutic games and performance feedback. We surveyed 5 chronic stroke patients who used the HandMATE device to further evaluate our system, receiving positive feedback on the exoskeleton and integrated app.


Assuntos
Exoesqueleto Energizado , Procedimentos Cirúrgicos Robóticos , Reabilitação do Acidente Vascular Cerebral , Dispositivos Eletrônicos Vestíveis , Mãos , Humanos
18.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 4917-4920, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33019091

RESUMO

Work-related musculoskeletal disorders (MSDs) are a major concern in industries and working environments. They cause not only suffering to the employee and decrease in performance, but also high economic losses to the companies and the society. Workers from assembly lines and machine operators are one of the most frequently affected working population. Moreover, one of the main types of MSDs in occupational environments are shoulder injuries. Exoskeletons have been applied and tested in rehabilitation and they are gaining ground in occupational environments as assistive devices to augment human force and minimize loads on muscles and joints. However, more evidence about the effects of several exoskeletons models in assisting different tasks is needed. We measured shoulder muscles activity (AD - anterior deltoid and MD - medial deltoid) of seven automotive workers using the SuitX® upper limb exoskeleton while performing different screwing tasks, at different shoulder levels while handling different tools. We found significant muscle activity reduction for 2 of the 4 proposed tasks, suggesting a task-specificity effectiveness. Therefore, it seems to be a viable option to reduce muscle effort in certain tasks.


Assuntos
Exoesqueleto Energizado , Ombro , Fenômenos Biomecânicos , Humanos , Músculo Esquelético , Ocupações
19.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 4921-4925, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33019092

RESUMO

Individuals with neurological impairment, particularly those with cervical level spinal cord injuries (SCI), often have difficulty with daily tasks due to triceps weakness or total loss of function. More demanding tasks, such as sit-skiing, may be rendered impossible due to their extreme strength demands. Design of exoskeletons that address this issue by providing supplemental strength in arm extension is an active field of research but commercial devices are not yet available for use. Most current designs employ electric motors that necessitate the addition of bulky power sources and extraneous wiring, rendering the devices impractical in daily life. The possibility of powering an upper extremity exoskeleton passively has been explored, but to date, none have delivered sufficient function or strength to provide useful assistance for sit-skiing. We seek to rectify this with the design of a passively actuated exoskeletal arm brace capable of operating in two, adjustable-strength modes: one for low level gravity compensation to aid in active range of motion, and the other for more stringent weight bearing activities. The mechanism developed through this paper allows for an affordable, lightweight, modular device that can be adjusted and customized for the needs of each individual patient.


Assuntos
Exoesqueleto Energizado , Braço , Fenômenos Biomecânicos , Humanos , Músculo Esquelético , Amplitude de Movimento Articular
20.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 4926-4929, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33019093

RESUMO

Wearable, mechanically passive (i.e. spring-powered) exoskeletons may be more practical and affordable than active, motorized exoskeletons for providing continuous, home-based, antigravity movement assistance for people with shoulder disability. However, the biomechanical moment due to gravity is a nonlinear function of shoulder elevation angle and, thus, challenging to counteract proportionally across the shoulder elevation range of motion with a spring alone. We designed, fabricated, and tested an integrated spring-cam-wheel system that can generate a nonlinear moment to proportionally compensate for the expected antigravity moment at the shoulder. We then incorporated the proposed system in a benchtop model and a novel wearable passive cable-driven exoskeleton that was intended to counteract half of the gravitational moment during shoulder elevation movements. The rotational moment measured from the benchtop model closely matched the theoretical moment during simulated positive shoulder elevation. However, a larger moment (up to 12.5% larger) was required during simulated negative shoulder elevation to stretch the spring to its initial length due to spring hysteresis and friction losses. The wearable exoskeleton prototype was qualitatively tested for assisting shoulder elevation movements; we identified several aspects of the prototype design that need to be improved before further testing on human participants. In future studies, we will quantitatively evaluate human kinematics and neuromuscular coordination with the exoskeleton to determine its suitability for assisting patients with shoulder disability.


Assuntos
Exoesqueleto Energizado , Dispositivos Eletrônicos Vestíveis , Gravitação , Humanos , Amplitude de Movimento Articular , Ombro
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