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Zha Q, Xu Z, Yang H, Zhang G, Cai X, Zhang W, Liu Y, Shen X, Li Y. Development of a robot-assisted reduction and rehabilitation system for distal radius fractures. Front Bioeng Biotechnol 2024; 11:1342229. [PMID: 38268941 PMCID: PMC10805860 DOI: 10.3389/fbioe.2023.1342229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 12/26/2023] [Indexed: 01/26/2024] Open
Abstract
Background: Closed reduction is the preferred treatment for distal radius fractures. However, it requires a multiple experienced medical staff and manually maintaining stable traction is difficult. Additionally, doctors cannot assess the reduction status of a fracture in real-time through radiographic images, which may lead to improper reduction. Furthermore, post-fracture complications such as joint adhesion, stiffness, and impaired mobility pose a challenge for the doctors. So it is necessary to optimize the treatment process of the distal radius fracture through technological means. Methods: A robot-assisted closed reduction and rehabilitation system, which could assist doctors throughout the entire process of reduction, fixation, and rehabilitation of distal radius fractures, was developed. A mechanical system, composed of two grippers and a cooperative robotic arm, was used to grasp and tract the affected limb. A doctor controlled the robot through a joystick console and Windows application program. A biplane radiographic device was integrated into the system, which is not only convenient for doctors to view radiographic images of the fracture at any time but also for them to select the rotation axis of the wrist on the images before reduction and rehabilitation. Important information including the anteroposterior and lateral radiographic data and force and position parameters during the reduction and rehabilitation process were displayed on a graphic user interface. Results: Experimental results showed that the proposed robotic system can meet the technical requirements for the reduction and rehabilitation of distal radius fractures, all the rotation angles could be achieved, a maximum force of more than 50 N could be achieved in all traction directions, and the error in selecting the wrist joint rotation axis line using radiographic images was less than 5 mm. Conclusion: The developed robot-assisted system was shown to be suitable for closed reduction and rehabilitation of distal radius fractures, contributing a potential improvement in the quality of the procedures.
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Affiliation(s)
- Qing Zha
- School of Biomedical Engineering (Suzhou), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Science, Suzhou, China
| | - Zeou Xu
- School of Biomedical Engineering (Suzhou), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Science, Suzhou, China
| | - Hongbo Yang
- School of Biomedical Engineering (Suzhou), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Science, Suzhou, China
| | - Guodong Zhang
- Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
| | - Xuefeng Cai
- Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
| | - Wanlin Zhang
- Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
| | - Yujiang Liu
- Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
| | - Xiaofeng Shen
- Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
| | - Yuwei Li
- Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
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Li W, Shi P, Li S, Yu H. Current status and clinical perspectives of extended reality for myoelectric prostheses: review. Front Bioeng Biotechnol 2024; 11:1334771. [PMID: 38260728 PMCID: PMC10800532 DOI: 10.3389/fbioe.2023.1334771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 12/13/2023] [Indexed: 01/24/2024] Open
Abstract
Training with "Extended Reality" or X-Reality (XR) systems can undoubtedly enhance the control of the myoelectric prostheses. However, there is no consensus on which factors improve the efficiency of skill transfer from virtual training to actual prosthesis abilities. This review examines the current status and clinical applications of XR in the field of myoelectric prosthesis training and analyses possible influences on skill migration. We have conducted a thorough search on databases in the field of prostheses using keywords such as extended reality, virtual reality and serious gaming. Our scoping review encompassed relevant applications, control methods, performance evaluation and assessment metrics. Our findings indicate that the implementation of XR technology for myoelectric rehabilitative training on prostheses provides considerable benefits. Additionally, there are numerous standardised methods available for evaluating training effectiveness. Recently, there has been a surge in the number of XR-based training tools for myoelectric prostheses, with an emphasis on user engagement and virtual training evaluation. Insufficient attention has been paid to significant limitations in the behaviour, functionality, and usage patterns of XR and myoelectric prostheses, potentially obstructing the transfer of skills and prospects for clinical application. Improvements are recommended in four critical areas: activities of daily living, training strategies, feedback, and the alignment of the virtual environment with the physical devices.
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Affiliation(s)
- Wei Li
- Institute of Rehabilitation Engineering and Technology, University of Shanghai for Science and Technology, Shanghai, China
- Shanghai Engineering Research Center of Assistive Devices, Shanghai, China
- Key Laboratory of Neural-Functional Information and Rehabilitation Engineering of the Ministry of Civil Affairs, Shanghai, China
| | - Ping Shi
- Institute of Rehabilitation Engineering and Technology, University of Shanghai for Science and Technology, Shanghai, China
- Shanghai Engineering Research Center of Assistive Devices, Shanghai, China
- Key Laboratory of Neural-Functional Information and Rehabilitation Engineering of the Ministry of Civil Affairs, Shanghai, China
| | - Sujiao Li
- Institute of Rehabilitation Engineering and Technology, University of Shanghai for Science and Technology, Shanghai, China
- Shanghai Engineering Research Center of Assistive Devices, Shanghai, China
- Key Laboratory of Neural-Functional Information and Rehabilitation Engineering of the Ministry of Civil Affairs, Shanghai, China
| | - Hongliu Yu
- Institute of Rehabilitation Engineering and Technology, University of Shanghai for Science and Technology, Shanghai, China
- Shanghai Engineering Research Center of Assistive Devices, Shanghai, China
- Key Laboratory of Neural-Functional Information and Rehabilitation Engineering of the Ministry of Civil Affairs, Shanghai, China
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Tian J, Wang H, Lu H, Yang Y, Li L, Niu J, Cheng B. Force/position-based velocity control strategy for the lower limb rehabilitation robot during active training: design and validation. Front Bioeng Biotechnol 2024; 11:1335071. [PMID: 38260744 PMCID: PMC10800786 DOI: 10.3389/fbioe.2023.1335071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 12/20/2023] [Indexed: 01/24/2024] Open
Abstract
Aiming at the shortcomings of most existing control strategies for lower limb rehabilitation robots that are difficult to guarantee trajectory tracking effect and active participation of the patient, this paper proposes a force/position-based velocity control (FPVC) strategy for the hybrid end-effector lower limb rehabilitation robot (HE-LRR) during active training. The configuration of HE-LRR is described and the inverse Jacobian analysis is carried out. Then, the FPVC strategy design is introduced in detail, including normal velocity planning and tangential velocity planning. The experimental platform for the HE-LRR system is presented. A series of experiments are conducted to validate the FPVC strategy's performance, including trajectory measurement experiments, force and velocity measurement experiments, and active participation experiments. Experimental studies show that the end effector possesses good following performance with the reference trajectory and the desired velocity, and the active participation of subjects can be adjusted by the control strategy parameters. The experiments have verified the rationality of the FPVC strategy, which can meet the requirements of trajectory tracking effect and active participation, indicating its good application prospects in the patient's robot-assisted active training.
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Affiliation(s)
- Junjie Tian
- Hebei Provincial Key Laboratory of Parallel Robot and Mechatronic System, Yanshan University, Qinhuangdao, China
- School of Mechanical Engineering, Yanshan University, Qinhuangdao, China
| | - Hongbo Wang
- Hebei Provincial Key Laboratory of Parallel Robot and Mechatronic System, Yanshan University, Qinhuangdao, China
- School of Mechanical Engineering, Yanshan University, Qinhuangdao, China
- Academy for Engineering and Technology, Fudan University, Shanghai, China
| | - Hao Lu
- Academy for Engineering and Technology, Fudan University, Shanghai, China
| | - Yang Yang
- Hebei Provincial Key Laboratory of Parallel Robot and Mechatronic System, Yanshan University, Qinhuangdao, China
- School of Mechanical Engineering, Yanshan University, Qinhuangdao, China
| | - Lianqing Li
- Hebei Provincial Key Laboratory of Parallel Robot and Mechatronic System, Yanshan University, Qinhuangdao, China
- School of Mechanical Engineering, Yanshan University, Qinhuangdao, China
| | - Jianye Niu
- Hebei Provincial Key Laboratory of Parallel Robot and Mechatronic System, Yanshan University, Qinhuangdao, China
- School of Mechanical Engineering, Yanshan University, Qinhuangdao, China
| | - Bo Cheng
- Qinhuangdao Hospital of Traditional Chinese Medicine, Qinhuangdao, China
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Ang BWK, Yeow CH, Lim JH. A Critical Review on Factors Affecting the User Adoption of Wearable and Soft Robotics. SENSORS (BASEL, SWITZERLAND) 2023; 23:3263. [PMID: 36991974 PMCID: PMC10051244 DOI: 10.3390/s23063263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 03/06/2023] [Accepted: 03/13/2023] [Indexed: 06/19/2023]
Abstract
In recent years, the advent of soft robotics has changed the landscape of wearable technologies. Soft robots are highly compliant and malleable, thus ensuring safe human-machine interactions. To date, a wide variety of actuation mechanisms have been studied and adopted into a multitude of soft wearables for use in clinical practice, such as assistive devices and rehabilitation modalities. Much research effort has been put into improving their technical performance and establishing the ideal indications for which rigid exoskeletons would play a limited role. However, despite having achieved many feats over the past decade, soft wearable technologies have not been extensively investigated from the perspective of user adoption. Most scholarly reviews of soft wearables have focused on the perspective of service providers such as developers, manufacturers, or clinicians, but few have scrutinized the factors affecting adoption and user experience. Hence, this would pose a good opportunity to gain insight into the current practice of soft robotics from a user's perspective. This review aims to provide a broad overview of the different types of soft wearables and identify the factors that hinder the adoption of soft robotics. In this paper, a systematic literature search using terms such as "soft", "robot", "wearable", and "exoskeleton" was conducted according to PRISMA guidelines to include peer-reviewed publications between 2012 and 2022. The soft robotics were classified according to their actuation mechanisms into motor-driven tendon cables, pneumatics, hydraulics, shape memory alloys, and polyvinyl chloride muscles, and their pros and cons were discussed. The identified factors affecting user adoption include design, availability of materials, durability, modeling and control, artificial intelligence augmentation, standardized evaluation criteria, public perception related to perceived utility, ease of use, and aesthetics. The critical areas for improvement and future research directions to increase adoption of soft wearables have also been highlighted.
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Affiliation(s)
- Benjamin Wee Keong Ang
- Department of Biomedical Engineering, National University of Singapore, Singapore 117583, Singapore; (B.W.K.A.); (C.-H.Y.)
| | - Chen-Hua Yeow
- Department of Biomedical Engineering, National University of Singapore, Singapore 117583, Singapore; (B.W.K.A.); (C.-H.Y.)
| | - Jeong Hoon Lim
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119074, Singapore
- Division of Rehabilitation Medicine, University Medicine Cluster, National University Hospital, Singapore 119077, Singapore
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Moeller T, Moehler F, Krell-Roesch J, Dežman M, Marquardt C, Asfour T, Stein T, Woll A. Use of Lower Limb Exoskeletons as an Assessment Tool for Human Motor Performance: A Systematic Review. SENSORS (BASEL, SWITZERLAND) 2023; 23:3032. [PMID: 36991743 PMCID: PMC10057915 DOI: 10.3390/s23063032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 03/06/2023] [Accepted: 03/07/2023] [Indexed: 06/19/2023]
Abstract
Exoskeletons are a promising tool to support individuals with a decreased level of motor performance. Due to their built-in sensors, exoskeletons offer the possibility of continuously recording and assessing user data, for example, related to motor performance. The aim of this article is to provide an overview of studies that rely on using exoskeletons to measure motor performance. Therefore, we conducted a systematic literature review, following the PRISMA Statement guidelines. A total of 49 studies using lower limb exoskeletons for the assessment of human motor performance were included. Of these, 19 studies were validity studies, and six were reliability studies. We found 33 different exoskeletons; seven can be considered stationary, and 26 were mobile exoskeletons. The majority of the studies measured parameters such as range of motion, muscle strength, gait parameters, spasticity, and proprioception. We conclude that exoskeletons can be used to measure a wide range of motor performance parameters through built-in sensors, and seem to be more objective and specific than manual test procedures. However, since these parameters are usually estimated from built-in sensor data, the quality and specificity of an exoskeleton to assess certain motor performance parameters must be examined before an exoskeleton can be used, for example, in a research or clinical setting.
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Affiliation(s)
- Tobias Moeller
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, 76131 Karlsruhe, Germany
| | - Felix Moehler
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, 76131 Karlsruhe, Germany
| | - Janina Krell-Roesch
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, 76131 Karlsruhe, Germany
| | - Miha Dežman
- Institute for Anthropomatics and Robotics, High Performance Humanoid Technologies (H2T), Karlsruhe Institute of Technology, 76131 Karlsruhe, Germany
| | - Charlotte Marquardt
- Institute for Anthropomatics and Robotics, High Performance Humanoid Technologies (H2T), Karlsruhe Institute of Technology, 76131 Karlsruhe, Germany
| | - Tamim Asfour
- Institute for Anthropomatics and Robotics, High Performance Humanoid Technologies (H2T), Karlsruhe Institute of Technology, 76131 Karlsruhe, Germany
| | - Thorsten Stein
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, 76131 Karlsruhe, Germany
| | - Alexander Woll
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, 76131 Karlsruhe, Germany
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Li Z, Liu C, Han Y, Wang T, Lei R. Design, fabrication and experiments of a hydraulic active-passive hybrid prosthesis knee. Technol Health Care 2023:THC220522. [PMID: 36641694 DOI: 10.3233/thc-220522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND Due to low friction, passive mechanical prostheses move compliantly followed by the stump and are used widely. Advanced semi-active prostheses can both move passively like passive prostheses and provide active torque under specific conditions. However, the current mechanical-hydraulic coupling driven semi-active prostheses, in order to meet the low passive friction requirements with a low active transmission ratio, lead to a significant problem of insufficient active torque. OBJECTIVE A hybrid active and passive prosthesis was developed to solve the incompatibility problem of low passive friction and high active driving torque of semi-active prostheses. METHODS The mechanical structure and control strategy of the prosthesis were demonstrated. The performance of the prosthesis was tested by bench and human tests. RESULTS Passive subsystem damping adjustment ranges from 0.4 N⋅(mm/s)-1 to 300 N⋅(mm/s)-1. The switching time between the damping and the active subsystem is 32 ± 2 ms. The continuous active torque output is more than 24 Nm. In level walking, the peak torque is about 28 Nm. CONCLUSION The proposed active-passive hybrid hydraulic prosthesis could satisfy both low passive friction and high active actuation.
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Affiliation(s)
- Zhennan Li
- School of Mechanical and Aerospace Engineering, Jilin University, Changchun, Jilin, China.,Key Laboratory of Bionic Engineering, Ministry of Education, Jilin University, Changchun, Jilin, China
| | - Chunbao Liu
- School of Mechanical and Aerospace Engineering, Jilin University, Changchun, Jilin, China.,Key Laboratory of Bionic Engineering, Ministry of Education, Jilin University, Changchun, Jilin, China
| | - Yang Han
- School of Mechanical and Aerospace Engineering, Jilin University, Changchun, Jilin, China.,Key Laboratory of Bionic Engineering, Ministry of Education, Jilin University, Changchun, Jilin, China
| | - Tongjian Wang
- School of Mechanical and Aerospace Engineering, Jilin University, Changchun, Jilin, China
| | - Ren Lei
- Key Laboratory of Bionic Engineering, Ministry of Education, Jilin University, Changchun, Jilin, China.,School of Mechanical, Aerospace and Civil Engineering, University of Manchester, Manchester, UK
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Force Transmission Analysis and Optimization of Bowden Cable on Body in a Flexible Exoskeleton. Appl Bionics Biomech 2022; 2022:5552166. [PMID: 35937097 PMCID: PMC9352506 DOI: 10.1155/2022/5552166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 07/01/2022] [Indexed: 11/17/2022] Open
Abstract
The Bowden cable is a significant force transmission equipment for a flexible exoskeleton. However, the previous researches of Bowden cable had emphasized on the data from experimenting test board, instead of on human body, which produced the inaccurate assisting analysis of the flexible exoskeleton. In this paper, a flexible exoskeleton for assisting knee extension was proposed, which provided an on-body condition. Then, the friction force and its influencing factors between the wire rope and sheath of the Bowden cable from the motor to the anchor of knee have been analyzed. The segment models of force transmission with the concern of three kinds of friction modes were established, and the relationship between various lengths and bending angles of Bowden cable was fitted to the equations of curve. Furthermore, the association rule between the force transmission and the lengths of Bowden cable was obtained, based on which, the optimal force transmission efficiency was 78.68% when the length value of the Bowden cable was 475 mm. A flexible exoskeleton prototype was assembled; then, the experiments with force transmission and metabolic cost have been developed. The results showed that the force transmission efficiency had strong association with the lengths of Bowden cable, instead of the transmission velocities. Furthermore, this knee assistance exoskeleton reduced the net metabolic cost of the testees during walking. These experiments results corroborated the force transmission modeling and simulation of the Bowden cable on body we proposed in this paper.
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