Robotic therapy devices have been an important part of clinical neurological rehabilitation for several years. Until now such devices are only available for patients receiving therapy inside rehabilitation hospitals. Since patients should continue rehabilitation training after hospital discharge at home, intelligent robotic rehab devices could help to achieve this goal. This paper proposes a novel multimodal home therapy concept and robot based system for motor telerehabilitation which is currently being further developed. The system is based on two haptic rehabilitation devices i) the Bi-Manu-Track (BMT) 2times1 DOF robotic haptic rehabilitation device with assist-as-needed control algorithms and ii) an enhanced version of the 3 DOF passive Reha-Slide system. The paper describes the technical system setup as well as user centered design aspects
A closed-loop control software for the new mobile Berlin Heart EXCORR driving unit was optimized to balance usability, durability, pump wash out, blood stress and power consumption. The piston of the electro-pneumatic cylinder is moved on a pump-cannula-specific trajectory. A friction and a valve model are adapted online. Verification and real world data show constant flow, low power consumption and the adherence of all limits.
Robot-assisted motor rehabilitation proved to be an effective supplement to conventional hand-to-hand therapy in stroke patients. In order to analyze and understand motor learning and performance during rehabilitation it is desirable to develop a monitor to provide objective measures of the corresponding brain activity at the rehabilitation progress. We used a portable time-domain near-infrared reflectometer to monitor the hemodynamic brain response to distal upper extremity activities. Four healthy volunteers performed two different robot-assisted wrist/forearm movements, flexionextension and pronation-supination in comparison with an unassisted squeeze ball exercise. A special headgear with four optical measurement positions to include parts of the pre-and postcentral gyrus provided a good overlap with the expected activation areas. Data analysis based on variance of time-of-flight distributions of photons through tissue was chosen to provide a suitable representation of intracerebral signals. In all subjects several of the four detection channels showed a response. In some cases indications were found of differences in localization of the activated areas for the various tasks.
EinleitungDer therapeutische Nutzen robotergestützter Therapie-Übungsgeräte in der Neurologischen Rehabilitation, insbesondere bei schwer betroffenen subakuten Schlaganfallpatienten, konnte inzwischen in klinischen Studien nachgewiesen werden (Hesse et al., 2008; Mehrholz et al., 2008). Bisher sind solche Geräte jedoch nur für die stationäre Reha-Therapie verfügbar. Da jeder Patient die Reha-Behandlung ambulant und zu Hause so intensiv wie möglich fortsetzen sollte, besteht ein großer Bedarf an intelligenten robotergestützten Therapiegeräten, die in neu zu entwickelnde Behandlungskonzepte einer fernbetreuten Therapie eingebunden werden. Hierfür bietet sich die Weiterentwicklung telemedizinischer Therapiekonzepte für eine haptische Telerehabilitation an, über die in diesem Beitrag berichtet wird.
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