Task-oriented repetitive movements can improve motor recovery in patients with neurological or orthopaedic lesions. The application of robotics can serve to assist, enhance, evaluate, and document neurological and orthopaedic rehabilitation. ARMin II is the second prototype of a robot for arm therapy applicable to the training of activities of daily living. ARMin II has a semi-exoskeletal structure with seven active degrees of freedom (two of them coupled), five adjustable segments to fit in with different patient sizes, and is equipped with position and force sensors. The mechanical structure, the actuators and the sensors of the robot are optimized for patient-cooperative control strategies based on impedance and admittance architectures. This paper describes the mechanical structure and kinematics of ARMin II.
In patients after stroke, ability of the upper limb is commonly assessed with standardised clinical tests that provide a complete upper limb assessment. This paper presents quantification of upper limb movement during the execution of Action research arm test (ARAT) using a wearable system of inertial measurement units (IMU) for kinematic quantification and electromyography (EMG) sensors for muscle activity analysis. The test was executed with each arm by a group of healthy subjects and a group of patients after stroke allocated into subgroups based on their clinical scores. Tasks were segmented into movement and manipulation phases. Each movement phase was quantified with a set of five parameters: movement time, movement smoothness, hand trajectory similarity, trunk stability, and muscle activity for grasping. Parameters vary between subject groups, between tasks, and between task phases. Statistically significant differences were observed between patient groups that obtained different clinical scores, between healthy subjects and patients, and between the unaffected and the affected arm unless the affected arm shows normal performance. Movement quantification enables differentiation between different subject groups within movement phases as well as for the complete task. Spearman’s rank correlation coefficient shows strong correlations between patient’s ARAT scores and movement time as well as movement smoothness. Weak to moderate correlations were observed for parameters that describe hand trajectory similarity and trunk stability. Muscle activity correlates well with grasping activity and the level of grasping force in all groups.
Existing motor pattern assessment methods, such as digital cameras and optoelectronic systems, suffer from object obstruction and require complex setups. To overcome these drawbacks, this paper presents a novel approach for biomechanical evaluation of newborn motor skills development. Multi-sensor measurement system comprising pressure mattress and IMUs fixed on trunk and arms is proposed and used as alternative to existing methods. Observed advantages seem appealing for the focused field and in general. Combined use of pressure distribution data and kinematic information is important also for posture assessment, ulcer prevention, and non-invasive sleep pattern analysis of adults.
17 July 2012 in Journal of NeuroEngineering and Rehabilitation
Background: Humans are capable of fast adaptation to new unknown dynamics that affect their movements. Such motor learning is also believed to be an important part of motor rehabilitation. Bimanual training can improve post-stroke rehabilitation outcome and is associated with interlimb coordination between both limbs. Some studies indicate partial transfer of skills among limbs of healthy individuals. Another aspect of bimanual training is the (a)symmetry of bimanual movements and how these affect motor learning and possibly post-stroke rehabilitation. Methods: A novel bimanual 2-DOF robotic system was used for both bimanual and unimanual reaching movements. 35 young healthy adults participated in the study. They were divided into 5 test groups that performed movements under different conditions (bimanual or unimanual movements and symmetric or asymmetric bimanual arm loads). The subjects performed a simple tracking exercise with the bimanual system. The exercise was developed to stimulate motor learning by applying a velocity-dependent disturbance torque to the handlebar. Each subject performed 255 trials divided into three phases: baseline without disturbance torque, training phase with disturbance torque and evaluation phase with disturbance torque. Results: Performance was assessed with the maximal values of rotation errors of the handlebar. After exposure to disturbance torque, the errors decreased for both unimanual and bimanual training. Errors in unimanual evaluation following the bimanual training phase were not significantly different from errors in unimanual evaluation following unimanual training. There was no difference in performance following symmetric or asymmetric training. Changing the arm force symmetry during bimanual movements from asymmetric to symmetric had little influence on performance. Conclusions: Subjects could adapt to an unknown disturbance torque that was changing the dynamics of the movements. The learning effect was present during both unimanual and bimanual training. Transfer of learned skills from bimanual training to unimanual movements was also observed, as bimanual training also improved single limb performance with the dominant arm. Changes of force symmetry did not have an effect on motor learning. As motor learning is believed to be an important mechanism of rehabilitation, our findings could be tested for future post-stroke rehabilitation systems.
1 January 2010 in Journal of NeuroEngineering and Rehabilitation
Robotic systems are becoming increasingly common in upper extremity stroke rehabilitation. Recent studies have already shown that the use of rehabilitation robots can improve recovery. This paper evaluates the effect of different modes of robot-assistances in a complex virtual environment on the subjects' ability to complete the task as well as on various haptic parameters arising from the human-robot interaction.