Design and evaluation of Driver's SEAT: A car steering simulation environment for upper limb stroke therapy

Robotica ◽  
2003 ◽  
Vol 21 (1) ◽  
pp. 13-23 ◽  
Author(s):  
M. J. Johnson ◽  
H. F. M. Van der Loos ◽  
C. G. Burgar ◽  
P. Shor ◽  
L. J. Leifer
Keyword(s):  
Upper Limb ◽  
Lower Limb ◽  
Neurological Impairment ◽  
Motor Deficits ◽  
Tracking Data ◽  
Upper Limbs ◽  
Robotic Device ◽  
Simulation Environment ◽  
Stroke Therapy ◽  
Bilateral Movement

Hemiplegia, affecting approximately 75% of all stroke survivors, is a common neurological impairment that results in upper and lower limb sensory and motor deficits. Recovery of coordinated movement of both upper limbs is important for bilateral function and promotes personal independence. This paper describes the philosophy and design of Driver's Simulation Environment for Arm Therapy, a one-degree-of-freedom robotic device that uses a modified Constraint-Induced therapy paradigm to promote coordinated bilateral movement in the upper limbs. Baseline force and tracking data for four neurologically unimpaired subjects who completed bilateral and unilateral steering with the impaired arm using the device are presented.

Designing the Armadillo Orthosis: User experience design for a wearable upper limb stroke therapy device.

2021 ◽  
Author(s):  
◽  
Jessica Saul
Keyword(s):  
Design Process ◽  
User Experience ◽  
Upper Limb ◽  
Stroke Rehabilitation ◽  
Robotic Device ◽  
Stroke Therapy ◽  
User Testing ◽  
Stroke Patients ◽  
Research Through Design ◽  
Human Centred Design

<p>Stroke is a medical condition causing disability worldwide (Feigin et al., 2014; Murray et al., 2012; National Heart Lung and Blood institute, 2016). It can leave people with physical and cognitive deficits. The individual’s function in everyday activities following a stroke depends on the severity of the stroke and the amount of therapy available to them. Rehabilitation for the physical impairments, such as upper limb deficits, can promote recovery and is delivered by physiotherapists and occupational therapists. Therapy takes place predominantly in the clinical environment. It is manual, task based, delivered one on one, and can be time intensive. Self-management methods for patients’ stroke rehabilitation are gaining attention from healthcare professionals (Taylor, Monsanto, Kilgour, Smith, & Hale, 2019). Rehabilitation that can be done at home has benefits for the individual, the family or caregiver, the therapist and the healthcare system. Independent rehabilitation at home reduces pressure on healthcare resources and can be beneficial for stroke patients recovery. So, medical interventions and products are shifting from clinical to community and home environments.   The use of robotics for rehabilitation has the potential to support recovery of function and assist with everyday tasks in a variety of ways. This paper explores the design of a robotic device for the hand. By involving stroke patients, clinicians and carers in the design process, this research aims to improve the user experiences of a robotic device for hand rehabilitation. Designing for the user experience has the potential to improve the engagement and acceptance of the robotic device for independent home therapy.   A combination of methods have been used to include users in the design process and gather qualitative data to inform the design. The methodologies include research through design and human-centred design. Research through design includes methods such as a literature review, using and adapting design criteria, prototyping, iteration, user-testing, and thematic analysis. Human-centred design is about involving users in the development process and include methods such as surveys, semi-structured interviews, observations, and user testing. There were four clinicians and seven stroke patients that met inclusion criteria and participated in the testing. Three patients and three clinician participants were involved in the interviews. Personas were used to understand user wants and needs, and to inform criteria for the design process.  By using these methods we gain a better understanding of the users’ needs in order to improve the design of the pre-existing robotic upper limb stroke rehabilitation device. The purpose of the design is to meet the needs of the stroke patient in his or her own home. This design study focuses on developing the user experience by addressing usability. Interactions considered during the iterative design process are putting on and taking off the device. It is found through testing and iterations that comfort, cleaning and safety were necessary for this wearable robotic upper limb stroke therapy device to be easily worn and used in the home.</p>

scholarly journals Cross-Sectional Survey of Musculoskeletal Disorders in Workers Practicing Traditional Methods of Underground Coal Mining

2020 ◽  
Vol 17 (7) ◽  
pp. 2566
Author(s):  
Madiha Ijaz ◽  
Sajid Rashid Ahmad ◽  
Muhammad M. Akram ◽  
Steven M. Thygerson ◽  
Falaq Ali Nadeem ◽  
...  
Keyword(s):  
Coal Mining ◽  
Upper Limb ◽  
Lower Limb ◽  
Lower Limbs ◽  
Underground Mines ◽  
Upper Limbs ◽  
Underground Coal Mining ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
R Programming

Background: In subcontinental underground mines, coal mining is carried out manually and requires many laborers to practice traditional means of coal excavation. Each task of this occupation disturbs workers’ musculoskeletal order. In order to propose and practice possible ergonomic interventions, it is necessary to know what tasks (drilling and blasting, coal cutting, dumping, transporting, timbering and supporting, loading and unloading) cause disorder in either upper limbs, lower limbs, or both. Methods: To this end, R-programming, version R 3.1.2 and SPSS, software 20, were used to calculate data obtained by studying 260 workers (working at different tasks of coal mining) from 20 mines of four districts of Punjab, Pakistan. In addition, a Standard Nordic Musculoskeletal Questionnaire (SNMQ) and Rapid Upper Limb Assessment (RULA) sheet were used to collect data and to analyze postures respectively. Results: In multi regression models, significance of the five tasks for upper and lower limb disorder is 0.00, which means that task based prevalence of upper and lower limb disorders are common in underground coal mines. The results of the multiple bar chart showed that 96 coal cutters got upper limb disorders and 82 got lower limb disorders. The task of timbering and supporting was shown to be dangerous for the lower limbs and relatively less dangerous for the upper limbs, with 25 workers reporting pain in their lower limbs, and 19 workers reporting pain in their upper limbs. Documented on the RULA sheet, all tasks got the maximum possible score (7), meaning that each of these tasks pose a threat to the posture of 100% of workers. The majority of participants (182) fell in the age group of 26 to 35 years. Of those workers, 131 reported pain in the lower limbs and slight discomfort (128) in the upper limbs. The significance value of age was 0.00 for upper limb disorder and was 0.012 for lower limb disorder. Frequency graphs show age in direct proportion to severity of pain while in inverse proportion with number of repetitions performed per min. Conclusions: All findings infer that each task of underground coal mining inflicts different levels of disorder in a workers’ musculoskeletal structure of the upper and lower limbs. It highlighted the need for urgent intervention in postural aspects of each task.

scholarly journals Neural coupling between upper and lower limbs during recumbent stepping

2004 ◽  
Vol 97 (4) ◽  
pp. 1299-1308 ◽  
Author(s):  
Helen J. Huang ◽  
Daniel P. Ferris
Keyword(s):  
Upper Limb ◽  
Lower Limb ◽  
Lower Limbs ◽  
Gait Rehabilitation ◽  
Upper Limbs ◽  
Neurologically Impaired ◽  
Resistance Level ◽  
Neuromuscular Activation ◽  
Lower Limb Muscles ◽  
Robotic Devices

During gait rehabilitation, therapists or robotic devices often supply physical assistance to a patient's lower limbs to aid stepping. The expensive equipment and intensive manual labor required for these therapies limit their availability to patients. One alternative solution is to design devices where patients could use their upper limbs to provide physical assistance to their lower limbs (i.e., self-assistance). To explore potential neural effects of coupling upper and lower limbs, we investigated neuromuscular recruitment during self-driven and externally driven lower limb motion. Healthy subjects exercised on a recumbent stepper using different combinations of upper and lower limb exertions. The recumbent stepper mechanically coupled the upper and lower limbs, allowing users to drive the stepping motion with upper and/or lower limbs. We instructed subjects to step with 1) active upper and lower limbs at an easy resistance level (active arms and legs); 2) active upper limbs and relaxed lower limbs at easy, medium, and hard resistance levels (self-driven); and 3) relaxed upper and lower limbs while another person drove the stepping motion (externally driven). We recorded surface electromyography (EMG) from six lower limb muscles. Self-driven EMG amplitudes were always higher than externally driven EMG amplitudes ( P < 0.05). As resistance and upper limb exertion increased, self-driven EMG amplitudes also increased. EMG bursts during self-driven and active arms and legs stepping occurred at similar times. These results indicate that active upper limb movement increases neuromuscular activation of the lower limbs during cyclic stepping motions. Neurologically impaired humans that actively engage their upper limbs during gait rehabilitation may increase neuromuscular activation and enhance activity-dependent plasticity.

scholarly journals Demography and Function of Children with Limb Loss

2005 ◽  
Vol 29 (2) ◽  
pp. 131-138 ◽  
Author(s):  
K. Yiİĝiİter ◽  
Ö. Ülger ◽  
G. Şener ◽  
S. Akdoğan ◽  
F. Erbahçecî ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Upper Limb ◽  
Lower Limb ◽  
Daily Living ◽  
Gait Pattern ◽  
Limb Loss ◽  
Upper Limbs ◽  
Congenital Limb ◽  
And Function ◽  
Functional Gait

This retrospective study was designed for the period 1982 – 2002 to collect the basic data on the demography, level and side of the amputation, involved limbs, age, gender, and prosthetic functional level in children with limb loss. A total of 232 children were assessed through their prosthetic records. Seventy-two percent (195 children) presented lower-limb involvement, and 28% (77 children) had upper-limb loss. The age of the children varied between 1 and 15 years with a mean age of 9.90 ± 2.32 years. Results of the study revealed that the leading amputation cause in children was congenital limb absence. The most frequent levels were determined as trans-tibial and trans-radial in lower and upper limbs, respectively. Findings showed that more boys (60%) were affected, and 84% of all amputations were found to be unilateral. It was also seen that right-side amputations (54%) were more common than left-side amputations (46%). The outcome of the study showed that 96% of children with lower-limb loss reached a functional gait pattern without any aids, while the percentage of independence in activities of daily living was found to be 88% in upper-limb loss.

scholarly journals Monoclonal Gammopathy Presenting as Peripheral Neuropathy

2021 ◽  
Author(s):  
Vishaka Agarwal ◽  
Koukutla Soundarya Rajeshwari ◽  
KT Jayakumar ◽  
. Satish ◽  
Chetan Somu
Keyword(s):  
Upper Limb ◽  
Lower Limb ◽  
Chronic Inflammatory Demyelinating Polyneuropathy ◽  
Position Sense ◽  
Joint Position Sense ◽  
Lower Limbs ◽  
Foot Drop ◽  
Thigh Muscle ◽  
Upper Limbs ◽  
Long Duration

Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) is a disorder of peripheral nervous system, which presents with a long duration (eight weeks) of sensory and/or motor, symmetric/asymmetric symptoms. Aetiology ranges from infections, inflammations, autoimmune disorders, to vasculitis and malignancies. Hereby, authors report a case of a male patient who presented with complains of bilateral lower limb numbness and weakness, and bilateral upper limb numbness, since two months, which was gradually progressive. On examination, he was found to have muscle wasting in his bilateral upper limb web spaces, left anterior thigh muscle, decreased tone in bilateral upper limbs and lower limbs, decreased power in both his upper limbs distally and decreased power in both his lower limbs (distal>>proximal) was seen. Superficial reflexes were normal with bilateral plantar being equivocal. Deep tendon reflexes were absent in bilateral upper and lower limbs. Tremors of bilateral upper limbs on extension were present. Loss of vibration sense throughout, loss of joint position sense at bilateral big toe and ankle joint and foot drop of his left lower limb were noticed. A diagnosis of CIDP with underlying plasma cell disorder was made after serum electrophoresis, immune-fixation and electrodiagnostic studies. The patient was started on prednisone 60 mg once daily, discharged and advised for monthly follow-up. Diagnosis of CIDP and the underlying cause is multifactorial, which can be misdiagnosed, presenting as a challenge. Hence, a detailed clinical examination, appropriate investigations are very crucial in diagnosing and treating a case of CIDP and its underlying cause. Treatment includes glucocorticoids like prednisone, IV Ig (Intravenous Immunoglobulin), plasma exchange, treating the underlying cause.

Recordings from Human Dorsal Column Nuclei Using Stimulation of the Lower Limb

Neurosurgery ◽  
1990 ◽  
Vol 26 (2) ◽  
pp. 291-299 ◽  
Author(s):  
Aage R. Møller ◽  
Peter J. Jannetta ◽  
Hae Dong Jho
Keyword(s):  
Upper Limb ◽  
Lower Limb ◽  
Peroneal Nerve ◽  
Dorsal Surface ◽  
Dorsal Column ◽  
Spasmodic Torticollis ◽  
Lower Limbs ◽  
Upper Limbs ◽  
Dorsal Column Nuclei ◽  
Stimulation Of

Abstract Responses from the surface of the dorsal column nuclei and the dorsal surface of the spinal cord were recorded using monopolar electrodes after stimulation of the lower limbs (common peroneal nerve at the knee and posterior tibial nerve at the ankle) in patients undergoing neurosurgical operations for spasmodic torticollis. Those responses were smaller in amplitude than responses to stimulation of the upper limbs (median nerve at the wrist), and the waveforms differed. The negative deflection that is prominent in the response to stimulation of the upper limbs is more variable, broader, and relatively smaller in amplitude than the response to upper limb stimulation. Another difference between responses to upper and lower limb stimulation was that multiple peaks were superimposed on the initial response to stimulation of the lower limbs, but were not as consistently seen in the responses to upper limb stimulation. The negative peak in the response from the dorsal column nuclei to lower limb stimulation was of about the same latency as the P27peak in the far-field response (somatosensory evoked potential) to stimulation of the peroneal nerve.

Emerging Technologies for Neuro-Rehabilitation after Stroke

2015 ◽  
pp. 1-21 ◽  
Author(s):  
Andrés F. Ruiz Olaya ◽  
Alberto López Delis
Keyword(s):  
Motor Learning ◽  
Motor Function ◽  
Upper Limb ◽  
Neural Plasticity ◽  
Lower Limb ◽  
Emerging Technologies ◽  
Research Field ◽  
Motor Deficits ◽  
Intensive Training ◽  
Learning Principles

Rehabilitation of motor function has been linked to motor learning that occurs during repetitive, frequent, and intensive training. Neuro-rehabilitation is based on the assumption that motor learning principles can be applied to motor recovery after injury, and that training can lead to permanent improvements in motor function in patients with motor deficits. The emergent research field of Rehabilitation Engineering may provide promised technologies for neuro-rehabilitation therapies, exploiting the motor learning and neural plasticity concepts. Among those promising technologies are robotic exoskeletons and active FES-assisted systems, which could provide repetitive training-based therapies and have been developed to aid or control the upper and lower limb movements in response to user's intentionality. This chapter describes those emerging technologies to enhance the neuro-rehabilitation processes of motor-disabled people at upper limb level and presents how a natural control to command above external devices from Electromyography could be implemented.

Design and control of an exoskeleton robot with EMG-driven electrical stimulation for upper limb rehabilitation

2020 ◽  
Vol 47 (4) ◽  
pp. 489-501
Author(s):  
Yassine Bouteraa ◽  
Ismail Ben Abdallah ◽  
Ahmed Elmogy
Keyword(s):  
Electrical Stimulation ◽  
Pain Relief ◽  
Upper Limb ◽  
Robotic Arm ◽  
Upper Limbs ◽  
Robotic Device ◽  
Motor Rehabilitation ◽  
Rehabilitation Process ◽  
Content Type ◽  
Stimulation Mode

Purpose The purpose of this paper is to design and develop a new robotic device for the rehabilitation of the upper limbs. The authors are focusing on a new symmetrical robot which can be used to rehabilitate the right upper limb and the left upper limb. The robotic arm can be automatically extended or reduced depending on the measurements of the patient's arm. The main idea is to integrate electrical stimulation into motor rehabilitation by robot. The goal is to provide automatic electrical stimulation based on muscle status during the rehabilitation process. Design/methodology/approach The developed robotic arm can be automatically extended or reduced depending on the measurements of the patient's arm. The system merges two rehabilitation strategies: motor rehabilitation and electrical stimulation. The goal is to take the advantages of both approaches. Electrical stimulation is often used for building muscle through endurance, resistance and strength exercises. However, in the proposed approach the electrical stimulation is used for recovery, relaxation and pain relief. In addition, the device includes an electromyography (EMG) muscle sensor that records muscle activity in real time. The control architecture provides the ability to automatically activate the appropriate stimulation mode based on the acquired EMG signal. The system software provides two modes for stimulation activation: the manual preset mode and the EMG driven mode. The program ensures traceability and provides the ability to issue a patient status monitoring report. Findings The developed robotic device is symmetrical and reconfigurable. The presented rehabilitation system includes a muscle stimulator associated with the robot to improve the quality of the rehabilitation process. The integration of neuromuscular electrical stimulation into the physical rehabilitation process offers effective rehabilitation sessions for neuromuscular recovery of the upper limb. A laboratory-made stimulator is developed to generate three modes of stimulation: pain relief, massage and relaxation. Through the control software interface, the physiotherapist can set the exercise movement parameters, define the stimulation mode and record the patient training in real time. Research limitations/implications There are certain constraints when applying the proposed method, such as the sensitivity of the acquired EMG signals. This involves the use of professional equipment and mainly the implementation of sophisticated algorithms for signal extraction. Practical implications Functional electrical stimulation and robot-based motor rehabilitation are the most important technologies applied in post-stroke rehabilitation. The main objective of integrating robots into the rehabilitation process is to compensate for the functions lost in people with physical disabilities. The stimulation technique can be used for recovery, relaxation and drainage and pain relief. In this context, the idea is to integrate electrical stimulation into motor rehabilitation based on a robot to obtain the advantages of the two approaches to further improve the rehabilitation process. The introduction of this type of robot also makes it possible to develop new exciting assistance devices. Originality/value The proposed design is symmetrical, reconfigurable and light, covering all the joints of the upper limbs and their movements. In addition, the developed platform is inexpensive and a portable solution based on open source hardware platforms which opens the way to more extensions and developments. Electrical stimulation is often used to improve motor function and restore loss of function. However, the main objective behind the proposed stimulation in this paper is to recover after effort. The novelty of the proposed solution is to integrate the electrical stimulation powered by EMG in robotic rehabilitation.

Use of upper-limb compression garments in the management of lipoedema

2021 ◽  
Vol 3 (Sup4) ◽  
pp. S2-S4
Author(s):  
Rebecca Elwell ◽  
Anna Rich
Keyword(s):  
Health Service ◽  
Upper Limb ◽  
Resource Use ◽  
Lower Limb ◽  
Lower Limbs ◽  
Upper Limbs ◽  
Compression Garments ◽  
Anti Inflammatory ◽  
Compression Treatment ◽  
Limb Compression

Compression hosiery is commonly used for the management of lymphoedema as well as lipoedema, but it is more commonly indicated for the lower limbs than for the upper limbs. The effects of compression hosiery on upper-limb lipoedema are poorly understood and researched. It is known that compression hosiery works in conjunction with activity or movement when standing or walking, which produces anti-inflammatory and oxygenating effects in the tissues. This effect is naturally difficult to realise in the upper limbs. Lymphoedema practitioners who treat those with lipoedema should bear in mind that compression treatment might not produce the same effects in upper-limb lipoedema as it does in lower-limb lipoedema. In these times of an overstretched health service, pragmatic resource use is essential.

Designing the Armadillo Orthosis: User experience design for a wearable upper limb stroke therapy device.

2021 ◽  
Author(s):  
◽  
Jessica Saul
Keyword(s):  
Design Process ◽  
User Experience ◽  
Upper Limb ◽  
Stroke Rehabilitation ◽  
Robotic Device ◽  
Stroke Therapy ◽  
User Testing ◽  
Stroke Patients ◽  
Research Through Design ◽  
Human Centred Design

<p>Stroke is a medical condition causing disability worldwide (Feigin et al., 2014; Murray et al., 2012; National Heart Lung and Blood institute, 2016). It can leave people with physical and cognitive deficits. The individual’s function in everyday activities following a stroke depends on the severity of the stroke and the amount of therapy available to them. Rehabilitation for the physical impairments, such as upper limb deficits, can promote recovery and is delivered by physiotherapists and occupational therapists. Therapy takes place predominantly in the clinical environment. It is manual, task based, delivered one on one, and can be time intensive. Self-management methods for patients’ stroke rehabilitation are gaining attention from healthcare professionals (Taylor, Monsanto, Kilgour, Smith, & Hale, 2019). Rehabilitation that can be done at home has benefits for the individual, the family or caregiver, the therapist and the healthcare system. Independent rehabilitation at home reduces pressure on healthcare resources and can be beneficial for stroke patients recovery. So, medical interventions and products are shifting from clinical to community and home environments.   The use of robotics for rehabilitation has the potential to support recovery of function and assist with everyday tasks in a variety of ways. This paper explores the design of a robotic device for the hand. By involving stroke patients, clinicians and carers in the design process, this research aims to improve the user experiences of a robotic device for hand rehabilitation. Designing for the user experience has the potential to improve the engagement and acceptance of the robotic device for independent home therapy.   A combination of methods have been used to include users in the design process and gather qualitative data to inform the design. The methodologies include research through design and human-centred design. Research through design includes methods such as a literature review, using and adapting design criteria, prototyping, iteration, user-testing, and thematic analysis. Human-centred design is about involving users in the development process and include methods such as surveys, semi-structured interviews, observations, and user testing. There were four clinicians and seven stroke patients that met inclusion criteria and participated in the testing. Three patients and three clinician participants were involved in the interviews. Personas were used to understand user wants and needs, and to inform criteria for the design process.  By using these methods we gain a better understanding of the users’ needs in order to improve the design of the pre-existing robotic upper limb stroke rehabilitation device. The purpose of the design is to meet the needs of the stroke patient in his or her own home. This design study focuses on developing the user experience by addressing usability. Interactions considered during the iterative design process are putting on and taking off the device. It is found through testing and iterations that comfort, cleaning and safety were necessary for this wearable robotic upper limb stroke therapy device to be easily worn and used in the home.</p>

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