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Borzelli D, De Marchis C, Quercia A, De Pasquale P, Casile A, Quartarone A, Calabrò RS, d’Avella A. Muscle Synergy Analysis as a Tool for Assessing the Effectiveness of Gait Rehabilitation Therapies: A Methodological Review and Perspective. Bioengineering (Basel) 2024; 11:793. [PMID: 39199751 PMCID: PMC11351442 DOI: 10.3390/bioengineering11080793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2024] [Revised: 07/19/2024] [Accepted: 07/29/2024] [Indexed: 09/01/2024] Open
Abstract
According to the modular hypothesis for the control of movement, muscles are recruited in synergies, which capture muscle coordination in space, time, or both. In the last two decades, muscle synergy analysis has become a well-established framework in the motor control field and for the characterization of motor impairments in neurological patients. Altered modular control during a locomotion task has been often proposed as a potential quantitative metric for characterizing pathological conditions. Therefore, the purpose of this systematic review is to analyze the recent literature that used a muscle synergy analysis of neurological patients' locomotion as an indicator of motor rehabilitation therapy effectiveness, encompassing the key methodological elements to date. Searches for the relevant literature were made in Web of Science, PubMed, and Scopus. Most of the 15 full-text articles which were retrieved and included in this review identified an effect of the rehabilitation intervention on muscle synergies. However, the used experimental and methodological approaches varied across studies. Despite the scarcity of studies that investigated the effect of rehabilitation on muscle synergies, this review supports the utility of muscle synergies as a marker of the effectiveness of rehabilitative therapy and highlights the challenges and open issues that future works need to address to introduce the muscle synergies in the clinical practice and decisional process.
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Affiliation(s)
- Daniele Borzelli
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98125 Messina, Italy; (A.Q.); (A.C.)
- Laboratory of Neuromotor Physiology, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy;
| | | | - Angelica Quercia
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98125 Messina, Italy; (A.Q.); (A.C.)
| | - Paolo De Pasquale
- IRCCS Centro Neurolesi “Bonino Pulejo”, 98124 Messina, Italy; (P.D.P.); (A.Q.); (R.S.C.)
| | - Antonino Casile
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98125 Messina, Italy; (A.Q.); (A.C.)
| | - Angelo Quartarone
- IRCCS Centro Neurolesi “Bonino Pulejo”, 98124 Messina, Italy; (P.D.P.); (A.Q.); (R.S.C.)
| | | | - Andrea d’Avella
- Laboratory of Neuromotor Physiology, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy;
- Department of Biology, University of Rome Tor Vergata, 00133 Rome, Italy
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Mate KKV, Abou-Sharkh A, Mansoubi M, Alosaimi A, Dawes H, Michael W, Stanwood O, Harding S, Gorenko D, Mayo NE. Evidence for the Efficacy of Commercially Available Wearable Biofeedback Gait Devices: Consumer-Centered Review. JMIR Rehabil Assist Technol 2023; 10:e40680. [PMID: 37074771 PMCID: PMC10157455 DOI: 10.2196/40680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 12/19/2022] [Accepted: 02/26/2023] [Indexed: 02/27/2023] Open
Abstract
BACKGROUND The number of wearable technological devices or sensors that are commercially available for gait training is increasing. These devices can fill a gap by extending therapy outside the clinical setting. This was shown to be important during the COVID-19 pandemic when people could not access one-on-one treatment. These devices vary widely in terms of mechanisms of therapeutic effect, as well as targeted gait parameters, availability, and strength of the evidence supporting the claims. OBJECTIVE This study aimed to create an inventory of devices targeting improvement in gait pattern and walking behavior and identify the strength of the evidence underlying the claims of effectiveness for devices that are commercially available to the public. METHODS As there is no systematic or reproducible way to identify gait training technologies available to the public, we used a pragmatic, iterative approach using both the gray and published literature. Four approaches were used: simple words, including some suggested by laypersons; devices endorsed by condition-specific organizations or charities; impairment-specific search terms; and systematic reviews. A findable list of technological devices targeting walking was extracted separately by 3 authors. For each device identified, the evidence for efficacy was extracted from material displayed on the websites, and full-text articles were obtained from the scientific databases PubMed, Ovid MEDLINE, Scopus, or Google Scholar. Additional information on the target population, mechanism of feedback, evidence for efficacy or effectiveness, and commercial availability was obtained from the published material or websites. A level of evidence was assigned to each study involving the device using the Oxford Centre for Evidence-Based Medicine classification. We also proposed reporting guidelines for the clinical appraisal of devices targeting movement and mobility. RESULTS The search strategy for this consumer-centered review yielded 17 biofeedback devices that claim to target gait quality improvement through various sensory feedback mechanisms. Of these 17 devices, 11 (65%) are commercially available, and 6 (35%) are at various stages of research and development. Of the 11 commercially available devices, 4 (36%) had findable evidence for efficacy potential supporting the claims. Most of these devices were targeted to people living with Parkinson disease. The reporting of key information about the devices was inconsistent; in addition, there was no summary of research findings in layperson's language. CONCLUSIONS The amount of information that is currently available to the general public to help them make an informed choice is insufficient, and, at times, the information presented is misleading. The evidence supporting the effectiveness does not cover all aspects of technology uptake. Commercially available technologies help to provide continuity of therapy outside the clinical setting, but there is a need to demonstrate effectiveness to support claims made by the technologies.
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Affiliation(s)
- Kedar K V Mate
- Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Ahmed Abou-Sharkh
- Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Maedeh Mansoubi
- Medical School, University of Exeter, Exeter, United Kingdom
| | - Aeshah Alosaimi
- King Faisal Specialized Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Helen Dawes
- Medical School, University of Exeter, Exeter, United Kingdom
| | - Wright Michael
- Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Olivia Stanwood
- Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Sarah Harding
- Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Daniel Gorenko
- Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Nancy E Mayo
- Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
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Hybart RL, Ferris DP. Preliminary Validation of Proportional Myoelectric Control of A Commercially Available Robotic Ankle Exoskeleton. IEEE Int Conf Rehabil Robot 2022; 2022:1-5. [PMID: 36176129 DOI: 10.1109/icorr55369.2022.9896537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Proportional myoelectric control of robotic lower limb exoskeletons can increase the variability and adaptability of biomechanical behaviors for assisting human movement compared to traditional state-based control. Previous exoskeletons using proportional myoelectric control have relied on pneumatic actuators and been limited to laboratory use. We applied proportional myoelectric control to a robotic ankle exoskeleton using a brushless DC motor (Dephy) and enabled it to work in community settings. Benchtop testing verified electromechanical responses similar to biological values (electromechanical delay of 22 ms and time to peak activation of 123 ms). Four healthy participants trained for thirty minutes each using bilateral ankle exoskeletons. From minute one of powered walking to minute 30 of powered walking, peak soleus EMG reduced by 17.9% as they learned to walk with exoskeleton assistance. Our future work will extend the powered walking period, measure metabolic cost, and measure gait variability between participants using proportional myoelectric control on fully portable, electromechanical ankle exoskeletons.
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Fernández-Gorgojo M, Salas-Gómez D, Sánchez-Juan P, Barbado D, Laguna-Bercero E, Pérez-Núñez MI. Clinical-Functional Evaluation and Test-Retest Reliability of the G-WALK Sensor in Subjects with Bimalleolar Ankle Fractures 6 Months after Surgery. SENSORS (BASEL, SWITZERLAND) 2022; 22:s22083050. [PMID: 35459036 PMCID: PMC9032166 DOI: 10.3390/s22083050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 04/11/2022] [Accepted: 04/11/2022] [Indexed: 05/14/2023]
Abstract
Ankle fractures can cause significant functional impairment in the short and long term. In recent years, gait analysis using inertial sensors has gained special relevance as a reliable measurement system. This study aimed to evaluate the differences in spatiotemporal gait parameters and clinical−functional measurements in patients with bimalleolar ankle fracture and healthy subjects, to study the correlation between the different variables, and to analyze the test−retest reliability of a single inertial sensor in our study population. Twenty-two subjects with bimalleolar ankle fracture six months after surgery and eleven healthy subjects were included in the study. Spatiotemporal parameters were analyzed with the G-WALK sensor. Functional scales and clinical measures were collected beforehand. In the ankle fracture group, the main differences were obtained in bilateral parameters (effect size: 0.61 ≤ d ≤ 0.80). Between-group differences were found in cadence, speed, stride length, and stride time (effect size: 1.61 ≤ d ≤ 1.82). Correlation was moderate (0.436 < r < 0.554) between spatiotemporal parameters and clinical−functional measures, explaining up to 46% of gait performance. Test−retest reliability scores were high to excellent (0.84 ≤ ICC ≤ 0.98), with the worst results in the gait phases. Our study population presents evident clinical−functional impairments 6 months after surgery. The G-WALK can be considered a reliable tool for clinical use in this population.
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Affiliation(s)
- Mario Fernández-Gorgojo
- Escuelas Universitarias Gimbernat (EUG), Physiotherapy School Cantabria, Movement Analysis Laboratory, University of Cantabria, 39005 Torrelavega, Spain; (M.F.-G.); (P.S.-J.); (E.L.-B.); (M.I.P.-N.)
- International Doctoral School, Rey Juan Carlos University (URJC), 28032 Madrid, Spain
| | - Diana Salas-Gómez
- Escuelas Universitarias Gimbernat (EUG), Physiotherapy School Cantabria, Movement Analysis Laboratory, University of Cantabria, 39005 Torrelavega, Spain; (M.F.-G.); (P.S.-J.); (E.L.-B.); (M.I.P.-N.)
- Correspondence:
| | - Pascual Sánchez-Juan
- Escuelas Universitarias Gimbernat (EUG), Physiotherapy School Cantabria, Movement Analysis Laboratory, University of Cantabria, 39005 Torrelavega, Spain; (M.F.-G.); (P.S.-J.); (E.L.-B.); (M.I.P.-N.)
- Alzheimer’s Centre Reina Sofia-CIEN Foundation, 28031 Madrid, Spain
| | - David Barbado
- Sports Research Centre, Department of Sport Science, Miguel Hernández University of Elche, 03202 Elche, Spain;
- Alicante Institute for Health and Biomedical Research (ISABIAL), 03550 Alicante, Spain
| | - Esther Laguna-Bercero
- Escuelas Universitarias Gimbernat (EUG), Physiotherapy School Cantabria, Movement Analysis Laboratory, University of Cantabria, 39005 Torrelavega, Spain; (M.F.-G.); (P.S.-J.); (E.L.-B.); (M.I.P.-N.)
- Traumatology Service and Orthopedic Surgery, University Hospital “Marqués de Valdecilla” (UHMV), 39008 Santander, Spain
| | - María Isabel Pérez-Núñez
- Escuelas Universitarias Gimbernat (EUG), Physiotherapy School Cantabria, Movement Analysis Laboratory, University of Cantabria, 39005 Torrelavega, Spain; (M.F.-G.); (P.S.-J.); (E.L.-B.); (M.I.P.-N.)
- Traumatology Service and Orthopedic Surgery, University Hospital “Marqués de Valdecilla” (UHMV), 39008 Santander, Spain
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Hong JC, Cheng H, Yasuda K, Ohashi H, Iwata H. Effects of Assisted Dorsiflexion Timing on Voluntary Efforts and Compensatory Movements: A Feasibility Study in Healthy Participants. IEEE Trans Neural Syst Rehabil Eng 2021; 29:2222-2231. [PMID: 34648451 DOI: 10.1109/tnsre.2021.3119873] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
In previous research, we found that modulating the assistance timing of dorsiflexion may affect a user's voluntary efforts. This could constitute a focus area based on assistive strategies that could be developed to foster patients' voluntary efforts. In this present study, we conducted an experiment to verify the effects of ankle dorsiflexion assistance under different timings using a high-dorsiflexion assistive system. Nine healthy and young participants wore a dorsiflexion-restrictive device that enabled them to use circumduction or steppage gaits. On the basis of the transition from the stance to the swing phase of the gait, the assistance timings of the high-dorsiflexion assistive system were set to have delays, which ranged from 0 to 300 ms. The index results from eight out of nine participants evaluated compensatory movements and revealed positive strong/moderate correlations with assistance delay times (r = 0.627-0.965, p <.001), whereas the other participants also performed compensatory movement when dorsiflexion assistance timing was late. Meanwhile, the results from tibialis anterior surface electromyography from six out of nine participants showed positive strong/moderate correlations with dorsiflexion assistance delay times (r = 0.598-0.922, p <.001), indicating that tuning the assistance timing did foster these participants' voluntary dorsiflexion movements. This result indicates that there should be a trade-off between ensuring voluntary dorsiflexion movements and preventing incorrect gait patterns at different assistance timings. The findings of this feasibility study indicate the potential of developing an adaptive control method to ensure voluntary efforts during robot-assisted gait rehabilitation based on assistance timing modification. A new assistance mechanism should also be required to stimulate and motivate a patient's voluntary efforts and should reinforce the effects of active gait rehabilitation.
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Clinical Walking Tests and Gait Pattern Characterization During 6-Minute Walk Test Using Inertial Sensors: Follow-Up in Individuals With Lower Limb Amputation. J Appl Biomech 2021; 37:440-449. [PMID: 34504044 DOI: 10.1123/jab.2020-0327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 05/19/2021] [Accepted: 06/17/2021] [Indexed: 11/18/2022]
Abstract
Inertial measurement units and normative values enable clinicians to quantify clinical walking tests and set rehabilitation goals. Objectives of this study were (1) to compare time- and distance-based walking tests in individuals with lower limb amputation (iLLA) and normative values following rehabilitation discharge (T1) and 6 weeks after discharge (T2) and (2) to investigate spatiotemporal and foot kinematic parameters over a 6-minute walk test using inertial measurement units. Twelve iLLA participated in this study. Distance, cadence, stance ratio, loading rate ratio, push-up ratio, path length, and minimum toe clearance were analyzed during 6-minute walk test. Nonparametric repeated-measures analysis of variance tests, Bonferroni corrections, were performed. Time of distance-based walking tests diminished at T2 (P < .02). Compared with normative values, walking performance in iLLA was reduced. Cadence at T2 increased significantly (P = .026). Stance ratio increased in both legs at T2 (P < .05). Push-up ratio tended to decrease at T2 in the amputated leg (P = .0003). Variability of path length and minimum toe clearance at T2 were less than at T1 in the nonamputated leg (P < .05). Spatiotemporal improvement at T2 could be due to prosthesis adaptation in iLLA. The lower performance of the functional walk test compared with normative values could be due to amputation and pain-related fatigue.
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Chaparro-Cárdenas SL, Castillo-Castañeda E, Lozano-Guzmán AA, Zequera M, Gallegos-Torres RM, Ramirez-Bautista JA. Characterization of muscle fatigue in the lower limb by sEMG and angular position using the WFD protocol. Biocybern Biomed Eng 2021. [DOI: 10.1016/j.bbe.2021.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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8
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Garcia A. DE, Sierra M. SD, Gomez-Vargas D, Jiménez MF, Múnera M, Cifuentes CA. Semi-Remote Gait Assistance Interface: A Joystick with Visual Feedback Capabilities for Therapists. SENSORS 2021; 21:s21103521. [PMID: 34069340 PMCID: PMC8158774 DOI: 10.3390/s21103521] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 05/03/2021] [Accepted: 05/06/2021] [Indexed: 11/21/2022]
Abstract
The constant growth of pathologies affecting human mobility has led to developing of different assistive devices to provide physical and cognitive assistance. Smart walkers are a particular type of these devices since they integrate navigation systems, path-following algorithms, and user interaction modules to ensure natural and intuitive interaction. Although these functionalities are often implemented in rehabilitation scenarios, there is a need to actively involve the healthcare professionals in the interaction loop while guaranteeing safety for them and patients. This work presents the validation of two visual feedback strategies for the teleoperation of a simulated robotic walker during an assisted navigation task. For this purpose, a group of 14 clinicians from the rehabilitation area formed the validation group. A simple path-following task was proposed, and the feedback strategies were assessed through the kinematic estimation error (KTE) and a usability survey. A KTE of 0.28 m was obtained for the feedback strategy on the joystick. Additionally, significant differences were found through a Mann–Whitney–Wilcoxon test for the perception of behavior and confidence towards the joystick according to the modes of interaction (p-values of 0.04 and 0.01, respectively). The use of visual feedback with this tool contributes to research areas such as remote management of therapies and monitoring rehabilitation of people’s mobility.
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Affiliation(s)
- Daniel E. Garcia A.
- Department of Biomedical Engineering, Colombian School of Engineering Julio Garavito, Bogota 111166, Colombia; (D.E.G.A.); (S.D.S.M.); (D.G.-V.); (M.M.)
| | - Sergio D. Sierra M.
- Department of Biomedical Engineering, Colombian School of Engineering Julio Garavito, Bogota 111166, Colombia; (D.E.G.A.); (S.D.S.M.); (D.G.-V.); (M.M.)
| | - Daniel Gomez-Vargas
- Department of Biomedical Engineering, Colombian School of Engineering Julio Garavito, Bogota 111166, Colombia; (D.E.G.A.); (S.D.S.M.); (D.G.-V.); (M.M.)
| | - Mario F. Jiménez
- School of Engineering, Science and Technology, Universidad del Rosario, Bogotá 111711, Colombia
- Correspondence: (M.F.J.); (C.A.C.); Tel.: +57-(1)-297-0200 (M.F.J.); +57-(031)-668-3600 (C.A.C.)
| | - Marcela Múnera
- Department of Biomedical Engineering, Colombian School of Engineering Julio Garavito, Bogota 111166, Colombia; (D.E.G.A.); (S.D.S.M.); (D.G.-V.); (M.M.)
| | - Carlos A. Cifuentes
- Department of Biomedical Engineering, Colombian School of Engineering Julio Garavito, Bogota 111166, Colombia; (D.E.G.A.); (S.D.S.M.); (D.G.-V.); (M.M.)
- Correspondence: (M.F.J.); (C.A.C.); Tel.: +57-(1)-297-0200 (M.F.J.); +57-(031)-668-3600 (C.A.C.)
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Evaluation of Physical Interaction during Walker-Assisted Gait with the AGoRA Walker: Strategies Based on Virtual Mechanical Stiffness. SENSORS 2021; 21:s21093242. [PMID: 34067133 PMCID: PMC8125083 DOI: 10.3390/s21093242] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/05/2021] [Accepted: 05/02/2021] [Indexed: 11/16/2022]
Abstract
Smart walkers are commonly used as potential gait assistance devices, to provide physical and cognitive assistance within rehabilitation and clinical scenarios. To understand such rehabilitation processes, several biomechanical studies have been conducted to assess human gait with passive and active walkers. Several sessions were conducted with 11 healthy volunteers to assess three interaction strategies based on passive, low and high mechanical stiffness values on the AGoRA Smart Walker. The trials were carried out in a motion analysis laboratory. Kinematic data were also collected from the smart walker sensory interface. The interaction force between users and the device was recorded. The force required under passive and low stiffness modes was 56.66% and 67.48% smaller than the high stiffness mode, respectively. An increase of 17.03% for the hip range of motion, as well as the highest trunk’s inclination, were obtained under the resistive mode, suggesting a compensating motion to exert a higher impulse force on the device. Kinematic and physical interaction data suggested that the high stiffness mode significantly affected the users’ gait pattern. Results suggested that users compensated their kinematics, tilting their trunk and lower limbs to exert higher impulse forces on the device.
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10
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Biofeedback Applied to Interactive Serious Games to Monitor Frailty in an Elderly Population. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11083502] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
This article proposes an example of a multiplatform interactive serious game, which is an additional tool and assistant used in the rehabilitation of patients with musculoskeletal system problems. In medicine, any actions and procedures aimed at helping the rehabilitation of patients should entail the most comfortable, but at the same time, effective approach. Regardless of how these actions are orientated, whether for rehabilitation following surgery, fractures, any problems with the musculoskeletal system, or just support for the elderly, rehabilitation methods undoubtedly have good goals, although often the process itself can cause all kinds of discomfort and aversion among patients. This paper presents an interactive platform which enables a slightly different approach to be applied in terms of routine rehabilitation activities and this will help make the process more exciting. The main feature of the system is that it works in several ways: for normal everyday use at home, or for more in-depth observation of various biological parameters, such as heart rate, temperature, and so on. The basic component of the system is the real-time tracking system of the body position, which constitutes both a way to control the game (controller) and a means to analyze the player’s activity. As for the closer control of rehabilitation, the platform also provides the opportunity for medical personnel to monitor the player in real time, with all the data obtained from the game being used for subsequent analysis and comparison. Following several laboratory tests and feedback analysis, the progress indicators are quite encouraging in terms of greater patient interest in this kind of interaction, and effectiveness of the developed platform is also on average about 30–50% compared to conventional exercises, which makes it more attractive in terms of patient support.
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Stubbs PW, Mehta P, Bryant L, Pinto RZ, Verhagen AP, McCambridge AB. Abstract spin in physiotherapy interventions using virtual reality or robotics: protocol for two Meta-research reviews. PHYSICAL THERAPY REVIEWS 2020. [DOI: 10.1080/10833196.2020.1832708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Peter W. Stubbs
- Graduate School of Health, Discipline of Physiotherapy, University of Technology Sydney, Sydney, Australia
| | - Poonam Mehta
- Graduate School of Health, Discipline of Physiotherapy, University of Technology Sydney, Sydney, Australia
| | - Lucy Bryant
- Graduate School of Health, Discipline of Speech Pathology, University of Technology Sydney, Sydney, Australia
| | - Rafael Z. Pinto
- Department of Physical Therapy, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Arianne P. Verhagen
- Graduate School of Health, Discipline of Physiotherapy, University of Technology Sydney, Sydney, Australia
| | - Alana B. McCambridge
- Graduate School of Health, Discipline of Physiotherapy, University of Technology Sydney, Sydney, Australia
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12
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Jamwal PK, Hussain S, Ghayesh MH. Robotic orthoses for gait rehabilitation: An overview of mechanical design and control strategies. Proc Inst Mech Eng H 2020; 234:444-457. [PMID: 31916511 DOI: 10.1177/0954411919898293] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The application of robotic devices in providing physiotherapies to post-stroke patients and people suffering from incomplete spinal cord injuries is rapidly expanding. It is crucial to provide valid rehabilitation for people who are experiencing abnormality in their gait performance; therefore, design and development of newer robotic devices for the purpose of facilitating patients' recovery is being actively researched. In order to advance the traditional gait treatment among patients, exoskeletons and orthoses were introduced over the last two decades. This article presents a thorough review of existing robotic gait rehabilitation devices. The latest advancements in the mechanical design, types of control and actuation are also covered. The study comprehends discussions on robotic rehabilitation devices developed both for the training on treadmill and over-ground training. The assist-as-needed strategy for the gait training is particularly emphasized while reviewing various control strategies applied to these robotic devices. This study further reviews experimental investigations and clinical assessments of different control strategies and mechanism designs of robotic gait rehabilitation devices using experimental and clinical trials.
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Affiliation(s)
- Prashant K Jamwal
- Department of Electrical and Computer Engineering, Nazarbayev University, Astana, Kazakhstan
| | - Shahid Hussain
- Human-Centred Technology Research Centre, Faculty of Science and Technology, University of Canberra, Canberra, ACT, Australia
| | - Mergen H Ghayesh
- School of Mechanical Engineering, The University of Adelaide, Adelaide, SA, Australia
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13
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Human-Robot-Environment Interaction Interface for Smart Walker Assisted Gait: AGoRA Walker. SENSORS 2019; 19:s19132897. [PMID: 31262036 PMCID: PMC6650898 DOI: 10.3390/s19132897] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 05/29/2019] [Accepted: 06/27/2019] [Indexed: 11/17/2022]
Abstract
The constant growth of the population with mobility impairments has led to the development of several gait assistance devices. Among these, smart walkers have emerged to provide physical and cognitive interactions during rehabilitation and assistance therapies, by means of robotic and electronic technologies. In this sense, this paper presents the development and implementation of a human-robot-environment interface on a robotic platform that emulates a smart walker, the AGoRA Walker. The interface includes modules such as a navigation system, a human detection system, a safety rules system, a user interaction system, a social interaction system and a set of autonomous and shared control strategies. The interface was validated through several tests on healthy volunteers with no gait impairments. The platform performance and usability was assessed, finding natural and intuitive interaction over the implemented control strategies.
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14
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Wang W, Qin L, Yuan X, Ming X, Sun T, Liu Y. Bionic control of exoskeleton robot based on motion intention for rehabilitation training. Adv Robot 2019. [DOI: 10.1080/01691864.2019.1621774] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Wendong Wang
- School of Mechanical Engineering, Northwestern Polytechnical University, Xi’an, People’s Republic of China
| | - Lei Qin
- School of Mechanical Engineering, Northwestern Polytechnical University, Xi’an, People’s Republic of China
| | - Xiaoqing Yuan
- School of Mechanical Engineering, Northwestern Polytechnical University, Xi’an, People’s Republic of China
| | - Xing Ming
- School of Mechanical Engineering, Northwestern Polytechnical University, Xi’an, People’s Republic of China
| | - Tongsen Sun
- School of Mechanical Engineering, Northwestern Polytechnical University, Xi’an, People’s Republic of China
| | - Yifan Liu
- School of Mechanical Engineering, Northwestern Polytechnical University, Xi’an, People’s Republic of China
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