Search Results (15)

This article presents a series of innovative systems developed through student laboratory projects, comprising two autonomous vehicles, a quadrupedal walking robot, an active ankle-foot orthosis, a ball-on-beam balancing mechanism, a ball-on-plate system, and a manipulator arm, all actuated by pneumatic artificial muscles (PAMs). Due to their flexibility, low weight, and compliance, fluidic muscles demonstrate substantial potential for integration into various mechatronic systems, robotic platforms, and manipulators. Their capacity to generate smooth and adaptive motion is particularly advantageous in applications requiring natural and human-like movements, such as rehabilitation technologies and assistive devices. Despite the inherent challenges associated with nonlinear behavior in PAM-actuated control systems, their biologically inspired design remains promising for a wide range of future applications. Potential domains include industrial automation, the automotive and aerospace sectors, as well as sports equipment, medical assistive devices, entertainment systems, and animatronics. The integration of self-constructed laboratory systems powered by PAMs into control systems education provides a comprehensive pedagogical framework that merges theoretical instruction with practical implementation. This methodology enhances the skillset of future engineers by deepening their understanding of core technical principles and equipping them to address emerging challenges in engineering practice. Full article

Monitoring orthosis compliance using patient diaries is subjective, as patients can overestimate their levels of device use. An objective way to monitor compliance is required because if an orthotic prescription is not followed, the orthosis will not work as intended. This study aimed to develop and validate a device that monitors orthosis compliance objectively using pressure and acceleration. Fifteen participants were recruited to test the device’s ability to estimate wear time during the performance of several grip patterns and whilst completing selected activities of daily living. Sensor threshold values were used to discern whether users were wearing their orthosis or not. No differences between pressure sensor and accelerometer-based wear time estimations were found. The device’s pressure-based wear time estimations were found to have a specificity of 92.7 ± 16.4% and sensitivity of 74.0 ± 41.3%, whilst accelerometer-based wear time estimates had a specificity of 66.1 ± 34.7% and sensitivity of 86.2 ± 8.0%. This study successfully demonstrated the feasibility of monitoring hand orthosis compliance using pressure or acceleration. This device has the potential to provide insight into the effectiveness of both existing and novel orthotics, benefitting both clinical practice and research. Full article

There is limited understanding of how well patients adhere to postoperative instructions following ankle surgery, particularly in outpatient settings regarding partial weight bearing (15–30 kg) and orthosis use. This study aims to assess orthosis compliance and load frequency over six weeks post-surgery using pressure-sensitive insoles, while also evaluating the effectiveness of continuous biofeedback. A total of 84 patients with isolated ankle fractures were enrolled. All participants were instructed to maintain partial weight bearing of 15–30 kg for six weeks with a lower leg orthosis equipped with insoles that continuously recorded daily step counts and maximum loads. In a prospective randomized design, the control group received no biofeedback, while the intervention group received audiovisual feedback whenever loads exceeded 20 kg. Adherence to the prescribed partial weight bearing and orthosis use was low in both groups, with only 10% of the control group wearing the orthosis by week three and overload occurring as early as week one. However, the implementation of biofeedback resulted in significant improvements in orthosis utilization (57.4% vs. 29.1%) and adherence to prescribed loading. The implementation of continuous biofeedback significantly enhanced adherence to prescribed loading and orthosis usage, highlighting its critical role in postoperative rehabilitation for ankle fractures. Full article

Orthosis-wearing compliance is crucial for achieving positive treatment outcomes in patients with adolescent idiopathic scoliosis (AIS), for whom 23 h of daily wear is typically prescribed. However, self-reported compliance is subjective and often based on patients’ memory, leading to inaccuracies. While portable electronic devices have been developed to objectively monitor compliance, relying solely on temperature or force data can be insufficient. This study introduced a novel method that integrated both force and temperature data to estimate orthosis-wearing compliance. Twelve patients (eight females and four males) diagnosed with moderate AIS were included. Each patient was prescribed a thoracic-lumbar-sacral orthosis equipped with an integrated force and temperature sensor system. After one month of orthotic treatment, self-reported wear time averaged 17.8 ± 6.2 h/day, while the sensor indicated an average wear time of 13.3 ± 5.0 h/day. Most patients overestimated their compliance. Nighttime was the most common period for orthosis wear (6.1 h/day), whereas compliance during school hours (2.8 h/day) and after-school hours (3.7 h/day) was lower. The integration of force and temperature sensors provides a more comprehensive understanding of orthosis compliance. Future studies with larger samples and longer monitoring periods are needed to investigate the correlation between compliance and treatment outcomes. Full article

Background/Objectives: Integrated design and simulation solutions enable the manufacturing of advanced personalized orthotics that improve patients gait characteristics and balance. The success of such a rehabilitation approach is highly dependent on compliance, i.e., users wearing the orthosis consistently. Specifically, for most young children, functionality is secondary to appearance and peer perception. However, the starting point of the traditional design approach is to address functionality and then try to make the appearance more palatable to the wearer. As a result, compliance is a common issue, resulting in slow and uneven rehabilitation progress. Methods: This work proposes a method that inverts this traditional approach and devises an attractive light design that can be adapted to ensure structural soundness. Results/Conclusions: The broader framework is called the user-centered design process. The main advantage is in the flexibility of the added manufacturing approach, allowing for a personalized design that is attractive to the user, promoting higher compliance. Full article

Background: Patient compliance is a major concern of hand orthosis in first carpometacarpal osteoarthritis. To address this issue, we established a method for creating a custom-made three-dimensional printed splint based on computed tomography. This prospective study evaluates the usefulness of the three-dimensional printed splint compared with the conventional splint. Methods: A total of 12 hands in nine patients were included. The mean age of the patients was 69 years (range: 58–84). Conventional orthoses were made by prosthetists using molds. Three-dimensional printed orthoses (long and short types) were digitally designed from computed tomography data and created using Fused Deposition Modeling. Subjects were instructed to use three types of orthoses for 2 weeks each. They completed questionnaires that indicated pain, function, percentage of daytime spent using the orthosis, satisfaction score, and discomfort caused by wearing orthoses. Results: The pain on motion showed an improvement of approximately 20% for all orthoses. There was no significant difference in pain scale, function, percentages of daytime spent using each orthosis, and satisfaction score among the three types of orthoses. Discomfort caused by wearing orthosis was more frequent in conventional orthosis than in 3D-printed orthosis, and there was a significant difference between the conventional type and the long-type 3D-printed orthosis. Conclusions: This study suggests that 3D-printed splints provide comparable pain relief to conventional splints with reduced discomfort. However, limitations such as small sample size, short follow-up, and reliance on CT imaging highlight the need for further research. Full article

So far, there have been no high-quality studies examining the efficacy of outpatient biofeedback devices in cases of prescribed partial weight-bearing, such as after surgery on the lower limbs. This study aimed to assess whether a biofeedback device is more effective than using a personal scale. Two groups of healthy individuals wearing an insole orthosis were trained to achieve partial loading in a three-point gait within a target zone of 15–30 kg during overground walking and going up and down stairs. The treatment group (20 women and 22 men) received continuous biofeedback, while the control group (26 women and 16 men) received no information. Findings were compared in a randomized controlled trial. Compliance with partial loading without biofeedback was poor; on level ground and stairs, only one in two steps fell within the target area, and overloading occurred on at least one in three steps. The treatment group reduced the percentage of steps taken in the overload zone to ≤8.4% (p < 0.001 across all three courses) and achieved more than two-thirds of their steps within the target zone (p < 0.001 on level ground, p = 0.008 upstairs, and p = 0.028 downstairs). In contrast, the control group did not demonstrate any significant differences in the target zone (p = 0.571 on level ground, p = 0.332 upstairs, and p = 0.392 downstairs). In terms of maintaining partial load, outpatient biofeedback systems outperform bathroom scales. Full article

Cervical orthoses, vital for neck immobilization in medical care and sports, often struggle to provide adequate support due to individual neck shape and size variations. This study addresses this issue by developing a specific computer-aided orthosis design software tailored for creating customized 3D-printed cervical orthoses. The self-developed software embedded anatomical and rehabilitation knowledge into the orthosis design process, ensuring consistency and reducing manual modification. Finite element analysis of cervical orthoses determined that a minimum thickness of 5 mm PLA (polylactic acid) material is necessary to meet safety requirements. This study highlights the automation potential of customized computer-aided orthosis design and underscores the potential to revolutionize orthopedic care. We also applied easy-to-access 3D printing technology to fabricate well-fitting and immobilized cervical orthoses. These customized cervical orthoses offer a promising future with the advantages of being cost-effective, lightweight, immobility, comfortable, easy to wear, and minimal accessories to meet clinical needs, enhancing patient comfort and compliance and providing reassurance about the economic benefits of the technology. Full article

Orthoses are commonly prescribed to relieve symptoms for musculoskeletal and neurological conditions; however, patients stop wearing orthoses as recommended for many reasons. When considering the effectiveness of orthoses, there needs to be an objective way to monitor whether participants wear the orthosis as instructed, because if this is not followed, the orthoses will not work as intended. This review aimed to identify, summarise, and compare objective methods used to measure compliance with orthoses applied to the extremities. Databases (Scopus, Web of Science, Embase, CINAHL, and MEDLINE) were searched for eligible studies. Twenty-three studies were accepted in the final review, including five studies that employed upper limb orthoses, two that employed hip orthoses, and fifteen that employed lower limb orthoses. To measure compliance objectively, studies utilised temperature sensors, pressure sensors, accelerometers, a step counter, or a combination of sensors. All sensor types have their own advantages and disadvantages and should be chosen based on study-specific parameters. Sensor-derived monitoring provides quantitative, objective data that are beneficial in both clinical and research settings. The ideal solution to monitoring compliance would consist of both objective and user-reported aspects that, in combination, would provide an all-encompassing picture of the orthotic treatment prescribed. Full article

Background: Clubfoot is a congenital deformity that can affect one or both of a newborn’s lower extremities. The main objective of the study is to evaluate and compare the outcomes of the Ponseti method for the management of different types of clubfoot. Methods: A retrospective analysis of 151 children with 253 clubfeet (idiopathic untreated, idiopathic recurrent, and syndromic) with at least one year of follow-up was conducted in four months after ethical approval. Data were collected with a structured proforma after the consent of the parents. An independent sample t-test was applied to show the comparison between the groups, and a p-value of 0.05 was considered significant. Results: Out of 151 patients, 76% were male and 24% were female. Out of a total of 235 feet, 96 (63%) were idiopathic untreated, 40 (26.5%) were idiopathic recurrent, and 15 (9.5%) were syndromic clubfoot. The average number of casts was higher in syndromic clubfoot (9 casts per foot). There was no significant difference in the baseline Pirani score of the three groups (p-value > 0.05); but after one year of follow-up, there was a significant difference in the Pirani score of idiopathic and syndromic clubfoot (p-value ≤ 0.05) and between recurrent clubfoot and syndromic clubfoot (p-value = 0.01). Conclusions: The aetiology of syndromic clubfoot affects the outcomes of the Ponseti method and leads to relapse. In idiopathic (untreated and recurrent) clubfoot, the Ponseti method does not produce a significant difference in outcome. Poor brace compliance and a lack of tenotomy lead to orthotic (ankle foot orthosis AFO and foot orthosis FO) use in the day time and the recurrence of clubfoot deformity in these three types of clubfoot. Full article

In the treatment of proximal humeral fractures (PHF), patients are often recommended to wear a sling or orthosis and to perform physiotherapy. However, some patients, especially elderly ones, struggle to comply with these rehabilitation regimens. Therefore, the aim of the study was to evaluate whether these incompliant patients have a worse functional outcome than those who adhere to the rehabilitation protocol. After receiving a diagnosis of a PHF, patients were divided into four groups according to fracture morphology: conservative with sling, operative with sling, conservative with abduction orthosis, and operative with abduction orthosis. At the 6-week follow-up, compliance regarding brace use and physiotherapy performance were assessed, as well as the constant score (CS) and complications or revision surgeries. The CS as well as the complications and revision surgeries were also surveyed after one year. In 149 participants, with a mean age of 73.9 ± 7.2 years, only 37% terminated orthosis and only 49% underwent physiotherapy as recommended. The statistical analysis showed no significant difference in the CS, complications, and revision surgeries between the groups. Full article

This study presents a prototype of Intelligent Brace—the gold medal winner in the 68th edition of the International EUREKA 2019 Competition, in Valencia, Spain. It shows how to improve the effectiveness of a static orthopedic brace, with modern technology based on advanced electronic solutions. The research uses in-house-made thin-film graphene sensors, an electronic system with a microcontroller and derotating pads, a mobile application for Android system, and a remote database. The article presents a description of the real project, the system principle of operation, and the layout of the system elements in the orthosis. A prototype device was designed and built that was tested not only in laboratory conditions, but also during trials with the first patient. Approximately two months of data were collected and interpreted. The collected research results provided basic knowledge about the range of forces exerted by the brace on the patient’s body, as well as the regularity of wearing the orthosis by the patient and compliance with the doctor’s recommendations. Full article

Osteoporotic spine fractures (OSF) are common sequelae of osteoporosis. OSF are directly correlated with increasing age and incidence of osteoporosis. OSF are treated conservatively or surgically. Associated acute pain, chronic disabilities, and progressive deformities are well documented. Conservative measures include a combination of initial bed rest, analgesia, early physiotherapy, and a spinal brace (orthosis), with the aim for early rehabilitation to prevent complications of immobile state. Spinal bracing is commonly used for symptomatic management of OSF. While traditional spinal braces aim to maintain the neutral spinal alignment and reduce the axial loading on the fractured vertebrae, they are well known for complications including discomfort with reduced compliance, atrophy of paraspinal muscles, and restriction of chest expansion leading to chest infections. Exoskeletons have been developed to passively assist and actively augment human movements with different types of actuators. Flexible, versatile spinal exoskeletons are designed to better support the spine. As new technologies enable the development of motorized wearable exoskeletons, several types have been introduced into the medical field application. We have provided a thorough review of the current spinal robotic technologies in this paper. The shortcomings in the current spinal exoskeletons were identified. Their limitations on the use for patients with OSF with potential improvement strategies were discussed. With our current knowledge of spinal orthosis for conservatively managed OSF, a semi-rigid backpack style thoracolumbar spinal robotic orthosis will reduce spinal bone stress and improve back muscle support. This will lead to back pain reduction, improved posture, and overall mobility. Early mobilization is an important part of management of patients with OSF as it reduces the chance of developing complications related to their immobile state for patients with OSF, which will be helpful for their recovery. Full article

Shape memory alloys (SMAs) have found widespread applications as biomedical devices. Biocompatibility, corrosion resistance, and ductility make these alloys attractive for medical devices such as stents and filters. For these implants, the superelastic property is the primary function of SMAs. Additionally, these alloys, such as NiTi as the prime example, can be used for actuation. Several modes of actuation such as displacement control, force control, and compliance control have been used as harnesses with SMA devices. These two unique properties have opened another application in the form of neurosurgery and robot-assisted surgery devices, as well as controlled assistive and rehabilitation devices. This paper reviews the state of the art of application of SMAs in the latter category where control is applied to harness innovative medical devices. To this end, two major subsets of these devices: prosthesis and orthosis which take the advantage of SMAs in assistive and rehabilitation devices are studied. These devices are further categorized to hand prosthetics, elbow, knee and ankle orthotics. In most of these designs, SMA wires act as artificial muscles to mimic the motion of limbs in the target joints. The evolution of each category is explained, and the specific results of them are reported. The paper also reviews the SMA applications for neurological and neuromuscular rehabilitation. To this end, different categories of rehabilitation devices as a passive and aided exercise for the ankle, knee, and elbow are highlighted. The SMA actuator in these devices can be EMG-controlled to improved patient outcome. In addition to providing a comprehensive overview of the biomedical devices, this paper identifies several possible future directions of SMA related research in the area of assistive and rehabilitation devices. Full article

Rehabilitation robots are designed to help patients improve their recovery from injury by supporting them to perform repetitive and systematic training sessions. These robots are not only able to guide the subjects’ lower-limb to a designate trajectory, but also estimate their disability and adapt the compliance accordingly. In this research, a new control strategy for a high compliant lower-limb rehabilitation orthosis system named AIRGAIT is developed. The AIRGAIT orthosis is powered by pneumatic artificial muscle actuators. The trajectory tracking controller based on a modified computed torque control which employs a fractional derivative is proposed for the tracking purpose. In addition, a new method is proposed for compliance control of the robotic orthosis which results in the successful implementation of the assist-as-needed training strategy. Finally, various subject-based experiments are carried out to verify the effectiveness of the developed control system. Full article