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Questions and Answers
CADEN-7 is designed to be portable for easy transportation.
CADEN-7 is designed to be portable for easy transportation.
False (B)
The L-EXOS system incorporates visual reality to assist patients during rehabilitation.
The L-EXOS system incorporates visual reality to assist patients during rehabilitation.
True (A)
The T-Wrex exoskeleton provides a sense of gravity during rehabilitation exercises.
The T-Wrex exoskeleton provides a sense of gravity during rehabilitation exercises.
False (B)
REHAROB is a passive rehabilitation robot designed specifically for the shoulder and elbow.
REHAROB is a passive rehabilitation robot designed specifically for the shoulder and elbow.
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The maximum torque of the L-EXOS system is 150 Nm.
The maximum torque of the L-EXOS system is 150 Nm.
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The T-Wrex has five degrees of freedom to assist upper limb rehabilitation.
The T-Wrex has five degrees of freedom to assist upper limb rehabilitation.
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CADEN-7 utilizes surface electromyography for controlling the upper limb.
CADEN-7 utilizes surface electromyography for controlling the upper limb.
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L-EXOS can generate movements without the use of sensors.
L-EXOS can generate movements without the use of sensors.
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MIME provides two treatment modes which are passive and active-receptive.
MIME provides two treatment modes which are passive and active-receptive.
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The ARM guide is considered a complex rehabilitation robot with multiple active degrees of freedom.
The ARM guide is considered a complex rehabilitation robot with multiple active degrees of freedom.
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ARMin has the capability to provide seven degrees of freedom for upper limb rehabilitation.
ARMin has the capability to provide seven degrees of freedom for upper limb rehabilitation.
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The Cable Actuated Dexterous Exoskeleton is limited to four degrees of freedom for neuro-rehabilitation.
The Cable Actuated Dexterous Exoskeleton is limited to four degrees of freedom for neuro-rehabilitation.
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In the active-resistive mode, the patient does not need to exert any effort to reach the target.
In the active-resistive mode, the patient does not need to exert any effort to reach the target.
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Bilateral rehabilitation is a feature of MIME that allows simultaneous limb training.
Bilateral rehabilitation is a feature of MIME that allows simultaneous limb training.
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An advantage of the ARM guide is its expensive nature, making it suitable for high-end rehabilitation.
An advantage of the ARM guide is its expensive nature, making it suitable for high-end rehabilitation.
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User intent interpretation is vital for robot systems to respond effectively to the user's movements.
User intent interpretation is vital for robot systems to respond effectively to the user's movements.
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REHAROB performs exercises that involve fast and unpredictable movements.
REHAROB performs exercises that involve fast and unpredictable movements.
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The BONES exoskeleton robot has the ability to perform internal and external rotations of the arm.
The BONES exoskeleton robot has the ability to perform internal and external rotations of the arm.
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The number of actuators used in the BONES is three.
The number of actuators used in the BONES is three.
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Exoskeleton robots can only be used during therapy sessions and not for daily activities.
Exoskeleton robots can only be used during therapy sessions and not for daily activities.
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The term degrees of freedom (DOF) refers to the number of independent movements a robot can perform.
The term degrees of freedom (DOF) refers to the number of independent movements a robot can perform.
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MIME is an abbreviation for 'Mirror Image Movement Enabler'.
MIME is an abbreviation for 'Mirror Image Movement Enabler'.
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Bilateral rehabilitation focuses solely on unilateral tasks to enhance therapy outcomes.
Bilateral rehabilitation focuses solely on unilateral tasks to enhance therapy outcomes.
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The evolution of upper extremity rehabilitation has moved from high impedance manipulators to low impedance dedicated robots.
The evolution of upper extremity rehabilitation has moved from high impedance manipulators to low impedance dedicated robots.
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Study Notes
Lecture 4: Exoskeletons Robots
- Course Title: Technology and Rehabilitation (ELE303)
- Lecturer: Dr. Hagar El-Hadidy
- Lecture Objectives: Students will be able to list types of rehabilitation treatments and their differences, define rehabilitation robots and their classification; draw examples of rehabilitation robots and their clinical results, and explain EMG-driven exoskeleton robots.
Development of Robotic Devices for Rehabilitation Therapy
- The development of robotic devices is a logical progression of efforts by therapists to use technology to assist in rehabilitation.
- The initial impetus for the technology was the concept of partial automation, allowing patients to practice repetitive aspects of therapy independently without constant therapist supervision.
Skepticism Regarding Robotic Devices
- Some clinicians doubted the effectiveness of robots in meeting rehabilitation goals, raising legitimate concerns.
- Concerns included the inability of robots to match the expertise and skill of therapists. Therapists' expertise comes from years of experience, expert mentorship, subtle manipulation of complex joints, perceptive assessments of patients' states, and adjusting treatment strategies based on this assessment, which are hard to replicate in robots.
- Robots are considered unsafe, and the issue is that while robots can manipulate patients' limbs, they may not possess the intelligence and awareness of contraindications to movements like human therapists. This lack of sensitivity to the potential for harm could lead to unexpected and harmful actions.
- There is also a concern that robots might replace human therapists. This concern is unfounded, as therapists handle more than just physical tasks; they are also involved in empathetic and interpersonal interactions that robots cannot replicate.
Motivation for Continuing Development
- Researchers are motivated by the potential of robotic tools to improve understanding of motor control and neuroplasticity after neurological injury.
- An increasing need for stroke rehabilitation due to aging populations and increased stroke survival rates drives the development.
- Cost-saving measures in healthcare have led to reductions in repetitive therapies. Research shows that repetitive therapy can improve recovery.
- Robotic therapy is viewed as a cost-effective approach to provide more repetitive therapy to stroke survivors with potential business opportunities.
Logical Target: Active Assist Exercise
- Active assist exercise is a common element in many therapy schools and is easily observed in rehabilitation clinics.
- The concept is that patients attempt to move, while therapists provide assistance for desired movements.
- Research teams focused on active assist exercise for their robotic therapy targets.
Benefits of Robot-Assisted Therapy
- Flexibility Enhancement: Active assist stretches soft tissues and muscles, potentially preventing contractures and spasticity.
- Plasticity Enhancement: Active assist provides somatosensory stimulation, potentially driving cortical plasticity—a neurological change making new pathways of movement possible.
- Motivation Enhancement: Successful movements performed with assistance can motivate patients to participate.
Robot-Assisted Rehabilitation: Standardized Environment and Increased Intensity
- Robots provide a standardized environment, enabling increased therapy intensity and repetition of targeted movements.
- Robots enable far greater performance of repetitions in the given time span than manual therapy
- Active physical and cognitive engagement during robot-assisted therapy is essential for successful recovery.
- Adaptive assistance in robot-driven therapies can prevent slacking off in the patient.
- Adaptive task difficulty enhances motivation by presenting appropriate challenge and motivating feedback to promote recovery
Considerations About Joints
- The development of exoskeletons that assist in all upper limb movements is an ongoing challenge.
- The first robotic therapy devices were primarily focused on the elbow and basic shoulder movements.
- Researchers focused on these joints due to simplicity of movement, existing technology to control the movements.
- Also the fact that upper extremity problems are more apparent and easy to diagnose and measure.
Rehabilitation Treatment Types
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Passive Therapy: Imparts no effort from the patient. Used in early stages of post-stroke symptoms or when there's no response from the impaired limb. Involves specific movement trajectories performed by rehabilitation robots. The movement of the limb is carefully planned to avoid any harm. Used to stretch and contract impaired limbs to assess range of motion and reduce stiffness and spasms. Exoskeleton robots aid in applying repetitive motion.
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Active Therapy: Prescribed for patients able to move their impaired limb to some extent. Active therapy is classified as active-assistive or active-resistive therapy. Active-assistive therapy: Therapists/robots apply external force to help the patient complete the task. Active-resistive therapy: involves applying an opposing force to the impaired limb to increase strength.
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Bilateral Therapy: Impaired limb mimics functional limb movements. This helps with control over the affected limb.
Robot Classification by Treatment Approaches
- Continuous Passive Movement (CPM): Robots exert continuous movements on the affected limb. This is effective in reducing muscle tone and improving mobility.
Robot Classification by Active Movements
- Active movement: EMG (electromyogram) is used as control to determine time duration of targeted movements in the robotic-driven rehabilitation session.
Robot Classification by structure
- End-effectors: Simple with distal movable handle to which the patient attaches their limb for targeted movement. Easy to adjust to various sizes and shapes of movements. Disadvantages of End-effectors include non-rotation movement. It's not suitable for pronation or supination.
- Exoskeletons: Encapsulates the limb with a splint or bionic structure. Controls limb movements. More complex than end-effectors, but requires less space to operate.
Examples of Rehabilitation Robots
- MIT-MANUS: Interactive workstation where the patient visually interacts with a PC game to perform specific movements. The robot provides five degrees of freedom; two translations for the elbow and forearm, three degrees for the wrist, and several other functions. Uses low torques and impedance control for safety.
- MIME: Utilizes a wheelchair with an adjustable table to place the affected limb. Affected limb is strapped for stabilization and the Puma 560 robot provides the movement. Provides six degrees of freedom and a wide range of movement. Allows passive and active resistive movements.
- ARM Guide: Provides a single degree linear constraint instead of multiple degrees of freedom. The user performs exercises in a therapy session. Easy to use and inexpensive.
- ARMin: Features seven degrees of freedom. It's equipped with many sensors to detect issues and avoid joint movement outside human range. Has a specific algorithm to monitor and shut down for malware issues during the exercises.
- CADEN-7: Cable-actuated device with seven degrees of freedom uses surface electromyography to control movements. Includes three levels of safety (electrical, mechanical and software) and is not portable.
- L-EXOS: Provides repetitive movements and uses visual reality to guide the patient through a pre-programmed trajectory. Offers force feedback and five degrees of freedom.
- T-Wrex: Provides gravity compensation, allowing the patient to experience floating arm movements. Uses multiple sensors to measure movements.
- REHAROB: Uses pre-programmed trajectories and slow repetitive movements with a constant velocity for rehabilitation of shoulder and elbow. The system is equipped with sensors for control and monitoring forces.
- BONES: Uses biomimetic design inspired by human mechanics, providing five actuators for a wide range of upper limb exercises. Four degrees of freedom.
Summary table of types of rehabilitation robots (page 47)
- Table summarizes the different types of robots, functionality, number of degrees of freedom, therapy classification and safety precautions
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Description
Explore the world of exoskeleton robots in rehabilitation during this insightful lecture. Understand the types of rehabilitation treatments, classifications of rehabilitation robots, and the effectiveness of EMG-driven exoskeletons. This quiz covers key concepts and developments in robotic devices for therapy.
