Design and Control of an Underactuated Finger Exoskeleton for Assisting Activities of Daily Living

The development of a portable assistive device to aid patients affected by neuromuscular disorders has been the ultimate goal of assistive robots since the late 1960s. Despite significant advances in recent decades, traditional rigid exoskeletons are constrained by limited portability, safety, ergonomics, autonomy and, most of all, cost. In this study, we present the design and control of a soft, textile-based exosuit for assisting elbow flexion/extension and hand open/close. We describe a model-based design, characterisation and testing of two independent actuator modules for the elbow and hand, respectively. Both actuators drive a set of artificial tendons, routed through the exosuit along specific load paths, that apply torques to the human joints by means of anchor points. Key features in our design are under-actuation and the use of electromagnetic clutches to unload the motors during static posture. These two aspects, along with the use of 3D printed components and off-the-shelf fabric materials, contribute to cut down the power requirements, mass and overall cost of the system, making it a more likely candidate for daily use and enlarging its target population. Low-level control is accomplished by a computationally efficient machine learning algorithm that derives the system’s model from sensory data, ensuring high tracking accuracy despite the uncertainties deriving from its soft architecture. The resulting system is a low-profile, low-cost and wearable exosuit designed to intuitively assist the wearer in activities of daily living.

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Predictors of Loss of Functional Independence in Parkinson’s Disease: Results from the COPPADIS Cohort at 2-Year Follow-Up and Comparison with a Control Group

Diagnostics ◽

10.3390/diagnostics11101801 ◽

2021 ◽

Vol 11 (10) ◽

pp. 1801

Author(s):

Diego Santos García ◽

Teresa de Deus Fonticoba ◽

Carlos Cores Bartolomé ◽

Lucía Naya Ríos ◽

Lucía García Roca ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Activities Of Daily Living ◽

Daily Living ◽

Functional Independence ◽

Control Group ◽

Lemeshow Test ◽

Group A ◽

And Control

Background and objective: The aim of this study was to compare the progression of independence in activities of daily living (ADL) in Parkinson’s disease (PD) patients versus a control group, as well as to identify predictors of disability progression and functional dependency (FD). Patients and Methods: PD patients and control subjects, who were recruited from 35 centers of Spain from the COPPADIS cohort between January 2016 and November 2017 (V0), were included. Patients and subjects were then evaluated again at the 2-year follow-up (V2). Disability was assessed with the Schwab & England Activities of Daily Living Scale (S&E-ADLS) at V0 and V2. FD was defined as an S&E-ADLS score less than 80%. Results: In the PD group, a significant decrease in the S&E-ADLS score from V0 to V2 (N = 507; from 88.58 ± 10.19 to 84.26 ± 13.38; p < 0.0001; Cohen’s effect size = −0.519) was observed but not in controls (N = 124; from 98.87 ± 6.52 to 99.52 ± 2.15; p = 0.238). When only patients considered functional independent at baseline were included, 55 out of 463 (11.9%) converted to functional dependent at V2. To be a female (OR = 2.908; p = 0.009), have longer disease duration (OR = 1.152; p = 0.002), have a non-tremoric motor phenotype at baseline (OR = 3.574; p = 0.004), have a higher score at baseline in FOGQ (OR = 1.244; p < 0.0001) and BDI-II (OR = 1.080; p = 0.008), have a lower score at baseline in PD-CRS (OR = 0.963; p = 0.008), and have a greater increase in the score from V0 to V2 in UPDRS-IV (OR = 1.168; p = 0.0.29), FOGQ (OR = 1.348; p < 0.0001) and VAFS-Mental (OR = 1.177; p = 0.013) (adjusted R-squared 0.52; Hosmer and Lemeshow test = 0.94) were all found to be independent predictors of FD at V2. Conclusions: In conclusion, autonomy for ADL worsens in PD patients compared to controls. Cognitive impairment, gait problems, fatigue, depressive symptoms, more advanced disease, and a non-tremor phenotype are independent predictors of FD in the short-term.

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Chilean version of the INECO Frontal Screening (IFS-Ch): Psychometric properties and diagnostic accuracy

Dementia & Neuropsychologia ◽

10.1590/s1980-57642013dn70100007 ◽

2013 ◽

Vol 7 (1) ◽

pp. 40-47 ◽

Cited By ~ 12

Author(s):

Josefina Ihnen ◽

Andrés Antivilo ◽

Carlos Muñoz-Neira ◽

Andrea Slachevsky

Keyword(s):

Diagnostic Accuracy ◽

Activities Of Daily Living ◽

Psychometric Properties ◽

Functional Status ◽

Content Validity ◽

Verbal Fluency ◽

Daily Living ◽

Control Subjects ◽

Dementia Patients ◽

And Control

ABSTRACT Objective: This study sought to analyze the psychometric properties and diagnostic accuracy of the Chilean version of the INECO Frontal Screening (IFS-Ch) in a sample of dementia patients and control Methods: After adapting the instrument to the Chilean context and obtaining content validity evidence through expert consultation, the IFS-Ch was administered to 31 dementia patients and 30 control subjects together with other executive assessments (Frontal Assessment Battery [FAB], Modified version of the Wisconsin Card Sorting Test [MCST], phonemic verbal fluencies [letters A and P] and semantic verbal fluency [animals]) and global cognitive efficiency tests (Mini mental State Examination [MMSE] and Addenbrooke's Cognitive Examination-Revised [ACE-R]). Caregivers of dementia patients and proxies of control subjects were interviewed with instruments measuring dysexecutive symptoms (Dysexecutive Questionnaire [DEX]), dementia severity (Clinical Dementia Rating Scale [CDR]) and functional status in activities of daily living (Activities of Daily Living Scale [IADL] and Technology-Activities of Daily Living Questionnaire [T-ADLQ]). Convergent and discriminant validity, internal consistency reliability, cut-off points, sensitivity and specificity for the IFS-Ch were estimated. Results: Evidence of content validity was obtained. Evidence of convergent validity was also found showing significant correlations (p<0.05) between the IFS-Ch and the other instruments measuring: executive functions (FAB, r=0.935; categories achieved in the MCST, r=0.791; perseverative errors in the MCST, r= -0.617; animal verbal fluency, r=0.728; A verbal fluency, r=0.681; and P verbal fluency, r=0.783), dysexecutive symptoms in daily living (DEX, r= -0.494), dementia severity (CDR, r= -0.75) and functional status in activities of daily living (T-ADLQ, r= -0.745; IADL, r=0.717). Regarding reliability, a Cronbach's alpha coefficient of 0.905 was obtained. For diagnostic accuracy, a cut-off point of 18 points (sensitivity=0.903; specificity=0.867) and an area under curve of 0.951 were estimated to distinguish between patients with dementia and control subjects. Discussion: The IFS-Ch showed acceptable psychometric properties, supported by evidence of validity and reliability for its use in the measurement of executive functions in patients with dementia. The diagnostic accuracy of the IFS-Ch for detecting dementia patients was also considered acceptable.

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Longitudinal association between housing accessibility and activities of daily living: the role of self-efficacy and control in people ageing with Parkinson’s disease

10.21203/rs.2.17069/v2 ◽

2020 ◽

Author(s):

Giedre Gefenaite ◽

Jonas Björk ◽

Susanne Iwarsson ◽

Björn Slaug ◽

Steven M. Schmidt ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Activities Of Daily Living ◽

Self Efficacy ◽

Daily Living ◽

Control Beliefs ◽

Ageing Population ◽

Longitudinal Association ◽

And Control

Abstract Background External housing-related control beliefs (HCB) and general self-efficacy (GSE) influence different health outcomes in the general ageing population, but there is no information of their role in people ageing with Parkinson’s disease (PD). This study aimed to longitudinally assess the role of external HCB and GSE on the association between housing accessibility and activities of daily living (ADL) among people ageing with PD.Methods Baseline and 3-year follow-up data on 130 community-living participants from the Swedish project ‘Home and Health in People Ageing with PD’ were collected. Assessments addressed housing accessibility, external HCB, GSE, generic ADL and ADL specific to PD. The moderating effects of external HCB and GSE were assessed by including an interaction term in multivariable logistic regression. Results There were statistically significant interactions between housing accessibility and GSE on ADL (p=0.03), and housing accessibility and external HCB on PD specific ADL (p=0.03). After stratifying the analyses by GSE, housing accessibility problems led to more dependence and difficulty in ADL in participants with low GSE (OR 1.14; 95% CI 1.02-1.28). After stratifying by external HCB, housing accessibility increased dependence and difficulty in PD specific ADL in participants with low external HCB (OR 1.35; 95% CI 1.03-1.76). Discussion The results suggest that housing accessibility predicts ADL in people with PD with GSE and external HCB playing a moderating role for generic ADL and ADL specific to PD, respectively. Further longitudinal studies should validate these findings and explore their potential application in PD-related care and rehabilitation.

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Design of a Wheelchair Robot for Active Postural Support

Journal of Mechanisms and Robotics ◽

10.1115/1.4042544 ◽

2019 ◽

Vol 11 (2) ◽

Cited By ~ 3

Author(s):

Rosemarie C. Murray ◽

Chawin Ophaswongse ◽

Sunil K. Agrawal

Keyword(s):

Activities Of Daily Living ◽

Daily Living ◽

Degrees Of Freedom ◽

Dynamic Range ◽

Sagittal Plane ◽

Control Architecture ◽

Lateral Bending ◽

Robotic Exoskeleton ◽

Postural Support ◽

And Control

This paper describes the design and control architecture of a novel wheelchair-mounted robot for active postural support (WRAPS). The WRAPS is a robotic exoskeleton that allows limited degrees-of-freedom of the trunk relative to the pelvis. There are three degrees-of-freedoms in the sagittal plane of the human body and one in lateral bending. The work is motivated by the needs of individuals with impaired trunk motor control, who currently rely on the use of passive and predominantly static supports to maintain a static posture. These devices can be overly restrictive and inhibit the user in their activities of daily living. The WRAPS is capable of supporting a human user within their active range of torso motion. It has the potential to assist users in their activities of daily living while encouraging a dynamic range of healthy postures.

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Development of Underactuated Prosthetic Fingers with Joint Locking and Electromyographic Control

Mechanical Engineering Research ◽

10.5539/mer.v3n1p130 ◽

2013 ◽

Vol 3 (1) ◽

pp. 130 ◽

Cited By ~ 5

Author(s):

Bart Peerdeman ◽

Stefano Stramigioli ◽

Edsko E. G. Hekman ◽

Dannis M. Brouwer ◽

Sarthak Misra

Keyword(s):

Control Systems ◽

Daily Living ◽

Degrees Of Freedom ◽

Single Motor ◽

Hand Prosthesis ◽

And Control ◽

Electromyographic Signals ◽

Underactuated Finger

Modern hand prostheses possess a large number of degrees of freedom. These degrees of freedom cannot simply be actuated by a single motor each, since their combined size and weight would exceed the limitations of an anthropomorphic prosthesis. Some hand prostheses try to remedy this by way of underactuation of the fingers or addition of entirely passive fingers, but this reduces the hand's ability to execute different grasp types. We present a joint locking system, allowing certain degrees of freedom to be fixed during actuation of an underactuated finger. These locks are actuated by miniature solenoids, and allow the fingers to support a variety of grasp types. In this paper, these locks are implemented in a two-fingered prosthesis prototype, which is able to perform several grasping motions important for prosthesis users. This prototype is controlled by pre-recorded electromyographic signals, which control different grasp types and their opening/closing. Various grasping experiments show that the prototype is able to execute three essential grasp types for daily living with a single main actuator, and can be intuitively controlled by means of six different electromyographic signals. This prototype demonstrates new joint locking mechanisms and control systems that can provide an anthropomorphic, myoelectric hand prosthesis with minimal actuation and intuitive control.

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Structured guideline-based physiotherapy reduces difficulties in activities of daily living in Parkinson’s disease

Neurorehabilitation ◽

10.3233/nre-210181 ◽

2021 ◽

pp. 1-10

Author(s):

Kadri Medijainen ◽

Mati Pääsuke ◽

Aet Lukmann ◽

Pille Taba

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Activities Of Daily Living ◽

Daily Living ◽

Assessment Tool ◽

Self Assessment ◽

Core Areas ◽

Conventional Physiotherapy ◽

And Control

BACKGROUND: In the long term, Parkinson’s disease (PD) leads to the development of difficulties in daily functional tasks. There remains a paucity of evidence on the effectiveness of physiotherapy on patient-perceived difficulties regarding basic activities of daily living (ADL). OBJECTIVES: To assess an effect of a versatile physiotherapy intervention on patient-perceived difficulties in basic ADL. METHODS: The study sample included 24 patients (10 men and 14 women) with PD. Participants were randomly assigned into intervention (IG) and control groups (CG). Two assessments were performed with a gap of 10 weeks. Following first assessment, during an 8-week period, IG participants attended sixteen physiotherapy 60-minutes sessions in groups that were divided into five parts to address the core areas recommended by the European Physiotherapy Guideline for PD (EPGPD): gait, transfers, balance, physical capacity, and manual activities. The main assessment tool was the Modified Patients Specific Functional Scale (ModPSFS), which represents a self-assessment rating on difficulties perceived in 17 different commonly occurring activities. RESULTS: IG members reported a significant reduction in self-perceived difficulties as assessed by ModPSFS (effect size 1.39; 95%CI 5.1, 26.6 points, p = 0.005). CONCLUSIONS: 2-months conventional physiotherapy with incorporated core areas recommended in EPGPD for PD reduced patient-perceived difficulties in basic ADL.

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Childhood socioeconomic circumstances and disability trajectories in older men and women: a European cohort study

European Journal of Public Health ◽

10.1093/eurpub/cky166 ◽

2018 ◽

Vol 29 (1) ◽

pp. 50-58 ◽

Cited By ~ 6

Author(s):

Aljoscha Landös ◽

Martina von Arx ◽

Boris Cheval ◽

Stefan Sieber ◽

Matthias Kliegel ◽

...

Keyword(s):

Activities Of Daily Living ◽

Old Age ◽

Daily Living ◽

Longitudinal Research ◽

Middle Age ◽

Population Based ◽

Older Age ◽

Socioeconomic Indicators ◽

Logistic Regression Models ◽

And Control

Abstract Background We observed a lack of population-based longitudinal research examining the association of disadvantaged childhood socioeconomic circumstances (CSC) and disability [activities of daily living (ADL) and instrumental activities of daily living (IADL)] in older age, and whether socioeconomic attainments in adulthood can compensate for a poor socioeconomic start in life. Methods Data on 24 440 persons aged 50–96 in 14 European countries (Survey of Health, Ageing and Retirement in Europe) were used to measure the associations between CSC and limitations with ADL and with IADL, using mixed-effects logistic regression models. Models stratified by gender were adjusted for education during young adulthood, main occupation during middle age, ability to make ends meet during old age and potential confounding and control variables. Results Risks of ADL and IADL limitations increased with age and were different between women and men. For women, a gradient across CSC strata was observed, showing that the more disadvantaged the CSC, the higher the risk of ADL and IADL limitations in old age, even after adjustment for adult socioeconomic indicators. For men, the association between CSC and disability was mediated by the main occupation in middle age and the ability to make ends meet at older age. Conclusion Women who grew up in socioeconomically disadvantaged households were at higher risk of disability in older age and this disadvantage was not attenuated by favourable adult socioeconomic conditions. Men were more likely to make up for a disadvantaged start in adulthood.

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Longitudinal association between housing accessibility and activities of daily living: the role of self-efficacy and control in people ageing with Parkinson’s disease

10.21203/rs.2.17069/v1 ◽

2019 ◽

Author(s):

Giedre Gefenaite ◽

Jonas Björk ◽

Susanne Iwarsson ◽

Björn Slaug ◽

Steven M. Schmidt ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Activities Of Daily Living ◽

Self Efficacy ◽

Daily Living ◽

Control Beliefs ◽

Ageing Population ◽

Longitudinal Association ◽

And Control

Abstract Objectives External housing-related control beliefs (HCB) and general self-efficacy (GSE) influence different health outcomes in the general ageing population, but there is no information of their role in people ageing with Parkinson’s disease (PD). This study aimed to longitudinally assess the role of external HCB and GSE on the association between housing accessibility and activities of daily living (ADL) among people ageing with PD.Methods Baseline and 3-year follow-up data on 130 community-living participants from the Swedish project ‘Home and Health in People Ageing with PD’ were collected. Assessments addressed housing accessibility, external HCB, GSE, generic ADL and ADL specific to PD. The moderating effects of external HCB and GSE were assessed by including an interaction term in multivariable logistic regression.Results There were statistically significant interactions between housing accessibility and GSE on ADL (p=0.03), and housing accessibility and external HCB on PD specific ADL (p=0.03). After stratifying the analyses by GSE, housing accessibility problems led to more dependence and difficulty in ADL in participants with low GSE (OR 1.14; 95% CI 0.98-1.32). After stratifying by external HCB, housing accessibility increased dependence and difficulty in PD specific ADL in participants with low external HCB (OR 1.35; 95% CI 1.03-1.76).Discussion The results suggest causal links between housing accessibility and ADL in people with PD with different moderators, namely GSE and external HCB, playing a role for generic ADL and ADL specific to PD. Further studies should validate these findings and explore their potential application in PD-related care and rehabilitation.

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