Journal of Rehabilitation and Assistive Technologies Engineering最新文献

Introduction: We have conducted research on building a robot dialogue system to support the independent living of older adults. In order to provide appropriate support for them, it is necessary to obtain as much information, particularly related to their health condition, as possible. As the first step, we have examined a method to allow dialogue to continue for longer periods.

Methods: A scenario-based dialogue system utilizing pause detection for turn-taking was built. The practicality of adjusting the system based on the dialogue rhythm of each individual was studied. The system was evaluated through user studies with a total of 20 users, 10 of whom were older adults.

Results: The system detected pauses in the user's speech using the sound level of their voice, and predicted the duration and number of pauses based on past dialogue data. Thus, the system initiated the robot's voice-call after the user's predicted speech.

Conclusions: Multiple turns of dialogue between robot and older adults are found possible under the system, despite several overlaps of robot's and users' speech observed. The users responded to the robot, including the questions related to health conditions. The feasibility of a scenario-based dialogue system was suggested; however, improvements are required.

The aim of this study was to estimate and compare the muscular metabolic power produced in the human body using musculoskeletal inverse-dynamics during cross-country sit-skiing. Two sitting positions were adapted for athletes with reduced trunk and hip muscle control, knee low with frontal trunk support (KL-fix), and knee high (KH). Five female national class able-bodied cross-country skiers performed submaximal and maximal exercise in both sitting positions, while recording 3-D kinematics, pole forces, electromyography and respiratory variables. Simulations were performed from these experimental results and muscular metabolic power was computed. The main part of the muscle metabolic power was produced in the upper limbs for both sitting positions, but KH produced more muscle metabolic power in lower limbs and trunk during maximal intensity. KH was also more efficient, utilizing less muscular metabolic power during submaximal intensities, relatively less power in the upper limbs and more power in the trunk, hip and lower limb muscles. This implies that sitting position KH is preferable for high power output when using able-bodied simulation models. This study showed the potential of using musculoskeletal simulations to improve the understanding of how different equipment design and muscles contribute to performance.

Introduction: Robotic exoskeletons are emerging as rehabilitation and assistive technologies that simultaneously restore function and enable independence for people with disabilities.

Aim: We investigated the feasibility and orthotic and restorative effects of an exoskeleton-supported goal-directed rehabilitation program for people with hand impairments after stroke or Spinal Cord Injury (SCI).

Method: A single-arm case-series feasibility study was conducted using a wearable untethered hand exoskeleton during goal-directed therapy programs with in-clinic and at-home components. Therapists trained stroke and SCI patients to use a hand exoskeleton during rehabilitation exercises, activities of daily living and patient-selected goals. Each patient received a 1-hour in-clinic training session on five consecutive days, then took the exoskeleton home for two consecutive days to perform therapist-recommended tasks. Goal Attainment Scaling (GAS) and the Box and Block Test (BBT) were administered at baseline, after in-clinic therapy and after home use, with and again without wearing the exoskeleton. The System Usability Scale (SUS), Motor Activity Log, and Fugl-Meyer Assessment were also administered to assess the intervention's acceptability, adherence, usability and effectiveness.

Results: Four stroke patients (Chedoke McMaster Stage of Hand 2-4) and one SCI patient (ASIA C8 Motor Stage 1) 23 ± 19 months post-injury wore the hand exoskeleton to perform 280 ± 23 exercise repetitions in the clinic and additional goal-oriented tasks at home. The patients performed their own goals and the dexterity task with higher performance following the 7-days therapy program in comparison to baseline for both exoskeleton-assisted (ΔGAS: 18 ± 10, ΔBBT: 1 ± 5) and unassisted (ΔGAS: 14 ± 14, ΔBBT: 3 ± 4) assessments. Therapists and patients provided 'good' SUS ratings of 78 ± 6 and no harmful events were reported.

Conclusions: The exoskeleton-supported stroke and SCI therapy program with in-clinic and at-home training components was feasible.

Introduction: Individuals with acquired brain injury may find it difficult to self-manage and live independently. Brain-in-Hand is a smartphone app designed to support psychological problems and encourage behaviour change, comprised of a structured diary, reminders, agreed solutions, and traffic light monitoring system.

Aim: To evaluate the potential use and effectiveness of Brain-in-Hand for self-management in adults with acquired brain injury.

Methods: A-B mixed-methods case-study design. Individuals with acquired brain injury (n = 10) received Brain-in-Hand for up to 12 months. Measures of mood, independence, quality of life, cognition, fatigue, goal attainment, participation administered at baseline, 6 and 12 months. Semi-structured interviews conducted with acquired brain injury participants (n = 9) and healthcare workers (n = 3) at 6 months.

Results: Significant increase in goal attainment after 6 months use (t(7) = 4.20, p = .004). No significant improvement in other outcomes. Qualitative data suggested improvement in anxiety management. Contextual (personal/environmental) factors were key in influencing the use and effectiveness of Brain-in-Hand. Having sufficient insight, appropriate support and motivation facilitated use.

Conclusions: Brain-in-Hand shows potential to support acquired brain injury, but further work is required to determine its effectiveness. Context played a pivotal role in the effectiveness and sustained use of Brain-in-Hand, and needs to be explored to support implementation.

Introduction: Prosthetic feet have limited adaptability in the frontal plane. Research shows walking on uneven terrain is difficult for many prosthesis users. A new prosthetic foot, the META Arc, was designed with a polycentric ankle joint that allows relatively free movement in the frontal plane to address this limitation. Previous simulations of the polycentric ankle mechanism found potential benefits such as reduced lateral movement of a proximal mass during forward progress and reduced forces being transferred upward from the ground through the foot.

Methods: Standard mechanical testing protocols were used to evaluate the Meta Arc prosthetic foot's performance and six comparable feet commercially available.

Results: The results found the META Arc prosthetic foot had increased frontal plane adaptability as well as reduced lateral forces, and reduced inversion eversion moment compared to the six comparison feet on 10-degree cross-slope test conditions. All included prosthetic feet had similar results for the percent of energy return and dynamic force in the sagittal plane.

Conclusions: These results suggest the inclusion of the polycentric ankle within the META Arc foot will provide more stability without sacrificing forward walking performance.

Introduction: Interactive game systems can motivate stroke survivors to engage with their rehabilitation exercises. However, it is crucial that systems are in place to detect if exercises are performed correctly as stroke survivors often perform compensatory movements which can be detrimental to recovery. Very few game systems integrate motion tracking algorithms to monitor performance and detect such movements. This paper describes the development of algorithms which monitor for compensatory movements during upper limb reaching movements in real-time and provides quantitative metrics for health professionals to monitor performance and progress over time. Methods: A real-time algorithm was developed to analyse reaching motions in real-time through a low-cost depth camera. The algorithm segments cyclical reaching motions into component parts, including compensatory movement, and provides a graphical representation of task performance. Healthy participants (n = 10) performed reaching motions facing the camera. The real-time accuracy of the algorithm was assessed by comparing offline analysis to real-time collection of data. Results: The algorithm's ability to segment cyclical reaching motions and detect the component parts in real-time was assessed. Results show that movement types can be detected in real time with accuracy, showing a maximum error of 1.71%. Conclusions: Using the methods outlined, the real-time detection and quantification of compensatory movements is feasible for integration within home-based, repetitive task practice game systems for people with stroke.

Background: It remains unknown whether access to elite blind sports opportunities is globally balanced or matches the prevalence of blindness/visual impairment (VI). The primary objective of this study was to determine the rate of elite blind sports participation in each world region registered in the International Blind Sports Federation's (IBSA) and to assess its association with the global and regional prevalence of blindness/VI. The secondary objective was to determine the association between other covariates, such as age, vision class, and sex, with the number of IBSA-registered athletes from each region. Methods: A baseline estimate of blindness/VI data was established and used when comparing participation rates to blindness/VI rates. Descriptive statistics were used to describe sports participation and associated co-variates. Results: Among 123 member countries registered in IBSA, 31 did not have any completed registrations in blind sports, of which 22 had a prevalence of blindness/VI higher than the global average. During the summer season 2019, 738 (29.52%) IBSA athletes were female and 1762 (70.48%) were male. Conclusions: These results suggest elite blind/VI sport participation is limited independently from blindness/VI prevalence. Increasing blind-friendly sport resources, especially in low-and-middle-income countries (LMICs), would improve the rate of elite sport participation among athletes with blindness/VI.

I provide a brief personal introduction including my professional background, interests, and qualifications. I invite authors with a wide diversity of interests to submitted manuscripts to the journal. My overarching goals is to improve the journal's impact through (1) strategic partnerships with professional organizations and research consortia, (2) publication of targeted Special Collections focused on topics of interest to the field and (3) improved efficiency in manuscript submission and review.

Introduction: The clinical benefits associated with the microprocessor regulation of prosthetic ankle position and resistance have largely been reported through manufacturer conducted research in controlled laboratory environments. Measures with greater ecological validity are needed. This study aimed to understand if there are differences in physical function and mobility outcomes as patients transitioned from a non-Microprocessor to Microprocessor Feet. Method: A retrospective analysis of patient outcomes was performed. Patient-reported benefits associated with the adoption of such prosthetic foot-ankle mechanisms were collected from 23 individuals through the longitudinal use of a custom short form of the Patient-Reported Outcomes Measurement Information System-Physical Function and individual items from the Prosthesis Evaluation Questionnaire. Results: The impact of Microprocessor Feet upon physical function and mobility were observed in a significant increase in physical function (mean increase in t-score of 5.4 ± 1.25; p = .0004) and significant improvements in several mobility items. Conclusions: Collectively, these measures support the beneficial impact of Microprocessor Feet on improving socket comfort, reducing back pain, improving sit to stand transfers and enhancing hill ascent and descent as well as stair negotiation.

This article describes the design and development of an upper-limb prosthesis for a current elite level paracyclist that was conceived for use in the 2020 Paralympic Games. The prosthetic limb was intended specifically for use in cycling time trial events. These are held on the road and in the velodrome whereby the athlete rides using a tucked aerodynamic position. The prosthesis was developed using computer aided design software and an extensive use of the 3D printed manufacturing process. The resulting technical note illustrates the design methodology and manufacturing considerations for a high performance form of assistive technology. However, it results in a solution that challenges the traditional aesthetic of prosthetic limbs intended for sport and physical activity.