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Pneumatic robotic systems for upper limb rehabilitation

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Abstract

The aim of rehabilitation robotic area is to research on the application of robotic devices to therapeutic procedures. The goal is to achieve the best possible motor, cognitive and functional recovery for people with impairments following various diseases. Pneumatic actuators are attractive for robotic rehabilitation applications because they are lightweight, powerful, and compliant, but their control has historically been difficult, limiting their use. This article first reviews the current state-of-art in rehabilitation robotic devices with pneumatic actuation systems reporting main features and control issues of each therapeutic device. Then, a new pneumatic rehabilitation robot for proprioceptive neuromuscular facilitation therapies and for relearning daily living skills: like taking a glass, drinking, and placing object on shelves is described as a case study and compared with the current pneumatic rehabilitation devices.

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References

  1. Aisen ML, Krebs HI, Hogan N, McDowell F, Volpe BT (1997) The effect of robot-assisted therapy and rehabilitative training on motor recovery following stroke. Arch Neurol 54:443–446

    PubMed  CAS  Google Scholar 

  2. Balasubramanian S, Ruihua W, Perez M, Shepard B, Koeneman E, Koeneman J, Jiping H (2008) Rupert: an exoskeleton robot for assisting rehabilitation of arm functions. In: Virtual rehabilitation, pp 163–167

  3. Bobath B (1990) Adult hemiplegia. Evaluation and treatment. Heinemann Medical, Oxford

  4. Bobrow J, McDonell BW (1998) Modeling, identification, and control of a pneumatically actuated, force controllable robot. IEEE Trans Robot Autom 14(5):732–742

    Google Scholar 

  5. Buetefisch C, Hummelsheim H, Denzel P, Mauritz KH (1995) Repetitive training of isolated movement improves the outcome of motor rehabilitation of the centrally paretic hand. J Neurol Sci 130:59–68

    Article  Google Scholar 

  6. Calautti C, Baron JC (2003) Functional neuroimaging studies of motor recovery after stroke in adults: a review. Stroke 34:1553–1566

    Article  PubMed  Google Scholar 

  7. Caldwell D, Tsagarakis N, Kousidou S, Costa N, Sarakoglou Y (2007) Soft exoskeletons for upper and lower body rehabilitation—design, control and testing. J Hum Robot 4(3):549–577

    Article  Google Scholar 

  8. Carr J, Shepherd R (1989) A motor learning model for stroke rehabilitation. Physiotherapy 75(7):372–380

    Article  Google Scholar 

  9. Culmer P, Jackson A, Makower S, Richardson R, Cozens J, Levesley M, Bhakta B (2010) A control strategy for upper limb robotic rehabilitation with a dual robot system. IEEE/ASME Trans Mechatron 15(4):575–585

    Article  Google Scholar 

  10. Dam M, Tonin P, Casson S, Ermani M, Pizzolato G, Iaia V, Battistin L (1993) The effects of long-term rehabilitation therapy on poststroke hemiplegic patients. Stroke 24:1186–1191

    Article  PubMed  CAS  Google Scholar 

  11. Dean CM, Shepherd RB (1997) Task-related training improves performance of seated reaching tasks after stroke: a randomized controlled trial. Stroke 28(4):722–728

    Article  PubMed  CAS  Google Scholar 

  12. Dickstein R, Hocherman S, Pillar T, Shaham R (1986) Stroke rehabilitation: three exercise therapy approaches. Phys Ther 66(8):1233–1238

    PubMed  CAS  Google Scholar 

  13. Fasoli SD, Krebs HI, Stein J, Frontera WR, Hogan N (2003) Effects of robotic therapy on motor impairment and recovery in chronic stroke. Arch Phys Med Rehabil 84:477–482

    Article  PubMed  Google Scholar 

  14. Feys H, Weerdt W, Selz B, Steck A, Spichiger R, Vereeck L, Putman K, Hoydonc G (1998) Effect of a therapeutic intervention for the hemiplegic upper limb in the acute phase after stroke: a single-blind, randomized, controlled multicenter trial. Stroke 29:785–792

    Article  PubMed  CAS  Google Scholar 

  15. Housman S, Le V, Rahman T, Sanchez R, Reinkensmeyer D (2007) Arm-training with t-wrex after chronic stroke: preliminary results of a randomized controlled trial. In: IEEE 10th international conference on rehabilitation robotics, Noordwijk, pp 562–568

  16. Jackson A, Culmer R, Makower S, Levesley M, Richardson R, Cozens J, Williams M, Bhakta B (2007) Initial patient testing of ipam—a robotic system for stroke rehabilitation. In: IEEE 10th international conference on rehabilitation robotics, ICORR 2007, Noordwijk, pp 250–256

  17. Jackson A, Holt R, Culmer R, Makower S, Levesley M, Richardson R, Cozens J, Williams M, Bhakta B (2007) Dual robot system for upper limb rehabilitation after stroke: the design process. J Mech Eng Sci C 221:845–857

    Article  Google Scholar 

  18. Jackson A, Levesley M, Culmer R (2006) Development of a mechanical arm model of the human arm for use with an exercise robotic system being developed for people with stroke. In: Proceedings of 2nd Cambridge workshop on universal access and assistive technoligies, Cambridge, pp 91–98

  19. Jones TA, Chu CJ, Grande LA, Gregory AD (1999) Motor skills training enhances lesion-induced structural plasticity in the motor cortex of adult rats. J Neurosci 19(22):10153–10163

    PubMed  CAS  Google Scholar 

  20. Kaas JH (1991) Plasticity of sensory and motor maps in adult mammals. Annu Rev Neurosci 14:137–167

    Google Scholar 

  21. Kempermann G, Praag HV, Gage F (2000) Activity-dependent regulation of neuronal plasticity and self repair. Prog Brain Res 127:35–48

    Article  PubMed  CAS  Google Scholar 

  22. Kousidou S, Tsagarakis N, Caldwell D, Smith C (2006) Assistive exoskeleton for task based physiotherapy in 3-dimensional space. In: The first IEEE/RAS-EMBS international conference on biomedical robotics and biomechatronics, BioRob 2006, Pisa, pp 266–271

  23. Kousidou S, Tsagarakis N, Smith C, Caldwell D (2007) Task orientated biofeedback system for the rehabilitation of the upper limb. In: IEEE 10th international conference on rehabilitation robotics, ICORR 2007, Noordwijk, pp 376–384

  24. Krebs HI, Hogan N, Aisen ML, Volpe BT (1998) Robot-aided neurorihabilitation. IEEE Trans Rehabil Eng 6:75–87

    Article  PubMed  CAS  Google Scholar 

  25. Lu B, Tao G, Xiang Z, Zhong W (2008) Modeling and control of the pneumatic modeling and control of the pneumatic constant pressure system for zero gravity simulation. In: IEEE ASME international conference on advanced intelligent mechatronics, AIM 2008, Xian, pp 688–693

  26. Lum PS, Burgar CG, Shor PC, Majmundar M, der Loos MV (2002) Robot-assisted movement training compared with conventional therapy techniques for the rehabilitation of upper-limb motor function after stroke. Arch Phys Med Rehabil 83:952–959

    Article  PubMed  Google Scholar 

  27. Matyas T, Mudie M (2000) Can simultaneous bilateral movement involve the undamaged hemisphere in reconstruction of neural networks damaged by stroke. J Disabil Rehabil 22(1/2):23–37

    Google Scholar 

  28. Miller EL, Murray L, Richards L, Zorowitz RD, Bakas T, Clark P, Billinger SA, American Heart Association Council on Cardiovascular Nursing, the Stroke Council (2010) Comprehensive overview of nursing and interdisciplinary rehabilitation care of the stroke patient: a scientific statement from the American Heart Association. Stroke 41(10):2402–2448

    Article  PubMed  Google Scholar 

  29. Morales R, Badesa FJ, Doménech LM, García N, Sabater JM, Menchón M, Fernández E (2010) Design and control of a rehabilitation robot driven by pneumatic swivel modules. In: IEEE (ed) 3rd IEEE RAS/EMBS internacional conference on biomedical robotics and biomechatronics, Tokyo, pp 566 –571

  30. Morales R, Badesa FJ, Doménech LM, García N, Sabater JM, Pérez C, Fernández E, Menchón M (2010) Pneumatic rehabilitation robot: modelling and control. In: Proceedings for the joint conference of ISR 2010 (41st international symposium on robotics) and ROBOTIK 2010 (6th German conference on robotics), Munich, pp 379–386

  31. Nudo RJ, Friel KM (1999) Cortical plasticity after stroke: implications for rehabilitation. Rev Neurol 155:713–717

    PubMed  CAS  Google Scholar 

  32. Rahman T, Sample W, Seliktar R (2004) Design and testing of wrex. In: Bien ZZ, Stefanov D (eds) Advances in rehabilitation robotics, vol 306. Springer, Berlin / Heidelberg, pp 243–250

  33. Rossini P, Pauri F (2000) Neuromagnetic integrated methods tracking human brain mechanism of sensorimotor areas “plastic” reorganization. Brain Res 33:131–154

    Article  CAS  Google Scholar 

  34. Sanchez R, Reinkensmeyer D, Shah J, Liu P, Rao S, Smith R, Cramer S, Rahman T, Bobrow J (2004) Monitoring functional arm movement for home-based therapy after stroke, vol 2. In: 26th annual international conference of the IEEE, engineering in medicine and biology society, IEMBS ’04, San Francisco, pp 4787–4790

  35. Sanchez R, Wolbrecht E, Smith R, Liu J, Rao S, Cramer S, Rahman T, Bobrow J, Reinkensmeyer D (2005) A pneumatic robot for re-training arm movement after stroke: rationale and mechanical design. In: Proceedings of the 9th international conference on rehabilitation robotics. Omnipress, Chicago/Madison, pp 500–504

  36. Sanville F (1971) A new method of specifying the flow capacity of pneumatic fluid power valves. Hydraul Pneum Power 17:195

    Google Scholar 

  37. Sawner K, Lavigne J (1992) Brunnstrom’s movement therapy in hemiplegia: a neurophysiological approach, 2 edn. Lippincott Williams and Wilkins, Philadelphia

  38. Staines WR, McIlroy WE, Graham SJ, Black SE (2001) Bilateral movement enhances ipsilesional cortical activity in acute stroke: a pilot functional MRI study. Neurology 51:401–404

    Google Scholar 

  39. Sugar T, He J, Koeneman E, Koeneman J, Herman R, Huang H, Schultz R, Herring D, Wanberg J, Balasubramanian S, Swenson P, Ward J (2007) Design and control of rupert: a device for robotic upper extremity repetitive therapy. IEEE Trans Neural Syst Rehabil Eng 15:336–346

    Article  PubMed  Google Scholar 

  40. Taub E, Miller NE, Novack TA, Cook EW, Fleming WC, Nepomuceno CS, Connell JS, Crago JE (1993) Technique to improve chronic motor deficit after stroke. Arch Phys Med Rehabil 74:347–354

    PubMed  CAS  Google Scholar 

  41. Taub E, Uswatte G (2006) Constraint-induced movement therapy: answers and questions after two decades of research. NeuroRehabilitation 21(2):93–95

    PubMed  Google Scholar 

  42. Tijs E, Matyas T (2007) Bilateral training does not facilitate performance of copying tasks in poststroke hemiplegia. Neurorehabil Neural Repair 20(4):473

    Google Scholar 

  43. Tsagarakis N, Kousidou S, Caldwell D (2008) Case study: soft-actuated exoskeleton for the use in physiotherapy and training. In: Pons JL (ed) Wearable robots: biomechatronic exoskeletons. Wiley, Chichester, pp 269–278

  44. van der Lee JH, Wagenaar RC, Lankhorst GJ, Vogelaar TW, Deville WL, Bouter LM (1999) Forced use of the upper extremity in chronic stroke patients: results from a single-blind randomized clinical trial. Stroke 30:2369–2375

    Article  PubMed  Google Scholar 

  45. van Peppen R, Kwakkel G, van der Wel BH, Kollen B, Hobbelen J, Buurke J, Halfens J, Wagenborg L, Vogel M, Berns M, van Klaveren R, Hendriks H, Dekker J (2004) KNGF clinical practice guideline for physical therapy in patients with stroke. review of the evidence. Nederlands Tijdschrift voor Fysiotherapie 114(5)

  46. Volpe BT, Krebs HI, Hogan N, Edelstein L, Diels C, Aisen ML (1999) Robot training enhanced motor outcome in patients with stroke maintained over three years. Neurology 53:1874–1876

    PubMed  CAS  Google Scholar 

  47. Wolbrecht E, Leavitt J, Reinkensmeyer D, Bobrow J (2006) Control of a pneumatic orthosis for upper extremity stroke rehabilitation. In: 28th annual international conference of the IEEE in engineering in medicine and biology society, EMBS ’06, New York

  48. Wolbrecht E, Reinkensmeyer D, Bobrow E (2010) Pneumatic control of robots for rehabilitation. Int J Robot Res 29:23–38

    Article  Google Scholar 

  49. Wolf S (1983) Electromyographic biofeedback applications to stroke patients: a critical review. Phys Ther 63:1448–1459

    PubMed  CAS  Google Scholar 

  50. Xiang F, Wikander J (2002) Block-oriented approximate feedback linearization for control of pneumatic actuator system. Control Eng Pract 12:387–399

    Article  Google Scholar 

  51. Zang H, Balasubramanian S, Ruihua W, Austin H, Buchanan S, Herman R, Jiping H (2010) Rupert closed loop control design. In: 2010 annual international conference of the IEEE engineering in medicine and biology society (EMBC), Buenos Aires, pp 3686–3689

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Morales, R., Badesa, F.J., García-Aracil, N. et al. Pneumatic robotic systems for upper limb rehabilitation. Med Biol Eng Comput 49, 1145–1156 (2011). https://doi.org/10.1007/s11517-011-0814-3

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