A Hybrid System for Upper Limb Movement Restoration in Quadriplegics

Abstract

Generally, quadriplegic individuals have difficulties performing object manipulation. Toward satisfactory manipulation, reach and grasp movements must be performed with voluntary control, and for that, grasp force feedback is essential. A hybrid system aiming at partial upper limb sensory-motor restoration for quadriplegics was built. Such device is composed of an elbow dynamic orthosis that provides elbow flexion/extension (range was approximately from 20 degrees to 120 degrees , and average angular speed was approximately 15 degrees /s) with forearm support, a wrist static orthosis and neuromuscular electrical stimulation for grasping generation, and a glove with force sensors that allows grasping force feedback. The glove presents two user interface modes: visual by light emitting diodes or audio emitted by buzzer. Voice control of the entire system (elbow dynamic orthosis and electrical stimulator) is performed by the patient. The movements provided by the hybrid system, combined with the scapular and shoulder movements performed by the patient, can aid quadriplegic individuals in tasks that involve reach and grasp movements.

Use and evaluation of assistive technologies for upper limb function in tetraplegia

“…1). Of the 24 selected studies, 13 were identified as case studies or series, [13][14][15][16][17][18][19][20][21][22][23][24][25] two as clinical trials, 26,27 one as a clinical study, 28 and eight as cohort studies. [29][30][31][32][33][34][35][36]…”

“…• Neuroprosthesis (invasive [20][21][22][23][24][25][26][29][30][31][32][33][34] and non-invasive 18,19,27,28 ) is a system where muscles are stimulated by small electrical currents to generate motor functions; • Orthosis is a non-invasive supportive device which assists with optimum use of remaining motor control; 16,35,36 • Hybrid system is a combination of multiple technologies such as neuroprosthesis and orthosis, 13,14 or powered orthosis; • Robot is a non-invasive device generating functional movements without the need for users to have any residual motor control, 17 and; • Antigravity arm support is an add-on device to other assistive technologies. 15 From the literature search, 20 of the selected studies focused on neuroprostheses, with sixteen on invasive and four on non-invasive neuroprostheses.…”

Experiencing Functional Electrical Stimulation Roots on Education, and Clinical Developments in Paraplegia and Tetraplegia With Technological Innovation

“…For that purpose, an upper‐limb robotic device combined with FES increases the range of reach movement; in addition, it enables patients to perform grasping and bringing an object next to the body (Fig. ) . Furthermore, the results of clinical assessment show the feasibility of such equipment for robot‐assisted therapy.…”

Artificial Organs 2008: A Year in Review

“…Renato Varoto et al. (78) of the University of São Paulo, São Carlos, SP, Brazil reported on a hybrid system aimed at partial upper limb sensory‐motor restoration for quadriplegics. The device is composed of an elbow dynamic orthosis that provides elbow flexion/extension with forearm support, a wrist static orthosis and neuromuscular electrical stimulation for grasping generation, and a glove with force sensors that allows grasping force feedback.…”