Journal of Rehabilitation and Assistive Technologies Engineering最新文献

Introduction: Inertial measurement units (IMUs) may be viable options to collect gait data in clinics. This study compared IMU to motion capture data in individuals who use unilateral lower-limb prostheses.

Methods: Participants walked with lower-body IMUs and reflective markers in a motion analysis space. Sagittal plane hip, knee, and ankle waveforms were extracted for the entire gait cycle. Discrete points of peak flexion, peak extension, and range of motion were extracted from the waveforms. Stance times were also extracted to assess the IMU software's accuracy at detecting gait events. IMU and motion capture-derived data were compared using absolute differences and root mean square error (RMSE).

Results: Five individuals (n = 3 transtibial; n = 2 transfemoral) participated. IMU prosthetic limb data was similar to motion capture (RMSE: waveform ≤4.65°; discrete point ≤9.04°; stance ≤0.03s). However, one transfemoral participant had larger differences at the microprocessor knee joint (RMSE: waveform ≤15.64°; discrete ≤29.21°) from IMU magnetometer interference. Intact limbs tended to have minimal differences between IMU and motion capture data (RMSE: waveform ≤6.33°; discrete ≤9.87°; stance ≤0.04s).

Conclusion: Findings from this pilot study suggest IMUs have the potential to collect data similar to motion capture systems in sagittal plane kinematics and stance time.

Introduction: An electrically stimulated intermittent fatigue test using mechanomyography was recently proposed as a possible tool for detecting clinically relevant changes in muscle function. This study was designed to determine whether the proposed test can detect additional fatigue when it should be present. Methods: Subjects (n = 10) underwent two trials each (occluded and normal blood flow) with a standardized fatigue protocol on the Ankle Dorsiflexors (AD) and Wrist Extensors (WE) using a clinical electrical stimulator. Results: Mean normalized twitch acceleration was strongly predictive of mean normalized torque (R ² = 0.828). The WE experienced lower twitch magnitudes throughout the tourniquet trial (10.81 ± 1.25 m/s²) compared to normal blood flow (18.05 ± 1.06 m/s²). The AD twitches were overall reduced in the tourniquet trial (3.87 ± 0.48 m/s²) compared with the control trial (8.57 ± 0.91 m/s²). Conclusion: Occluding blood flow to a muscle should cause greater muscle fatigue. The ability to detect reduced contraction magnitudes during an electrically stimulated fatigue protocol resulting from low blood flow suggests the proposed test may be capable of detecting clinically relevant muscle deficits.

Introduction: Electrical stimulation is increasingly relevant in a variety of medical treatments. In this study, the quality of referred sensations evoked using surface electrical stimulation was evaluated using the rubber hand and foot illusions.

Methods: The rubber hand and foot illusions were attempted under 4 conditions: (1) multi-location tapping; (2) one-location tapping; (3) electrical stimulation of sensation referred to the hand or foot; (4) asynchronous control. The strength of each illusion was quantified using a questionnaire and proprioceptive drift, where a stronger response suggested embodiment of the rubber limb.

Results: 45 able-bodied individuals and two individuals with amputations participated in this study. Overall, the illusion evoked by nerve stimulation was not as strong as illusions evoked by physically tapping but stronger than the control illusion.

Conclusion: This study has found that the rubber hand and foot illusion can be performed without touching the distal limb of the participant. Electrical stimulation that produced referred sensation in the distal extremity was realistic enough to partially incorporate the rubber limb into a person's body image.

Dr. Tamsyn Street is an interdisciplinary researcher working for the National Health Service (NHS) in the UK with a background in motor neurorehabilitation. In the last couple of decades there has been a rapid advancement in assistive technology solutions using electrical stimulation for neurorehabilitation. This editorial examines whether these advancements have translated into good inclusive design performance for clinician and patient end users. Suggestions for overcoming some of the existing challenges are proposed.

Introduction: Task-specific neurorehabilitation is crucial to optimize hand recovery shortly after a stroke, but intensive neurorehabilitation remains limited in resource-constrained healthcare systems. This has led to a growing interest in the use of robotic gloves as an adjunct intervention to intensify hand-specific neurorehabilitation. This study aims to develop and assess the usability of an operating interface supporting such a technology coupled with a virtual environment through a user-centered design approach.

Methods: Fourteen participants with hand hemiparesis following a stroke were invited to don the robotic glove before browsing through the operating interface and its functionalities, and perform two mobility exercises in a virtual environment. Feedback was collected for improving technology usability. Participants completed the System Usability Scale and ABILHAND questionnaires and their recommendations were gathered and prioritized in a Pugh Matrix.

Results: The System Usability Scale (SUS) score for the operating interface was excellent (M = 87.0 SD = 11.6). A total of 74 recommendations to improve the user interface, calibration process, and exercise usability were identified.

Conclusion: The application of a full cycle of user-centred design approach confirms the high level of usability of the system which is perceived by end users as acceptable and useful for intensifying neurorehabilitation.

Many rehabilitation devices are not adopted by therapists in practice. One major barrier is therapists' limited time and resources to get training. The objective of this study was to develop/evaluate an efficient training program for a novel rehabilitation device. The program was developed based on structured interviews with seven therapists for training preference and composed of asynchronous and in-person trainings following efficient teaching methods. The training program was evaluated for six occupational therapy doctoral students and six licensed therapists in neurorehabilitation practice. Training effectiveness was evaluated in a simulated treatment session in which 3 trainees shifted their roles among therapist applying the device, client, and peer assessor. In results, 11 of the 12 trainees passed the assessment of using the device in simulated treatment sessions. One trainee did not pass because s/he did not plug in the device to charge at the end. The in-person training fit within 1-h lunch break. All trainees perceived that they could effectively use the device in their practice and both asynchronous and in-person training easily fit into their schedule. This project serves as an example for development of an efficient and effective training program for a novel rehabilitation device to facilitate clinical adoption.

Objective: To examine the treatment effect of commercially available robotic-assisted devices, compared to traditional occupational- and physiotherapy on arm and hand function in persons with stroke. Methods: A systematic literature search was conducted in Medline, EMBASE, CINAHL and Cochrane Central Register of Controlled Trials up to January 2022. Randomized controlled trials (RCT's) involving persons with stroke of all ages and robot-assisted exercise as method for arm and hand function, compared to traditional therapy methods were included. Three authors performed the selection independently. The quality of evidence across studies was assessed using GRADE. Results: Eighteen RCT's were included in the study. A random effects meta-analysis showed a statistically significantly higher treatment effect in the robotic-assisted exercise group (p=<0.0001) compared to the traditional treatment group, with a total effect size of 0.44 (CI = 0.22-0.65). Heterogeneity was high, measured with I² of 65%). Subgroup analyses showed no significant effects of the type of robotic device, treatment frequency or duration of intervention. Discussion and conclusion: Even though the analysis showed significant improvement in arm and hand function in favor of the robotic-assisted exercise group, the results in this systematic review should be interpreted with caution. This is due to high heterogeneity among the studies included and the presence of possible publication bias. Results of this study highlight the need for larger and more methodological robust RCT's, with a focus on reporting training intensity during robotic exercise.

Purpose: Trunk stability, an important prerequisite for many activities of daily living, can be impaired in children with movement disorders. Current treatment options can be costly and fail to fully engage young participants. We developed an affordable, smart screen-based intervention and tested if it engages young children in physical therapy goal driven exercises.

Methods: Here we describe the ADAPT system, Aiding Distanced and Accessible Physical Therapy, which is a large touch-interactive device with customizable games. One such game, "Bubble Popper," encourages high repetitions of weight shifts, reaching, and balance training as the participant pops bubbles in sitting, kneeling, or standing positions.

Results: Sixteen participants aged 2-18 years were tested during physical therapy sessions. The number of screen touches and length of game play indicate high participant engagement. In trials lasting less than 3 min, on average, older participants (12-18 years) made 159 screen touches per trial while the younger participants (2-7 years) made 97. In a 30-min session, on average, older participants actively played the game for 12.49 min while younger participants played for 11.22 min.

Conclusion: The ADAPT system is a feasible means to engage young participants in reaching and balance training during physical therapy.

The use of robots in a telerehabilitation paradigm could facilitate the delivery of rehabilitation on demand while reducing transportation time and cost. As a result, it helps to motivate patients to exercise frequently in a more comfortable home environment. However, for such a paradigm to work, it is essential that the robustness of the system is not compromised due to network latency, jitter, and delay of the internet. This paper proposes a solution to data loss compensation to maintain the quality of the interaction between the user and the system. Data collected from a well-defined collaborative task using a virtual reality (VR) environment was used to train a robotic system to adapt to the users' behaviour. The proposed approach uses nonlinear autoregressive models with exogenous input (NARX) and long-short term memory (LSTM) neural networks to smooth out the interaction between the user and the predicted movements generated from the system. LSTM neural networks are shown to learn to act like an actual human. The results from this paper have shown that, with an appropriate training method, the artificial predictor can perform very well by allowing the predictor to complete the task within 25 s versus 23 s when executed by the human.

Background: Preferences of informal caregivers of people with neurocognitive disorders for technological solutions are important in user- centered design approaches. It is crucial to take into consideration the needs and preferences of users when developing new technology to facilitate their uptake.

Objectives: The objective of this study was to determine caregiver preferences for potential technological solutions to help address their needs and compare technology preferences of caregivers who provide care to those with and without neurocognitive disorders (NCD).

Methods: This was a quantitative descriptive study. We surveyed informal caregivers of older adults with disability in Canada. Participants were asked to answer questions about their preferences for 10 potential technological solutions that could be developed to make caregiving easier.

Results: Data from 125 respondents (72 caregivers of people with NCD and 53 caregivers of people with non-NCD-related disabilities) were analyzed. Generally, caregivers preferred web-based solutions as these were among the first five choices for both groups combined. However, there were some differences in the order of preference of potential solutions in both groups.

Conclusion: Informal caregivers of people with NCD preferred web-based solutions to help address their needs.