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

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.

Continuous Passive Motion Not Affect the Knee Motion and the Surgical wound Aspect After Total Knee Arthroplasty

2021 ◽  
Author(s):  
Sergi Gil-Gonzalez ◽  
Ricardo Andrés Barja Rodriguez ◽  
Antoni Lopez Pujol ◽  
Hussein Berjaoui ◽  
Jose Enrique Fernandez Bengoa ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Range Of Motion ◽  
Knee Arthroplasty ◽  
Continuous Passive Motion ◽  
Surgical Wound ◽  
Knee Motion ◽  
Passive Motion ◽  
Significant Difference ◽  
Flexion Extension ◽  
Total Knee

Abstract Background. This study aimed to assess whether use of continuous passive motion (CPM) can improve range of motion in patients after total knee arthroplasty (TKA). Moreover, the relationship between the use of CPM with the surgical wound aspect (SWA) and pain management after TKA was analysed.Methods. We randomized 210 patients, 102 patients in the CPM group, who received a standard rehabilitation protocol together with CPM application; and 108 patients in the no-CPM group, without CPM. Variables as knee motion (flexion, extension, range of motion) and pain was measured before surgery, on the 1s, 2nd and 3rd postoperative day, and in the 2nd, 6th, 12th and 24th postoperative weeks following TKA. The SWA was determined by the “surgical wound aspect score” (SWAS) in the next 48 hours after surgery. This scale analyses swelling, erythema, haematoma, blood drainage and blisters. Results. There was an improvement in the knee motion over the course of follow-up in both groups, without significant difference in flexion parameter. We found no significant differences in the total score of SWA, except for haematoma, with less severity in the CPM group. Furthermore, we found no differences in the others SWAS parameters and pain. Conclusions. The application of CPM does not provide benefit to our patients undergoing TKA in terms of either improved flexion mobility or decreased pain. No relationship was found between the use of CPM and the global score of SWA following a TKA, except for a decrease in haematoma appearance.

Functional Reorganization in Chronic Hemiparetic Patients after Training: fMRI Studies

2006 ◽  
Vol 321-323 ◽  
pp. 1016-1021
Author(s):  
Ki Sik Tae ◽  
Sung Jae Song ◽  
So Young Lee ◽  
Gi Young Park ◽  
Chul Ho Sohn ◽  
...  
Keyword(s):  
Training Program ◽  
Upper Limb ◽  
Hand Movement ◽  
Active Movement ◽  
Wrist Flexion ◽  
Motor Tasks ◽  
Neural Basis ◽  
Motor Network ◽  
Flexion Extension ◽  
Before And After

The aim of this study was to evaluate effects of short-term repetitive-bilateral exercise on the activation of motor network using functional magnetic resonance imaging (fMRI). Eight control subjects and four chronic hemiparetic patients were investigated for the present study. The training program with a symmetrical upper-limb motion trainer was performed at 1 hr/day, 5 days/week during 6 weeks. Fugl-Meyer assessments (FMA) were performed every two weeks during the training. We compared cerebral and cerebellar cortical activations in two different tasks before and after the training program: (1) the only unaffected hand movement (Task 1), and (2) passive movements of the affected hand by the active movement of the unaffected hand (Task 2). fMRI was performed at 3T with wrist flexion-extension movement at 1 Hz during the motor tasks. All patients showed significant improvements of FMA scores in their paretic limbs after training. fMRI studies in Task 1 showed that cortical activations decreased in ipsilateral SMC but increased in contralateral sensorimotor cortex (SMC) and ipsilateral cerebellum (CRB). Task 2 showed cortical reorganizations in bilateral SMC, pre-motor area (PMA), supplementary area (SMA) and CRB. This study demonstrated that plastic changes of motor network occurred as a neural basis of the improvement subsequent to repetitive-bilateral exercises using the symmetrical upper-limb motion trainer.

scholarly journals Continuous passive motion not affect the knee motion and the surgical wound aspect after total knee arthroplasty

2022 ◽  
Vol 17 (1) ◽  
Author(s):  
Sergi Gil-González ◽  
Ricardo Andrés Barja-Rodríguez ◽  
Antoni López-Pujol ◽  
Hussein Berjaoui ◽  
Jose Enrique Fernández-Bengoa ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Range Of Motion ◽  
Knee Arthroplasty ◽  
Continuous Passive Motion ◽  
Surgical Wound ◽  
Knee Motion ◽  
Passive Motion ◽  
Significant Difference ◽  
Flexion Extension ◽  
Total Knee

Abstract Background This study aimed to assess whether use of continuous passive motion (CPM) could improve range of motion in patients after total knee arthroplasty (TKA), if it could affect the surgical wound aspect (SWA) and if it could influence on pain management after TKA. Methods We randomized 210 patients in two groups, 102 patients in the CPM group, who received a standard rehabilitation protocol together with CPM application; and 108 patients in the no-CPM group, without CPM. Variables as knee motion (flexion, extension, range of motion) and pain were measured before surgery, on the 1st, 2nd and 3rd postoperative day, and in the 2nd, 6th, 12th and 24th postoperative weeks following TKA. The SWA was determined by the “surgical wound aspect score” (SWAS) in the next 48 h after surgery. This scale analyzes swelling, erythema, hematoma, blood drainage and blisters. Results There was an improvement in the knee motion over the course of follow-up in both groups, without significant difference in flexion parameter. We found no significant differences in the total score of SWA, except for hematoma, with less severity in the CPM group. Furthermore, we found no differences in the others SWAS parameters and pain. Conclusions The application of CPM does not provide benefit to our patients undergoing TKA in terms of either improved flexion mobility or decreased pain. No relationship was found between the use of CPM and the global score of SWA following a TKA, except for a decrease in hematoma appearance.

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