A myocontrolled neuroprosthesis integrated with a passive exoskeleton to support upper limb activities

Ambrosini, Emilia; Ferrante, Simona; Schauer, Thomas; Klauer, Christian; Gaffuri, Marina; Ferrigno, Giancarlo; Pedrocchi, Alessandra

doi:10.1016/j.jelekin.2014.01.006

Cited by 60 publications

(49 citation statements)

References 28 publications

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“…43 Further, cycling training combines FES with the residual voluntary effort to enhance FES therapeutic effects. [44][45][46] The two phases of the intervention were applied in sequence, favoring gradual skill acquisition. The characteristics of the multimodal biofeedback training made it safe, applicable soon after stroke, and cost-effective since it does not require a continuous one-to-one supervision of the therapist and may reduce the time spent by the therapist with individual patient.…”

Section: Discussionmentioning

confidence: 99%

A multimodal training with visual biofeedback in subacute stroke survivors: a randomized controlled trial

Ambrosini

Peri

Nava

et al. 2020

Eur J Phys Rehabil Med

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This provisional PDF corresponds to the article as it appeared upon acceptance.A copyedited and fully formatted version will be made available soon. The final version may contain major or minor changes. Subscription: Information about subscribing to Minerva Medica journals is online at:http://www.minervamedica.it/en/how-to-order-journals.php Reprints and permissions: For information about reprints and permissionssend an email to: journals.dept@minervamedica.it -journals2.dept@minervamedica.it -journals6.dept@minervamedica.it EDIZIONI MINERVA MEDICA ABSTRACT BACKGROUND: Early interventions maximizing patient's involvement are essential to promote gait restoration and motor recovery after stroke. AIM: To evaluate the effects of a multimodal biofeedback training involving cycling augmented by Functional Electrical Stimulation (FES) and balance exercises on walking ability and motor recovery. DESIGN: Randomized controlled trial (NCT02439515). SETTING: Inpatient rehabilitation facility. POPULATION: Subacute stroke survivors (less than 6 months from the first event) with an age of up to 90 years old. METHODS: 68 participants were randomly allocated to an experimental group, performing 15 sessions of biofeedback FES-cycling training followed by 15 sessions of biofeedback balance training (20 minutes each) in addition to usual care (70 minutes), and a control group performing 30 sessions (90 minutes) of usual care. Participants were evaluated before training, after 15 sessions, after 30 sessions, and at 6-month follow-up through: gait speed (primary outcome), spatio-temporal gait parameters, Six Minute Walking Test, Functional Independence Measure, Motricity Index, Trunk Control Test, Berg Balance Scale, and Fall Efficacy Scale. RESULTS: Both groups significantly improved over time, but no group and interaction effects were found for any outcomes. The 73% of the experimental group achieved a clinically meaningful change in gait speed compared to the 38% of the control group (p-value=0.048).These percentages were even more unbalanced for patients with a moderate to severe gait impairment at baseline (91% versus 36%; p-value=0.008). COPYRIGHT© EDIZIONI MINERVA MEDICAThis document is

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Section: Discussionmentioning

confidence: 99%

A multimodal training with visual biofeedback in subacute stroke survivors: a randomized controlled trial

Ambrosini

Peri

Nava

et al. 2020

Eur J Phys Rehabil Med

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“…FES has been strongly used to enhance functional recovery of the paretic arm in stroke survivors [8]. When FES is combined with the patient's residual voluntary effort [1], cortical plasticity seems to be enhanced, having therefore the potential to improve the therapeutic effects of FES [6]. The combined action of robotassisted therapy supporting elbow and wrist motion and EMG-triggered FES has shown positive effects on muscle coordination in subacute [24] and chronic stroke survivors [25].…”

Section: Functional Electrical Stimulationmentioning

confidence: 99%

Upper-Limb Exoskeletons for Stroke Rehabilitation

et al. 2019

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Upper-limb exoskeletons provide high-intensity, repetitive, task-specific, interactive and individualized training, making effective use of neuroplasticity for functional recovery in neurological patients. Most exoskeletons have robot axes aligned with the anatomical axes of the subject and provide direct control of individual joints. Recently, novel mechanical structures and actuation mechanisms have been proposed, but still result in bulky and heavy exoskeletons, limiting their applicability into clinical practice. Technological efforts are needed to promote light and wearable exoskeletons that implement active-assistive controllers, providing "assisted-as-needed" rehabilitation therapy, towards patient's motivation and self-esteem. An overview of upper-limb exoskeletons, including mechanical design and control algorithms, will be provided. Special focus will be put on the current evidence about the efficacy of wearable robotic technologies on motor recovery and about other therapies that can be combined with exoskeletons to improve their therapeutic effects.

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“…Therefore, the unnatural discrete non-proportional control scheme achieved by the pattern classification approach results in the lack of a successful clinical application of this technique. Nowadays, robust continuous proportional and simultaneous myoelectric control, in which multiple degrees of freedom (DOFs) can be controlled at the same time via EMG inputs, is a necessary requirement for commercial applications in robotic control, prostheses, and orthoses [7]- [10]. A simple control strategy is represented by two independent muscles controlling each single DOF [1], [11].…”

Section: Introductionmentioning

confidence: 99%

Robustness and Reliability of Synergy-Based Myocontrol of a Multiple Degree of Freedom Robotic Arm

Lunardini

Casellato

d’Avella

et al. 2016

IEEE Trans. Neural Syst. Rehabil. Eng.

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Abstract-In this study, we test the feasibility of the synergybased approach for application in the realistic and clinically oriented framework of multi-degree of freedom (DOF) robotic control. We developed and tested online ten able-bodied subjects in a semi-supervised method to achieve simultaneous, continuous control of two DOFs of a robotic arm, using muscle synergies extracted from upper limb muscles while performing flexion-extension movements of the elbow and shoulder joints in the horizontal plane. To validate the efficacy of the synergy-based approach in extracting reliable control signals, compared to the simple muscle-pair method typically used in commercial applications, we evaluated the repeatability of the algorithm over days, the effect of the arm dynamics on the control performance, and the robustness of the control scheme to the presence of co-contraction between pairs of antagonist muscles. Results showed that, without the need for a daily calibration, all subjects were able to intuitively and easily control the synergy-based myoelectric interface in different scenarios, using both dynamic and isometric muscle contractions. The proposed control scheme was shown to be robust to co-contraction between antagonist muscles, providing better performance compared to the traditional muscle-pair approach. The current study is a first step toward user-friendly application of synergy-based myocontrol of assistive robotic devices.

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A myocontrolled neuroprosthesis integrated with a passive exoskeleton to support upper limb activities

Cited by 60 publications

References 28 publications

A multimodal training with visual biofeedback in subacute stroke survivors: a randomized controlled trial

A multimodal training with visual biofeedback in subacute stroke survivors: a randomized controlled trial

Upper-Limb Exoskeletons for Stroke Rehabilitation

Robustness and Reliability of Synergy-Based Myocontrol of a Multiple Degree of Freedom Robotic Arm

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