RESUMEN
In this paper we present a review of the most current avenues of research into Kinect-based elderly care and stroke rehabilitation systems to provide an overview of the state of the art, limitations, and issues of concern as well as suggestions for future work in this direction. The central purpose of this review was to collect all relevant study information into one place in order to support and guide current research as well as inform researchers planning to embark on similar studies or applications. The paper is structured into three main sections, each one presenting a review of the literature for a specific topic. Elderly Care section is comprised of two subsections: Fall detection and Fall risk reduction. Stroke Rehabilitation section contains studies grouped under Evaluation of Kinect's spatial accuracy, and Kinect-based rehabilitation methods. The third section, Serious and exercise games, contains studies that are indirectly related to the first two sections and present a complete system for elderly care or stroke rehabilitation in a Kinect-based game format. Each of the three main sections conclude with a discussion of limitations of Kinect in its respective applications. The paper concludes with overall remarks regarding use of Kinect in elderly care and stroke rehabilitation applications and suggestions for future work. A concise summary with significant findings and subject demographics (when applicable) of each study included in the review is also provided in table format.
Asunto(s)
Terapia por Ejercicio/métodos , Rehabilitación de Accidente Cerebrovascular , Anciano , HumanosRESUMEN
In this paper, we present design, implementation and specifications of the Wrist Gimbal, a three degree-of-freedom (DOF) exoskeleton developed for forearm and wrist rehabilitation. Wrist Gimbal has three active DOF, corresponding to pronation/supination, flexion/extension and adduction/abduction joints. We mainly focused on a robust, safe and practical device design to facilitate clinical implementation, testing and acceptance. Robustness and mechanical rigidity was achieved by implementing two bearing supports for each of the pronation/supination and adduction/abduction axes. Rubber hard stops for each axis, an emergency stop button and software measures ensured safe operation. An arm rest with padding and straps, a handle with adjustable distal distance and height and a large inner volume contribute to ease of use, of patient attachment and to comfort. We present the specifications of Wrist Gimbal in comparison with similar devices in the literature and example data collected from a healthy subject.
Asunto(s)
Antebrazo/fisiología , Rehabilitación/instrumentación , Robótica/instrumentación , Rehabilitación de Accidente Cerebrovascular , Muñeca/fisiología , Fenómenos Biomecánicos/fisiología , Diseño de Equipo , Humanos , Sistemas Hombre-MáquinaRESUMEN
Robotic rehabilitation has gained significant traction in recent years, due to the clinical demonstration of its efficacy in restoring function for upper extremity movements and locomotor skills, demonstrated primarily in stroke populations. In this paper, we present the design of MAHI Exo II, a robotic exoskeleton for the rehabilitation of upper extremity after stroke, spinal cord injury, or other brain injuries. The five degree-of-freedom robot enables elbow flexion-extension, forearm pronation-supination, wrist flexion-extension, and radial-ulnar deviation. The device offers several significant design improvements compared to its predecessor, MAHI Exo I. Specifically, issues with backlash and singularities in the wrist mechanism have been resolved, torque output has been increased in the forearm and elbow joints, a passive degree of freedom has been added to allow shoulder abduction thereby improving alignment especially for users who are wheelchair-bound, and the hardware now enables simplified and fast swapping of treatment side. These modifications are discussed in the paper, and results for the range of motion and maximum torque output capabilities of the new design and its predecessor are presented. The efficacy of the MAHI Exo II will soon be validated in a series of clinical evaluations with both stroke and spinal cord injury patients.
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Robótica/instrumentación , Robótica/métodos , Traumatismos de la Médula Espinal/rehabilitación , Rehabilitación de Accidente Cerebrovascular , Brazo/fisiología , Articulación del Codo/fisiología , Antebrazo/fisiología , Humanos , Muñeca/fisiologíaRESUMEN
In this paper, we present a neuromuscular elbow model with both motor unit pool recruitment and Hill-based contraction dynamics. The model builds upon various models reported in the literature and provides a way to quantify force and movement variability in both isometric and non-isometric contractions. The model's accuracy in estimating muscle force variability at low force levels (at less than 20% maximum voluntary contraction) is evaluated in isometric contraction case and compared with experimental results from the literature. This comparison suggests that the model is accurate in estimating force variability within the low force range and can be used to explore effects of muscle force variability in increased kinematic variability during slow movements.
Asunto(s)
Codo/fisiología , Modelos Neurológicos , Movimiento/fisiología , Unión Neuromuscular/fisiología , Fenómenos Biomecánicos/fisiología , Humanos , Contracción Muscular/fisiología , Músculo Esquelético/fisiologíaRESUMEN
In this paper, we analyze the correlations between four clinical measures (Fugl-Meyer upper extremity scale, Motor Activity Log, Action Research Arm Test, and Jebsen-Taylor Hand Function Test) and four robotic measures (smoothness of movement, trajectory error, average number of target hits per minute, and mean tangential speed), used to assess motor recovery. Data were gathered as part of a hybrid robotic and traditional upper extremity rehabilitation program for nine stroke patients. Smoothness of movement and trajectory error, temporally and spatially normalized measures of movement quality defined for point-to-point movements, were found to have significant moderate to strong correlations with all four of the clinical measures. The strong correlations suggest that smoothness of movement and trajectory error may be used to compare outcomes of different rehabilitation protocols and devices effectively, provide improved resolution for tracking patient progress compared to only pre- and post-treatment measurements, enable accurate adaptation of therapy based on patient progress, and deliver immediate and useful feedback to the patient and therapist.