Design, Manufacturing, and Control of a Pneumatic-Driven Passive Robotic Gait Training System for Muscle-Weakness in a Lower Limb

We designed and manufactured a pneumatic-driven robotic passive gait training system (PRPGTS), providing the functions of body-weight support, postural support, and gait orthosis for patients who suffer from weakened lower limbs. The PRPGTS was designed as a soft-joint gait training rehabilitation system. The soft joints provide passive safety for patients. The PRPGTS features three subsystems: a pneumatic body weight support system, a pneumatic postural support system, and a pneumatic gait orthosis system. The dynamic behavior of these three subsystems are all involved in the PRPGTS, causing an extremely complicated dynamic behavior; therefore, this paper applies five individual interval type-2 fuzzy sliding controllers (IT2FSC) to compensate for the system uncertainties and disturbances in the PRGTS. The IT2FSCs can provide accurate and correct positional trajectories under passive safety protection. The feasibility of weight reduction and gait training with the PRPGTS using the IT2FSCs is demonstrated with a healthy person, and the experimental results show that the PRPGTS is stable and provides a high-trajectory tracking performance.

A comparative analysis of the compression characteristics of a thermoplastic polyurethane 3D printed in four infill patterns for comfort applications

Purpose Most support surfaces in comfort applications and sporting equipment are made from pressure-relieving foam such as viscoelastic polyurethane. However, for some users, foam is not the best material as it acts as a thermal insulator and it may not offer adequate postural support. The additive manufacturing of such surfaces and equipment may alleviate these issues, but material and design investigation is needed to optimize the printing parameters for use in pressure relief applications. This study aims to assess the ability of an additive manufactured flexible polymer to perform similarly to a viscoelastic foam for use in comfort applications. Design/methodology/approach Three-dimensional (3D) printed samples of thermoplastic polyurethane (TPU) are tested in uniaxial compression with four different infill patterns and varying infill percentage. The behaviours of the samples are compared to a viscoelastic polyurethane foam used in various comfort applications. Findings Results indicate that TPU experiences an increase in strength with an increasing infill percentage. Findings from the study suggest that infill pattern impacts the compressive response of 3D printed material, with two-dimensional patterns inducing an elasto-plastic buckling of the cell walls in TPU depending on infill percentage. Such buckling may not be a beneficial property for comfort applications. Based on the results, the authors suggest printing from TPU with a low-density 3D infill, such as 5% gyroid. Originality/value Several common infill patterns are characterised in compression in this work, suggesting the importance of infill choices when 3D printing end-use products and design for manufacturing.

Development and usability of the EasySeating App as a tool for wheelchair and postural support devices prescription (Preprint)

BACKGROUND EasySeating is a mobile health (mHealth) app that supports the prescription of wheelchair and postural support devices (WPSD). It can be used by occupational therapists (OT) and physiotherapists (PT) who prescribe these devices. The app offers a framework for the prescription procedures, showing images, metrics and details that can guide the prescriber to decide the best equipment for wheelchair users. OBJECTIVE to present the development and usability of the EasySeating app. METHODS This study was divided into three stages and was carried out as an iterative process with eighty eight participants (n=88) that provided information for the software development and its usability. In the Stage 1 data was gathered to develop the first prototype, followed by the Stage 2 where four prototypes were improved by the feedback from experts. Finally in the Stage 3 the usability was tested. Data collection was performed through semi-structured interviews, focus groups and heuristics evaluation. Data analysis was descriptive and qualitative. RESULTS In the Stage 1 was identified the lack of a uniform terminology used by practitioners; however this information was used to create the first prototype based on a range of postural devices reported. In the Stage 2, qualitative information was used to improve the app including images, more options of devices. In Stage 3, the usability test improved the app in the following aspects: smartness, increasing the dialog and feedback with the practitioner. CONCLUSIONS The three stages enable to define a uniform terminology; to identify and recommend a framework for prescription comprising rehabilitation practitioners, technicians and wheelchair users; to document a method to develop a mHealth that can have reproducibility by the international community interested in assistive technology assessment using technology, a new trend in an era of the fourth industrial revolution.

Constructive optimization of a wheelchair for sport activities

BACKGROUND: The wheelchair is a medical device that provides mobility and postural support, for those who have walking difficulties. At present, there are many types of wheelchairs, which aim to improve the quality of life for people who have lost some motor functions. Each model is designed according to the severity of the trauma and the mobility available to the patient; in other words, in addition to standard type seats, each model is customized according to user needs and the environment to be used in. OBJECTIVE: This article aims at making an important contribution in the development of assistive equipment wheelchair type for disabled people, with the achievement of an adaptable central axis, enabling the change of angle between the wheels and the ground. By help of this change, people who need such devices can use a single seat for both everyday activities and sports activities. The most important problem in the production of medical devices (prostheses, orthotics, assistive equipment), is the need to personalize these devices depending on the exact dimensions of the human subject requiring assistance. METHODS: The qualitative research regarding the opinion of disabled persons took place at the Sports Club VeraFlor Brasov, over a period of 8 months, and at the gym room of Transylvania University, the subjects of the research being athletes in wheelchairs, from the department of handball. RESULTS: The players of the ACSH VeraFlor club participated in the European wheelchair championship in wheelchair in November 2019, where they got sixth place. Based on the results of the questionnaire made at the beginning of the research we found that most wheelchair users who wish to participate in various sports have to purchase several types of such equipment. CONCLUSIONS: Therefore, this paper aims to eliminate the economic barrier, making it possible to use a wheelchair in certain environments - both the everyday and sports facilities. In doing so we have adjusted the central axis, to make it easy to handle even by the user.

Mixed-Methods Evaluation as Scaffold to the Development of a Mobile Health Application to Support the Prescription of Wheelchairs and Postural Support Devices (Preprint)

BACKGROUND EasySeating is a mobile health (mHealth) app that supports the prescription of wheelchair and postural support devices (WPSD). It can be used by occupational therapists (OT) and physiotherapists (PT) who prescribe WPSD. The app offers a standardization of the prescription procedure, showing images, metrics and details that guide the prescriber to decide on the best equipment. It was developed with an iterative mixed-methods evaluation approach. Objective: The aim of this study was to investigate the processes involved in the prescription of WPSD and to propose, develop and evaluate a mHealth to support OT and PT prescribers. OBJECTIVE The aim of this study was to investigate the processes involved in the prescription of WPSD and to propose, develop and evaluate a mHealth to support OT and PT prescribers. METHODS This study was divided into three phases and was carried out as an iterative process composed of user consulting/testing (using a mixed-methods evaluation approach), system (re)design and software development. The first phase consisted of the collection of qualitative and quantitative data to map and understand the users requirements and of the development of the first prototype (v1) of the app. This data collection was performed through semi-structured interviews with 14 OT and PT prescribers, 5 specialized technicians and 5 WPSD users. The second phase aimed at improving the overall functionality of the app and consisted in the development, test and evaluation of the prototypes v1, v2, v3 and v4. A total of 59 prescribers tested and evaluated these prototypes by means of open interviews, semi-structured questionnaires and focus groups. The third phase focused in the usability aspects of the app. It consisted in the development and test of the prototype v5. Eight technology specialists assessed its usability through heuristics evaluation. RESULTS Data collected in phase one indicated there is a lack of standardization on the prescription of postural support devices (PSD). A divergent nomenclature for the PSDs was also found and classified in eight categories. These information guided the development of the first prototype of the EasySeating app. Phase two results pointed that the prescribers value the insertion of the app into their clinical practice, as it accelerates and increases the quality of the evaluation process and improves the organization of the prescription information. Significant suggestions for the improvement of the app were given during the users tests, including the use of images to represent the PSDs. The usability tests from the third phase revealed two strong issues that must be solved: the need of greater feedback and failures in the persistence of the input data. CONCLUSIONS This study demonstrated that there is a lack of systematization of the WPSD prescription process. The evaluation of the developed EasySeating app demonstrated that there is a potential to standardize, integrate and organize the WPSD prescription information, supporting and facilitating the decision making process of the prescribers. CLINICALTRIAL This study was approved by the Research Ethics Board of the Universidade de São Paulo (registered protocol n°53929516.6.0000.0065) URL - http://plataformabrasil.saude.gov.br/login.jsf

Beginning power mobility: An exploration of factors associated with child use of early power mobility devices and parent device preference

Objectives Describe and compare young children’s use of four early power mobility devices and examine associations between child and environmental factors that may influence power mobility use and parent device preference. Design Cross-sectional observational study. Methods Power Mobility Days introduced four devices: Wizzybug, Bugzi, Tiger Cub, and a switch-adapted ride-on toy car in a single 60–90 min, play-based session. Results A convenience sample of 74 children, aged 9–68 months (mean: 32.45, SD: 14.08) with mobility limitations, and their parents participated. Children had a range of motor, postural and communication profiles, with cerebral palsy being the most common condition ( n = 55; 73.33%). Assessment of Learning Powered mobility use phase achieved ranged from 1 to 6; mean: 2.34; median: 2. For children who tried all four devices ( n = 51), Friedman test (χ2: 8.27, p = 0.04) suggests Assessment of Learning Powered mobility use phase differs across devices. Of 73 parents who identified a device preference, 43 (59%) chose Wizzybug. Regression analyses suggest that access method and communication function may influence children’s power mobility use, while age, access and postural support requirements may influence parent device choice. Discussion Parent impressions of an early power mobility device may be influenced by many factors, yet be less influenced by child performance.