Abstract:BackgroundCerebral Palsy (CP) is the most common cause of permanent serious physical disability in childhood. Although many platforms have been developed, so far there are still not precise guidelines for the rehabilitation of the population with CP. The CPWalker is a robotic platform for the rehabilitation of children with CP, through which they can start experiencing autonomous locomotion in the rehabilitation environment. It allows the possibility of free movement and includes physical and cognitive interfa… Show more
“…However, 91.7% of the therapists had never interacted with robotic walkers, and 66.7% said they had not used any robotic devices for assistive applications. These results support the need to actively, closely, and safely [ 20 , 75 ] have therapists during robotic walker therapies [ 23 , 76 ]. Furthermore, such inexperience on the part of the therapists may be related to the low development of tools to facilitate their task in the course of their therapy [ 50 , 77 ].…”
Section: Results and Discussionsupporting
confidence: 69%
“…This has allowed the therapy manager to focus on more specific tasks such as functional rehabilitation and supervision of patients, optimizing their expertise and time [ 7 , 21 , 22 ]. In this sense, when using mobile robots such as walkers, it is crucial to provide the therapists with a communication channel that allows them to interact with the patient and the device without affecting independence or adding cognitive burden to the patient [ 17 , 23 , 24 ]. With such a communication channel, the therapists would command the robot remotely, perceive environment constraints, avoid hazardous situations, and monitor the patient state.…”
The constant growth of pathologies affecting human mobility has led to developing of different assistive devices to provide physical and cognitive assistance. Smart walkers are a particular type of these devices since they integrate navigation systems, path-following algorithms, and user interaction modules to ensure natural and intuitive interaction. Although these functionalities are often implemented in rehabilitation scenarios, there is a need to actively involve the healthcare professionals in the interaction loop while guaranteeing safety for them and patients. This work presents the validation of two visual feedback strategies for the teleoperation of a simulated robotic walker during an assisted navigation task. For this purpose, a group of 14 clinicians from the rehabilitation area formed the validation group. A simple path-following task was proposed, and the feedback strategies were assessed through the kinematic estimation error (KTE) and a usability survey. A KTE of 0.28 m was obtained for the feedback strategy on the joystick. Additionally, significant differences were found through a Mann–Whitney–Wilcoxon test for the perception of behavior and confidence towards the joystick according to the modes of interaction (p-values of 0.04 and 0.01, respectively). The use of visual feedback with this tool contributes to research areas such as remote management of therapies and monitoring rehabilitation of people’s mobility.
“…However, 91.7% of the therapists had never interacted with robotic walkers, and 66.7% said they had not used any robotic devices for assistive applications. These results support the need to actively, closely, and safely [ 20 , 75 ] have therapists during robotic walker therapies [ 23 , 76 ]. Furthermore, such inexperience on the part of the therapists may be related to the low development of tools to facilitate their task in the course of their therapy [ 50 , 77 ].…”
Section: Results and Discussionsupporting
confidence: 69%
“…This has allowed the therapy manager to focus on more specific tasks such as functional rehabilitation and supervision of patients, optimizing their expertise and time [ 7 , 21 , 22 ]. In this sense, when using mobile robots such as walkers, it is crucial to provide the therapists with a communication channel that allows them to interact with the patient and the device without affecting independence or adding cognitive burden to the patient [ 17 , 23 , 24 ]. With such a communication channel, the therapists would command the robot remotely, perceive environment constraints, avoid hazardous situations, and monitor the patient state.…”
The constant growth of pathologies affecting human mobility has led to developing of different assistive devices to provide physical and cognitive assistance. Smart walkers are a particular type of these devices since they integrate navigation systems, path-following algorithms, and user interaction modules to ensure natural and intuitive interaction. Although these functionalities are often implemented in rehabilitation scenarios, there is a need to actively involve the healthcare professionals in the interaction loop while guaranteeing safety for them and patients. This work presents the validation of two visual feedback strategies for the teleoperation of a simulated robotic walker during an assisted navigation task. For this purpose, a group of 14 clinicians from the rehabilitation area formed the validation group. A simple path-following task was proposed, and the feedback strategies were assessed through the kinematic estimation error (KTE) and a usability survey. A KTE of 0.28 m was obtained for the feedback strategy on the joystick. Additionally, significant differences were found through a Mann–Whitney–Wilcoxon test for the perception of behavior and confidence towards the joystick according to the modes of interaction (p-values of 0.04 and 0.01, respectively). The use of visual feedback with this tool contributes to research areas such as remote management of therapies and monitoring rehabilitation of people’s mobility.
“…In addition to the above, it is worth mentioning that the paradigm of multiple assistance levels is not exclusive to walker-assisted gait. In particular, these strategies can be easily implemented in other assistive devices such as exoskeletons or hybrid devices [ 54 , 55 , 56 ]. Finally, future works will address the assessment of these interaction strategies in a clinical scenario with pathological patients or older people.…”
Smart walkers are commonly used as potential gait assistance devices, to provide physical and cognitive assistance within rehabilitation and clinical scenarios. To understand such rehabilitation processes, several biomechanical studies have been conducted to assess human gait with passive and active walkers. Several sessions were conducted with 11 healthy volunteers to assess three interaction strategies based on passive, low and high mechanical stiffness values on the AGoRA Smart Walker. The trials were carried out in a motion analysis laboratory. Kinematic data were also collected from the smart walker sensory interface. The interaction force between users and the device was recorded. The force required under passive and low stiffness modes was 56.66% and 67.48% smaller than the high stiffness mode, respectively. An increase of 17.03% for the hip range of motion, as well as the highest trunk’s inclination, were obtained under the resistive mode, suggesting a compensating motion to exert a higher impulse force on the device. Kinematic and physical interaction data suggested that the high stiffness mode significantly affected the users’ gait pattern. Results suggested that users compensated their kinematics, tilting their trunk and lower limbs to exert higher impulse forces on the device.
“…38, F. Chrif et al, Control design for a lower-limb paediatric therapy device using linear motor technology, Page 121, Copyright (2017), with permission from Elsevier Fig. 5 Picture of lower limb exoskeletons rehabilitation robots: a Lokomat [ 90 ], b HAL [ 91 ], c CPWalker [ 92 ], d PediAnklebot [ 93 ], e wearable ankle rehabilitation robot developed by the Rehabilitation Institute of Chicago [ 94 ], f P.REX [ 95 ] Fig. 6 Picture of KPT Cycla [ 96 ] an end-effectors rehabilitation robot for both a lower and b upper limbs …”
Children with physical disabilities often have limited performance in daily activities, hindering their physical development, social development and mental health. Therefore, rehabilitation is essential to mitigate the adverse effects of the different causes of physical disabilities and improve independence and quality of life. In the last decade, robotic rehabilitation has shown the potential to augment traditional physical rehabilitation. However, to date, most robotic rehabilitation devices are designed for adult patients who differ in their needs compared to paediatric patients, limiting the devices’ potential because the paediatric patients’ needs are not adequately considered. With this in mind, the current work reviews the existing literature on robotic rehabilitation for children with physical disabilities, intending to summarise how the rehabilitation robots could fulfil children’s needs and inspire researchers to develop new devices. A literature search was conducted utilising the Web of Science, PubMed and Scopus databases. Based on the inclusion–exclusion criteria, 206 publications were included, and 58 robotic devices used by children with a physical disability were identified. Different design factors and the treated conditions using robotic technology were compared. Through the analyses, it was identified that weight, safety, operability and motivation were crucial factors to the successful design of devices for children. The majority of the current devices were used for lower limb rehabilitation. Neurological disorders, in particular cerebral palsy, were the most common conditions for which devices were designed. By far, the most common actuator was the electric motor. Usually, the devices present more than one training strategy being the assistive strategy the most used. The admittance/impedance method is the most popular to interface the robot with the children. Currently, there is a trend on developing exoskeletons, as they can assist children with daily life activities outside of the rehabilitation setting, propitiating a wider adoption of the technology. With this shift in focus, it appears likely that new technologies to actuate the system (e.g. serial elastic actuators) and to detect the intention (e.g. physiological signals) of children as they go about their daily activities will be required.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
