Continuous Passive Motion Machine for Elbow Rehabilitation

Continuous Passive Machines (CPM) facilitate patients in eliminating joint stiffness after surgery and lead to a faster and more efficient recovery. However, many previous CPM machined are mechanically complicated, expensive, and lack a user interface. This paper presents a new CPM machine for elbow flexion-extension and forearm pronation-supination. The machine is simple, low-cost, and equipped with Graphical User Interface (GUI). Its mechanism is designed so that it can be used on the left or right arms interchangeably. It is developed using aluminum, perspex, and steel rods. The electrical part of the machine consists of Arduino Uno to drive the motors and a potentiometer to measure the patients’ Range of Motion (ROM). The GUI for setting the exercise parameters and monitoring the patients’ progress has been developed using MATLAB software. The experimental results show that the machine has successfully provided the repetitive desired motions. The machine realizes elbow flexion-extension and forearm pronation-supination movements with 0ᵒ-135ᵒ and 0ᵒ-90ᵒ ranges of motion (ROM), respectively. The machine is also capable of increasing the elbow joint’s ROM by 5ᵒ increments for the therapy. The results show that the machine has the potential to be used in hospitals and rehabilitation centers.

Download Full-text

Design of Continuous Passive Motion Machine Based on Kinematic Model of Lower Limb

Applied Mechanics and Materials ◽

10.4028/www.scientific.net/amm.712.93 ◽

2015 ◽

Vol 712 ◽

pp. 93-97

Author(s):

Renata Dwornicka ◽

Ireneusz Dominik

Keyword(s):

Lower Limb ◽

Kinematic Model ◽

Continuous Passive Motion ◽

Surgical Interventions ◽

Passive Motion ◽

Rehabilitation Centers ◽

Continuous Passive Motion Machine

The article presents the design of Continuous Passive Motion machine based on kinematic model of lower limb. The machines are used to prevent the stiffening of joints and allow recovering their full functionality after surgical interventions. The research conducted in rehabilitation centers states, that there is a necessity of using the CPM machines. The types of the machines that are currently used do not provide all the natural movements of a healthy organism, though. Such limitations concern not only motions in particular level, but also ranges of motions. There is a need to modernize already existing models, by introducing brand new functions or improving and re-constructing the functions already implemented. Such information resulted in designing a new solution of a CPM machine for the lower limb exercises.

Download Full-text

Selection of Drives for Prototype of Continuous Passive Motion Machine

Applied Mechanics and Materials ◽

10.4028/www.scientific.net/amm.759.51 ◽

2015 ◽

Vol 759 ◽

pp. 51-57

Author(s):

Ireneusz Dominik ◽

Renata Dwornicka

Keyword(s):

Hip Joint ◽

Proper Choice ◽

Continuous Passive Motion ◽

Joint Motion ◽

Passive Motion ◽

Ongoing Process ◽

Universal Machine ◽

Rehabilitation Centers ◽

Continuous Passive Motion Machine ◽

Selection Of

The paper contains a description of a research into selecting drives for prototype of Continuous Passive Motion machine. Designing and constructing automated rehabilitation devices aims to increase effectiveness as well as shorten the time of a therapy. Information drew from literature, market researches and interviews in Krakow’s rehabilitation centers enabled the assessment of changes that are necessary to improve the ongoing process of automation. The article focuses on problem of designing and appropriate location of drives in accordance with durability calculations. Additionally, designing the universal machine that would allow conducting the ankle, knee and hip joint motion simultaneously, involved proper choice of drives and planning their placement, so they would not disturb the therapy.

Download Full-text

Wearable upper limb motion assist robot for eating activity

Applied Research and Smart Technology (ARSTech) ◽

10.23917/arstech.v1i1.28 ◽

2020 ◽

Vol 1 (1) ◽

pp. 1-10

Author(s):

Uzair Kashtwari ◽

Norsinnira Zainul Azlan ◽

Ifrah Shahdad

Keyword(s):

Upper Limb ◽

Daily Living ◽

Degrees Of Freedom ◽

Low Cost ◽

Elbow Flexion ◽

Disabled People ◽

Flexion Extension ◽

Feeding Cycle ◽

The Disabled ◽

Upper Limb Movements

Many people all around the world are suffering from various types of disabilities and need to depend on others to perform activities of daily living. One of the essential daily living activities is eating. The disabled people should be able to eat their food independently at any time and place, without relying on the caregivers. This paper presents the development of a new wearable upper limb motion assist robot for helping the disabled to eat by themselves. The motion assists robot consists of two degrees of freedom (DOF) movement, focusing on the two most crucial upper limb movements in eating activity, which is the elbow flexion/extension and forearm pronation/supination. A light-weight material was used for the fabrication of the wearable motion assist robot, and Arduino was utilized as the microcontroller. The originality of the study was in terms of the design, operational sequence setting, and kinematic analysis of the wearable upper limb motion assist robot that was explicitly focusing on eating activity. The resulted prototype was portable, compact, light in weight, simple and low cost. The experimental results have proven that the proposed wearable upper limb motion assist robot for eating activity was successful in helping the users to perform the main upper extremity motions in eating. The success rate of the proposed system was 80%, and it took 6 seconds for the system to complete one feeding cycle.

Download Full-text

Including Social Interaction in Stroke VR-Based Motor Rehabilitation Enhances Performance: A Pilot Study

Presence Teleoperators & Virtual Environments ◽

10.1162/pres_a_00129 ◽

2012 ◽

Vol 21 (4) ◽

pp. 490-501 ◽

Cited By ~ 22

Author(s):

Belén Rubio Ballester ◽

Sergi Bermúdez i Badia ◽

Paul F. M. J. Verschure

Keyword(s):

Virtual Reality ◽

Social Interaction ◽

Social Factors ◽

Social Engagement ◽

Low Cost ◽

Elbow Flexion ◽

Motor Rehabilitation ◽

Stroke Patients ◽

Rehabilitation Process ◽

Flexion Extension

Social factors and motivation are key factors for recovery in stroke patients (Glass, Matchar, Belyea, & Feussner, 1993). The goal of this study is to enhance accessibility and evaluate the effects of including social interaction in a virtual reality (VR) -based system for stroke rehabilitation. We hypothesize that a multiplayer competitive context will have a positive effect on the involvement of the patients in the therapy and thus on the rehabilitation process. We test this hypothesis using the Rehabilitation Gaming System (RGS), an ICT virtual reality tool for upper extremities motor rehabilitation. First, we implemented and evaluated a new interface based on a low-cost key-glove. Then, we developed a dedicated RGS scenario where the player has to match pairs of cards from a stack of playing cards. This task trains cognitive (memory) and motor tasks (grasping and reaching). Eight stroke patients participated in two sessions lasting 20 min, one using a single-player VR environment and another using a multiplayer version of the same game. A usability test showed that participants interact with the system much faster when using the new key-glove–based interface (p = .02) in comparison to a mouse and keyboard. In addition, our results showed that upper limb exercises performed by the patients in multiplayer mode reached wider elbow flexion/extension movements than the ones performed during the single-player game session (p = .04). Considering that the presence of spasticity is very common in patients affected by an ictus and that it causes an ongoing level of contraction, these results suggest that the patients affected displayed more effort in reaching if engaged in a social task. Our study shows that accessibility and social engagement in multiplayer environments positively affects the patients' performance and enjoyment during the task. Although the long-term impact of this enhanced motivation needs to be further assessed, our results do suggest that the inclusion of social factors such as multiplayer capabilities is an important factor for the rehabilitation process in VR-based therapy and might have an impact on both performance and mood of stroke patients.

Download Full-text

A domestic robotic rehabilitation device for assessment of wrist function for outpatients

Journal of Rehabilitation and Assistive Technologies Engineering ◽

10.1177/2055668320961233 ◽

2020 ◽

Vol 7 ◽

pp. 205566832096123

Author(s):

Matthias Panny ◽

Andreas Mayr ◽

Marco Nagiller ◽

Yeongmi Kim

Keyword(s):

Range Of Motion ◽

Home Environment ◽

Degrees Of Freedom ◽

Low Cost ◽

Joint Stiffness ◽

Torsional Stiffness ◽

Preliminary Evaluation ◽

Robotic Rehabilitation ◽

Flexion Extension ◽

Wrist Function

Introduction Available robot-assisted stroke rehabilitation systems are often limited in their utilization in the home environment, due to several barriers such as high cost, absence of therapists, tedious training tasks, or encumbering interfaces. This paper presents a low-cost robotic rehabilitation and assessment device for restoring wrist function, offering wrist exercises incorporating pronation-supination and flexion-extension movements. Furthermore, the device is designed for the assessment of joint stiffness of the wrist, and range of motion in two degrees of freedom. Methods: Mechanical/electrical design of the device as well as the control system is described. A preliminary evaluation focused on the measurement of the torsional stiffness of the limb is presented. It is evaluated by reconstructing the known stiffness values of torsional springs by measuring the motor current required to displace them. Results The device demonstrates the ability to determine the stiffness of an object with low-cost hardware. Use case scenarios of the device for training and assessment of the wrist are presented, allowing for a range of motion of [Formula: see text] and [Formula: see text], for pronation-supination and flexion-extension respectively. Conclusion The device shows potential to help objectively quantify the stiffness of the wrist movement, which consecutively could be used to represent and quantify the degree of impairment of patients after stroke in a more objective manner. Further clinical study is necessary to examine this.

Download Full-text

Measurements of Tendon Movement Within the Bicipital Groove After Suprapectoral Intra-articular Biceps Tenodesis in a Cadaveric Model

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120977538 ◽

2021 ◽

Vol 9 (1) ◽

pp. 232596712097753

Author(s):

Brian J. Kelly ◽

Alan W. Reynolds ◽

Patrick J. Schimoler ◽

Alexander Kharlamov ◽

Mark Carl Miller ◽

...

Keyword(s):

Biceps Tendon ◽

Full Range ◽

Elbow Flexion ◽

Biceps Tenodesis ◽

Bicipital Groove ◽

Biceps Tenotomy ◽

Flexion Extension ◽

Before And After ◽

Long Head ◽

Scapular Motion

Background: Lesions of the long head of the biceps can be successfully treated with biceps tenotomy or tenodesis when surgical management is elected. The advantage of a tenodesis is that it prevents the potential development of a cosmetic deformity or cramping muscle pain. Proponents of a subpectoral tenodesis believe that “groove pain” may remain a problem after suprapectoral tenodesis as a result of persistent motion of the tendon within the bicipital groove. Purpose/Hypothesis: To evaluate the motion of the biceps tendon within the bicipital groove before and after a suprapectoral intra-articular tenodesis. The hypothesis was that there would be minimal to no motion of the biceps tendon within the bicipital groove after tenodesis. Study Design: Controlled laboratory study. Methods: Six fresh-frozen cadaveric arms were dissected to expose the long head of the biceps tendon as well as the bicipital groove. Inclinometers and fiducials (optical markers) were used to measure the motions of the scapula, forearm, and biceps tendon through a full range of shoulder and elbow motions. A suprapectoral biceps tenodesis was then performed, and the motions were repeated. The motion of the biceps tendon was quantified as a function of scapular or forearm motion in each plane, both before and after the tenodesis. Results: There was minimal motion of the native biceps tendon during elbow flexion and extension but significant motion during all planes of scapular motion before tenodesis, with the most motion occurring during shoulder flexion-extension (20.73 ± 8.21 mm). The motion of the biceps tendon after tenodesis was significantly reduced during every plane of scapular motion compared with the native state ( P < .01 in all planes of motion), with a maximum motion of only 1.57 mm. Conclusion: There was a statistically significant reduction in motion of the biceps tendon in all planes of scapular motion after the intra-articular biceps tenodesis. The motion of the biceps tendon within the bicipital groove was essentially eliminated after the suprapectoral biceps tenodesis. Clinical Relevance: This arthroscopic suprapectoral tenodesis technique can significantly reduce motion of the biceps tendon within the groove in this cadaveric study, possibly reducing the likelihood of groove pain in the clinical setting.

Download Full-text

Design and Development of Continuous Passive Motion (CPM) for Fingers and Wrist Grounded-Exoskeleton Rehabilitation System

Applied Sciences ◽

10.3390/app11020815 ◽

2021 ◽

Vol 11 (2) ◽

pp. 815

Author(s):

Husam Almusawi ◽

Géza Husi

Keyword(s):

Experimental Testing ◽

Hand Movement ◽

Evaluation Process ◽

Continuous Passive Motion ◽

Wrist Flexion ◽

Design And Development ◽

Passive Motion ◽

Assistive Robots ◽

Flexion Extension ◽

Design Characteristics

Impairments of fingers, wrist, and hand forearm result in significant hand movement deficiencies and daily task performance. Most of the existing rehabilitation assistive robots mainly focus on either the wrist training or fingers, and they are limiting the natural motion; many mechanical parts associated with the patient’s arms, heavy and expensive. This paper presented the design and development of a new, cost-efficient Finger and wrist rehabilitation mechatronics system (FWRMS) suitable for either hand right or left. The proposed machine aimed to present a solution to guide individuals with severe difficulties in their everyday routines for people suffering from a stroke or other motor diseases by actuating seven joints motions and providing them repeatable Continuous Passive Motion (CPM). FWRMS approach uses a combination of; grounded-exoskeleton structure to provide the desired displacement to the hand’s four fingers flexion/extension (F/E) driven by an indirect feed drive mechanism by adopting a leading screw and nut transmission; and an end-effector structure to provide angular velocity to the wrist flexion/ extension (F/E), wrist radial/ulnar deviation (R/U), and forearm supination/pronation (S/P) driven by a rotational motion mechanism. We employed a single dual-sided actuator to power both mechanisms. Additionally, this article presents the implementation of a portable embedded controller. Moreover, this paper addressed preliminary experimental testing and evaluation process. The conducted test results of the FWRMS robot achieved the required design characteristics and executed the motion needed for the continuous passive motion rehabilitation and provide stable trajectories guidance by following the natural range of motion (ROM) and a functional workspace of the targeted joints comfortably for all trainable movements by FWRMS.

Download Full-text

Clinical findings in C5-C6 and C5-C7 root palsies with brachial plexus traction lesions

Journal of Hand Surgery (European Volume) ◽

10.1177/1753193412471009 ◽

2012 ◽

Vol 38 (3) ◽

pp. 237-241 ◽

Cited By ~ 8

Author(s):

J. A. Bertelli ◽

M. F. Ghizoni

Keyword(s):

Brachial Plexus ◽

External Rotation ◽

Elbow Flexion ◽

Clinical Findings ◽

Hand Strength ◽

Shoulder Abduction ◽

Finger Extension ◽

Root Injury ◽

Flexion Extension

Stretch injuries of the C5-C7 roots of the brachial plexus traditionally have been associated with palsies of shoulder abduction/external rotation, elbow flexion/extension, and wrist, thumb, and finger extension. Based on current myotome maps we hypothesized that, as far as motion is concerned, palsies involving C5-C6 and C5-C7 root injuries should be similar. In 38 patients with upper-type palsies of the brachial plexus, we examined for correlations between clinical findings and root injury level, as documented by CT tomomyeloscan. Contrary to commonly held beliefs, C5-C7 root injuries were not associated with loss of extension of the elbow, wrist, thumb, or fingers, but residual hand strength was much lower with C5-C7 vs C5-C6 lesions.

Download Full-text