Motivation, expectations, and usability of a driven gait orthosis in stroke patients and their therapists

Swinnen, Eva; Lefeber, Nina; Willaert, Ward; Neef, Fallon De; Bruyndonckx, Lyn; Spooren, Annemie; Michielsen, Marc; Ramon, Tine; Kerckhofs, Eric

doi:10.1080/10749357.2016.1266750

Cited by 27 publications

(39 citation statements)

References 35 publications

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“…In den Fokusgruppen berichteten die Therapeutinnen und Therapeuten ferner, dass die funktionalen Möglichkeiten der Roboter noch begrenzt seien und nicht alle notwendigen Bewegungen abdecken, ferner sei die Handhabung zum Teil noch sehr aufwendig und wenig benutzerfreundlich. Auch in den Befragungen von Swinnen et al (2017) sehen die Therapeutinnen und Therapeuten noch Raum für Verbesserung von Nützlichkeit und Usability des roboterunterstützten Gangtrainings.…”

Section: Professionelle Nutzerinnen Und Nutzerunclassified

Robotik in der Gesundheitsversorgung: Hoffnungen, Befürchtungen und Akzeptanz aus Sicht der Nutzerinnen und Nutzer

Becker

2018

Pflegeroboter

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Um den steigenden Versorgungsbedarf im Gesundheitsbereich bei gleichzeitigem Mangel an Fachkräften zu sichern, wird zunehmend auch auf den Einsatz von Robotik gesetzt. Eine breite Vielfalt an Geräten wird dabei für verschiedene Nutzergruppen und Anwendungssituationen entwickelt. Die Geräte wecken einerseits Hoffnungen, aber auch Befürchtungen bei nichtprofessionellen und professionellen Nutzergruppen. Ob ein Roboter von Nutzenden tatsächlich akzeptiert wird, hängt von zahlreichen Faktoren ab. Die Aussagen in diesem Beitrag beruhen auf Literatur, eigenen Befragungen im Rahmen der Studie zur Technologiefolgenabschätzung für TA-SWISS in 2011-2012 (Becker et al., Robotik in Betreuung und Gesundheitsversorgung. vdf Hochschulverlag, Zürich, 2013) und verschiedenen Diskussionen mit Gesundheitspersonal, Expertinnen und Experten und Betroffenen im Rahmen von Vorträgen und Podiumsdiskussionen. 13.1 Einleitung Um den steigenden Versorgungsbedarf im Gesundheitsbereich bei gleichzeitigem Mangel an Fachkräften zu sichern, wird zunehmend auch auf den Einsatz von Robotik gesetzt. Eine breite Vielfalt an Geräten wird dabei für verschiedene Nutzergruppen und Anwendungssituationen entwickelt. In diesem Kapitel werden die Geräte nach ihrer Funktion in Gruppen zusammengefasst und Anwendungsbeispiele aufgezeigt. Es werden nichtprofessionelle und professionelle Nutzergruppen unterschieden und ihre

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Section: Professionelle Nutzerinnen Und Nutzerunclassified

Robotik in der Gesundheitsversorgung: Hoffnungen, Befürchtungen und Akzeptanz aus Sicht der Nutzerinnen und Nutzer

Becker

2018

Pflegeroboter

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“…Given the influence that user opinion has on the adoption of an assistive device, the authors felt it was important to include user acceptance criteria in the evaluation of a preliminary design. Important influences on nonuse of assistive devices are related to their appearance and ease of use [ 33 – 35 ]. Translating this to the design requirements calls for a device that is lightweight, close to the body, requires short donning time, and is suited for autonomous donning.…”

Section: Design Requirementsmentioning

confidence: 99%

Bilateral, Misalignment-Compensating, Full-DOF Hip Exoskeleton: Design and Kinematic Validation

Junius

Degelaen

Lefeber

et al. 2017

Applied Bionics and Biomechanics

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A shared design goal for most robotic lower limb exoskeletons is to reduce the metabolic cost of locomotion for the user. Despite this, only a limited amount of devices was able to actually reduce user metabolic consumption. Preservation of the natural motion kinematics was defined as an important requirement for a device to be metabolically beneficial. This requires the inclusion of all human degrees of freedom (DOF) in a design, as well as perfect alignment of the rotation axes. As perfect alignment is impossible, compensation for misalignment effects should be provided. A misalignment compensation mechanism for a 3-DOF system is presented in this paper. It is validated by the implementation in a bilateral hip exoskeleton, resulting in a compact and lightweight device that can be donned fast and autonomously, with a minimum of required adaptations. Extensive testing of the prototype has shown that hip range of motion of the user is maintained while wearing the device and this for all three hip DOFs. This allowed the users to maintain their natural motion patterns when they are walking with the novel hip exoskeleton.

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“…Therapists mainly base their decisions on visual assessments of the patient, which means that training outcomes can be influenced by subjective decisions. Some studies address this issue by defining guidelines on how to set the assistance [6][7][8][9]. However, these guidelines are often not really specific and require experienced therapists to adjust training parameters.…”

Section: Introductionmentioning

confidence: 99%

Automatic versus manual tuning of robot-assisted gait training in people with neurological disorders

Fricke

Bayón

Kooij

et al. 2020

J NeuroEngineering Rehabil

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Background: In clinical practice, therapists choose the amount of assistance for robot-assisted training. This can result in outcomes that are influenced by subjective decisions and tuning of training parameters can be time-consuming. Therefore, various algorithms to automatically tune the assistance have been developed. However, the assistance applied by these algorithms has not been directly compared to manually-tuned assistance yet. In this study, we focused on subtask-based assistance and compared automatically-tuned (AT) robotic assistance with manually-tuned (MT) robotic assistance. Methods: Ten people with neurological disorders (six stroke, four spinal cord injury) walked in the LOPES II gait trainer with AT and MT assistance. In both cases, assistance was adjusted separately for various subtasks of walking (in this study defined as control of: weight shift, lateral foot placement, trailing and leading limb angle, prepositioning, stability during stance, foot clearance). For the MT approach, robotic assistance was tuned by an experienced therapist and for the AT approach an algorithm that adjusted the assistance based on performances for the different subtasks was used. Time needed to tune the assistance, assistance levels and deviations from reference trajectories were compared between both approaches. In addition, participants evaluated safety, comfort, effect and amount of assistance for the AT and MT approach. Results: For the AT algorithm, stable assistance levels were reached quicker than for the MT approach. Considerable differences in the assistance per subtask provided by the two approaches were found. The amount of assistance was more often higher for the MT approach than for the AT approach. Despite this, the largest deviations from the reference trajectories were found for the MT algorithm. Participants did not clearly prefer one approach over the other regarding safety, comfort, effect and amount of assistance. Conclusion: Automatic tuning had the following advantages compared to manual tuning: quicker tuning of the assistance, lower assistance levels, separate tuning of each subtask and good performance for all subtasks. Future clinical trials need to show whether these apparent advantages result in better clinical outcomes.

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Motivation, expectations, and usability of a driven gait orthosis in stroke patients and their therapists

Cited by 27 publications

References 35 publications

Robotik in der Gesundheitsversorgung: Hoffnungen, Befürchtungen und Akzeptanz aus Sicht der Nutzerinnen und Nutzer

Robotik in der Gesundheitsversorgung: Hoffnungen, Befürchtungen und Akzeptanz aus Sicht der Nutzerinnen und Nutzer

Bilateral, Misalignment-Compensating, Full-DOF Hip Exoskeleton: Design and Kinematic Validation

Automatic versus manual tuning of robot-assisted gait training in people with neurological disorders

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