Diseño y Modelado Cinemático de Exoesqueleto de Hombro para Paciente con Enfermedad Cerebrovascular

2021 ◽  
Author(s):  
◽  
E. G. Ibarra Zea

Currently, there are people worldwide with motor disabilities due to cerebrovascular diseases. To face this problem, people are subjected to physiotherapies to help them recover the motor mobility of the upper limb, but currently, it is not possible to meet the high demand of people who require it. This gave rise to the development and use of exoskeletons to meet the high demand of patients, however, the problem with the exoskeletons currently positioned in the market is that they do not adapt to the anthropometry of the Mexican population. In the present work, we present the design of an exoskeleton to assist physical therapists in the motor rehabilitation of the shoulder for the Mexican population over 18 years old. This exoskeleton can perform the three basic shoulder movements (abduction-adduction, flexion-extension and internal-external rotation) and an extra movement is considered in the elbow part which is flexion-extension. In addition, kinematic modelling is presented, and use is made of MATLAB® software to visualize the movements of each joint.

2019 ◽  
pp. 121-131

Introduction: Breast cancer is the most common type of cancer among women in Brazil and in the worl. The surgical treatment procedure may cause severe morbidity in the upper limb homolateral to surgery, including the reduction of the range of motion, with consequent impairment of function. A physiotherapeutic approach has an important role in the recover range of motion and the functionality of these women, guaranteeing the occupational, domestestic, familiar and conjugated activities, and, in this way, also improving the quality of life. Objectives: To analyse chances in the shoulder's range of motion and the functional capacity of the upper limbs, promoted by the deep running procedure in women with late postoperative mastectomy. Methods: All the patients were submitted to an evaluation in the beginning and end of the treatment, including: goniometry of flexion, extension, abduction, adduction, internal and external rotation of the shoulder joint; and function capacity analysis in activities that involve the upper members by DASH questionnaire. The treatment protocol includes twelve sessions of deep running, realized twice a week, in deep pool, for 20-minute during six weeks. Results: Were submitted to treatment a total of 4 patients. Despite the improvement in the numerical values, statistically significant differences were not found on the range of movements and in the functional capacity of upper members before and after the deep running sessions in post-mastectomy women. Conclusion: Deep running had effects on the numerical values of range of movement and upper limb functionality in women in the late postoperative period of the mastectomy procedure, but without statistically significant differences.


Robotica ◽  
2014 ◽  
Vol 33 (1) ◽  
pp. 19-39 ◽  
Author(s):  
M. H. Rahman ◽  
M. J. Rahman ◽  
O. L. Cristobal ◽  
M. Saad ◽  
J. P. Kenné ◽  
...  

SUMMARYTo assist physically disabled people with impaired upper limb function, we have developed a new 7-DOF exoskeleton-type robot named Motion Assistive Robotic-Exoskeleton for Superior Extremity (ETS-MARSE) to ease daily upper limb movements and to provide effective rehabilitation therapy to the superior extremity. The ETS-MARSE comprises a shoulder motion support part, an elbow and forearm motion support part, and a wrist motion support part. It is designed to be worn on the lateral side of the upper limb in order to provide naturalistic movements of the shoulder (vertical and horizontal flexion/extension and internal/external rotation), elbow (flexion/extension), forearm (pronation/supination), and wrist joint (radial/ulnar deviation and flexion/extension). This paper focuses on the modeling, design, development, and control of the ETS-MARSE. Experiments were carried out with healthy male human subjects in whom trajectory tracking in the form of passive rehabilitation exercises (i.e., pre-programmed trajectories recommended by a therapist/clinician) were carried out. Experimental results show that the ETS-MARSE can efficiently perform passive rehabilitation therapy.


2021 ◽  
Vol 12 ◽  
Author(s):  
Michela Goffredo ◽  
Sanaz Pournajaf ◽  
Stefania Proietti ◽  
Annalisa Gison ◽  
Federico Posteraro ◽  
...  

Background: The efficacy of upper-limb Robot-assisted Therapy (ulRT) in stroke subjects is well-established. The robot-measured kinematic data can assess the biomechanical changes induced by ulRT and the progress of patient over time. However, literature on the analysis of pre-treatment kinematic parameters as predictive biomarkers of upper limb recovery is limited.Objective: The aim of this study was to calculate pre-treatment kinematic parameters from point-to-point reaching movements in different directions and to identify biomarkers of upper-limb motor recovery in subacute stroke subjects after ulRT.Methods: An observational retrospective study was conducted on 66 subacute stroke subjects who underwent ulRT with an end-effector robot. Kinematic parameters were calculated from the robot-measured trajectories during movements in different directions. A Generalized Linear Model (GLM) was applied considering the post-treatment Upper Limb Motricity Index and the kinematic parameters (from demanding directions of movement) as dependent variables, and the pre-treatment kinematic parameters as independent variables.Results: A subset of kinematic parameters significantly predicted the motor impairment after ulRT: the accuracy in adduction and internal rotation movements of the shoulder was the major predictor of post-treatment Upper Limb Motricity Index. The post-treatment kinematic parameters of the most demanding directions of movement significantly depended on the ability to execute elbow flexion-extension and abduction and external rotation movements of the shoulder at baseline.Conclusions: The multidirectional analysis of robot-measured kinematic data predicts motor recovery in subacute stroke survivors and paves the way in identifying subjects who may benefit more from ulRT.


Author(s):  
Zachary Bons ◽  
Taylor Dickinson ◽  
Ryan Clark ◽  
Kari Beardsley ◽  
Steven Charles

Abstract Most motion capture measurements suffer from soft-tissue artifacts (STA). Especially affected are rotations about the long axis of a limb segment, such as humeral internal-external rotation (HIER) and forearm pronation-supination (FPS). Unfortunately, most existing methods to compensate for STA were designed for optoelectronic motion capture systems. We present and evaluate a STA compensation method that 1) compensates for STA in HIER and/or FPS, 2) is developed specifically for electromagnetic motion capture systems, and 3) does not require additional calibration or data. To compensate for STA, calculation of HIER angles rely on forearm orientation, and calculation of FPS angles rely on hand orientation. To test this approach, we recorded whole-arm movement data from eight subjects and compared their joint angle trajectories calculated according to progressive levels of STA compensation. Compensated HIER and FPS angles were significantly larger than uncompensated angles. Although the effect of STA compensation on other joint angles (besides HIER and FPS) was usually modest, significant effects were seen in certain DOF under some conditions. Overall, the method functioned as intended during most of the range of motion of the upper limb, but it becomes unstable in extreme elbow extension and extreme wrist flexion-extension. Specifically, this method is not recommended for movements within 20° of full elbow extension, full wrist flexion, or full wrist extension. Since this method does not require additional calibration of data, it can be applied retroactively to data collected without the intent to compensate for STA.


2019 ◽  
Vol 6 ◽  
pp. 205566831986215
Author(s):  
Md Assad-Uz-Zaman ◽  
Md Rasedul Islam ◽  
Suruz Miah ◽  
Mohammad H Rahman

Introduction The aim of this research is to develop a robot-assistive training approach for the disabled individuals with impaired upper limb functions. People with impaired upper limb function can regain their motor functionality undergoing intense rehabilitation exercises. With increasing number of disabled individuals, we face deficiency in the number of expert therapists. One promising remedy could be the use of robotic assistive devices. Method To instruct and demonstrate rehabilitation exercise, this research used NAO robot. A library of recommended rehabilitation exercises involving shoulder (i.e., abduction/adduction, vertical flexion/extension, and internal/external rotation), and elbow (i.e., flexion/extension) joint movements was formed in Choregraphe (graphical programming interface). For this purpose, a kinematic model of human upper-extremity was developed based on modified Denavit-Hartenberg notations. Result In experiments, NAO robot gave voice instruction and was maneuvered to cooperate and demonstrate the exercises from the library. NAO also plays some complex game with the subject that represents a multi-joint movement's exercise, which was also included in the library. Conclusions Experimental results with healthy participants reveal that the NAO robot can successfully instruct and demonstrate upper-extremity rehabilitation exercises for single and multi-joint movements. It implies a technical development of cooperative rehabilitation system for which target group will be individuals with upper limb impairment.


Sensors ◽  
2020 ◽  
Vol 20 (7) ◽  
pp. 1903 ◽  
Author(s):  
Ye Ma ◽  
Dongwei Liu ◽  
Laisi Cai

We develop a deep learning refined kinematic model for accurately assessing upper limb joint angles using a single Kinect v2 sensor. We train a long short-term memory recurrent neural network using a supervised machine learning architecture to compensate for the systematic error of the Kinect kinematic model, taking a marker-based three-dimensional motion capture system (3DMC) as the golden standard. A series of upper limb functional task experiments were conducted, namely hand to the contralateral shoulder, hand to mouth or drinking, combing hair, and hand to back pocket. Our deep learning-based model significantly improves the performance of a single Kinect v2 sensor for all investigated upper limb joint angles across all functional tasks. Using a single Kinect v2 sensor, our deep learning-based model could measure shoulder and elbow flexion/extension waveforms with mean CMCs >0.93 for all tasks, shoulder adduction/abduction, and internal/external rotation waveforms with mean CMCs >0.8 for most of the tasks. The mean deviations of angles at the point of target achieved and range of motion are under 5° for all investigated joint angles during all functional tasks. Compared with the 3DMC, our presented system is easier to operate and needs less laboratory space.


Author(s):  
Florian Grimm ◽  
Jelena Kraugmann ◽  
Georgios Naros ◽  
Alireza Gharabaghi

Abstract Background The clinical evaluation of the upper limb of severely impaired stroke patient is challenging. Sensor-based assessments may allow for an objective evaluation of this patient population. This study investigated the validity of a device-assisted approach in comparison to the clinical outcome that it is supposed to reflect. Methods In nineteen severely impaired chronic stroke patients, we applied a gravity-compensating, multi-joint arm exoskeleton (Armeo Spring) and compared this sensor-based assessment with the clinical outcome measure Upper Extremity Fugl-Meyer Assessment (UE-FMA) scale. Specifically, we assessed separately and subsequently the range of motion in joint space for four single joints (i.e., wrist, elbow and shoulder flexion/extension (FE), and shoulder internal/external rotation (IER)), and the closing and opening of the hand with a pressure sensor placed in the handle. Results Within the kinematic parameters, a strong correlation was observed between wrist and elbow FE (r > 0.7, p < 0.003; Bonferroni corrected). The UE-FMA was significantly predicted by a multiple regression model (F (5, 13) = 12.22, p < 0.0005, adj. R2 = 0.83). Both shoulder IER and grip pressure added significantly (p < 0.05) to the prediction with the standardized coefficients β of 0.55 and 0.38, respectively. Conclusions By applying an exoskeleton-based self-contained evaluation of single-joint movements, a clinically valid assessment of the upper limb range of motion in severely impaired stroke patients is feasible. Shoulder IER contributed most relevantly to the prediction of the clinical status. These findings need to be confirmed in a large, independent patient cohort.


1970 ◽  
Vol 1 (1) ◽  
pp. 78-82
Author(s):  
Paulo José Oliveira Cortez ◽  
José Elias Tomazini ◽  
Mauro Gonçalves

Introdução: A diminuição da capacidade de exercer esforços por parte dos músculos rotadores pode criar uma variedade de problemas. O conhecimento preciso do nível de força muscular de um indivíduo é importante, tanto para a avaliação da capacidade funcional ocupacional, como para uma apropriada prescrição de exercícios atléticos e de reabilitação. Percebe-se escassez de informação sobre as articulações do ombro, bem como os fatores envolvidos na força muscular dessa região. O objetivo deste estudo foi comparar a força gerada pelos músculos do manguito rotador entre o membro superior direito e o membro superior esquerdo em indivíduos saudáveis. Métodos: Participaram do estudo 22 sujeitos do sexo masculino, com idade de 18 e 19 anos, militares, saudáveis e sem história clínica de patologia ortopédica ou qualquer tipo de lesão no sistema musculoesquelético. Foram aplicados dois testes de força: Rotação Interna e Rotação Externa. Resultado : A força média de rotação interna no membro superior direito (MSD) foi maior que a força média de rotação interna no membro superior esquerdo (MSE) (p=0,723) e a força de rotação externa no MSD foi menor que a força média de rotação externa no MSE (p=0,788). Não houve diferença estatística na comparação dos valores de força de todos os testes de força isométrica. Conclusão: Para amostra estudada e metodologia utilizada na avaliação da força muscular, não houve diferença estatística na comparação da força gerada pelos músculos do manguito rotador do membro superior direito e do membro superior esquerdo.Rotator Cuff Muscle Strength in Healthy Individuals Introduction: Decreased ability to exert efforts by the rotator muscles can create a variety of problems. The precise knowledge of the level of muscular strength of an individual is important for both the functional capacity evaluation for occupational as an appropriate exercise prescription and rehabilitation of athletic. It is perceived scarcity of information on the shoulder joints as well as factors involved in muscle strength in this region. Objective: Develop a device for measuring the strength generated by the muscles of the upper limbs and the verification of efficiency and adaptability of this device through a comparative study of muscle strength in healthy subjects. Methods: The study included 22 male subjects, aged 18 and 19 years, military personnel, body mass between 57.7 and 93 kg (71.8 ± 9.45 kg) and height between 1.67 and 1.90 m (1.75 ± 0.06 m), healthy and without a history of orthopaedic disease or any kind of damage to the musculoskeletal system. Three strength tests were applied: Internal Rotation and External Rotation. For each type of effort three maximum voluntary contractions were required for 10 seconds, with an interval of 30 seconds between each contraction.  Results: Internal rotation in the right upper limb (RUL) was higher than the average strength of internal rotation in the left upper limb (LUL) (p = 0, 723) and the external rotation strength in RUL was lower than the average strength of external rotation in the LUL (p=0,788).  No statistical difference in comparing the strength values of all isometric strength tests. Conclusion: For sample and methodology used to assess muscle strength, there was no statistical difference in comparing the force generated by the muscles of the rotator cuff of the right and left upper limb.


Sensors ◽  
2021 ◽  
Vol 21 (6) ◽  
pp. 2146
Author(s):  
Manuel Andrés Vélez-Guerrero ◽  
Mauro Callejas-Cuervo ◽  
Stefano Mazzoleni

Processing and control systems based on artificial intelligence (AI) have progressively improved mobile robotic exoskeletons used in upper-limb motor rehabilitation. This systematic review presents the advances and trends of those technologies. A literature search was performed in Scopus, IEEE Xplore, Web of Science, and PubMed using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) methodology with three main inclusion criteria: (a) motor or neuromotor rehabilitation for upper limbs, (b) mobile robotic exoskeletons, and (c) AI. The period under investigation spanned from 2016 to 2020, resulting in 30 articles that met the criteria. The literature showed the use of artificial neural networks (40%), adaptive algorithms (20%), and other mixed AI techniques (40%). Additionally, it was found that in only 16% of the articles, developments focused on neuromotor rehabilitation. The main trend in the research is the development of wearable robotic exoskeletons (53%) and the fusion of data collected from multiple sensors that enrich the training of intelligent algorithms. There is a latent need to develop more reliable systems through clinical validation and improvement of technical characteristics, such as weight/dimensions of devices, in order to have positive impacts on the rehabilitation process and improve the interactions among patients, teams of health professionals, and technology.


2021 ◽  
Vol 11 (8) ◽  
pp. 3391
Author(s):  
Jan Marušič ◽  
Goran Marković ◽  
Nejc Šarabon

The purpose of this study was to evaluate intra- and inter-session reliability of the new, portable, and externally fixated dynamometer called MuscleBoard® for assessing the strength of hip and lower limb muscles. Hip abduction, adduction, flexion, extension, internal and external rotation, knee extension, ankle plantarflexion, and Nordic hamstring exercise strength were measured in three sessions (three sets of three repetitions for each test) on 24 healthy and recreationally active participants. Average and maximal value of normalized peak torque (Nm/kg) from three repetitions in each set and agonist:antagonist ratios (%) were statistically analyzed; the coefficient of variation and intra-class correlation coefficient (ICC2,k) were calculated to assess absolute and relative reliability, respectively. Overall, the results display high to excellent intra- and inter-session reliability with low to acceptable within-individual variation for average and maximal peak torques in all bilateral strength tests, while the reliability of unilateral strength tests was moderate to good. Our findings indicate that using the MuscleBoard® dynamometer can be a reliable device for assessing and monitoring bilateral and certain unilateral hip and lower limb muscle strength, while some unilateral strength tests require some refinement and more extensive familiarization.


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