General rightsThis document is made available in accordance with publisher policies. Please cite only the published version using the reference above. Abstract-Robotic healthcare is a growing and multi-faceted field where robots help perform surgery, remotely provide care to patients, aid in supplying various physical therapies and further medical research. Robotic simulators of human physiology provide a powerful platform to advance the development of novel treatments, prostheses and therapies. This study focuses on the design, building, testing and characterisation of a novel simulator of the human respiratory system. The comparison between healthy subjects breathing and coughing physiological values and the values achieved utilising our novel bioinspired respiratory simulator shows that the latter is able to reproduce peak flow rates and volumes.
Pathologies affecting the respiratory system can lead to a debilitating decrease in quality of life and can be fatal. To test medical devices and implants for the human respiratory system, a simulation system that can reproduce multiple respiratory features is necessary. Currently available respiratory simulators only focus on reproducing flow rate profiles of breathing while coughing simulators focus on aerosol analysis. In this paper we propose a novel, bioinspired robotic simulator that can physically replicate both breathing and coughing flow rate characteristics of healthy adults. We conducted a study on 31 healthy adult participants to gather the flow rate measurement of normal breathing, deep breathing, breathing while running and coughing. Coughing flow rate profiles vary considerably between participants, making an accurate simulation of coughs a challenge. To enable cough flow rate simulation, a new methodology based on the identification of four cough phases, Attack, Decay, Sustain and Release (ADSR) and their parametrization was devised. This methodology leads to the unprecedented ability to reproduce diverse and complex coughing flow rate profiles. Our simulator is able to reproduce respiratory flows with a root mean square error (RMSE) of 1.8 L/min between normal participant breathing and its simulation, 5% of the maximum flow rate simulated for that participant (pMFR), an RMSE of 10.08 L/min for deep breathing, 18% of the pMFR and an RMSE of 13.29 L/min for exertion breathing, 17% of pMFR. For the simulation of an average cough we recorded an RMSE of 51.43 L/min, 13% of the pMFR and for a low flow rate cough an RMSE of 12.38 L/min, 9.5% of the pMFR. The presented simulator matches the fundamentals of human breathing and coughing, advancing the current capability of respiratory system simulators.
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People who have undergone total laryngectomy typically have difficulties speaking and coughing. Coughing, the protective reflex action where air is rapidly expelled from the lungs to clear the airway, is crucial in everyday life. Insufficiency in coughing can lead to serious chest infections. In this research we present a bionic assistive coughing device (RoboCough) to improve coughing efficacy among laryngectomy patients by increasing pressure and flow rate. RoboCough was designed to mimic the function of the glottis and trachea in the upper respiratory system. Experimental results show a significant increase (t(64) = 4.9, p < 0.0001) in peak cough flow rate and peak cough pressure (t(64) = 12.6, p < 0.0001) among 33 control participants using RoboCough. A pilot study with a smaller cohort of laryngectomy patients shows improvement in peak cough pressure (p = 0.0159) using RoboCough. Preliminary results also show that post-laryngectomy coughs achieved similar peak cough flow (Z = -0.9933, p = 0.32) to the control group's natural cough. Coughing capabilities could be improved through using RoboCough. Applications of RoboCough include simulation of vocal folds and respiratory conditions, rehabilitation of ineffective coughs from laryngeal and respiratory diseases and as a test-bed for the development of medical devices for respiratory support.
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