IEEE Transactions on Medical Robotics and Bionics

Journal: IEEE Transactions on Medical Robotics and Bionics

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IEEE

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2576-3202

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Publications1 - 10 of 13

Differentiable Biomechanics for Markerless Motion Capture in Upper Limb Stroke Rehabilitation: A Comparison With Optical Motion Capture
Unger, Tim; Moslehian, Arash Sal; Pfeiffer, J.D.; et al. (2025)
IEEE Transactions on Medical Robotics and Bionics
Marker-based Optical Motion Capture (OMC) paired with biomechanical modeling is currently considered the most precise and accurate method for measuring human movement kinematics. However, combining differentiable biomechanical modeling with Markerless Motion Capture (MMC) offers a promising approach to motion capture in clinical settings, requiring only minimal equipment, such as webcams, and minimal effort for data collection. This study compares key kinematic outcomes from biomechanically modeled MMC and OMC data in 15 individuals with stroke performing the drinking task, a functional task recommended for assessing upper limb movement quality. We observed a high level of agreement in kinematic trajectories between MMC and OMC, as indicated by high correlations (median r > 0.95 for the majority of kinematic trajectories) and median RMSE (root mean squared error) values ranging from 2∘-5∘ for joint angles, 0.04 m/s for end-effector velocity, and 6mm for trunk displacement. Trial-to-trial biases between OMC and MMC were consistent within participant sessions, with interquartile ranges of bias around 1-3∘ for joint angles, 0.01m/s in end-effector velocity, and approximately 3mm for trunk displacement. Our findings indicate that our MMC for arm tracking is approaching the accuracy of marker-based methods, supporting its potential for use in clinical settings. MMC could provide valuable insights into movement rehabilitation after stroke, potentially enhancing the effectiveness of rehabilitation strategies.
Activities with a Microprocessor-Controlled Leg Brace for Patients with Lower Limb Paralysis: A Series of Case Studies
Auberger, Roland Adolf; Pobatschnig, Barbara; Russold, Michael; et al. (2021)
IEEE Transactions on Medical Robotics and Bionics
Lower limb paralysis often leads to depreciation in mobility of the affected individuals. Computer-controlled leg brace systems open up new possibilities for these patients, by improving the safety of mobility tasks in everyday life, especially when walking on uneven terrain, inclined surfaces, steps and stairs. This paper introduces such a system. To investigate the use of device functionalities in the patient’s everyday environment, the knee joint of the brace was configured to store data of various sensors, measuring motion with a high temporal resolution over several weeks of home use. Results from a clinical trial including 8 patients with different pathologies show that the system was used by the patients for more than 10 hours per day on average, taking more than 2,100 steps per day. Maximum use time was more than 20.24 hours with 12,609 steps per day. An implemented yielding function to support walking down slopes or stairs was used by all patients. This function can also catch the user in case of stumbling, which on average happened 3 times per day. Seven out of eight patients reported improvements in quality and safety of many activities in daily life using the novel system, compared to their previous device.
Bayesian Optimization for Design of Multi-Actuator Soft Catheter Robots
Ghoreishi, Seyede Fatemeh; Sochol, Ryan D.; Gandhi, Dheeraj; et al. (2021)
IEEE Transactions on Medical Robotics and Bionics
Catheter-based diagnosis and therapy have grown increasingly in recent years due to their improved clinical outcomes including decreased morbidity, shorter recovery time and minimally invasiveness compared to open surgeries. Although the scalability, customizability, and diversity of soft catheter robots are widely recognized, designers and roboticists still lack comprehensive techniques for modeling and designing them. This difficulty arises due to their continuum nature, which makes characterizing the properties and predicting a soft catheter’s behavior challenging, complicating robot design tasks. In this paper, we propose modeling multi-actuator soft catheters to enable alignment with desired vessel shapes near the target area. We develop mathematical models to simulate the catheter’s positioning due to the moments exerted by multiple pneumatic actuators along the catheter and use those models to compare optimization approaches that can achieve catheter alignment along a desired vessel shape. Specifically, our approach proposes finding the optimal geometric and material properties for a multi-actuator soft catheter robot using a bi-level optimization framework. The upper-level optimization process uses a modified Bayesian technique to seek the optimal geometric and material properties of the soft catheter, which minimize the deviance of the actuated catheter from a desired vessel shape, while the lower-level optimization process uses a gradient-based technique to obtain the actuator moments required to achieve that vessel shape. The results demonstrate the capability of our proposed multi-actuator soft catheter to align with the desired vessel shapes, and show that the proposed framework which is in the context of Bayesian optimization has the potential to expedite the design process.
Human-in-the-Loop Personalization of a Bi-Articular Wearable Robot’s Assistance for Downhill Walking
Koginov, Gleb; Bergmann, Lukas; Xiloyannis, Michele; et al. (2024)
IEEE Transactions on Medical Robotics and Bionics
Wearable robots hold great promise in supporting people during activities of daily living. Personalizing the assistance provided by this technology for not just level ground walking, but also other real-life activities like uphill and downhill walking, will foster its wider adoption. In this paper, we propose an approach to personalize the assistance delivered by a wearable robot -the Myosuit, a tendon-driven soft robot for mobility assistance -for downhill walking. We use a human-in-the-loop method with candidate profiles of 15-steps which aims to minimize knee extensor muscle activity, utilizing the covariance matrix adaptation evolution strategy algorithm (CMA-ES) and a cost function based on normalized RMS of surface EMG signals. By utilizing CMA-ES, we vary the magnitude and timing of Myosuit’s support to find the most appropriate assistance profiles. We compared the optimal profiles to assistance off (transparency) condition and a general trajectory derived using a model-based approach. Relative to the transparency condition, the average muscle activity was reduced by 12.67% (SD: ±8.73; t(20) = 5.25, p≤.01) across all participants and muscle groups. The results of our study may support future development of personalized assistance algorithms for wearable robots and lead to better adoption of this technology.
Can Robotic Feedback and Adaptation Possibilities Match Therapeutic Needs? - An Observational Study
Sommerhalder, Michael; Buchi, Madlaina; Risch, Saskia; et al. (2026)
IEEE Transactions on Medical Robotics and Bionics
An observational study with the Swiss Paraplegic Centre, Nottwil, aimed to tailor robotic systems to therapists’ preferences by quantifying therapist-patient interactions, as understanding the therapists’ adaptation strategies is essential for effective customization. A total of 2297 interactions were recorded in 198 exercises with 16 patient-therapist pairs, either directly or through a robotic device with enhanced analysis tools. Derived correlation maps quantified three preferred interaction strategies: Observation of compensatory movement and posture issues caused direct tactile reaction, issues with robotic settings led to robotic support adaptations, and robotic support adaptations preceded additional support adaptations without intermediate patient observation. Strategies varied by exercise type, with direct tactile reactions dominating reach-goal exercises and robotic adjustments dominating in nominal path exercises. We conclude that a limited set of robotic feedback and adaptation options fails to meet therapeutic needs, given the wide variability in individual rehabilitation strategies. In contrast, offering an exhaustive range of options overwhelms therapists, often causing them to favor direct patient interaction over engaging with the robotic system. Therefore, an optimal robotic system must incorporate methods that understand the therapist’s strategic intent and dynamically adapt the presented information and adjustable parameters to the specific needs and preferences of the operating therapist.
Patient Motion Using a Computerized Leg Brace in Everyday Locomotion Tasks
Auberger, Roland Adolf; Russold, Michael F.; Riener, Robert; et al. (2019)
IEEE Transactions on Medical Robotics and Bionics
Development of a Textile Integrated, Two-State Controlled Tremor Suppression Orthosis for the Wrist
Fromme, Nicolas P.; Esser, Adrian; Camenzind, Martin; et al. (2023)
IEEE Transactions on Medical Robotics and Bionics
Tremor is one of the most common movement disorders with the highest prevalence in the upper limb. Apart from medication or surgery, the mechanical suppression of the involuntary movement with an orthosis can be used as alternative treatment. Here we propose a controlled energy dissipating suppression orthosis using a mechanical brake. For this approach, we focused on improved wearability with voluntary movement preservation and ergonomics while providing tremor suppression. The novelty of this orthosis is the decentralization of the tremor suppression mechanism and the integration of textiles in the orthosis structure. We performed computational and test bench simulations of a controlled two-state brake with a 1D human model to optimize the brake duration and timing. The objective was to optimize the trade-off between tremor suppression and voluntary movement suppression. The textile-integrated prototype, with the optimized parameter, was validated in a proof-of-concept case study with a tremor-affected person performing activities of daily living. With the optimized parameters, we achieved a tremor suppression of 78.8%, 66.5%, and 40.8% for the simulation, test bench, and case study, respectively as measured by the change in power spectral density (PSD) at the tremor frequency peak. While minimizing the voluntary movement suppression in the simulation and test bench by introducing the trajectory distance as new validation method (23.7% and 31.2%), no voluntary movements suppression was measured in the case study using PSD analysis. Our new orthosis has the potential to become a daily wearable device that can improve the quality of life for tremor-affected people.
Competitive Versus Cooperative Forms of Therapeutic Gaming With Subacute Stroke Patients
Baur, Kilian; Wolf, Peter; Novak, Vesna; et al. (2023)
IEEE Transactions on Medical Robotics and Bionics
Background: Two player games have been suggested to be more motivating than single-player games when applied to neurorehabilitation. This work aimed to contrast cooperative and competitive forms of therapeutic gaming. Methods: An air hockey computer game was played by twenty dyads of subacute stroke patients who did not know each other beforehand. Using an arm-weight compensating exoskeleton robot, each dyad tested four modes: i) single-player competitive, ii) single-player cooperative, iii) two-player competitive, and iv) two-player cooperative. For each mode, the patients rated statements of the Intrinsic Motivation Inventory (IMI) subscales interest/enjoyment and effort/importance. Hand velocity was used to estimate the participants' actual effort in the task. Results: Sixteen patients preferred one of the two two-player modes. On intrinsic motivation, no effect of two-player modes as opposed to single-player modes could be found. However, patients rated competitive modes more interesting ({p}= 0.044) in the IMI and exercised in those modes with higher effort (p < 0.001) compared to cooperative modes. Conclusions: Two-player modes played by unfamiliar co-players are preferred by some of the subacute patients and were as motivating and intense as single-player modes, but no more. This result contrasts with other studies with familiar co-players where the two-player modes were found to be more motivating.
REALITI: A Robotic Endoscope Automated via Laryngeal Imaging for Tracheal Intubation
Boehler, Quentin; Gage, David S.; Hofmann, Phyllis; et al. (2020)
IEEE Transactions on Medical Robotics and Bionics
Tracheal intubation is considered the gold standard to secure the airway of patients in need of respiratory assistance, yet this procedure relies on the dexterity and experience of the physician to correctly place a tracheal tube into the patient’s trachea. Such a complex procedure may greatly benefit from robotic assistance in order to make the intubation safer and more efficient. We developed the first device to provide such assistance, the REALITI, which stands for Robotic Endoscope Automated via Laryngeal Imaging for Tracheal Intubation. This device allies the automated detection of key anatomical features in an endoscopic image to the robotic steering toward the recognized features in the task of guiding the tracheal tube into its correct position. The pre-clinical prototype presented in this paper has been developed to perform in vitro tracheal inbutation on a standard airway management training manikin. We performed a robust detection of anatomical features to steer the endoscope in a visual servoing fashion. Our prototype has been successfully used to perform automated and manual insertions into the trachea of an airway manikin.
Supporting and Stabilizing the Scapulohumeral Rhythm with a Body- or Robot-Powered Orthosis
Georgarakis, Anna-Maria; Zimmermann, Yves; Wolf, Peter; et al. (2022)
IEEE Transactions on Medical Robotics and Bionics
The versatile functionality of the human upper limb is owed to the coordinated rotation of the scapula and humerus, a pattern called the scapulohumeral rhythm (SHR). Various medical conditions can alter the SHR, frequently leading to limitations in activities of daily living. However, to date, supporting the SHR in practice is often not feasible. We present a textile orthosis that assists the SHR both in stand-alone use and in combination with the ANYexo, a therapy exoskeleton, or the Myoshirt, an assistive exomuscle. The SHR Orthosis comprised a textile harness and a scapula interface that was coupled with the upper arm to promote scapular upward rotation. In a technical evaluation including four participants without impairments and one with a partial hemiparesis, the SHR Orthosis followed the desired scapular rotation with an average deviation of less than 5 %, thus providing accurate support and guidance towards the physiological SHR. The SHR Orthosis substituted for <=42 % of the normal forces, and <=19.6 % of the tangential forces required for scapular stabilization and rotation, providing sufficient support for patients with remaining muscular function. At last, the SHR Orthosis provides practicable scapula support in daily life, during conventional therapy, and in combination with assistive and therapy robots.

Publications1 - 10 of 13

Journal: IEEE Transactions on Medical Robotics and Bionics

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