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1.
Urol Clin North Am ; 48(1): 147-150, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33218589

RESUMO

"The new frontier of robotic surgery is well under way. Current research and development is rapidly progressing, allowing for the creation of many new robotic companies. Each company has its own identity and platform for what their vision for the future entails. The competition generated between these companies will shortly be forcing newer, cheaper, more accessible robotic systems worldwide."


Assuntos
Procedimentos Cirúrgicos Robóticos/instrumentação , Procedimentos Cirúrgicos Urológicos/instrumentação , Inteligência Artificial/tendências , Previsões , Humanos , Procedimentos Cirúrgicos Robóticos/métodos , Procedimentos Cirúrgicos Robóticos/tendências , Robótica/instrumentação , Robótica/tendências , Procedimentos Cirúrgicos Urológicos/métodos , Procedimentos Cirúrgicos Urológicos/tendências
2.
PLoS One ; 15(12): e0241117, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33326434

RESUMO

Deafferentation and weight offloading can increase brain and spinal motor neuron excitability, respectively. End-effector gait robots (EEGRs) can blend these effects with stereotyped movement-induced neuroplasticity. The authors aimed to evaluate the usefulness of EEGRs as a postoperative neuro-muscular rehabilitation tool. This prospective randomized controlled trial included patients who had undergone unilateral total knee arthroplasty (TKA). Patients were randomly allocated into two groups: one using a 200-step rehabilitation program in an EEGR or the other using a walker on a floor (WF) three times a day for five weekdays. The two groups were compared by electrophysiological and biomechanical methods. Since there were no more enrollments due to funding issues, interim analysis was performed. Twelve patients were assigned to the EEGR group and eight patients were assigned to the WF group. Although the muscle volume of the quadriceps and hamstring did not differ between the two groups, the normalized peak torque of the operated knee flexors (11.28 ± 16.04 Nm/kg) was improved in the EEGR group compared to that of the operated knee flexors in the WF group (4.25 ± 14.26 Nm/kg) (p = 0.04). The normalized compound motor action potentials of the vastus medialis (VM) and biceps femoris (BF) were improved in the EEGR group (p < 0.05). However, the normalized real-time peak amplitude and total, mean area under the curve of VM were decreased during rehabilitation in the EEGR group (p < 0.05). No significant differences were found between operated and non-operated knees in the EEGR group. Five-day EEGR-assisted rehabilitation induced strengthening in the knee flexors and the muscular reactivation of the BF and VM after TKA, while reducing the real-time use of the VM. This observation may suggest the feasibility of this technique: EEGR modulated the neuronal system of the patients rather than training their muscles. However, because the study was underpowered, all of the findings should be interpreted with the utmost caution.


Assuntos
Artroplastia do Joelho/reabilitação , Osteoartrite do Joelho/reabilitação , Osteoartrite do Joelho/cirurgia , Robótica/instrumentação , Idoso , Idoso de 80 Anos ou mais , Fenômenos Biomecânicos , Terapia por Exercício , Feminino , Marcha , Humanos , Articulação do Joelho/fisiopatologia , Articulação do Joelho/cirurgia , Movimento , Osteoartrite do Joelho/fisiopatologia , Estudos Prospectivos , Recuperação de Função Fisiológica , Robótica/métodos , Método Simples-Cego , Andadores , Suporte de Carga/fisiologia
3.
PLoS One ; 15(11): e0242078, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33211736

RESUMO

Telepresence robots allow users to be spatially and socially present in remote environments. Yet, it can be challenging to remotely operate telepresence robots, especially in dense environments such as academic conferences or workplaces. In this paper, we primarily focus on the effect that a speed control method, which automatically slows the telepresence robot down when getting closer to obstacles, has on user behaviors. In our first user study, participants drove the robot through a static obstacle course with narrow sections. Results indicate that the automatic speed control method significantly decreases the number of collisions. For the second study we designed a more naturalistic, conference-like experimental environment with tasks that require social interaction, and collected subjective responses from the participants when they were asked to navigate through the environment. While about half of the participants preferred automatic speed control because it allowed for smoother and safer navigation, others did not want to be influenced by an automatic mechanism. Overall, the results suggest that automatic speed control simplifies the user interface for telepresence robots in static dense environments, but should be considered as optionally available, especially in situations involving social interactions.


Assuntos
Robótica/instrumentação , Navegação Espacial , Algoritmos , Cibernética , Humanos , Interface Usuário-Computador
4.
PLoS One ; 15(11): e0242005, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33166328

RESUMO

Transhumeral percutaneous osseointegrated prostheses provide upper-extremity amputees with increased range of motion, more natural movement patterns, and enhanced proprioception. However, direct skeletal attachment of the endoprosthesis elevates the risk of bone fracture, which could necessitate revision surgery or result in loss of the residual limb. Bone fracture loads are direction dependent, strain rate dependent, and load rate dependent. Furthermore, in vivo, bone experiences multiaxial loading. Yet, mechanical characterization of the bone-implant interface is still performed with simple uni- or bi-axial loading scenarios that do not replicate the dynamic multiaxial loading environment inherent in human motion. The objective of this investigation was to reproduce the dynamic multiaxial loading conditions that the humerus experiences in vivo by robotically replicating humeral kinematics of advanced activities of daily living typical of an active amputee population. Specifically, 115 jumping jack, 105 jogging, 15 jug lift, and 15 internal rotation trials-previously recorded via skin-marker motion capture-were replicated on an industrial robot and the resulting humeral trajectories were verified using an optical tracking system. To achieve this goal, a computational pipeline that accepts a motion capture trajectory as input and outputs a motion program for an industrial robot was implemented, validated, and made accessible via public code repositories. The industrial manipulator utilized in this study was able to robotically replicate over 95% of the aforementioned trials to within the characteristic error present in skin-marker derived motion capture datasets. This investigation demonstrates the ability to robotically replicate human motion that recapitulates the inertial forces and moments of high-speed, multiaxial activities for biomechanical and orthopaedic investigations. It also establishes a library of robotically replicated motions that can be utilized in future studies to characterize the interaction of prosthetic devices with the skeletal system, and introduces a computational pipeline for expanding this motion library.


Assuntos
Membros Artificiais , Úmero/cirurgia , Robótica/instrumentação , Atividades Cotidianas , Amputados , Fenômenos Biomecânicos , Interface Osso-Implante/fisiologia , Humanos , Úmero/fisiologia , Cinética , Osseointegração , Desenho de Prótese , Amplitude de Movimento Articular
5.
Science ; 370(6518): 768-769, 2020 11 13.
Artigo em Inglês | MEDLINE | ID: mdl-33184195
6.
Nature ; 587(7833): 219-224, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33177670

RESUMO

Soft machines are a promising design paradigm for human-centric devices1,2 and systems required to interact gently with their environment3,4. To enable soft machines to respond intelligently to their surroundings, compliant sensory feedback mechanisms are needed. Specifically, soft alternatives to strain gauges-with high resolution at low strain (less than 5 per cent)-could unlock promising new capabilities in soft systems. However, currently available sensing mechanisms typically possess either high strain sensitivity or high mechanical resilience, but not both. The scarcity of resilient and compliant ultra-sensitive sensing mechanisms has confined their operation to laboratory settings, inhibiting their widespread deployment. Here we present a versatile and compliant transduction mechanism for high-sensitivity strain detection with high mechanical resilience, based on strain-mediated contact in anisotropically resistive structures (SCARS). The mechanism relies upon changes in Ohmic contact between stiff, micro-structured, anisotropically conductive meanders encapsulated by stretchable films. The mechanism achieves high sensitivity, with gauge factors greater than 85,000, while being adaptable for use with high-strength conductors, thus producing sensors resilient to adverse loading conditions. The sensing mechanism also exhibits high linearity, as well as insensitivity to bending and twisting deformations-features that are important for soft device applications. To demonstrate the potential impact of our technology, we construct a sensor-integrated, lightweight, textile-based arm sleeve that can recognize gestures without encumbering the hand. We demonstrate predictive tracking and classification of discrete gestures and continuous hand motions via detection of small muscle movements in the arm. The sleeve demonstration shows the potential of the SCARS technology for the development of unobtrusive, wearable biomechanical feedback systems and human-computer interfaces.


Assuntos
Retroalimentação Sensorial , Maleabilidade , Robótica/instrumentação , Robótica/métodos , Interface Usuário-Computador , Dispositivos Eletrônicos Vestíveis , Mãos/fisiologia , Humanos , Movimento (Física) , Movimento , Têxteis
7.
J Vis Exp ; (164)2020 10 03.
Artigo em Inglês | MEDLINE | ID: mdl-33074255

RESUMO

Avoidance behavior is a key contributor to the transition from acute pain to chronic pain disability. Yet, there has been a lack of ecologically valid paradigms to experimentally investigate pain-related avoidance. To fill this gap, we developed a paradigm (the robotic arm-reaching paradigm) to investigate the mechanisms underlying the development of pain-related avoidance behavior. Existing avoidance paradigms (mostly in the context of anxiety research) have often operationalized avoidance as an experimenter-instructed, low-cost response, superimposed on stimuli associated with threat during a Pavlovian fear conditioning procedure. In contrast, the current method offers increased ecological validity in terms of instrumental learning (acquisition) of avoidance, and by adding a cost to the avoidance response. In the paradigm, participants perform arm-reaching movements from a starting point to a target using a robotic arm, and freely choose between three different movement trajectories to do so. The movement trajectories differ in probability of being paired with a painful electrocutaneous stimulus, and in required effort in terms of deviation and resistance. Specifically, the painful stimulus can be (partly) avoided at the cost of performing movements requiring increased effort. Avoidance behavior is operationalized as the maximal deviation from the shortest trajectory on each trial. In addition to explaining how the new paradigm can help understand the acquisition of avoidance, we describe adaptations of the robotic arm-reaching paradigm for (1) examining the spread of avoidance to other stimuli (generalization), (2) modeling clinical treatment in the lab (extinction of avoidance using response prevention), as well as (3) modeling relapse, and return of avoidance following extinction (spontaneous recovery). Given the increased ecological validity, and numerous possibilities for extensions and/or adaptations, the robotic arm-reaching paradigm offers a promising tool to facilitate the investigation of avoidance behavior and to further our understanding of its underlying processes.


Assuntos
Braço/patologia , Aprendizagem da Esquiva/fisiologia , Dor Crônica/terapia , Robótica/instrumentação , Condicionamento Clássico/fisiologia , Feminino , Humanos , Masculino
8.
J Stroke Cerebrovasc Dis ; 29(12): 105377, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33091753

RESUMO

OBJECTIVE: Although studies on the efficacy of the rehabilitation robot are increasing, there are few reports using the robot for gait training in the actual clinical setting. This study aimed to investigate the effectiveness of gait training using Welwalk in hemiparetic stroke patients in a real clinical setting. MATERIALS AND METHODS: This prospective study included 36 hemiparetic stroke patients who underwent gait training using Welwalk. We examined the walking ability improvement efficiency using Functional Independence Measure (FIM)-walk as the primary outcome, which was compared with that of 36 patients (matched control group) who underwent conventional rehabilitation. Other outcomes were the actual gait training period using Welwalk, raw FIM-walk score, lower extremity motor functions score in Stroke Impairment Assessment Set at discharge, and duration from stroke onset until discharge. RESULTS: The improvement efficiency of the FIM-walk was significantly higher in the Welwalk group than in the matched control group (control 0.48 ± 0.31, Welwalk 0.80 ± 0.38, p-value < 0.001). The mean gait training period using Welwalk was 5 weeks. No significant differences were found in other outcomes between the Welwalk group and the matched control group. CONCLUSION: This study demonstrated the effectiveness of gait training using Welwalk on the improvement efficiency of the FIM-walk in hemiparetic stroke patients in an actual clinical setting.


Assuntos
Marcha , Atividade Motora , Paresia/reabilitação , Robótica/instrumentação , Reabilitação do Acidente Vascular Cerebral/instrumentação , Acidente Vascular Cerebral/terapia , Idoso , Avaliação da Deficiência , Exoesqueleto Energizado , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Paresia/diagnóstico , Paresia/fisiopatologia , Estudos Prospectivos , Recuperação de Função Fisiológica , Estudos Retrospectivos , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/fisiopatologia , Fatores de Tempo , Resultado do Tratamento
9.
Cochrane Database Syst Rev ; 10: CD006185, 2020 10 22.
Artigo em Inglês | MEDLINE | ID: mdl-33091160

RESUMO

BACKGROUND: Electromechanical- and robot-assisted gait-training devices are used in rehabilitation and might help to improve walking after stroke. This is an update of a Cochrane Review first published in 2007 and previously updated in 2017. OBJECTIVES: Primary • To determine whether electromechanical- and robot-assisted gait training versus normal care improves walking after stroke Secondary • To determine whether electromechanical- and robot-assisted gait training versus normal care after stroke improves walking velocity, walking capacity, acceptability, and death from all causes until the end of the intervention phase SEARCH METHODS: We searched the Cochrane Stroke Group Trials Register (last searched 6 January 2020); the Cochrane Central Register of Controlled Trials (CENTRAL; 2020 Issue 1), in the Cochrane Library; MEDLINE in Ovid (1950 to 6 January 2020); Embase (1980 to 6 January 2020); the Cumulative Index to Nursing and Allied Health Literature (CINAHL; 1982 to 20 November 2019); the Allied and Complementary Medicine Database (AMED; 1985 to 6 January 2020); Web of Science (1899 to 7 January 2020); SPORTDiscus (1949 to 6 January 2020); the Physiotherapy Evidence Database (PEDro; searched 7 January 2020); and the engineering databases COMPENDEX (1972 to 16 January 2020) and Inspec (1969 to 6 January 2020). We handsearched relevant conference proceedings, searched trials and research registers, checked reference lists, and contacted trial authors in an effort to identify further published, unpublished, and ongoing trials. SELECTION CRITERIA: We included all randomised controlled trials and randomised controlled cross-over trials in people over the age of 18 years diagnosed with stroke of any severity, at any stage, in any setting, evaluating electromechanical- and robot-assisted gait training versus normal care. DATA COLLECTION AND ANALYSIS: Two review authors independently selected trials for inclusion, assessed methodological quality and risk of bias, and extracted data. We assessed the quality of evidence using the GRADE approach. The primary outcome was the proportion of participants walking independently at follow-up. MAIN RESULTS: We included in this review update 62 trials involving 2440 participants. Electromechanical-assisted gait training in combination with physiotherapy increased the odds of participants becoming independent in walking (odds ratio (random effects) 2.01, 95% confidence interval (CI) 1.51 to 2.69; 38 studies, 1567 participants; P < 0.00001; I² = 0%; high-quality evidence) and increased mean walking velocity (mean difference (MD) 0.06 m/s, 95% CI 0.02 to 0.10; 42 studies, 1600 participants; P = 0.004; I² = 60%; low-quality evidence) but did not improve mean walking capacity (MD 10.9 metres walked in 6 minutes, 95% CI -5.7 to 27.4; 24 studies, 983 participants; P = 0.2; I² = 42%; moderate-quality evidence). Electromechanical-assisted gait training did not increase the risk of loss to the study during intervention nor the risk of death from all causes. Results must be interpreted with caution because (1) some trials investigated people who were independent in walking at the start of the study, (2) we found variation between trials with respect to devices used and duration and frequency of treatment, and (3) some trials included devices with functional electrical stimulation. Post hoc analysis showed that people who are non-ambulatory at the start of the intervention may benefit but ambulatory people may not benefit from this type of training. Post hoc analysis showed no differences between the types of devices used in studies regarding ability to walk but revealed differences between devices in terms of walking velocity and capacity. AUTHORS' CONCLUSIONS: People who receive electromechanical-assisted gait training in combination with physiotherapy after stroke are more likely to achieve independent walking than people who receive gait training without these devices. We concluded that eight patients need to be treated to prevent one dependency in walking. Specifically, people in the first three months after stroke and those who are not able to walk seem to benefit most from this type of intervention. The role of the type of device is still not clear. Further research should consist of large definitive pragmatic phase 3 trials undertaken to address specific questions about the most effective frequency and duration of electromechanical-assisted gait training, as well as how long any benefit may last. Future trials should consider time post stroke in their trial design.


Assuntos
Aparelhos Ortopédicos , Robótica/instrumentação , Reabilitação do Acidente Vascular Cerebral/métodos , Caminhada , Idoso , Viés , Causas de Morte , Terapia Combinada/instrumentação , Terapia Combinada/métodos , Intervalos de Confiança , Terapia por Estimulação Elétrica , Desenho de Equipamento , Terapia por Exercício/métodos , Marcha , Humanos , Pessoa de Meia-Idade , Razão de Chances , Ensaios Clínicos Controlados Aleatórios como Assunto , Reabilitação do Acidente Vascular Cerebral/instrumentação , Velocidade de Caminhada
10.
Comput Math Methods Med ; 2020: 5248569, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33082839

RESUMO

In this paper, we developed a model that suggests the use of robots in identifying COVID-19-positive patients and which studied the effectiveness of the government policy of prohibiting migration of individuals into their countries especially from those countries that were known to have COVID-19 epidemic. Two compartmental models consisting of two equations each were constructed. The models studied the use of robots for the identification of COVID-19-positive patients. The effect of migration ban strategy was also studied. Four biologically meaningful equilibrium points were found. Their local stability analysis was also carried out. Numerical simulations were carried out, and the most effective strategy to curtail the spread of the disease was shown.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Modelos Biológicos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Técnicas de Laboratório Clínico/instrumentação , Técnicas de Laboratório Clínico/estatística & dados numéricos , Biologia Computacional , Simulação por Computador , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Humanos , Conceitos Matemáticos , Modelos Estatísticos , Pandemias/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Robótica/instrumentação , Robótica/estatística & dados numéricos , Viagem
11.
J Stroke Cerebrovasc Dis ; 29(10): 105176, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32912532

RESUMO

PURPOSE: There is limited evidence of gait training using newly developed exoskeletal lower limb robot called Hybrid Assistive Limb (HAL) on the function and ability to perform ADL in stroke patients. In clinical settings, we frequently find it challenging to conduct a randomized controlled trial; thus, a large-scale observational study using propensity score analysis methods is a feasible alternative. The present study aimed to determine whether exoskeletal lower limb robot training improved the ability to perform ADL in stroke patients. MATERIALS AND METHODS: Acute stroke patients who were admitted to our facility from April 2016 to March 2017 were evaluated in the conventional rehabilitation period (CRP) and those admitted from April 2017 to June 2019 were evaluated in the HAL rehabilitation period (HRP). We started a new gait rehabilitation program using HAL at the midpoint of these two periods. The functional outcomes or ADL ability outcomes of the patients in the CRP and the subsequent HRP were compared using propensity score matched analyses. RESULTS: Propensity score matching analysis was performed for 108 stroke patients (63 from the CRP and 45 from the HRP), and 36 pairs were matched. The ADL ability, defined by the FIM scores and FIM score change, was significantly higher in patients admitted during the HRP. In addition, more stroke patients obtained practical walking ability during hospitalization in the HRP. CONCLUSION: Gait training using HAL affects the ADL ability and obtaining of practical walking ability of stroke patients.


Assuntos
Atividades Cotidianas , Exoesqueleto Energizado , Marcha , Extremidade Inferior/inervação , Robótica/instrumentação , Reabilitação do Acidente Vascular Cerebral/instrumentação , Acidente Vascular Cerebral/terapia , Idoso , Idoso de 80 Anos ou mais , Avaliação da Deficiência , Desenho de Equipamento , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pontuação de Propensão , Recuperação de Função Fisiológica , Estudos Retrospectivos , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/fisiopatologia , Resultado do Tratamento
12.
Sci Rep ; 10(1): 15480, 2020 09 23.
Artigo em Inglês | MEDLINE | ID: mdl-32968184

RESUMO

In medical robotics, micromanipulation becomes particularly challenging in the presence of blood and secretions. Nature offers many examples of adhesion strategies, which can be divided into two macro-categories: morphological adjustments and chemical adaptations. This paper analyzes how two successful specializations from different marine animals can converge into a single biomedical device usable in moist environments. Taking inspiration from the morphology of the octopus sucker and the chemistry of mussel secretions, we developed a protein-coated octopus-inspired micro-sucker device that retains in moist conditions about half of the adhesion it shows in dry environments. From a robotic perspective, this study emphasizes the advantages of taking inspiration from specialized natural solutions to optimize standard robotic designs.


Assuntos
Micromanipulação , Octopodiformes , Robótica , Adesividade , Animais , Materiais Biomiméticos , Micromanipulação/instrumentação , Micromanipulação/métodos , Mytilus edulis , Octopodiformes/anatomia & histologia , Robótica/instrumentação , Robótica/métodos , Água
13.
Nat Commun ; 11(1): 4536, 2020 09 10.
Artigo em Inglês | MEDLINE | ID: mdl-32913189

RESUMO

Natural musculoskeletal systems have been widely recognized as an advanced robotic model for designing robust yet flexible microbots. However, the development of artificial musculoskeletal systems at micro-nanoscale currently remains a big challenge, since it requires precise assembly of two or more materials of distinct properties into complex 3D micro/nanostructures. In this study, we report femtosecond laser programmed artificial musculoskeletal systems for prototyping 3D microbots, using relatively stiff SU-8 as the skeleton and pH-responsive protein (bovine serum albumin, BSA) as the smart muscle. To realize the programmable integration of the two materials into a 3D configuration, a successive on-chip two-photon polymerization (TPP) strategy that enables structuring two photosensitive materials sequentially within a predesigned configuration was proposed. As a proof-of-concept, we demonstrate a pH-responsive spider microbot and a 3D smart micro-gripper that enables controllable grabbing and releasing. Our strategy provides a universal protocol for directly printing 3D microbots composed of multiple materials.


Assuntos
Biomimética/métodos , Compostos de Epóxi/efeitos da radiação , Fenômenos Fisiológicos Musculoesqueléticos , Polímeros/efeitos da radiação , Robótica/métodos , Soroalbumina Bovina/efeitos da radiação , Biomimética/instrumentação , Compostos de Epóxi/química , Hidrogéis/química , Hidrogéis/efeitos da radiação , Concentração de Íons de Hidrogênio , Lasers , Polimerização/efeitos da radiação , Polímeros/química , Impressão Tridimensional , Robótica/instrumentação , Soroalbumina Bovina/química
14.
J Neuroeng Rehabil ; 17(1): 115, 2020 08 24.
Artigo em Inglês | MEDLINE | ID: mdl-32831097

RESUMO

BACKGROUND: Hand function is often impaired after stroke, strongly affecting the ability to perform daily activities. Upper limb robotic devices have been developed to complement rehabilitation therapy offered to persons who suffered a stroke, but they rarely focus on the training of hand sensorimotor function. The primary goal of this study was to evaluate whether robot-assisted therapy of hand function following a neurocognitive approach (i.e., combining motor training with somatosensory and cognitive tasks) produces an equivalent decrease in upper limb motor impairment compared to dose-matched conventional neurocognitive therapy, when embedded in the rehabilitation program of inpatients in the subacute stage after stroke. METHODS: A parallel-group, randomized controlled trial was conducted on subjects with subacute stroke receiving either conventional or robot-assisted neurocognitive hand therapy using a haptic device. Therapy was provided for 15, 45-min sessions over four weeks, nested within the standard therapy program. Primary outcome was the change from baseline in the upper extremity part of the Fugl-Meyer Assessment (FMA-UE) after the intervention, which was compared between groups using equivalence testing. Secondary outcome measures included upper limb motor, sensory and cognitive assessments, delivered therapy dose, as well as questionnaires on user technology acceptance. RESULTS: Thirty-three participants with stroke were enrolled. 14 subjects in the robot-assisted and 13 subjects in the conventional therapy group completed the study. At the end of intervention, week 8 and week 32, the robot-assisted/conventional therapy group improved by 7.14/6.85, 7.79/7.31, and 8.64/8.08 points on the FMA-UE, respectively, establishing that motor recovery in the robot-assisted group is non-inferior to that in the control group. CONCLUSIONS: Neurocognitive robot-assisted therapy of hand function allows for a non-inferior motor recovery compared to conventional dose-matched neurocognitive therapy when performed during inpatient rehabilitation in the subacute stage. This allows the early familiarization of subjects with stroke to the use of such technologies, as a first step towards minimal therapist supervision in the clinic, or directly at home after hospital discharge, to help increase the dose of hand therapy for persons with stroke. TRIAL REGISTRATION: EUDAMED database (CIV-13-02-009921), clinicaltrials.gov (NCT02096445). Registered 26 March 2014 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT02096445.


Assuntos
Terapia por Exercício/instrumentação , Recuperação de Função Fisiológica , Robótica/instrumentação , Reabilitação do Acidente Vascular Cerebral/instrumentação , Adulto , Idoso , Feminino , Mãos/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Acidente Vascular Cerebral/fisiopatologia
15.
J Neuroeng Rehabil ; 17(1): 116, 2020 08 25.
Artigo em Inglês | MEDLINE | ID: mdl-32843058

RESUMO

BACKGROUND: State-of-the-art bionic hands incorporate hi-tech devices which try to overcome limitations of conventional single grip systems. Unfortunately, their complexity often limits mechanical robustness and intuitive prosthesis control. Recently, the translation of neuroscientific theories (i.e. postural synergies) in software and hardware architecture of artificial devices is opening new approaches for the design and control of upper-limb prostheses. METHODS: Following these emerging principles, previous research on the SoftHand Pro, which embeds one physical synergy, showed promising results in terms of intuitiveness, robustness, and grasping performance. To explore these principles also in hands with augmented capabilities, this paper describes the SoftHand 2 Pro, a second generation of the device with 19 degrees-of-freedom and a second synergistic layer. After a description of the proposed device, the work explores a continuous switching control method based on a myoelectric pattern recognition classifier. RESULTS: The combined system was validated using standardized assessments with able-bodied and, for the first time, amputee subjects. Results show an average improvement of more than 30% of fine grasp capabilities and about 10% of hand function compared with the first generation SoftHand Pro. CONCLUSIONS: Encouraging results suggest how this approach could be a viable way towards the design of more natural, reliable, and intuitive dexterous hands.


Assuntos
Membros Artificiais , Mãos , Desenho de Prótese/métodos , Robótica/instrumentação , Adulto , Amputados , Eletromiografia/métodos , Feminino , Força da Mão , Voluntários Saudáveis , Humanos , Masculino , Software , Adulto Jovem
16.
NeuroRehabilitation ; 47(2): 209-215, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32741790

RESUMO

OBJECTIVE: To explore the impact of rehabilitation robot training (RRT) on upper limb motor function and daily activity ability in patients with stroke. METHODS: Forty patients meeting the inclusion criteria were randomly divided into the treatment group (TRE) and the control group (CON). Group TRE was trained with an upper limb rehabilitation robot and group CON was trained with traditional occupational therapy. The training time was six weeks, and the upper limb function and daily activities were then assessed. RESULTS: (1) There was no statistical significance in the Fugl-Meyer (FM) score, Wolf Motor Function Test (WMFT) score, and Modified Barthel Index (MBI) score between the two groups before treatment (P > 0.05). (2) After treatment, the FM score, WMFT score, and MBI score were significantly higher than before treatment (P < 0.01). (3) There was no significant significance between the two groups after treatment (P > 0.05). CONCLUSIONS: Both RRT and traditional occupational therapy training are useful for the recovery of upper limb motor function and daily life ability in the sub-acute stage of stroke.


Assuntos
Biorretroalimentação Psicológica/métodos , Terapia Ocupacional/métodos , Robótica/métodos , Reabilitação do Acidente Vascular Cerebral/métodos , Acidente Vascular Cerebral/fisiopatologia , Extremidade Superior/fisiopatologia , Atividades Cotidianas/psicologia , Idoso , Biorretroalimentação Psicológica/instrumentação , Terapia por Exercício/instrumentação , Terapia por Exercício/métodos , Terapia por Exercício/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Terapia Ocupacional/instrumentação , Terapia Ocupacional/psicologia , Recuperação de Função Fisiológica/fisiologia , Robótica/instrumentação , Acidente Vascular Cerebral/psicologia , Acidente Vascular Cerebral/terapia , Reabilitação do Acidente Vascular Cerebral/instrumentação , Reabilitação do Acidente Vascular Cerebral/psicologia
17.
PLoS One ; 15(8): e0238133, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32822438

RESUMO

Since social robots are increasingly entering areas of people's personal lives, it is crucial to examine what affects people's perceptions and evaluations of these robots. In this study, three potential influences are examined: 1) the robot's level of interaction skills, 2) the robot's expected future role as a helpful assistant or a threatening competitor, and 3) people's individual background with regard to robots and technology in general. In an experimental lab study with a 2x2 between-subjects-design (N = 162), people read a vignette describing the social robot Nao either as assistant or competitor and subsequently interacted with Nao, which either displayed high or low interaction skills. Results of a structural equation model show that the robot's interaction skill level had the strongest effect, with a low level leading to a negative evaluation of the robot's sociability and competence and subsequently a negative general evaluation of the interaction with the robot. A robot which was expected to become a competitor was also evaluated as less sociable than a robot expected to become an assistant. Overall, in case of an actual interaction with a social robot, the robot's behavior is more decisive for people's evaluations of it than their expectations or individual backgrounds.


Assuntos
Relações Interpessoais , Robótica/instrumentação , Robótica/métodos , Adulto , Feminino , Humanos , Masculino , Motivação/fisiologia , Habilidades Sociais
18.
J Neuroeng Rehabil ; 17(1): 107, 2020 08 10.
Artigo em Inglês | MEDLINE | ID: mdl-32778109

RESUMO

BACKGROUND: Experimental designs using surrogate gait-like movements, such as in functional magnetic resonance imaging (MRI), cannot fully capture the cortical activation associated with overground gait. Overground gait in a robotic exoskeleton may be an ideal tool to generate controlled sensorimotor stimulation of gait conditions like 'active' (i.e. user moves with the device) and 'passive' (i.e. user is moved by the device) gait. To truly understand these neural mechanisms, functional near-infrared spectroscopy (fNIRS) would yield greater ecological validity. Thus, the aim of this experiment was to use fNIRS to delineate brain activation differences between 'Active' and 'Passive' overground gait in a robotic exoskeleton. METHODS: Fourteen healthy adults performed 10 walking trials in a robotic exoskeleton for Passive and Active conditions, with fNIRS over bilateral frontal and parietal lobes, and electromyography (EMG) over bilateral thigh muscles. Digitization of optode locations and individual T1 MRI scans were used to demarcate the brain regions fNIRS recorded from. RESULTS: Increased oxyhemoglobin in the right frontal cortex was found for Passive compared with Active conditions. For deoxyhemoglobin, increased activation during Passive was found in the left frontal cortex and bilateral parietal cortices compared with Active; one channel in the left parietal cortex decreased during Active when compared with Passive. Normalized EMG mean amplitude was higher in the Active compared with Passive conditions for all four muscles (p ≤ 0.044), confirming participants produced the conditions asked of them. CONCLUSIONS: The parietal cortex is active during passive robotic exoskeleton gait, a novel finding as research to date has not recorded posterior to the primary somatosensory cortex. Increased activation of the parietal cortex may be related to the planning of limb coordination while maintaining postural control. Future neurorehabilitation research could use fNIRS to examine whether exoskeletal gait training can increase gait-related brain activation with individuals unable to walk independently.


Assuntos
Encéfalo/fisiologia , Exoesqueleto Energizado , Robótica/instrumentação , Caminhada/fisiologia , Adulto , Mapeamento Encefálico/métodos , Terapia por Exercício/instrumentação , Feminino , Voluntários Saudáveis , Humanos , Imagem por Ressonância Magnética , Masculino , Espectroscopia de Luz Próxima ao Infravermelho
19.
J Neuroeng Rehabil ; 17(1): 108, 2020 08 10.
Artigo em Inglês | MEDLINE | ID: mdl-32778127

RESUMO

BACKGROUND: Body weight support systems with three or more degrees of freedom (3-DoF) are permissive and safe environments that provide unloading and allow unrestricted movement in any direction. This enables training of walking and balance control at an early stage in rehabilitation. Transparent systems generate a support force vector that is near vertical at all positions in the workspace to only minimally interfere with natural movement patterns. Patients with impaired balance, however, may benefit from additional mediolateral support that can be adjusted according to their capacity. An elegant solution for providing balance support might be by rendering viscous damping along the mediolateral axis via the software controller. Before use with patients, we evaluated if control-rendered mediolateral damping evokes the desired stability enhancement in able-bodied individuals. METHODS: A transparent, cable-driven robotic body weight support system (FLOAT) was used to provide transparent body weight support with and without mediolateral damping to 21 able-bodied volunteers while walking at preferred gait velocity on a treadmill. Stability metrics reflecting resistance to small and large perturbations were derived from walking kinematics and compared between conditions and to free walking. RESULTS: Compared to free walking, the application of body weight support per-se resulted in gait alterations typically associated with body weight support, namely increased step length and swing phase. Frontal plane dynamic stability, measured by kinematic variability and nonlinear dynamics of the center of mass, was increased under body weight support, indicating reduced balance requirements in both damped and undamped support conditions. Adding damping to the body weight support resulted in a greater increase of frontal plane stability. CONCLUSION: Adding mediolateral damping to 3-DoF body weight support systems is an effective method of increasing frontal plane stability during walking in able-bodied participants. Building on these results, adjustable mediolateral damping could enable therapists to select combinations of unloading and stability specifically for each patient and to adapt this in a task specific manner. This could extend the impact of transparent 3-DoF body weight support systems, enabling training of gait and active balance from an early time point onwards in the rehabilitation process for a wide range of mobility activities of daily life.


Assuntos
Doenças do Sistema Nervoso/reabilitação , Equilíbrio Postural/fisiologia , Robótica/instrumentação , Caminhada/fisiologia , Adulto , Fenômenos Biomecânicos , Peso Corporal , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
20.
PLoS One ; 15(8): e0226052, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32756553

RESUMO

Children with movement impairments needing assistive devices for activities of daily living often require novel methods for controlling these devices. Body-machine interfaces, which rely on body movements, are particularly well-suited for children as they are non-invasive and have high signal-to-noise ratios. Here, we examined the use of a head-joystick to enable a child with congenital absence of all four limbs to control a seven degree-of-freedom robotic arm. Head movements were measured with a wireless inertial measurement unit and used to control a robotic arm to perform two functional tasks-a drinking task and a block stacking task. The child practiced these tasks over multiple sessions; a control participant performed the same tasks with a manual joystick. Our results showed that the child was able to successfully perform both tasks, with movement times decreasing by ~40-50% over 6-8 sessions of training. The child's performance with the head-joystick was also comparable to the control participant using a manual joystick. These results demonstrate the potential of using head movements for the control of high degree-of-freedom tasks in children with limited movement repertoire.


Assuntos
Robótica/instrumentação , Interface Usuário-Computador , Atividades Cotidianas , Adolescente , Cabeça/fisiologia , Movimentos da Cabeça/fisiologia , Humanos , Masculino , Movimento/fisiologia , Equipamentos de Autoajuda/tendências , Tecnologia sem Fio/instrumentação
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