Search Results (19)

The global surge in the elderly population has increased the awareness of their needs. Supporting mobility and perception is vital to improving their quality of life. This project introduces a prototype of an active smart walker with obstacle avoidance and assistive navigation features to aid the elderly. The system can plan routes and move in familiar environments, adjusting its actions based on the user’s intentions. To accomplish this, a shared control approach employs a force–torque sensor to gauge the user’s will. The proposed system has been tested in multiple scenarios, replicating a common use in real-world environments. Full article

Background: Canines play a vital functional and aesthetic role in human dentition, yet impacted canines, particularly in the mandible, are rare and can lead to functional disorders, such as the absence of canine guidance, while negatively affecting a patient’s self-esteem. Transmigration of mandibular canines adds complexity to treatment. One method to reduce the treatment time, especially for impacted teeth, is corticotomy-assisted orthodontic therapy (CAOT). Methods: A 13-year-old patient presented with a horizontally impacted lower right canine, positioned below the roots of the lower incisors, showing transmigration. A digitally designed and 3D-printed lingual appliance was attached to the lower molars with hooks on the lingual side, enabling the application of multi-directional orthodontic forces. CAOT was performed using an Er:YAG laser (LightWalker, Fotona, Ljubljana, Slovenia) at 200 mJ, 12 Hz, 2.4 W, with a pulse duration of 100 µs, and an MSP H14 conical tip (0.6 mm spot diameter). Photobiomodulation (PBM) with a 635 nm diode laser (Lasotronix, Smart ProM, Piaseczno, Poland) was applied at 10 J per point (20 J/cm²) for 100 s per point, with a total energy of 20 J per session to reduce the risk of root resorption, manage pain, and accelerate healing as the tooth was moved into the alveolar ridge. Results: The treatment duration was two and a half years. The lingual appliance with hooks allowed precise traction of the canine, aided by exposure from the lingual side and the attachment of a hook. Gentle forces applied via orthodontic thread gradually moved the canine beneath the oral mucosa. Mid-treatment cone beam computed tomography (CBCT) scans confirmed the absence of root resorption of the lower incisors. A corticotomy, enhanced by laser therapy, was performed before moving the canine into the alveolar ridge. The canine was successfully rotated 180° and positioned without any signs of resorption in the canine or adjacent teeth. Conclusions: The use of a digitally designed and 3D-printed lingual appliance with hooks allowed the precise control of the traction of impacted teeth. When combined with corticotomy and laser therapy, it minimised root resorption risks, reduced pain, accelerated healing, and improved the overall success of the orthodontic treatment. Full article

With the progression of an aging society, the importance of walking assistance technology has been increasing. The research and development of robotic walkers for individuals requiring walking support are advancing. However, there was a problem that the conventional constant support amount did not satisfy the propulsion force required for the walking speed that users wanted. In this study, in order to solve this problem, we propose an algorithm for determining the support amount to maintain the walking speed when the average walking speed of each user is set as the target speed. A robotic walker was developed by attaching BLDC motors to an actual walker, along with a control algorithm for assistance based on sampling-type PID control. The effectiveness of the assistance determination algorithm and the usefulness of the parameters were demonstrated through experiments using weights loaded on the forearm support and target speeds. Subsequently, subject experiments were conducted to verify the ability to maintain target speeds, and a questionnaire survey confirmed that the assistance did not interfere with actual walking. The proposed algorithm for determining the assistance levels demonstrated the ability to maintain target speeds and allowed for adjustments in the necessary level of assistance. Full article

Robotic walking devices can be used for intensive exercises to enhance gait rehabilitation therapies. Mixed Reality (MR) techniques may improve engagement through immersive and interactive environments. This article introduces an MR-based multimodal human–robot interaction strategy designed to enable shared control with a Smart Walker. The MR system integrates virtual and physical sensors to (i) enhance safe navigation and (ii) facilitate intuitive mobility training in personalized virtual scenarios by using an interface with three elements: an arrow to indicate where to go, laser lines to indicate nearby obstacles, and an ellipse to show the activation zone. The multimodal interaction is context-based; the presence of nearby individuals and obstacles modulates the robot’s behavior during navigation to simplify collision avoidance while allowing for proper social navigation. An experiment was conducted to evaluate the proposed strategy and the self-explanatory nature of the interface. The volunteers were divided into four groups, with each navigating under different conditions. Three evaluation methods were employed: task performance, self-assessment, and observational measurement. Analysis revealed that participants enjoyed the MR system and understood most of the interface elements without prior explanation. Regarding the interface, volunteers who did not receive any introductory explanation about the interface elements were mostly able to guess their purpose. Volunteers that interacted with the interface in the first session provided more correct answers. In future research, virtual elements will be integrated with the physical environment to enhance user safety during navigation, and the control strategy will be improved to consider both physical and virtual obstacles. Full article

The decline in neuromusculoskeletal capabilities of older adults can affect motor control, independence, and locomotion. Because the elderly population is increasing worldwide, assisting independent mobility and improving rehabilitation therapies has become a priority. The combination of rehabilitation robotic devices and virtual reality (VR) tools can be used in gait training to improve clinical outcomes, motivation, and treatment adherence. Nevertheless, VR tools may be associated with cybersickness and changes in gait kinematics. This paper analyzes the gait parameters of fourteen elderly participants across three experimental tasks: free walking (FW), smart walker-assisted gait (AW), and smart walker-assisted gait combined with VR assistance (VRAW). The kinematic parameters of both lower limbs were captured by a 3D wearable motion capture system. This research aims at assessing the kinematic adaptations when using a smart walker and how the integration between this robotic device and the VR tool can influence such adaptations. Additionally, cybersickness symptoms were investigated using a questionnaire for virtual rehabilitation systems after the VRAW task. The experimental data indicate significant differences between FW and both AW and VRAW. Specifically, there was an overall reduction in sagittal motion of 16%, 25%, and 38% in the hip, knee, and ankle, respectively, for both AW and VRAW compared to FW. However, no significant differences between the AW and VRAW kinematic parameters and no adverse symptoms related to VR were identified. These results indicate that VR technology can be used in walker-assisted gait rehabilitation without compromising kinematic performance and presenting potential benefits related to motivation and treatment adherence. Full article

Osteoporosis constitutes a significant public health concern necessitating proactive prevention, treatment, and monitoring efforts. Timely identification holds paramount importance in averting fractures and alleviating the overall disease burden. The realm of osteoporosis diagnosis has witnessed a surge in interest in machine learning applications. This burgeoning technology excels at recognizing patterns and forecasting the onset of osteoporosis, paving the way for more efficacious preventive and therapeutic interventions. Smart walkers emerge as valuable tools in this context, serving as data acquisition platforms for datasets tailored to machine learning techniques. These datasets, trained to discern patterns indicative of osteoporosis, play a pivotal role in enhancing diagnostic accuracy. In this study, encompassing 40 participants—20 exhibiting robust health and 20 diagnosed with osteoporosis—data from force sensors embedded in the handlebars of conventional walkers were gathered. A windowing action was used to increase the size of the dataset. The data were normalized, and k-fold cross-validation was applied to assess how well our model performs on untrained data. We used multiple machine learning algorithms to create an accurate model for automatic monitoring of users’ gait, with the Random Forest classifier performing the best with 95.40% accuracy. To achieve the best classification accuracy on the validation dataset, the hyperparameters of the Random Forest classifier were further adjusted on the training data. The results suggest that machine learning-based automatic monitoring of gait parameters could lead to accurate, non-laborious, cost-effective, and efficient diagnostic tools for osteoporosis and other musculoskeletal disorders. Further research is needed to validate these findings. Full article

Fragility fractures, caused by low-energy trauma, are a significant global health concern, with 158 million people aged 50 and over at risk. Hip fractures, a common issue in elderly patients, are often linked to underlying conditions such as osteoporosis. This study proposed a cost-effective solution using a non-wheeled smart walker with load sensors to measure gait parameters, addressing the high cost of traditional gait analysis equipment, the prototype used PASCO load cells PS2200 for force measurement, eliminating the need for Arduino UNO or microcontroller-based hardware. A lightweight amplifier PS2198 amplified the signal, which was transmitted via USB to a personal computer. PASCO capstone software was used for data recording and visualization. The smart walker was tested on forty volunteers divided into two equal groups: those with osteoporosis and those without, by performing a 10 m walk test three times. ANOVA comparing spatiotemporal parameters (TSPs) of the two participant groups (α = 0.05) showed that significant differences lay in terms of time taken to complete the walk test (p < 0.01), left step length (p = 0.03), walking speed (p = 0.02), and stride length (p < 0.02). The results indicate that this smart walker is a reliable tool for assessing gait patterns in individuals with osteoporosis. The proposed system can be an alternative for time consuming and costly methods such as motion capture, and for socially stigmatizing devices such as exoskeletons. It can also be used further to identify risk factors of osteoporosis. Full article

People with diabetic foot ulcers (DFUs) are commonly prescribed offloading walkers, but inadequate adherence to prescribed use can be a barrier to ulcer healing. This study examined user perspectives of offloading walkers to provide insight on ways to help promote adherence. Participants were randomized to wear: (1) irremovable, (2) removable, or (3) smart removable walkers (smart boot) that provided feedback on adherence and daily walking. Participants completed a 15-item questionnaire based on the Technology Acceptance Model (TAM). Spearman correlations assessed associations between TAM ratings with participant characteristics. Chi-squared tests compared TAM ratings between ethnicities, as well as 12-month retrospective fall status. A total of 21 adults with DFU (age 61.5 ± 11.8 years) participated. Smart boot users reported that learning how to use the boot was easy (ρ =−0.82, p$\le$ 0.001). Regardless of group, people who identified as Hispanic or Latino, compared to those who did not, reported they liked using the smart boot (p = 0.05) and would use it in the future (p = 0.04). Non-fallers, compared to fallers, reported the design of the smart boot made them want to wear it longer (p = 0.04) and it was easy to take on and off (p = 0.04). Our findings can help inform considerations for patient education and design of offloading walkers for DFUs. Full article

The increase in the number of elderly patients with degenerative diseases has brought additional medical and financial pressures, which are adding to the burden on society. The development of sports rehabilitation robotics (SRR) is becoming increasingly sophisticated at the technical level of its application; however, few studies have analyzed how it works and how effective it is in aiding rehabilitation, and fewer individualized exercise rehabilitation programs have been developed for elderly patients. The purpose of this study was to analyze the working methods and the effects of different types of SRR and then to suggest the feasibility of applying SRR to enhance the physical abilities of elderly patients with degenerative diseases. The researcher’s team searched 633 English-language journal articles, which had been published over the past five years, and they selected 38 of them for a narrative literature review. Our summary found the following: (1) The current types of SRR are generally classified as end-effector robots, smart walkers, intelligent robotic rollators, and exoskeleton robots—exoskeleton robots were found to be the most widely used. (2) The current working methods include assistant tools as the main intermediaries—i.e., robots assist patients to participate; patients as the main intermediaries—i.e., patients dominate the assistant tools to participate; and sensors as the intermediaries—i.e., myoelectric-driven robots promote patient participation. (3) Better recovery was perceived for elderly patients when using SRR than is generally achieved through the traditional single-movement recovery methods, especially in strength, balance, endurance, and coordination. However, there was no significant improvement in their speed or agility after using SRR. Full article

Public green spaces (e.g., parks, green trails, greenways) and motivations to engage in active transport are essential for encouraging walking and cycling. However, how these key factors influence walker and cyclist behavior is potentially being increasingly influenced by the use of smart apps, as they become more ubiquitous in everyday practices. To fill this research gap, this work creates and tests a theoretically integrated study framework grounded in an extended model of goal-directed behavior, including public green space and motivation with perceived usefulness of smart apps. In order to accomplish the purpose of this study, we conducted an online survey of Korean walkers (n = 325) and cyclists (n = 326) between 10 and 25 July 2021 and applied partial least squares, structural equation, and multi-group analysis to validate the research model. Results revealed that active transport users’ awareness of public green space positively influences attitude toward (γ = 0.163), as well as behavioral intention of (γ = 0.159), walking and cycling. Additionally, motivation (extrinsic and intrinsic) greatly influences attitude (γ = 0.539) and behavioral intention (γ = 0.535). Subjective norms (γ = 0.137) and positive (γ = 0.466) and negative anticipated emotions (γ = 0.225) have a significant impact on the desire that leads to behavioral intention. High and low perceived smart app usefulness also significantly moderates between public green space and attitude (t-value = 25.705), public green space and behavioral intention (t-value = 25.726), motivation and attitude (t-value = −25.561), and motivation and behavioral intention (t-value = −15.812). Consequently, the findings are useful to academics and practitioners by providing new knowledge and insights. Full article

Smart walkers have been developed for assistance and rehabilitation of elderly people and patients with physical health conditions. A force sensor mounted under the handle is widely used in smart walkers to establish a human–machine interface. The interaction force can be used to control the walker and estimate gait parameters using methods such as the Kalman filter for real-time estimation. However, the estimation performance decreases when the peaks of the interaction force are not captured. To improve the stability and accuracy of gait parameter estimation, we propose an online estimation method to continuously estimate the gait phase and cadence. A multiple model switching mechanism is introduced to improve the estimation performance when gait is asymmetric, and an adaptive rule is proposed to improve the estimation robustness and accuracy. Simulations and experiments demonstrate the effectiveness and accuracy of the proposed gait parameter estimation method. Here, the average estimation error for the gait phase is 0.691 rad when the gait is symmetric and 0.722 rad when it is asymmetric. Full article

The constant growth of pathologies affecting human mobility has led to developing of different assistive devices to provide physical and cognitive assistance. Smart walkers are a particular type of these devices since they integrate navigation systems, path-following algorithms, and user interaction modules to ensure natural and intuitive interaction. Although these functionalities are often implemented in rehabilitation scenarios, there is a need to actively involve the healthcare professionals in the interaction loop while guaranteeing safety for them and patients. This work presents the validation of two visual feedback strategies for the teleoperation of a simulated robotic walker during an assisted navigation task. For this purpose, a group of 14 clinicians from the rehabilitation area formed the validation group. A simple path-following task was proposed, and the feedback strategies were assessed through the kinematic estimation error (KTE) and a usability survey. A KTE of 0.28 m was obtained for the feedback strategy on the joystick. Additionally, significant differences were found through a Mann–Whitney–Wilcoxon test for the perception of behavior and confidence towards the joystick according to the modes of interaction (p-values of 0.04 and 0.01, respectively). The use of visual feedback with this tool contributes to research areas such as remote management of therapies and monitoring rehabilitation of people’s mobility. Full article

In recent years, significant work has been done in technological enhancements for mobility aids (smart walkers). However, most of this work does not cover the millions of people who have both mobility and visual impairments. In this paper, we design and study four different configurations of smart walkers that are specifically targeted to the needs of this population. We investigated different sensing technologies (ultrasound-based, infrared depth cameras and RGB cameras with advanced computer vision processing), software configurations, and user interface modalities (haptic and audio signal based). Our experiments show that there are several engineering choices that can be used in the design of such assistive devices. Furthermore, we found that a holistic evaluation of the end-to-end performance of the systems is necessary, as the quality of the user interface often has a larger impact on the overall performance than increases in the sensing accuracy beyond a certain point. Full article

Smart walkers are commonly used as potential gait assistance devices, to provide physical and cognitive assistance within rehabilitation and clinical scenarios. To understand such rehabilitation processes, several biomechanical studies have been conducted to assess human gait with passive and active walkers. Several sessions were conducted with 11 healthy volunteers to assess three interaction strategies based on passive, low and high mechanical stiffness values on the AGoRA Smart Walker. The trials were carried out in a motion analysis laboratory. Kinematic data were also collected from the smart walker sensory interface. The interaction force between users and the device was recorded. The force required under passive and low stiffness modes was $56.66\%$ and $67.48\%$ smaller than the high stiffness mode, respectively. An increase of $17.03\%$ for the hip range of motion, as well as the highest trunk’s inclination, were obtained under the resistive mode, suggesting a compensating motion to exert a higher impulse force on the device. Kinematic and physical interaction data suggested that the high stiffness mode significantly affected the users’ gait pattern. Results suggested that users compensated their kinematics, tilting their trunk and lower limbs to exert higher impulse forces on the device. Full article

The Internet of Things paradigm envisions the interoperation among objects, people, and their surrounding environment. In the last decade, the spread of IoT-based solutions has been supported in various domains and scenarios by academia, industry, and standards-setting organizations. The wide variety of applications and the need for a higher level of autonomy and interaction with the environment have recently led to the rise of the Internet of Robotic Things (IoRT), where smart objects become autonomous robotic systems. As mentioned in the recent literature, many of the proposed solutions in the IoT field have to tackle similar challenges regarding the management of resources, interoperation among objects, and interaction with users and the environment. Given that, the concept of the IoT pattern has recently been introduced. In software engineering, a pattern is defined as a general solution that can be applied to a class of common problems. It is a template suggesting a solution for the same problem occurring in different contexts. Similarly, an IoT pattern provides a guide to design an IoT solution with the difference that the software is not the only element involved. Starting from this idea, we propose the novel concept of the IoRT pattern. To the authors’ knowledge, this is the first attempt at pattern authoring in the Internet of Robotic Things context. We focus on pattern identification by abstracting examples also in the Ambient Assisted Living (AAL) scenario. A case study providing an implementation of the proposed patterns in the AAL context is also presented and discussed. Full article