Research

11 pages, 3416 KiB

Open AccessArticle

Control Strategies for Gait Tele-Rehabilitation System Based on Parallel Robotics

by Antonio P. L. Bo, Leslie Casas, Gonzalo Cucho-Padin, Mitsuhiro Hayashibe and Dante Elias

Appl. Sci. 2021, 11(23), 11095; https://doi.org/10.3390/app112311095 - 23 Nov 2021

Cited by 6 | Viewed by 1730

Among end-effector robots for lower limb rehabilitation, systems based on Stewart–Gough platforms enable independent movement of each foot in six degrees of freedom. Nevertheless, control strategies described in recent literature have not been able to fully explore the potential of such a mechatronic [...] Read more.

Among end-effector robots for lower limb rehabilitation, systems based on Stewart–Gough platforms enable independent movement of each foot in six degrees of freedom. Nevertheless, control strategies described in recent literature have not been able to fully explore the potential of such a mechatronic system. In this work, we propose two novel approaches for controlling a gait simulator based on Stewart–Gough platforms. The first strategy provides the therapist direct control of each platform using movement data measured by wearable sensors. The following scheme is designed to improve the level of engagement of the patient by enabling a limited degree of control based on trunk inclination. Both strategies are designed to facilitate future studies in tele-rehabilitation settings. Experimental results have illustrated the feasibility of both control interfaces, either in terms of system performance or user subjective evaluation. Technical capacity to deploy in tele-rehabilitation was also verified in this work. Full article

(This article belongs to the Special Issue Tele-Rehabilitation Robotics)

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15 pages, 37481 KiB

Open AccessArticle

Tele-Rehabilitation Versus Local Rehabilitation Therapies Assisted by Robotic Devices: A Pilot Study with Patients

by José M. Catalán, José V. García-Pérez, Andrea Blanco, Santiago Ezquerro, Alicia Garrote, Teresa Costa, Arturo Bertomeu-Motos, Iñaki Díaz and Nicolás García-Aracil

Appl. Sci. 2021, 11(14), 6259; https://doi.org/10.3390/app11146259 - 06 Jul 2021

Cited by 5 | Viewed by 2127

Abstract

The present study aims to evaluate the advantages of a master-slave robotic rehabilitation therapy in which the patient is assisted in real-time by a therapist. We have also explored if this type of strategy is applicable in a tele-rehabilitation environment. A pilot study [...] Read more.

The present study aims to evaluate the advantages of a master-slave robotic rehabilitation therapy in which the patient is assisted in real-time by a therapist. We have also explored if this type of strategy is applicable in a tele-rehabilitation environment. A pilot study has been carried out involving 10 patients who have performed a point-to-point rehabilitation exercise supported by three assistance modalities: fixed assistance (without therapist interaction), local therapist assistance, and remote therapist assistance in a simulated tele-rehabiliation scenario. The rehabilitation exercise will be performed using an upper-limb rehabilitation robotic device that assists the patients through force fields. The results suggest that the assistance provided by the therapist is better adapted to patient needs than fixed assistance mode. Therefore, it maximizes the patient’s level of effort, which is an important aspect to improve the rehabilitation outcomes. We have also seen that in a tele-rehabilitation environment it is more difficult to assess when to assist the patient than locally. However, the assistance suits patients better than the fixed assistance mode. Full article

(This article belongs to the Special Issue Tele-Rehabilitation Robotics)

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21 pages, 1148 KiB

Open AccessArticle

Balance Measurement Using Microsoft Kinect v2: Towards Remote Evaluation of Patient with the Functional Reach Test

by Ines Ayed, Antoni Jaume-i-Capó, Pau Martínez-Bueso, Arnau Mir and Gabriel Moyà-Alcover

Appl. Sci. 2021, 11(13), 6073; https://doi.org/10.3390/app11136073 - 30 Jun 2021

Cited by 7 | Viewed by 1902

Abstract

To prevent falls, it is important to measure periodically the balance ability of an individual using reliable clinical tests. As Red Green Blue Depth (RGBD) devices have been increasingly used for balance rehabilitation at home, they may also be used to assess objectively [...] Read more.

To prevent falls, it is important to measure periodically the balance ability of an individual using reliable clinical tests. As Red Green Blue Depth (RGBD) devices have been increasingly used for balance rehabilitation at home, they may also be used to assess objectively the balance ability and determine the effectiveness of a therapy. For this, we developed a system based on the Microsoft Kinect v2 for measuring the Functional Reach Test (FRT); one of the most used balance clinical tools to predict falls. Two experiments were conducted to compare the FRT measures computed by our system using the Microsoft Kinect v2 with those obtained by the standard method, i.e., manually. In terms of validity, we found a very strong correlation between the two methods (r = 0.97 and r = 0.99 (p < 0.05), for experiments 1 and 2, respectively). However, we needed to correct the measurements using a linear model to fit the data obtained by the Kinect system. Consequently, a linear regression model has been applied and examining the regression assumptions showed that the model works well for the data. Applying the paired t-test to the data after correction indicated that there is no statistically significant difference between the measurements obtained by both methods. As for the reliability of the test, we obtained good to excellent within repeatability of the FRT measurements tracked by Kinect (ICC = 0.86 and ICC = 0.99, for experiments 1 and 2, respectively). These results suggested that the Microsoft Kinect v2 device is reliable and adequate to calculate the standard FRT. Full article

(This article belongs to the Special Issue Tele-Rehabilitation Robotics)

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21 pages, 4368 KiB

Open AccessArticle

Proteo: A Framework for Serious Games in Telerehabilitation

by Giuseppe Bernava, Andrea Nucita, Giancarlo Iannizzotto, Tindara Caprì and Rosa Angela Fabio

Appl. Sci. 2021, 11(13), 5935; https://doi.org/10.3390/app11135935 - 25 Jun 2021

Cited by 5 | Viewed by 1780

Abstract

Within the context of telerehabilitation, serious games have a significant role, but creating software for serious games is resource demanding. We present Proteo, a modular and open-source framework for developing serious games from scratch. We also present two serious game implementation examples with [...] Read more.

Within the context of telerehabilitation, serious games have a significant role, but creating software for serious games is resource demanding. We present Proteo, a modular and open-source framework for developing serious games from scratch. We also present two serious game implementation examples with analysis of end user and therapist/researcher satisfaction. By involving a group of 11 specialized therapists and 9 end users we analyzed the Proteo’s user satisfaction. We found that both groups scored high for the level of involvement, and the therapists scored also high for the level of suitability. More in depth, both groups showed significant differences between positive and negative feelings, with positive feelings scoring higher than negative ones. Finally, the user level of suitability was reported as high while the difficulty of the system and the difficulty of the task were reported as low. Proteo has proven to be a useful tool to develop serious games for telerehabilitation and has been well accepted by the users involved in the evaluation tests. Full article

(This article belongs to the Special Issue Tele-Rehabilitation Robotics)

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18 pages, 4318 KiB

Open AccessArticle

Advanced Statistical Analysis of 3D Kinect Data: A Comparison of the Classification Methods

by Lenka Červená, Pavel Kříž, Jan Kohout, Martin Vejvar, Ludmila Verešpejová, Karel Štícha, Jan Crha, Kateřina Trnková, Martin Chovanec and Jan Mareš

Appl. Sci. 2021, 11(10), 4572; https://doi.org/10.3390/app11104572 - 17 May 2021

Cited by 3 | Viewed by 1710

Abstract

This paper focuses on the statistical analysis of mimetic muscle rehabilitation after head and neck surgery causing facial paresis in patients after head and neck surgery. Our work deals with an evaluation problem of mimetic muscle rehabilitation that is observed by a Kinect [...] Read more.

This paper focuses on the statistical analysis of mimetic muscle rehabilitation after head and neck surgery causing facial paresis in patients after head and neck surgery. Our work deals with an evaluation problem of mimetic muscle rehabilitation that is observed by a Kinect stereo-vision camera. After a specific brain surgery, patients are often affected by face palsy, and rehabilitation to renew mimetic muscle innervation takes several months. It is important to be able to observe the rehabilitation process in an objective way. The most commonly used House–Brackmann (HB) scale is based on the clinician’s subjective opinion. This paper compares different methods of supervised learning classification that should be independent of the clinician’s opinion. We compare a parametric model (based on logistic regression), non-parametric model (based on random forests), and neural networks. The classification problem that we have studied combines a limited dataset (it contains only 122 measurements of 93 patients) of complex observations (each measurement consists of a collection of time curves) with an ordinal response variable. To balance the frequencies of the considered classes in our data set, we reclassified the samples from HB4 to HB3 and HB5 to HB6—it means that only four HB grades are used for classification algorithm. The parametric statistical model was found to be the most suitable thanks to its stability, tractability, and reasonable performance in terms of both accuracy and precision. Full article

(This article belongs to the Special Issue Tele-Rehabilitation Robotics)

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10 pages, 953 KiB

Open AccessArticle

The Efficacy of Tele-Rehabilitation Program for Improving Upper Limb Function among Adults Following Elbow Fractures: A Pilot Study

by Naomi Mayer, Sigal Portnoy, Ram Palti and Yafa Levanon

Appl. Sci. 2021, 11(4), 1708; https://doi.org/10.3390/app11041708 - 14 Feb 2021

Cited by 6 | Viewed by 2994

Abstract

Background: Active mobilization post-elbow fractures reduces the incidence of complications. Occupational therapists use tele-rehabilitation, incorporating technology into their practices. There is a lack of evidence-based trials regarding the integration of tele-rehabilitation during treatment. We therefore aimed to compare tele-rehabilitation treatment outcomes with [...] Read more.

Background: Active mobilization post-elbow fractures reduces the incidence of complications. Occupational therapists use tele-rehabilitation, incorporating technology into their practices. There is a lack of evidence-based trials regarding the integration of tele-rehabilitation during treatment. We therefore aimed to compare tele-rehabilitation treatment outcomes with conventional rehabilitation in improving the upper limb function post-elbow fractures. Methods: Eighteen participants post-elbow surgery due to fracture were divided into two groups according to age and fracture type. The groups received one month of treatment: the tele-rehabilitation group (N = 9, median age 33.0 ± 27.9 years, range 18.5–61.0) received 1–2 tele-rehabilitation treatments per week via a biofeedback system of elbow motion (the ArmTutor and 3D Tutor systems, MediTouch Ltd., Netanya, Israel) and 1–2 treatments in an outpatient clinic, and the control group (N = 9, median age 60.0 ± 37.0 years, range 20.5–73.0) received 3–4 treatments per week in the clinic. Both groups were instructed to self-practice at home. Four evaluations were performed: before and after the intervention, and 3 months and 1 year from surgery. The outcome measures included the Jebsen–Taylor hand function test; the disabilities of the arm, shoulder, and hand questionnaire; the patient-rated elbow evaluation; satisfaction; passive and active range of motion (ROM); and strength measurements. Results: Findings demonstrated a significant improvement in the ROM and in functional assessments in both groups. No statistically significant differences were found between the groups. The subjects in the tele-rehabilitation group reported a higher level of satisfaction and needed less help from a family member during practice. Conclusions: Tele-rehabilitation programs could be incorporated in the framework of treatment following elbow fractures. Tele-rehabilitation is a cost-effective treatment, suitable for patients with accessibility difficulties or who have difficulty arriving at the clinic. Full article

(This article belongs to the Special Issue Tele-Rehabilitation Robotics)

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19 pages, 14255 KiB

Open AccessArticle

A Construction Method of Lower Limb Rehabilitation Robot with Remote Control System

by Mingda Miao, Xueshan Gao and Wei Zhu

Appl. Sci. 2021, 11(2), 867; https://doi.org/10.3390/app11020867 - 19 Jan 2021

Cited by 10 | Viewed by 3773

Abstract

In response to the rehabilitation needs of stroke patients who are unable to benefit from conventional rehabilitation due to the COVID-19 epidemic, this paper designs a robot that combines on-site and telerehabilitation. The objective is to assist the patient in walking. We design [...] Read more.

In response to the rehabilitation needs of stroke patients who are unable to benefit from conventional rehabilitation due to the COVID-19 epidemic, this paper designs a robot that combines on-site and telerehabilitation. The objective is to assist the patient in walking. We design the electromechanical system with a gantry mechanism, body-weight support system, information feedback system, and man-machine interactive control system. The proposed rehabilitation robot remote system is based on the client/server (C/S) network framework to realize the remote control of the robot state logic and the transmission of patient training data. Based on the proposed system, doctors can set or adjust the training modes and control the parameters of the robot and guide remote patient rehabilitation training through video communication. The robotic system can further store and manage the rehabilitation data of the patient during training. Experiments show the human-computer interaction system of the lower limb rehabilitation robot has good performance, can accurately recognize the information of human motion posture, and achieve the goal of actively the following motion. Experiments confirm the feasibility of the proposed design, the information management of stroke patients, and the efficiency of rehabilitation training. The proposed system can reduce the workload of the doctors in practical training. Full article

(This article belongs to the Special Issue Tele-Rehabilitation Robotics)

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26 pages, 2250 KiB

Open AccessArticle

Smart Intravenous Infusion Dosing System

by Dragana Oros, Marko Penčić, Jovan Šulc, Maja Čavić, Stevan Stankovski, Gordana Ostojić and Olivera Ivanov

Appl. Sci. 2021, 11(2), 513; https://doi.org/10.3390/app11020513 - 07 Jan 2021

Cited by 21 | Viewed by 14837

Abstract

Intravenous (IV) infusion therapy allows the infusion fluid to be inserted directly into the patient’s vein. It is used to place medications directly into the bloodstream or for blood transfusions. The probability that a hospitalized patient will receive some kind of infusion therapy, [...] Read more.

Intravenous (IV) infusion therapy allows the infusion fluid to be inserted directly into the patient’s vein. It is used to place medications directly into the bloodstream or for blood transfusions. The probability that a hospitalized patient will receive some kind of infusion therapy, intravenously, is 60–80%. The paper presents a smart IV infusion dosing system for detection, signaling, and monitoring of liquid in an IV bottle at a remote location. It consists of (i) the sensing and computation layer—a system for detection and signaling of fluid levels in the IV bottle and a system for regulation and closing of infusion flow, (ii) the communication layer—a wireless exchange of information between the hardware part of the system and the client, and (iii) the user layer—monitoring and visualization of IV therapy reception at a remote location in real time. All layers are modular, allowing upgrades of the entire system. The proposed system alerts medical staff to continuous and timely changes of IV bottles, which can have positive effects on increasing the success of IV therapy, especially in oncology patients. The prescribed drip time of IV chemotherapy for the full effect of cytostatics should be imperative. Full article

(This article belongs to the Special Issue Tele-Rehabilitation Robotics)

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14 pages, 2240 KiB

Open AccessArticle

Stability Analysis and User Perception of Haptic Rendering Combining Virtual Elastic, Viscous and Inertial Effects

by Jorge Juan Gil, Axier Ugartemendia and Inaki Diaz

Appl. Sci. 2020, 10(24), 8807; https://doi.org/10.3390/app10248807 - 09 Dec 2020

Cited by 4 | Viewed by 1635

Abstract

Virtual Reality environments are being used on a mass scale in fields, such as Industry and Medicine. These virtual scenarios serve very different purposes such as prototyping, gaming and exercising. Interaction with the virtual environment is mainly achieved by senses of sight and [...] Read more.

Virtual Reality environments are being used on a mass scale in fields, such as Industry and Medicine. These virtual scenarios serve very different purposes such as prototyping, gaming and exercising. Interaction with the virtual environment is mainly achieved by senses of sight and hearing through devices, such as a mouse or VR glasses. To this end, haptic research started a few decades ago with the aim of improving this interaction through a sense of touch. A key element, hitherto not researched, is the effective combination of virtual elastic, viscous, and inertial effects in haptic feedback restored to the user and the safety implications of these feedback effects. It is of particular importance in neurological rehabilitation exercising, as interaction realism and safety are of great importance in therapy and for the patient. Therefore, this work addresses the stability analysis of the combination of three haptic effects—elastic, viscous, and inertial—and the subjective feeling on the part of users regarding different combinations of these effects. A theoretical analysis is presented with a view to establishing stable control principles, and a user-study was carried out in order to help understand the perception of users to different combinations of haptic effects. Full article

(This article belongs to the Special Issue Tele-Rehabilitation Robotics)

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