Due to the ever-increasing proportion of older people in the total population and the growing awareness of the importance of protecting workers against physical overload during long-time hard work, the idea of supporting exoskeletons progressed from high-tech fiction to almost commercialized products within the last six decades. Sensors, as part of the perception layer, play a crucial role in enhancing the functionality of exoskeletons by providing as accurate real-time data as possible to generate reliable input data for the control layer. The result of the processed sensor data is the information about current limb position, movement intension, and needed support. With the help of this review article, we want to clarify which criteria for sensors used in exoskeletons are important and how standard sensor types, such as kinematic and kinetic sensors, are used in lower limb exoskeletons. We also want to outline the possibilities and limitations of special medical signal sensors detecting, e.g., brain or muscle signals to improve data perception at the human-machine interface. A topic-based literature and product research was done to gain the best possible overview of the newest developments, research results, and products in the field. The paper provides an extensive overview of sensor criteria that need to be considered for the use of sensors in exoskeletons, as well as a collection of sensors and their placement used in current exoskeleton products. Additionally, the article points out several types of sensors detecting physiological or environmental signals that might be beneficial for future exoskeleton developments.
- Klíčová slova
- exoskeletons, lower limbs, powered orthosis, sensors, wearable robots,
- MeSH
- biomechanika MeSH
- dolní končetina fyziologie MeSH
- exoskeleton * MeSH
- lidé MeSH
- pohyb fyziologie MeSH
- senioři MeSH
- Check Tag
- lidé MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
AIM OF THE STUDY: To evaluate the effectiveness of virtual reality therapy (VRT) Armeo Spring® upper limb exoskeleton (Armeo), in early post-stroke rehabilitation with a focus on the elderly. CLINICAL RATIONALE FOR THE STUDY: Convalescence from a stroke is a complex process driven by a spontaneous recovery supported by multifactorial activation. Novel technology-based rehabilitation methods are being introduced to support brain plasticity. MATERIALS AND METHODS: Using a randomised controlled study design, participants within 30 days after stroke with arm paresis were, in addition to a daily rehabilitation programme, assigned to an intervention group (45 minutes Armeo IG n = 25; mean age 66.5 years) performing VRT, or to a conventional physiotherapy (45 minutes) control group (Armeo CG, n = 25, mean age 68.1 years). Montreal Cognitive Assessment (MoCA), Functional Independence Measure (FIM) and Fugl Mayer Assessment Upper Extremity Scale (FMA-UE) were performed before and after the three-week therapy with 12 therapeutic sessions. Results of participants < 65 and ≥ 65 years old were compared. RESULTS: Paretic upper arm function improved significantly in both the IG and CG groups, the improvement in FMA-UE was significantly higher in the IG compared to the CG (p = 0.02), and patients ≥ 65 years old presented an equal magnitude of improvement in paretic arm function compared to younger patients. CONCLUSIONS AND CLINICAL IMPLICATIONS: Early post-stroke rehabilitation strategies using, in addition to the daily rehabilitation programme, VRT with visual biofeedback is more effective on upper extremity motor performance than conventional physiotherapy, and the effectiveness does not diminish with patient age. This may be a promising addition to conventional physiotherapy in older stroke patients as well as in younger.
- Klíčová slova
- early neurorehabilitation, elderly, exoskeleton, stroke, upper limb, virtual reality,
- MeSH
- cévní mozková příhoda * komplikace MeSH
- exoskeleton * MeSH
- horní končetina MeSH
- lidé MeSH
- obnova funkce MeSH
- rehabilitace po cévní mozkové příhodě * MeSH
- senioři MeSH
- virtuální realita * MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
- randomizované kontrolované studie MeSH
A lower-extremity exoskeleton can facilitate the lower limbs' rehabilitation by providing additional structural support and strength. This article discusses the design and implementation of a functional prototype of lower extremity brace actuation and its wireless communication control system. The design provides supportive torque and increases the range of motion after complications reducing muscular strength. The control system prototype facilitates elevating a leg, gradually followed by standing and slow walking. The main control modalities are based on an Artificial Neural Network (ANN). The prototype's functionality was tested by time-angle graphs. The final prototype demonstrates the potential application of the ANN in the control system of exoskeletons for joint impairment therapy.
- Klíčová slova
- Keras, Lower-extremity, control system, exoskeleton, neural network, walking,
- MeSH
- chůze MeSH
- dolní končetina MeSH
- exoskeleton * MeSH
- neuronové sítě MeSH
- točivý moment MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Motor impairment and loss of ambulatory function are major consequences of a spinal cord injury (SCI). Exoskeletons are robotic devices that allow SCI patients with limited ambulatory function to walk. The mean walking speed of SCI patients using an exoskeleton is low: 0.26 m/s. Moreover, literature shows that a minimum speed of 0.59 m/s is required to replace wheelchairs in the community. OBJECTIVE: To investigate the highest ambulatory speed for SCI patients in a Lokomat. METHODS: This clinical pilot study took place in the Rehabilitation Center Kladruby, in Kladruby (Czech Republic). Six persons with motor-complete sub-acute SCI were recruited. Measurements were taken at baseline and directly after a 30 min Lokomat training. The highest achieved walking speed, vital parameters (respiratory frequency, heart rate, and blood pressure), visual analog scale for pain, and modified Ashworth scale for spasticity were recorded for each person. RESULTS: The highest reached walking speed in the Lokomat was on average 0.63 m/s (SD 0.03 m/s). No negative effects on the vital parameters, pain, or spasticity were observed. A significant decrease in pain after the Lokomat training was observed: 95% CI [0.336, 1.664] (p = 0.012). CONCLUSION: This study shows that it is possible for motor-complete SCI individuals to ambulate faster on a Lokomat (on average 0.63 m/s) than what is currently possible with over-ground exoskeletons. No negative effects were observed while ambulating on a Lokomat. Further research investigating walking speed in exoskeletons after SCI is recommended.
- Klíčová slova
- Ambulation, Exoskeleton, Lokomat, Spinal cord injury, Walking speed,
- MeSH
- dospělí MeSH
- exoskeleton MeSH
- lidé středního věku MeSH
- lidé MeSH
- pilotní projekty MeSH
- poranění míchy patologie rehabilitace terapie MeSH
- robotika přístrojové vybavení metody MeSH
- rychlost chůze * MeSH
- svalová spasticita MeSH
- terapie cvičením přístrojové vybavení metody MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- klinická studie MeSH
THE OBJECTIVE: The main objective of the research was to find out the effectivity of the combined therapy suitable for patients after ischemic stroke (promoting social adaptability). The therapy itself is then focused on robotic, psychomotor and cognitive therapy. The research indicators were divided into three categories of psychological, social and cognitive indicators. PROBAND SAMPLE: We have a 58 probands diagnosed with a stroke participated on the research (ischemic type I60-I69; ICD-10; the 10th revision of the International Statistical Classification of Diseases and Related Health Problem), out of which 49 were male patients ages between 48-55 and women between the age of 45-51. The data collection was then done during 2018. Indicators were evaluated and tested firstly after the initiation of the combined therapy, then after 10 weeks of intensive therapy, which took place 3 times a week 45 minutes for each patient participating in the research. RESULTS: The results of the research point to the fact, that combined therapy of robotic, psychomotor and cognitive can have positive effect on, and be suitable as a treatment for patients after ischemic stroke, regarding their productive age. Positive results have been therefore overt among all tested areas. CONCLUSION: The results of the research point to the fact, that combined therapy of robotic, psychomotor and cognitive can have positive effect on, and be suitable as a treatment for patients after ischemic stroke, regarding their productive age. Positive results have been therefore overt among all tested areas.
- MeSH
- afekt MeSH
- cévní mozková příhoda patofyziologie MeSH
- činnosti denního života MeSH
- exoskeleton MeSH
- fyzická vytrvalost MeSH
- ischemie mozku patofyziologie rehabilitace MeSH
- kognitivně behaviorální terapie * MeSH
- kombinovaná terapie MeSH
- lidé středního věku MeSH
- lidé MeSH
- rehabilitace po cévní mozkové příhodě metody MeSH
- sociální přizpůsobení * MeSH
- techniky fyzikální terapie * MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: The application of rehabilitation robots has grown during the last decade. While meta-analyses have shown beneficial effects of robotic interventions for some patient groups, the evidence is less in others. We established the Advanced Robotic Therapy Integrated Centers (ARTIC) network with the goal of advancing the science and clinical practice of rehabilitation robotics. The investigators hope to exploit variations in practice to learn about current clinical application and outcomes. The aim of this paper is to introduce the ARTIC network to the clinical and research community, present the initial data set and its characteristics and compare the outcome data collected so far with data from prior studies. METHODS: ARTIC is a pragmatic observational study of clinical care. The database includes patients with various neurological and gait deficits who used the driven gait orthosis Lokomat® as part of their treatment. Patient characteristics, diagnosis-specific information, and indicators of impairment severity are collected. Core clinical assessments include the 10-Meter Walk Test and the Goal Attainment Scaling. Data from each Lokomat® training session are automatically collected. RESULTS: At time of analysis, the database contained data collected from 595 patients (cerebral palsy: n = 208; stroke: n = 129; spinal cord injury: n = 93; traumatic brain injury: n = 39; and various other diagnoses: n = 126). At onset, average walking speeds were slow. The training intensity increased from the first to the final therapy session and most patients achieved their goals. CONCLUSIONS: The characteristics of the patients matched epidemiological data for the target populations. When patient characteristics differed from epidemiological data, this was mainly due to the selection criteria used to assess eligibility for Lokomat® training. While patients included in randomized controlled interventional trials have to fulfill many inclusion and exclusion criteria, the only selection criteria applying to patients in the ARTIC database are those required for use of the Lokomat®. We suggest that the ARTIC network offers an opportunity to investigate the clinical application and effectiveness of rehabilitation technologies for various diagnoses. Due to the standardization of assessments and the use of a common technology, this network could serve as a basis for researchers interested in specific interventional studies expanding beyond the Lokomat®.
