Restoring patients' independence in the Activities of Daily Living (ADLs), enhancing motor relearning, is the final goal of post-stroke neurorehabilitation. To support therapists in providing the repetitive and bilateral Impairment Oriented Training (IOT), assistive technologies have been developed. Within the upper limb rehabilitation devices there is Reha Slide ("Das Nudelholz", Hesse S and Krebs HI, 2007), a class I end-effector device, constituted by a sliding handlebar; it is non-actuated, addressed to hemiplegic patients whose healthy arm can guide the plegic one. Objective of the project is the renewal of the device to adapt it to home therapy, basing on the indications provided in a recent survey study (Ya-Xuan Hung et al, 2016), which suggests improving design, biofeedback strategies and entertaining features. Due to its efficacy in motor control recovery, the mechanical functioning has been maintained. Instead a substantial costs revision has led to develop two versions: a low-cost version completely independent on the software, and a high-level version with the incorporate software. For both versions new exercises have been developed. The two proposed versions are more compact and maneuverable than their precursor, easy to be used and set even without the supervision of a therapist. Providing real-time feedback, they make the patient aware of his own performance during the exercises and games, which are now more diversified and challanging. Further design solutions and clinical studies remain to be completed. Telerehabilitation application represents also an ambitious frontier for Reha Slide.
Il recupero dell'indipendenza nelle attività quotidiane (ADLs, Activities of Daily Living) grazie alla stimolazione del riapprendimento motorio (motor relearning) è il fine ultimo della neuroriabilitazione di pazienti post-ictus. Per supportare i terapisti nel fornire ai pazienti un allenamento ripetitivo, bilaterale e mirato al danno (IOT, Impairment Oriented Training) sono state sviluppate diverse tecnologie assistive. Tra i dispositivi di riabilitazione per l'arto superiore, si pone Reha Slide ("Das Nudelholz", Hesse S e Krebs HI, 2007), un dispositivo di classe I a effettore finale, costituito da un manubrio scorrevole; è un dispositivo passivo (senza attuatore) rivolto a pazienti emiplegici, il cui braccio sano può guidare il braccio compromesso. Obiettivo del progetto è il rinnovo del dispositivo per renderlo adatto alla terapia in contesto domestico (home therapy), sulla base delle indicazioni definite in un recente studio (Ya-Xuan Hung et al, 2016). In questo studio si suggerisce un miglioramento del desing, delle strategie di feedback, e delle funzioni. Grazie alla sua efficacia nella riabilitazione motoria, il funzionamento meccanico è rimasto inalterato. Una revisione sostanziale dei costi, invece, ha portato allo sviluppo di due versioni: una versione Low-Level, completamente indipendente dal software, e una versione High-Level con software incorporato. Per entrambe le versioni sono stati definiti nuovi esercizi. Le due versioni proposte sono più compatte e maneggevoli rispetto al loro precursore, facili da usare e impostare, persino senza la supervisione di un terapista. Fornendo un feedback in tempo reale, il paziente è reso consapevole delle proprie abilità durante gli esercizi e i giochi, ora più diversificati e stimolanti. Ulteriori revisioni del design e studi clinici rimangono da completare. Inoltre, l'applicazione in ambito teleriabilitativo reppresenta una frontiera ambiziosa per Reha Slide.
Design optimization of a bilateral upper limb device for home rehabilitation
LUALDI, VALENTINA
2017/2018
Abstract
Restoring patients' independence in the Activities of Daily Living (ADLs), enhancing motor relearning, is the final goal of post-stroke neurorehabilitation. To support therapists in providing the repetitive and bilateral Impairment Oriented Training (IOT), assistive technologies have been developed. Within the upper limb rehabilitation devices there is Reha Slide ("Das Nudelholz", Hesse S and Krebs HI, 2007), a class I end-effector device, constituted by a sliding handlebar; it is non-actuated, addressed to hemiplegic patients whose healthy arm can guide the plegic one. Objective of the project is the renewal of the device to adapt it to home therapy, basing on the indications provided in a recent survey study (Ya-Xuan Hung et al, 2016), which suggests improving design, biofeedback strategies and entertaining features. Due to its efficacy in motor control recovery, the mechanical functioning has been maintained. Instead a substantial costs revision has led to develop two versions: a low-cost version completely independent on the software, and a high-level version with the incorporate software. For both versions new exercises have been developed. The two proposed versions are more compact and maneuverable than their precursor, easy to be used and set even without the supervision of a therapist. Providing real-time feedback, they make the patient aware of his own performance during the exercises and games, which are now more diversified and challanging. Further design solutions and clinical studies remain to be completed. Telerehabilitation application represents also an ambitious frontier for Reha Slide.| File | Dimensione | Formato | |
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https://hdl.handle.net/10589/141682