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Liu C, Liu Y, Xie R, Li Z, Bai S, Zhao Y. The evolution of robotics: research and application progress of dental implant robotic systems. Int J Oral Sci 2024; 16:28. [PMID: 38584185 PMCID: PMC10999443 DOI: 10.1038/s41368-024-00296-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 03/11/2024] [Accepted: 03/13/2024] [Indexed: 04/09/2024] Open
Abstract
The use of robots to augment human capabilities and assist in work has long been an aspiration. Robotics has been developing since the 1960s when the first industrial robot was introduced. As technology has advanced, robotic-assisted surgery has shown numerous advantages, including more precision, efficiency, minimal invasiveness, and safety than is possible with conventional techniques, which are research hotspots and cutting-edge trends. This article reviewed the history of medical robot development and seminal research papers about current research progress. Taking the autonomous dental implant robotic system as an example, the advantages and prospects of medical robotic systems would be discussed which would provide a reference for future research.
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Affiliation(s)
- Chen Liu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Xi'an, China
- National Clinical Research Center for Oral Diseases, Xi'an, China
- Shaanxi Key Laboratory of Stomatology, Xi'an, China
- Digital Center, School of Stomatology, The Fourth Military Medical University, Xi'an, China
| | - Yuchen Liu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Xi'an, China
- National Clinical Research Center for Oral Diseases, Xi'an, China
- Shaanxi Key Laboratory of Stomatology, Xi'an, China
- Digital Center, School of Stomatology, The Fourth Military Medical University, Xi'an, China
| | - Rui Xie
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Xi'an, China
- National Clinical Research Center for Oral Diseases, Xi'an, China
- Shaanxi Key Laboratory of Stomatology, Xi'an, China
- Digital Center, School of Stomatology, The Fourth Military Medical University, Xi'an, China
| | - Zhiwen Li
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Xi'an, China
- National Clinical Research Center for Oral Diseases, Xi'an, China
- Shaanxi Key Laboratory of Stomatology, Xi'an, China
- Digital Center, School of Stomatology, The Fourth Military Medical University, Xi'an, China
| | - Shizhu Bai
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Xi'an, China.
- National Clinical Research Center for Oral Diseases, Xi'an, China.
- Shaanxi Key Laboratory of Stomatology, Xi'an, China.
- Digital Center, School of Stomatology, The Fourth Military Medical University, Xi'an, China.
| | - Yimin Zhao
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Xi'an, China.
- National Clinical Research Center for Oral Diseases, Xi'an, China.
- Shaanxi Key Laboratory of Stomatology, Xi'an, China.
- Digital Center, School of Stomatology, The Fourth Military Medical University, Xi'an, China.
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Takahashi K, Mizukami M, Watanabe H, Kuroda MM, Shimizu Y, Nakajima T, Mutsuzaki H, Kamada H, Tokeji K, Hada Y, Koseki K, Yoshikawa K, Nakayama T, Iwasaki N, Kawamoto H, Sankai Y, Yamazaki M, Matsumura A, Marushima A. Feasibility and safety study of wearable cyborg Hybrid Assistive Limb for pediatric patients with cerebral palsy and spinal cord disorders. Front Neurol 2023; 14:1255620. [PMID: 38020664 PMCID: PMC10656736 DOI: 10.3389/fneur.2023.1255620] [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: 07/09/2023] [Accepted: 10/24/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction The wearable cyborg Hybrid Assistive Limb (HAL) is the world's first cyborg-type wearable robotic device, and it assists the user's voluntary movements and facilitates muscle activities. However, since the minimum height required for using the HAL is 150 cm, a smaller HAL (2S size) has been newly developed for pediatric use. This study aimed to (1) examine the feasibility and safety of a protocol for treatments with HAL (2S size) in pediatric patients and (2) explore the optimal method for assessing the efficacy of HAL. Methods This clinical study included seven pediatric patients with postural and motor function disorders, who received 8-12 sessions of smaller HAL (2S size) treatment. The primary outcome was the Gross Motor Function Measure-88 (GMFM-88). The secondary outcomes were GMFM-66, 10-m walk test, 2- and 6-min walking distances, Canadian Occupational Performance Measure (COPM), a post-treatment questionnaire, adverse events, and device failures. Statistical analyses were performed using the paired samples t-test or Wilcoxon signed-rank test. Results All participants completed the study protocol with no serious adverse events. GMFM-88 improved from 65.51 ± 21.97 to 66.72 ± 22.28 (p = 0.07). The improvements in the secondary outcomes were as follows: GMFM-66, 53.63 ± 11.94 to 54.96 ± 12.31, p = 0.04; step length, 0.32 ± 0.16 to 0.34 ± 0.16, p = 0.25; 2-MWD, 59.1 ± 57.0 to 62.8 ± 63.3, p = 0.54; COPM performance score, 3.7 ± 2.0 to 5.3 ± 1.9, p = 0.06; COPM satisfaction score, 3.3 ± 2.1 to 5.1 ± 2.1, p = 0.04. Discussion In this exploratory study, we applied a new size of wearable cyborg HAL (2S size), to children with central nervous system disorders. We evaluated its safety, feasibility, and identified an optimal assessment method for multiple treatments. All participants completed the protocol with no serious adverse events. This study suggested that the GMFM would be an optimal assessment tool for validation trials of HAL (2S size) treatment in pediatric patients with posture and motor function disorders.
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Affiliation(s)
- Kazushi Takahashi
- Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences Hospital, Ami, Japan
- Graduate School of Health Science, Ibaraki Prefectural University of Health Sciences, Ami, Japan
| | - Masafumi Mizukami
- Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences, Ami, Japan
| | - Hiroki Watanabe
- Department of Neurosurgery, Institute of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Mayumi Matsuda Kuroda
- Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences, Ami, Japan
| | - Yukiyo Shimizu
- Department of Rehabilitation Medicine, Institute of Medicine, University of Tsukuba, Tsukuba, Japan
- Center for Cybernics Research, University of Tsukuba, Tsukuba, Japan
| | - Takashi Nakajima
- Department of Neurology, National Hospital Organization Niigata National Hospital, Kashiwazaki, Japan
| | - Hirotaka Mutsuzaki
- Center for Medical Science, Ibaraki Prefectural University of Health Sciences, Ami, Japan
| | - Hiroshi Kamada
- Department of Orthopaedic Surgery, Institute of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Kayo Tokeji
- Department of Rehabilitation Medicine, Institute of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Yasushi Hada
- Department of Rehabilitation Medicine, Institute of Medicine, University of Tsukuba, Tsukuba, Japan
- Center for Cybernics Research, University of Tsukuba, Tsukuba, Japan
| | - Kazunori Koseki
- Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences Hospital, Ami, Japan
| | - Kenichi Yoshikawa
- Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences Hospital, Ami, Japan
| | - Tomohiro Nakayama
- Department of Pediatric, Ibaraki Prefectural University of Health Sciences Hospital, Ami, Japan
| | - Nobuaki Iwasaki
- Department of Pediatric Neurology, Tsuchiura Rehabilitation Hospital, Tsuchiura, Japan
| | - Hiroaki Kawamoto
- Center for Cybernics Research, University of Tsukuba, Tsukuba, Japan
| | - Yoshiyuki Sankai
- Center for Cybernics Research, University of Tsukuba, Tsukuba, Japan
| | - Masashi Yamazaki
- Department of Orthopaedic Surgery, Institute of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Akira Matsumura
- Graduate School of Health Science, Ibaraki Prefectural University of Health Sciences, Ami, Japan
| | - Aiki Marushima
- Department of Neurosurgery, Institute of Medicine, University of Tsukuba, Tsukuba, Japan
- Center for Cybernics Research, University of Tsukuba, Tsukuba, Japan
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Robotic rehabilitation therapy using Hybrid Assistive Limb (HAL) for patients with spinal cord lesions: A narrative review. NORTH AMERICAN SPINE SOCIETY JOURNAL (NASSJ) 2023; 14:100209. [PMID: 37113251 PMCID: PMC10127119 DOI: 10.1016/j.xnsj.2023.100209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 02/27/2023] [Accepted: 03/01/2023] [Indexed: 03/12/2023]
Abstract
Background The Hybrid Assistive Limb (HAL) is a rehabilitation device that utilizes the "interactive biofeedback" hypothesis to facilitate the motion of the device according to the user's motion intention and appropriate sensory input evoked by HAL-supported motion. HAL has been studied extensively for its potential to promote walking function in patients with spinal cord lesions, including spinal cord injury. Methods We performed a narrative review of HAL rehabilitation for spinal cord lesions. Results Several reports have shown the effectiveness of HAL rehabilitation in the recovery of walking ability in patients with gait disturbance caused by compressive myelopathy. Clinical studies have also demonstrated potential mechanisms of action leading to clinical findings, including normalization of cortical excitability, improvement of muscle synergy, attenuation of difficulties in voluntarily initiating joint movement, and gait coordination changes. Conclusions However, further investigation with more sophisticated study designs is necessary to prove the true efficacy of HAL walking rehabilitation. HAL remains one of the most promising rehabilitation devices for promoting walking function in patients with spinal cord lesions.
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Soma Y, Kubota S, Kadone H, Shimizu Y, Hada Y, Koda M, Sankai Y, Yamazaki M. Postoperative Acute-Phase Gait Training Using Hybrid Assistive Limb Improves Gait Ataxia in a Patient with Intradural Spinal Cord Compression Due to Spinal Tumors. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58121825. [PMID: 36557027 PMCID: PMC9782825 DOI: 10.3390/medicina58121825] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 11/29/2022] [Accepted: 12/09/2022] [Indexed: 12/14/2022]
Abstract
Sensory ataxia due to posterior cord syndrome is a relevant, disabling condition in nontraumatic spinal cord dysfunction. Ataxic gait is a common symptom of sensory ataxia that restricts activities of daily living. A 70-year-old woman with severe sensory disturbance was diagnosed with intradural extramedullary spinal cord tumors found in the thoracic spine region (T8). Surgical management of the tumors was performed. The patient received gait training 20 days after surgery (postoperative acute phase) using a hybrid assistive limb (HAL). HAL is a wearable exoskeleton cyborg that provides real-time assistance to an individual for walking and limb movements through actuators mounted on the bilateral hip and knee joints. Walking ability was assessed using the 10 m walking test, which included evaluating walking speed, step length, and cadence in every session. To evaluate the immediate effects of HAL training, walking speed and step length were measured before and after the training in each session. During the 10 m walking test, gait kinematics and lower muscle activity were recorded using a motion capture system and wireless surface electromyography before the first session and after completion of all HAL sessions. After the HAL training sessions, improvement in the patient’s gait performance was observed in the gait joint angles and muscle activity of the lower limb. After 10 training sessions, we observed the following changes from baseline: walking speed (from 0.16 m/s to 0.3 m/s), step length (from 0.19 m to 0.37 m), and cadence (from 50.9 steps/min to 49.1 steps/min). The average standard deviations of the knee (from right, 7.31; left, 6.75; to right, 2.93; p < 0.01, left, 2.63; p < 0.01) and ankle joints (from right, 6.98; left, 5.40; to right, 2.39; p < 0.01, left, 2.18; p < 0.01) were significantly decreased. Additionally, walking speed and step length improved immediately after completing all the HAL training sessions. This suggests that HAL gait training might be a suitable physical rehabilitation program for patients with sensory ataxia causing dysfunctional movement of the lower limb.
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Affiliation(s)
- Yuichiro Soma
- Department of Rehabilitation Medicine, University of Tsukuba, Tsukuba 305-8576, Ibaraki, Japan
| | - Shigeki Kubota
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8576, Ibaraki, Japan
- Correspondence: ; Tel.: +81-29-853-3219
| | - Hideki Kadone
- Center for Innovating Medicine and Engineering (CIME), University of Tsukuba, Tsukuba 305-8576, Ibaraki, Japan
| | - Yukiyo Shimizu
- Department of Rehabilitation Medicine, University of Tsukuba, Tsukuba 305-8576, Ibaraki, Japan
| | - Yasushi Hada
- Department of Rehabilitation Medicine, University of Tsukuba, Tsukuba 305-8576, Ibaraki, Japan
| | - Masao Koda
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8576, Ibaraki, Japan
| | - Yoshiyuki Sankai
- Faculty of Systems and Information Engineering, University of Tsukuba, Tsukuba 305-0006, Ibaraki, Japan
| | - Masashi Yamazaki
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8576, Ibaraki, Japan
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Lafitte MN, Kadone H, Kubota S, Shimizu Y, Tan CK, Koda M, Hada Y, Sankai Y, Suzuki K, Yamazaki M. Alteration of muscle activity during voluntary rehabilitation training with single-joint Hybrid Assistive Limb (HAL) in patients with shoulder elevation dysfunction from cervical origin. Front Neurosci 2022; 16:817659. [PMID: 36440285 PMCID: PMC9682184 DOI: 10.3389/fnins.2022.817659] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 10/17/2022] [Indexed: 08/27/2023] Open
Abstract
Shoulder elevation, defined here as arm raising, being essential for activities of daily living, dysfunctions represent a substantial burden in patients' lives. Owing to the complexity of the shoulder joint, the tightly coordinated muscular activity is a fundamental component, and neuromuscular impairments have devastating effects. A single-joint shoulder type version of the Hybrid Assistive Limb (HAL) allowing motion assistance based on the intention of the user via myoelectric activation has recently been developed, and its safety was demonstrated for shoulder rehabilitation. Yet, little is known about the physiological effects of the device. This study aims to monitor the changes in muscle activity and motion during shoulder HAL rehabilitation in several patients suffering from shoulder elevation dysfunction from cervical radicular origin. 8 patients (6 males, 2 females, mean age 62.4 ± 9.3 years old) with weakness of the deltoid muscle resulting from a damage to the C5 nerve root underwent HAL-assisted rehabilitation. We combined surface electromyography and three-dimensional motion capture to record muscular activity and kinematics. All participants showed functional recovery, with improvements in their Manual Muscle Testing (MMT) scores and range of motion (ROM). During training, HAL decreased the activity of deltoid and trapezius, significantly more for the latter, as well as the coactivation of both muscles. We also report a reduction of the characteristic shrugging compensatory motion which is an obstacle to functional recovery. This reduction was notably demonstrated by a stronger reliance on the deltoid rather than the trapezius, indicating a muscle coordination tending toward a pattern similar to healthy individuals. Altogether, the results of the evaluation of motion and muscular changes hint toward a functional recovery in acute, and chronic shoulder impairments from cervical radicular origin following shoulder HAL rehabilitation training and provide information on the physiological effect of the device.
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Affiliation(s)
- Margaux Noémie Lafitte
- School of Integrative and Global Majors, University of Tsukuba, Tsukuba, Japan
- Artificial Intelligence Laboratory, University of Tsukuba, Tsukuba, Japan
| | - Hideki Kadone
- Center for Cybernics Research, University of Tsukuba, Tsukuba, Japan
| | - Shigeki Kubota
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Yukiyo Shimizu
- Department of Rehabilitation Medicine, University of Tsukuba Hospital, Tsukuba, Japan
| | - Chun Kwang Tan
- Artificial Intelligence Laboratory, University of Tsukuba, Tsukuba, Japan
| | - Masao Koda
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Yasushi Hada
- Department of Rehabilitation Medicine, University of Tsukuba Hospital, Tsukuba, Japan
| | - Yoshiyuki Sankai
- Center for Cybernics Research, University of Tsukuba, Tsukuba, Japan
| | - Kenji Suzuki
- Artificial Intelligence Laboratory, University of Tsukuba, Tsukuba, Japan
- Center for Cybernics Research, University of Tsukuba, Tsukuba, Japan
| | - Masashi Yamazaki
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
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Wang X, Liu G, Feng Y, Li W, Niu J, Gan Z. Measurement Method of Human Lower Limb Joint Range of Motion Through Human-Machine Interaction Based on Machine Vision. Front Neurorobot 2021; 15:753924. [PMID: 34720913 PMCID: PMC8554162 DOI: 10.3389/fnbot.2021.753924] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 09/14/2021] [Indexed: 11/13/2022] Open
Abstract
To provide stroke patients with good rehabilitation training, the rehabilitation robot should ensure that each joint of the limb of the patient does not exceed its joint range of motion. Based on the machine vision combined with an RGB-Depth (RGB-D) camera, a convenient and quick human-machine interaction method to measure the lower limb joint range of motion of the stroke patient is proposed. By analyzing the principle of the RGB-D camera, the transformation relationship between the camera coordinate system and the pixel coordinate system in the image is established. Through the markers on the human body and chair on the rehabilitation robot, an RGB-D camera is used to obtain their image data with relative position. The threshold segmentation method is used to process the image. Through the analysis of the image data with the least square method and the vector product method, the range of motion of the hip joint, knee joint in the sagittal plane, and hip joint in the coronal plane could be obtained. Finally, to verify the effectiveness of the proposed method for measuring the lower limb joint range of motion of human, the mechanical leg joint range of motion from a lower limb rehabilitation robot, which will be measured by the angular transducers and the RGB-D camera, was used as the control group and experiment group for comparison. The angle difference in the sagittal plane measured by the proposed detection method and angle sensor is relatively conservative, and the maximum measurement error is not more than 2.2 degrees. The angle difference in the coronal plane between the angle at the peak obtained by the designed detection system and the angle sensor is not more than 2.65 degrees. This paper provides an important and valuable reference for the future rehabilitation robot to set each joint range of motion limited in the safe workspace of the patient.
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Affiliation(s)
- Xusheng Wang
- Academy for Engineering & Technology, Fudan University, Shanghai, China
| | - Guowei Liu
- Parallel Robot and Mechatronic System Laboratory of Hebei Province and Key Laboratory of Advanced Forging & Stamping Technology and Science of Ministry of Education, Yanshan University, Qinhuangdao, China
| | - Yongfei Feng
- Faculty of Mechanical Engineering & Mechanics, Ningbo University, Ningbo, China
| | - Wei Li
- Academy for Engineering & Technology, Fudan University, Shanghai, China
| | - Jianye Niu
- Parallel Robot and Mechatronic System Laboratory of Hebei Province and Key Laboratory of Advanced Forging & Stamping Technology and Science of Ministry of Education, Yanshan University, Qinhuangdao, China
| | - Zhongxue Gan
- Academy for Engineering & Technology, Fudan University, Shanghai, China
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