scholarly journals Preliminary design and control of a soft exosuit for assisting elbow movements and hand grasping in activities of daily living

2017 ◽  
Vol 4 ◽  
pp. 205566831668031 ◽  
Author(s):  
Michele Xiloyannis ◽  
Leonardo Cappello ◽  
Khanh D Binh ◽  
Chris W Antuvan ◽  
Lorenzo Masia
Keyword(s):  
Activities Of Daily Living ◽  
Daily Living ◽  
Learning Algorithm ◽  
Neuromuscular Disorders ◽  
Assistive Device ◽  
Tracking Accuracy ◽  
Level Control ◽  
Assistive Robots ◽  
Flexion Extension ◽  
And Control

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.

A pediatric robotic thumb exoskeleton for at-home rehabilitation

2014 ◽  
Vol 7 (3) ◽  
pp. 233-252 ◽  
Author(s):  
Patrick Aubin ◽  
Kelsey Petersen ◽  
Hani Sallum ◽  
Conor Walsh ◽  
Annette Correia ◽  
...  
Keyword(s):  
Activities Of Daily Living ◽  
Daily Living ◽  
Degrees Of Freedom ◽  
Hand Function ◽  
Maximum Efficiency ◽  
Fine Motor ◽  
Content Type ◽  
Flexion Extension ◽  
Linear Force ◽  
At Home

Purpose – Pediatric disorders, such as cerebral palsy and stroke, can result in thumb-in-palm deformity greatly limiting hand function. This not only limits children's ability to perform activities of daily living but also limits important motor skill development. Specifically, the isolated orthosis for thumb actuation (IOTA) is 2 degrees of freedom (DOF) thumb exoskeleton that can actuate the carpometacarpal (CMC) and metacarpophalangeal (MCP) joints through ranges of motion required for activities of daily living. The paper aims to discuss these issues. Design/methodology/approach – IOTA consists of a lightweight hand-mounted mechanism that can be secured and aligned to individual wearers. The mechanism is actuated via flexible cables that connect to a portable control box. Embedded encoders and bend sensors monitor the 2 DOF of the thumb and flexion/extension of the wrist. A linear force characterization was performed to test the mechanical efficiency of the cable-drive transmission and the output torque at the exoskeletal CMC and MCP joints was measured. Findings – Using this platform, a number of control modes can be implemented that will enable the device to be controlled by a patient to assist with opposition grasp and fine motor control. Linear force and torque studies showed a maximum efficiency of 44 percent, resulting in a torque of 2.39±1.06 in.-lbf and 0.69±0.31 in.-lbf at the CMC and MCP joints, respectively. Practical implications – The authors envision this at-home device augmenting the current in-clinic and at-home therapy, enabling telerehabilitation protocols. Originality/value – This paper presents the design and characterization of a novel device specifically designed for pediatric grasp telerehabilitation to facilitate improved functionality and somatosensory learning.

scholarly journals 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 ◽  
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.

The iHand clinical trial protocol: the therapeutic effect of using a soft-robotic glove as assistive device to support people with impaired hand strength during activities of daily living (Preprint)

2021 ◽  
Author(s):  
Anke Ida Roza Kottink ◽  
Corien D.M. Nikamp ◽  
Foskea Bos ◽  
Corry K. van der Sluis ◽  
Marieke van den Broek ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Activities Of Daily Living ◽  
Therapeutic Effect ◽  
Daily Living ◽  
Hand Function ◽  
Daily Activities ◽  
Hand Strength ◽  
Assistive Device ◽  
Specific Training ◽  
And Task

BACKGROUND Decline of hand function, especially reduced hand strength, is a common problem amongst many disorders, resulting in difficulties to perform activities of daily living (ADLs). A wearable soft-robotic glove may be a possible solution, enabling use of the affected arm and hand repeatedly during functional daily activities, and providing intensive and task-specific training simultaneously with assistance of hand function. OBJECTIVE The current multi-center uncontrolled intervention study aims to investigate the therapeutic effect of an assistive soft-robotic glove (Carbonhand). METHODS The study design consists of three pre-assessments (T0, T1 and T2), a post-assessment (T3) and a follow-up assessment (T4). Participants are patients who experience hand function limitations, which can result from a wide range of chronic disorders. As intervention, all participants will use the Carbonhand glove during ADLs at home for six weeks, with a recommended use of at least 180 minutes/week. The primary outcome measure is handgrip strength and secondary outcome measures are related to arm and hand function, functional arm and hand abilities, amount of glove use and quality of life. RESULTS The first participant was included on the 25th of June 2019. Currently, the iHand study is extended because of the COVID-19 pandemic and data collection and analysis are expected to be completed in 2022. CONCLUSIONS The Carbonhand system is a wearable assistive device, allowing performance of functional activities to be enhanced directly during functional daily activities. At the same time, active movement of the user is encouraged as much as possible, which has potential to provide highly intensive and task-specific training. As such it is one of the first assistive devices incorporating assist-as-needed principles. This is the first powered clinical trial that investigates the unique application of an assistive grip-supporting soft-robotic glove outside of the clinical setting with the aim to have a therapeutic effect. CLINICALTRIAL The iHand study was prospectively registered on March 4th 2019 in the Netherlands Trial Register: NTR NL7561 (www.trialregister.nl/7561).

Resection of the Distal Scaphoid for Scaphotrapeziotrapezoid Osteoarthritis

1999 ◽  
Vol 24 (4) ◽  
pp. 448-452 ◽  
Author(s):  
M. GARCIA-ELIAS ◽  
A. L. LLUCH ◽  
A. FARRERES ◽  
F. CASTILLO ◽  
Ph. SAFFAR
Keyword(s):  
Patient Satisfaction ◽  
Soft Tissue ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Pinch Strength ◽  
Wrist Flexion ◽  
Flexion Extension ◽  
Preoperative Status

Twenty-one patients with symptomatic scaphotrapeziotrapezoid osteoarthritis were treated with partial distal scaphoid excision. In 12 wrists the joint defect was filled with either capsular or tendinous tissue, while in nine no fibrous interposition was done. At an average follow-up time of 29 (range, 12–61) months, 13 wrists were painfree, while eight had occasional mild discomfort. Mean wrist flexion-extension was 119°. Grip and pinch strength improved by an average of 26% and 40% respectively compared with their preoperative status. Fifteen patients returned to their original jobs, while six, who were unemployed, felt unrestricted for activities of daily living. Although patient satisfaction was comparable for both types of treatment, the wrists without fibrous interposition showed significantly greater wrist flexion-extension than patients with soft-tissue interposition. Removal of the distal scaphoid resulted in a DISI pattern of carpal malalignment in 12 wrists. At follow-up, none of these wrists showed further joint deterioration due to residual malalignment.

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

2013 ◽  
Vol 7 (1) ◽  
pp. 40-47 ◽  
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.

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

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.

Soft Wearable Deltoid Assistive Device

2019 ◽  
Author(s):  
Francisco Javier Lopez Arellano ◽  
Sushrut Gandhi ◽  
Dhiraj Patil ◽  
Bryan Roquemore ◽  
Trent Maruyama ◽  
...  
Keyword(s):  
Activities Of Daily Living ◽  
Daily Living ◽  
Frontal Plane ◽  
Assistive Device

The soft actuated wearable deltoid assistance device presented in this paper aims at assisting patients with activities of daily living by dynamically producing flexion and abduction movements for them. By counteracting the force of gravity on the patient’s arm it allows them to move in the frontal plane to perform activities of daily living.

Wheelchair Modification for Hands-Free Motion for Dancers With Disabilities

2008 ◽  
Author(s):  
Peter J. Schrock ◽  
M. Elisa McQueen ◽  
Kathryn J. De Laurentis ◽  
Merry L. Morris ◽  
Rajiv V. Dubey
Keyword(s):  
Activities Of Daily Living ◽  
Performing Arts ◽  
Daily Living ◽  
South Florida ◽  
Free Motion ◽  
Assistive Device ◽  
Upper Body ◽  
Persons With Disabilities ◽  
Research Framework ◽  
The University

Functional modifications to power and manual chairs are currently advancing in the areas of rehabilitation, sports and recreation and in the activities of daily living; however, these modification have yet to be directly applied in the field of performing arts. An assistive device was developed at the University of South Florida (USF) during collaboration between the Department of Mechanical Engineering and the School of Theatre and Dance. The project was initiated by Professor Merry Lynn Morris who identified a need for new conceptions of mobility; her work with dancers, with and without disabilities established the research framework in which choreographic vision could be supported with technological applications. Therefore, a device was designed to alleviate the constraints of current wheelchair designs which inhibit the user’s upper-body artistic movement range and capacity for interaction. The main purpose of the design was to create hands-free motion through the modification of a power wheelchair, which make it useful in the performing arts, but also as an assistive device for persons with disabilities. This device is in its first research phase of development as a prototype and is patent pending.

Design of a Wheelchair Robot for Active Postural Support

2019 ◽  
Vol 11 (2) ◽  
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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