Wearable Robots: An Original Mechatronic Design of a Hand Exoskeleton for Assistive and Rehabilitative Purposes

Robotic devices are being employed in more and more sectors to enhance, streamline, and augment the outcomes of a wide variety of human activities. Wearable robots arise indeed as of-vital-importance tools for telerehabilitation or home assistance targeting people affected by motor disabilities. In particular, the field of “Robotics for Medicine and Healthcare” is attracting growing interest. The development of such devices is a primarily addressed topic since the increasing number of people in need of rehabilitation or assistive therapies (due to population aging) growingly weighs on the healthcare systems of the nation. Besides, the necessity to move to clinics represents an additional logistic burden for patients and their families. Among the various body parts, the hand is specially investigated since it most ensures the independence of an individual, and thus, the restoration of its dexterity is considered a high priority. In this study, the authors present the development of a fully wearable, portable, and tailor-made hand exoskeleton designed for both home assistance and telerehabilitation. Its purpose is either to assist patients during activities of daily living by running a real-time intention detection algorithm or to be used for remotely supervised or unsupervised rehabilitation sessions by performing exercises preset by therapists. Throughout the mechatronic design process, special attention has been paid to the complete wearability and comfort of the system to produce a user-friendly device capable of assisting people in their daily life or enabling recorded home rehabilitation sessions allowing the therapist to monitor the state evolution of the patient. Such a hand exoskeleton system has been designed, manufactured, and preliminarily tested on a subject affected by spinal muscular atrophy, and some results are reported at the end of the article.

SmartCards as Analogous Tools to Operate Tablet Computers for Elderly—A Feasibility Study

Background: Older adults sometimes shy away from using modern digital communication devices due to lacking experience and fear of failure. Within the present project, SmartCards were developed as analogous means to operate tablet computers for older adults with little previous computer experience. We investigated whether the SmartCards-Tablet-System would (a) increase use of digital communication and (b) affect loneliness, autonomy, cognitive ability and wellbeing of the users. Methods: The suitability and acceptance of the system was evaluated during a three month trial period with seniors in retirement homes, seniors with home assistance care and a waiting control group. Results: Acceptance, duration of use and frequency of use were high in both experimental groups. Cognitive ability significantly improved after three months’ use in both experimental groups. Effects on loneliness, autonomy and wellbeing could not be observed. Discussion: Our results indicate that seniors are very much able and curious to use modern digital devices if the interface and hardware are adjusted to their needs and capabilities without being stigmatizing. The use of modern communication services and the World Wide Web can promote contact of seniors with their (younger) relatives.

A Survey of Human Activity Recognition in Smart Homes Based on IoT Sensors Algorithms: Taxonomies, Challenges, and Opportunities with Deep Learning

Recent advances in Internet of Things (IoT) technologies and the reduction in the cost of sensors have encouraged the development of smart environments, such as smart homes. Smart homes can offer home assistance services to improve the quality of life, autonomy, and health of their residents, especially for the elderly and dependent. To provide such services, a smart home must be able to understand the daily activities of its residents. Techniques for recognizing human activity in smart homes are advancing daily. However, new challenges are emerging every day. In this paper, we present recent algorithms, works, challenges, and taxonomy of the field of human activity recognition in a smart home through ambient sensors. Moreover, since activity recognition in smart homes is a young field, we raise specific problems, as well as missing and needed contributions. However, we also propose directions, research opportunities, and solutions to accelerate advances in this field.

Integrating Digital Health Technology to Alleviate Caregiver Burden

The elder population in our country is growing at an exponential pace. Studies have shown that elders who are aged 80 years and older are projected to suffer from age related issues such as Alzheimer’s, dementia, and osteoporosis and will need assistance with Long Term Services and Support (LTSS). Additionally, many elders are also projected to suffer from more severe chronic illnesses such as diabetes, cancer, and heart related illnesses. Because many of these elders are aging in place, residing in their own homes, they will require the services of at home assistance, which high probability will be a neighbor, friend, or family member, serving in the role as an informal caregiver. As the pace of elders increasingly outnumbers informal caregivers, strategic methods must be evaluated, researched, and implemented to ensure caregivers are not becoming overwhelmed and contributing to our chronic health population due to caregiver burden, and to also ensure informal caregivers have the appropriate level of holistic support (emotionally, physically, financially, and spiritually) needed to provide adequate care to our aging population. This paper will focus on the emergence of digital health technology and how it can be beneficial to informal caregivers and care recipients.

External validity in a multicenter randomized clinical trial of proximal humeral fractures: the DelPhi trial

Background Randomized controlled trials (RCT) are regarded as the gold standard for effect evaluation in clinical interventions. However, RCTs may not produce relevant results to all patient groups. We aimed to assess the external validity of a multicenter RCT (DelPhi trial). Methods The DelPhi RCT investigated whether elderly patients with displaced proximal humeral fractures (PHFs) receiving reversed total shoulder prosthetic replacement (RTSA) gained better functional outcomes compared to open reduction and internal fixation (ORIF) using an proximal humerus locking plate (PHILOS). Eligible patients were between 65 and 85 years old with severely displaced 11-B2 or 11-C2 fractures (AO/OTA-classification, 2007). We compared baseline and follow-up data of patients for two of the seven hospitals that were included in the DelPhi trial (n = 54) with non-included patients (n = 69). Comparisons were made based on reviewing medical records regarding demographic, health and fracture parameters. Results Forty-four percent of the eligible patients were included in the DelPhi trial. Comparing included and non-included patients indicated higher incidences of serious heart disease (P = 0.044) and a tendency toward higher tobacco intake (P = 0.067) in non-included patients. Furthermore, non-included patients were older (P = 0.040) and had higher ASA classification (P < 0.001) and were in more need for resident aid (in-home assistance) (P = 0.022) than included patients. The cause of PHF was more frequently related to fall indoors in non-included vs. included patients (P = 0.018) and non-included patients were more prone to other concomitant fractures (P = 0.004). Having concomitant fractures was associated with osteoporosis (P = 0.014). We observed no significant differences in rates of complications or deaths between included and non-included patients within 3 months after treatment. In descending order, non-included patients were treated conservatively, with PHILOS, RTSA, anatomic hemi-prothesis or an alternative type of ORIF. RTSA was the preferred treatment choice for C2-type fractures (P < 0.001). Conclusions Results from the DelPhi RCT may not directly apply to older PHFs patients with lower health status or concomitant fractures. Level of evidence Level 4.

On the Suspension Design of Paquitop, a Novel Service Robot for Home Assistance Applications

The general and constant ageing of the world population that has been observed in the last decade has led robotics researchers community to focus its aims to answer the ever-growing demand for health care, housing, care-giving, and social security. Among others, the researchers at Politecnico di Torino are developing a novel platform to enhance the performance offered by present-day issues, and to assess many others which were not even taken into consideration before they have been highlighted by the pandemic emergency currently in progress. This situation, in fact, made dramatically clear how important it is to have reliable non-human operators whom one can trust when the life of elderly or weak patients is endangered by the simple presence of other people. The platform, named Paquitop, features an innovative architecture conceived for omni-directional planar motion. The machine is designed for domestic, unstructured, and variously populated environments. Therefore, the mobile robot should be able to avoid or pass over small obstacles, passing through the capability to achieve specific person tracking tasks, and arriving to the need of operating with an high dynamic performance. Given its purpose, this work addresses the design of the suspension system which enables the platform to ensure a steady floor contact and adequate stability in every using condition. Different configurations of such system are then presented and compared through use-case simulations.