Strategies to overcome size and mechanical disadvantages in manual therapy

Adaptive Swarm Fuzzy Logic Controller of Multi-Joint Lower Limb Assistive Robot

The idea of developing a multi-joint rehabilitation robot is to satisfy the demands for recovery of lower limb functionality in hemiplegic impairments and assist the physiotherapists with their therapy plans. This work aims at to implement the Lyapunov Adaptive and Swarm-Fuzzy Logic Control (LASFC) strategy of 4-degree of freedom (4-DoF) Lower Limb Assistive Robot (LLAR) application, in which the control law is an integration of swarm-fuzzy logic control (SFLC) and Lyapunov adaptive control (LAC) with particle swarm optimization (PSO). The controller is established based on the sliding filtered steady-state error for SFLC. Its parameters are tuned by using PSO for the mathematical model of LLAR. The fuzzy defuzzification membership is set based on the tuned parameters for the real-time control system. LAC strategy is determined using stability analysis of the system to choose the controller’s parameters by observation of the system’s output and reference. The control law implemented in LLAR is the integration of SFLC and LAC to adjust the input voltage of joints. The parameters tuned by PSO are compared with the genetic algorithm (GA) statistically. In addition, the real-time trajectory tracking of the proposed controller for each joint is compared with LAC and SFLC separately. The experiment revealed that the LASFC has superior performance to the other two methods in trajectory tracking. For example, the average error for left hip by LASFC is 53.57% and 68% lower than SFLC and LAC, respectively. By the statistical analysis, it can be ascertained that the LASFC strategy performed efficiently for real-time control of the joint trajectory tracking.

Work-related musculoskeletal disorders in physical therapists attributable to manual therapy

Background: Use of manual therapy (MT) is a risk factor for the development of work-related musculoskeletal disorders (WRMDs) in physical therapists (PTs) although the current evidence is limited on this topic.Objectives: The purpose of this study was to understand the type, association, and prevalence of WRMDs among practitioners of MT, explore relationships between MT and WRMD, and determine impacts of WRMDs on PTs.Design: Cross-sectional survey design.Methods: A web-based survey was distributed through the Academy of Orthopaedic Physical Therapy of the American Physical Therapy Association. The survey gathered information on the respondents' professional profiles, any WRMDs sustained, and how those injuries affected their professional and personal lives.Results: Overall, 38.5% of PT respondents using MT reported having sustained an MT attributable WRMD. Female respondents reported a greater rate of MT attributable injuries. Although exposure risk is cumulative, novice practitioners are also injured.Limitations: Generalizability of these results may be limited because of the sample size and specific population responding.Conclusion: Over one-third of PT survey respondents reported WRMDs attributable to MT. The results indicated WRMDs may begin early in one's career and tend to accumulate over years of practice. MT educational programming at all levels warrants emphasis on practitioner safety.