User Local Coordinate-Based Accompanying Robot for Human Natural Movement of Daily Life.

Considering the trend of aging societies, accompanying technology can help frail, elderly individuals participate in daily activities. The ideal accompanying robot should accompany the user in a proper position according to the activity scenarios and context; the prerequisite is that the accompanying robot should quickly move to a designated position and closely maintain it regardless of the direction in which the user moves. This paper proposes a user local coordinate-based strategy to satisfy this need. As a proof of concept, a novel "string-pot" approach was utilized to measure the position difference between the robot and the target. We implemented the control strategy and assessed its performance in our gait lab. The results showed that the robot can follow the user in the designated position while the user performs forward, backward, and lateral movements, turning, and walking along a curve.

Feasibility and effectiveness of interactive stepping exercise on community-dwelling older adults: A pilot randomized controlled trial.

Recently, the interactive stepping exercise (ISE) was developed on the basis of square stepping exercise. The aim of this study was to examine the feasibility and effectiveness of ISE on executive function and gait variability among community-dwelling older adults. Fourteen participants were recruited and randomly assigned to the experimental group (n=7) or control group (n=7) and received ISE or home exercise program, respectively, three times a week for 12 weeks. The outcomes included retention rate, attendance rate, Trail Making Test, and dual-task walking. The results showed that participants had high retention and attendance rate for the ISE intervention. Moreover, significant improvement in the part A of Trail Making Test and stride length variability during cognitive dual-task walking after 12-week ISE intervention. The current results suggested that ISE is a feasible and effective intervention on executive function and gait variability in community-dwelling older adults.

Development of an Objective Portable Measurement Device for Spinal Joint Accessory Motion Testing.

Joint accessory motion testing (JAMT) is a standard procedure used by manual therapists to assess and treat musculoskeletal disorders. Joint accessory motion (JAM) is movement that occurs between joint surfaces, and can be induced by applying force. The motion amount, end feel, symptoms, and resistance perceived by therapists during test procedures are recorded as evidence for the diagnosis, prognosis, treatment decision making, and intervention outcome. However, previous studies have shown that accessory motion tests have insufficient reliability. Recently, many instruments have been developed to increase test reliability, but these instruments quantify the test results with a single probe and utilize the external environment as a reference. Therefore, the measured displacement amount may be affected by other spinal segments. This study proposes an objective portable measurement device with two indenter probes for spinal JAMT, wherein the JAM was quantified by displacement and force measurements between two bones. The instrument was verified with a homemade spinal simulator and computer simulation. The results showed that the force-displacement curves measured by the JAMT device (JAMTD) and those simulated by the computer model exhibited similar characteristics. Moreover, a two-probe measurement could distinguish the differences in stiffness better than a one-probe measurement.

Clinical applications and consideration of interventions of electrotherapy for orthopedic and neurological rehabilitation.

Electrotherapy or electrical stimulation (ES) is a part of clinical intervention in the rehabilitation field. With rehabilitation intervention, electrotherapy may be provided as a treatment for pain relief, strengthening, muscle education, wound recovery, or functional training. Although these interventions may not be considered as the primary therapy for patients, the advantages of the ease of operation, lower costs, and lower risks render ES to be applied frequently in clinics. There have also been emerging ES tools for brain modulation in the past decade. ES interventions are not only considered analgesics but also as an important assistive therapy for motor improvement in orthopedic and neurological rehabilitation. In addition, during the coronavirus disease pandemic, lockdowns and self-quarantine policies have led to the discontinuation of orthopedic and neurological rehabilitation interventions. Therefore, the feasibility and effectiveness of home-based electrotherapy may provide opportunities for the prevention of deterioration or extension of the original therapy. The most common at-home applications in previous studies showed positive effects on pain relief, functional ES, muscle establishment, and motor training. Currently, there is a lack of certain products for at-home brain modulation; however, transcranial direct current stimulation has shown the potential of future home-based rehabilitation due to its relatively small and simple design. We have organized the features and applications of ES tools and expect the future potential of remote therapy during the viral pandemic.

A novel instrumented walker for individualized visual cue setting for gait training in patients with Parkinson's disease.

Patients with Parkinson's disease suffer from gait disturbances, such as a shuffling and festinating gait, which reduces their quality of life. To circumvent this problem, external visual cues may be applied in gait training to maintain the integrity of motor function. However, conventional training methods, such as transverse lines stuck on the ground, are difficult to adjust and adapt to personalized gait ability. This study proposes a convenient instrumented wheel walker that provides gap adjustable visual cues and selectable projection modes onto the ground with and without motion relative to the user. Ten subjects with Parkinson's disease were recruited, and the efficacy of the proposed device for their gait training was assessed. We demonstrated the applicability of our device to address personalized demands in gait guidance. With a personalized setting for patients with Parkinson's disease, a significantly lengthened stride length may be achieved.