Journal of Rehabilitation and Assistive Technologies Engineering最新文献

Introduction: This study aimed to explore the relationship between training volume during 4 weeks of robot-assisted arm training (RAAT) and changes in arm-and hand function, grip strength, gross motor skills, spasticity, and daily activities.

Methods: Twenty participants, >18 years of age, in subacute phase following stroke, with impaired arm function admitted to Sunnaas Rehabilitation Hospital, completed 4 weeks robot-assisted arm training (45 min, 3-5 times a week). Before and after this intervention, the participants' arm and hand function, grip strength, gross motor dexterity, spasticity and activities of daily living were assessed.

Results: The key findings of this study indicated no association between training volume and improvements in arm and hand function, grip strength, gross motor dexterity, spasticity, or activities of daily living. Also, no significant associations between changes in arm and hand function and age, gender, or affected side. However, subgroup analysis showed significant improvements in arm-hand function for participants with shorter time post-stroke (p = 0.01) and better initial arm and hand function (p < 0.0001).

Conclusion: These findings highlight the importance of early initiation and individualized treatment based on initial function when using robot-assisted arm training in stroke survivors.

Introduction: We report findings from two feasibility studies with persons with SCI that aimed to leverage social support to increase PA: a two-week study with nine participants and a four-week study with six participants.

Method: We recruited a total of 17 participants across two phases (10 participants in Phase 1 and seven participants in Phase 2). In dyads, participants used a smartphone-smartwatch application that we iteratively developed based on participant feedback. The application delivered just-in-time support based on measured PA and encouraged reciprocal self-disclosure to increase closeness within dyads.

Results: Participants found the delivery of messages during detected PA to be motivational. Some liked automatically sharing tracked PA with others and did not have privacy concerns about doing so, and most preferred exchanging real-time messages more than context- or activity-triggered messages. Participants also expressed that feeling connected to their partner increased motivation to engage in PA.

Conclusion: Participants expressed that they liked being able to connect with individuals with shared life experience to exchange encouraging messages. There are, however, challenges that need to be addressed before a large-scale deployment of this technology, including user concerns about automatically detected activity.

The Study was done to examine the use, non-use, the quality of clinical advice, challenges in acquiring AFOs (Ankle Foot Orthosis), and user satisfaction, using a WHO based Rapid Assistive Technology Assessment (rATA) and Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST) questionnaire. The cohort (n = 100) consisted mainly of males (71%) and residents of city (82%). It was found that 98 subjects were under advice from healthcare providers to use an AFO but only 59 subjects were using AFO at present. Common complaints were pain, fitting related and social stigma among users. The majority of the subjects (87%) paid for their AFOs. It was found that the majority of the subjects were "more or less satisfied" with the device however 59% strongly agree that they dislike the appearance of their AFO and 37% were completely dissatisfied with the accessibility of their home and surroundings while using the AFO. It is evident that we should work on improving the design and fit of the orthosis so that the acceptance and satisfaction improves. This study also explores the possibility of usage of rATA for the specific assistive Technology (like AFO in this context) assessment. It was observed that patients often have high expectations regarding a cure with the use of an AFO. Therefore, it is essential for service providers to explain that the AFO is intended to improve function rather than provider a cure. This mismatch of understanding may contribute to dissatisfaction by patients using AFOs, hence user education is essential along with technology provision.

Forward head posture (FHP), defined as the anterior positioning of the cervical spine where the head protrudes forward in relation to the body's vertical line, has become increasingly common, primarily due to sedentary lifestyles and extensive use of technology, impacting approximately 66% of the population. This condition frequently leads to secondary hyperkyphosis and various musculoskeletal problems, highlighting the urgent need for effective intervention strategies. A systematic review was performed across multiple databases, including Web of Science, PubMed, Scopus, and Google Scholar, encompassing studies published until June 2024. The review specifically targeted studies utilizing orthotic devices to address FHP. Two independent reviewers screened titles and abstracts, followed by comprehensive data extraction using a standardized form. The review included 10 studies involving a total of 450 patients with FHP. The findings demonstrated that orthotic devices significantly enhance postural parameters, notably improving spinal alignment and reducing FHP. However, the studies also underscored the necessity for better device design to improve comfort and usability for patients. Orthotic devices exhibit considerable potential in improving postural conditions associated with FHP. Future research should concentrate on optimizing device design and examining long-term effectiveness to enhance clinical application and patient outcomes.

Adaptive kayaking devices currently limit biomechanical fidelity, constraining range of motion and introducing unnatural dynamic profiles that impair user performance. This study proposes a four-bar linkage mechanism that replicates the natural semi-ellipsoidal and multi-phase forward stroke, grounded in biomechanics research and motion capture data. The stroke path was benchmarked against a standard derived from a prior kayak stroke analysis and refined using data characterizing movement across three spatial axes. A representative stroke profile was developed and implemented in a computer-aided design environment, with design optimization performed using engineering simulation tools. Two adaptive linkage models-one for high-performance use and one for recreational users-were validated by comparing their motion paths to the target profile. The high-performance model achieved a deviation of 22.0 mm; the recreational model achieved 79.7 mm. In contrast, a widely used commercial mount showed a deviation of 272.7 mm. This conceptual redesign addresses known biomechanical limitations, offering a scalable assistive solution with translational potential in rehabilitation and adaptive recreation.

Introduction: Prolonged immobilization during long-range aeromedical evacuation (LAE) is vital for stabilizing patients with spinal fractures, spinal cord injuries, and traumatic brain injuries. However, pressure injuries are a significant risk during long periods of immobilization, as continuous high pressure on soft tissues can lead to ulceration. This paper introduces a novel adaptive spine board (ASB) overlay, an air-cell-based support surface, designed to optimize interface pressure redistribution during LAE. Methods: The ASB overlay was developed, tested, and compared with currently available MedEvac Litter and warrior evacuation litter pad (WELP) in terms of immersion and interface pressure. Furthermore, a pressure-maintaining algorithm was tested to ensure that the pressure within the air cells remains constant, regardless of environmental effects due to climate and elevation changes. Results: The American National Standard for Support Surfaces immersion test showed the ASB overlay achieved 10 mm more immersion than the WELP. The interface pressures for all regions of the ASB overlay were lower than those seen in the litter and the WELP, with values remaining below 40 mmHg. Conclusions: These results demonstrated that the ASB overlay can reduce more interface pressure compared to commercial support surfaces while maintaining set air cell pressure under varying pressure and temperature conditions.

Introduction: To reduce muscle strain and enhance user comfort, a Pneumatically Actuated Soft Wearable Robotic Elbow Exoskeleton was developed. The design integrates human joint mechanics with a single-piece pneumatic structure for optimal assistance and reduced complexity.

Methods: Nineteen participants performed tasks under "Support On" and "Support Off" conditions to evaluate their effectiveness and feasibility. Muscle activity was measured using Surface Electromyography, while torque output and inflation times were assessed to gauge mechanical performance.

Results: The Soft Wearable Robotic Elbow Exoskeleton reduced muscle activity in the biceps by 22.36% and in the triceps by 18.19% at 18 PSI (Pounds per Square Inch). Torque tests revealed a maximum output of 4.39 Nm at 21 PSI. Inflation time tests showed that the exoskeleton could reach total inflation in as little as 0.22 seconds in high mode at 25 PSI, demonstrating the ability to achieve rapid actuation speed and efficiency.

Conclusions: These results indicate that the Soft Wearable Robotic Elbow Exoskeleton significantly reduces muscle activation, which may help mitigate the risk of work-related musculoskeletal disorders. By providing effective assistance during repetitive tasks, the exoskeleton enhances both mechanical performance and user comfort.

Introduction: The purpose of this study was to test the performance of an adjustable socket for transtibial prosthesis users during military relevant tasks. Methods: Investigational sockets with motor-driven adjustable panels were fabricated for each participant. Sensors to detect liner-to-socket distance were embedded in the socket wall during fabrication, and collected data were used to calculate a socket fit metric (SFM). Participants completed two military readiness assessments, the Readiness Evaluation during simulated Dismounted Operations and the Common Military Tasks, in each of three socket volume adjustment modes: static (non-adjustable), user-adjusted (using a phone app), and auto (adjusted by a controller). Socket and participant performance and self-reported outcome metrics were collected. Results: In 11 Service members or Veterans, the SFM distribution was significantly lower for the auto mode compared with the user-adjusted and static modes (P = 0.023, 0.010, respectively). The socket volume was adjusted more often (P = 0.003) and underwent a greater range of adjustment (P = 0.001) for auto versus user-adjusted. The change in pre- and post-activity socket comfort score (SCS) was not significantly different between modes. Conclusions: The results highlight the errors in socket fit in static and user-adjusted sockets and demonstrate how an automatically adjusting socket can minimize error without impeding task performance.

Introduction: The study reports the results from piloting an 8-step program for social skills training using VR technology in a municipal mental health service. Method: 14 mental health service users were recruited to test the 8-step programme. Eight mental health professionals delivered the programme and registered information about the participants and their experiences. Results: All participants lived socially isolated lives before they started, and various social and personal problems contributed to the complexity of their situation. Seven participants completed the programme, while seven did not. Two participants did not complete because they stopped isolating themselves before completing and these two, and the seven that completed the programme, experienced a positive effect on their social skills. Two of those who did not complete were able to attend group therapy sessions instead, and two were too ill to complete. The last one just stopped showing up to the appointments. Conclusion: The pilot study shows promising results and efforts should now be made to develop relevant, flexible, and high-quality VR scenarios, as this technology has the potential to help socially isolated persons become more socially active and thus increase their quality of life.

Introduction: Maintaining balance during perturbations is essential for the effectiveness of exoskeletal assistive devices in individuals with spinal cord injuries (SCI). We tested new ankle actuators in a muscles-first, motor-assisted hybrid neuroprosthesis (MAHNP) to evaluate their ability to maintain upright posture under various perturbations.

Methods: Participants with SCI (n = 2) performed standing balance tasks while wearing the MAHNP with and without ankle control, combined with electrical stimulation for one participant. A proportional, integral, derivative (PID) controller maintained 5° dorsiflexion based on input from an angle encoder. MAHNP's balance control mechanisms were evaluated by the center of pressure (CoP) excursion during unexpected perturbations for both participants, while hands-free standing, range-of-motion tasks, and functional reach tests were completed by one participant.

Results: Active control provided important functional benefits by improving forward reach by 4.3 cm compared to no control, and extending hands-free standing time by 28.3% compared to no control. Additionally, variance in mediolateral CoP excursion was reduced from approximately 57% with no control to around 50% with control.

Conclusion: These findings suggest that while PID-controlled ankle actuators perform well in quiet standing, further optimization may be required for tasks involving more dynamic movements and voluntary postural tasks.