Current status and future perspectives of active knee joint rehabilitation device

Background: Today, living standards and medical technology are improving, and the aging global population is increasing. Moreover, more and more older adults are suffering from knee diseases. This will seriously affect patients’ daily life and their mental state. In many studies, repetitive physical exercises and motor activities in real-world environments have been shown to help improve knee muscle strength and restore damaged nerves. Therefore, physical knee therapy is very necessary. The use of rehabilitation training devices for movement therapy has shown great potentia Objective: The structural features, functions and development status of the knee rehabilitation training device are introduced Method: This review explores the structure and function of various current knee rehabilitation devices based on structural and kinematic properties of the knee joint in relation to requirements of physical knee rehabilitation. This paper aims to present a systematic guideline and to outline a reference for future designers of rehabilitation devices. Results: By analyzing the structure and movement of the knee joint and combining the strategies of physical knee rehabilitation, movement requirements during knee rehabilitation training are concluded. According to the structure, drive form, transmission mode and rehabilitation environment of knee rehabilitation devices, the devices are classified and compared; some typical features are summarized; some current problems are analyzed; and the future trends and development directions of rehabilitation devices are discussed. Conclusion: Current rehabilitation equipment has a variety of structures and functions, but a good balance between weight and volume is hardly maintained. The protection of the body needs to be further improved. Many knee rehabilitation devices are only concepts, not physical objects, and lack clinical trial data. Power sources and drives are large and heavy, which can compress the knee joint and place a burden on the patient. Strong and light-weight materials should be chosen to assist knee rehabilitation. It will be a good development in the future

Stretchable and anti-impact iontronic pressure sensor with an ultrabroad linear range for biophysical monitoring and deep learning-aided knee rehabilitation

Monitoring biophysical signals such as body or organ movements and other physical phenomena is necessary for patient rehabilitation. However, stretchable flexible pressure sensors with high sensitivity and a broad range that can meet these requirements are still lacking. Herein, we successfully monitored various vital biophysical features and implemented in-sensor dynamic deep learning for knee rehabilitation using an ultrabroad linear range and high-sensitivity stretchable iontronic pressure sensor (SIPS). We optimized the topological structure and material composition of the electrode to build a fully stretching on-skin sensor. The high sensitivity (12.43 kPa−1), ultrabroad linear sensing range (1 MPa), high pressure resolution (6.4 Pa), long-term durability (no decay after 12000 cycles), and excellent stretchability (up to 20%) allow the sensor to maintain operating stability, even in emergency cases with a high sudden impact force (near 1 MPa) applied to the sensor. As a practical demonstration, the SIPS can positively track biophysical signals such as pulse waves, muscle movements, and plantar pressure. Importantly, with the help of a neuro-inspired fully convolutional network algorithm, the SIPS can accurately predict knee joint postures for better rehabilitation after orthopedic surgery. Our SIPS has potential as a promising candidate for wearable electronics and artificial intelligent medical engineering owing to its unique high signal-to-noise ratio and ultrabroad linear range.

Vision-Based Hybrid Controller to Release a 4-DOF Parallel Robot from a Type II Singularity

The high accuracy and dynamic performance of parallel robots (PRs) make them suitable to ensure safe operation in human–robot interaction. However, these advantages come at the expense of a reduced workspace and the possible appearance of type II singularities. The latter is due to the loss of control of the PR and requires further analysis to keep the stiffness of the PR even after a singular configuration is reached. All or a subset of the limbs could be responsible for a type II singularity, and they can be detected by using the angle between two output twist screws (OTSs). However, this angle has not been applied in control because it requires an accurate measure of the pose of the PR. This paper proposes a new hybrid controller to release a 4-DOF PR from a type II singularity based on a real time vision system. The vision system data are used to automatically readapt the configuration of the PR by moving the limbs identified by the angle between two OTSs. This controller is intended for a knee rehabilitation PR, and the results show how this release is accomplished with smooth controlled movements where the patient’s safety is not compromised.

Research Advances on Passive Knee Joints Rehabilitation Device

Background: After a smooth development of life expectancy per capita and fertility in the nineteenth century, the global population exploded in size. Along with the demographic shift in the late nineteenth century, the phenomenon of population aging began to appear in developed countries. And a survey from UN reports that by 2050, one in six people worldwide will be over 65 years old (16%), compared to 11 (9%) in 2019. According to a survey, 55% of people over the age of 60 suffer from joint diseases, and the number of people suffering from stroke, arthritis and other knee diseases will also increase accordingly. Objective: An overview of the classification and characteristics of today's knee rehabilitation devices and future developments. Methods: This review discusses the existing knee rehabilitation devices, including various products on the market, patents and some conceptual devices, in the context of the structural characteristics of the knee joint and the rehabilitation requirements of various knee conditions or after knee arthroplasty, and systematically introduces their structural features, differences and the rehabilitation effects achieved. Results: A comparative analysis of three types of passive knee rehabilitation devices according to their use was conducted to summarize the typical characteristics. The problems that exist in today's rehabilitation devices are also analyzed, and their development trends are looked forward to. Conclusion: Knee rehabilitation equipment has a high degree of structural richness, but it does not achieve a good balance of convenience, comfort and functionality, and there should be some room for improvement in the materials, volume of the power source and transmission form of the power system. knee joint recovery. There will be a good development in the future.

Continuous Epidural Analgesia and Continuous Femoral Nerve Block for Postoperative Pain after Unilateral Total Knee Arthroplasty: A Prospective Cohort Study

Introduction: Total Knee Arthroplasty (TKA) surgeries are associated with moderate to severe postoperative pain. Inadequate analgesia leads to patient distress, suboptimal knee mobilisation and complications due to delayed rehabilitation. Peripheral nerve blocks and central neuraxial techniques are in the vanguard of various analgesic strategies to minimise pain after TKA. Aim: To compare the effects of Continuous Epidural Analgesia (CEA) and Continuous Femoral Nerve Block (CFNB) on postoperative analgesia, knee rehabilitation and adverse effects after TKA surgeries. Materials and Methods: A prospective cohort study was conducted among 90 patients undergoing unilateral TKA at the Government Medical College, Kozhikode, Kerala, India. They were divided into two groups of 45 each. CEA (Group E) and CFNB (Group F) were given for postoperative pain management. Effectiveness of postoperative analgesia was measured by Numerical Rating Scale (NRS) scores at 6, 12, 24, 48 and 72 hours and also by need for rescue analgesics during the first 48 hours. Postoperative knee rehabilitation indices were measured on 1st, 2nd and 3rd Postoperative Days (POD). Incidence of adverse effects in each group was also noted. Continuous variables were analysed using students t-test, categorical variables using Chi-square test and NRS scores using Mann Whitney U test. Results: NRS scores were similar in both CEA (E) and CFNB (F) groups. On POD 1, 75.6% of group E and 71.1% of group F (p=0.630), on POD 2, 71.1% of group E and 68.9% of group F (p=0.818) and on POD 3, 62.2% of group E and 66.7% of group F (p=0.66) achieved specific rehabilitation indices. There was no statistically significant difference in pain scores, rescue analgesic requirement and rehabilitation indices between the two groups. No significant adverse effects were noted in either group. Conclusion: CFNB is as effective as continuous epidural block for postoperative analgesia and knee rehabilitation after TKA without any significant side-effects.