Browsing by Keyword "Upper limb"
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Item European evidence-based recommendations for clinical assessment of upper limb in neurorehabilitation (CAULIN): data synthesis from systematic reviews, clinical practice guidelines and expert consensus: data synthesis from systematic reviews, clinical practice guidelines and expert consensus(2021-12) Prange-Lasonder, Gerdienke B.; Alt Murphy, Margit; Lamers, Ilse; Hughes, Ann-Marie; Buurke, Jaap H.; Feys, Peter; Keller, Thierry; Klamroth-Marganska, Verena; Tarkka, Ina M.; Timmermans, Annick; Burridge, Jane H.; Tecnalia Research & InnovationBackground: Technology-supported rehabilitation can help alleviate the increasing need for cost-effective rehabilitation of neurological conditions, but use in clinical practice remains limited. Agreement on a core set of reliable, valid and accessible outcome measures to assess rehabilitation outcomes is needed to generate strong evidence about effectiveness of rehabilitation approaches, including technologies. This paper collates and synthesizes a core set from multiple sources; combining existing evidence, clinical practice guidelines and expert consensus into European recommendations for Clinical Assessment of Upper Limb In Neurorehabilitation (CAULIN). Methods: Data from systematic reviews, clinical practice guidelines and expert consensus (Delphi methodology) were systematically extracted and synthesized using strength of evidence rating criteria, in addition to recommendations on assessment procedures. Three sets were defined: a core set: strong evidence for validity, reliability, responsiveness and clinical utility AND recommended by at least two sources; an extended set: strong evidence OR recommended by at least two sources and a supplementary set: some evidence OR recommended by at least one of the sources. Results: In total, 12 measures (with primary focus on stroke) were included, encompassing body function and activity level of the International Classification of Functioning and Health. The core set recommended for clinical practice and research: Fugl-Meyer Assessment of Upper Extremity (FMA-UE) and Action Research Arm Test (ARAT); the extended set recommended for clinical practice and/or clinical research: kinematic measures, Box and Block Test (BBT), Chedoke Arm Hand Activity Inventory (CAHAI), Wolf Motor Function Test (WMFT), Nine Hole Peg Test (NHPT) and ABILHAND; the supplementary set recommended for research or specific occasions: Motricity Index (MI); Chedoke-McMaster Stroke Assessment (CMSA), Stroke Rehabilitation Assessment Movement (STREAM), Frenchay Arm Test (FAT), Motor Assessment Scale (MAS) and body-worn movement sensors. Assessments should be conducted at pre-defined regular intervals by trained personnel. Global measures should be applied within 24 h of hospital admission and upper limb specific measures within 1 week. Conclusions: The CAULIN recommendations for outcome measures and assessment procedures provide a clear, simple, evidence-based three-level structure for upper limb assessment in neurological rehabilitation. Widespread adoption and sustained use will improve quality of clinical practice and facilitate meta-analysis, critical for the advancement of technology-supported neurorehabilitation.Item Functional synergy recruitment index as a reliable biomarker of motor function and recovery in chronic stroke patients(2021-05-18) Irastorza-Landa, Nerea; García-Cossio, Eliana; Sarasola-Sanz, Andrea; Brötz, Doris; Birbaumer, Niels; Ramos-Murguialday, Ander; Tecnalia Research & Innovation; Medical TechnologiesObjective. Stroke affects the expression of muscle synergies underlying motor control, most notably in patients with poorer motor function. The majority of studies on muscle synergies have conventionally approached this analysis by assuming alterations in the inner structures of synergies after stroke. Although different synergy-based features based on this assumption have to some extent described pathological mechanisms in post-stroke neuromuscular control, a biomarker that reliably reflects motor function and recovery is still missing. Approach. Based on the theory of muscle synergies, we alternatively hypothesize that functional synergy structures are physically preserved and measure the temporal correlation between the recruitment profiles of healthy modules by paretic and healthy muscles, a feature hereafter reported as the FSRI. We measured clinical scores and extracted the muscle synergies of both ULs of 18 chronic stroke survivors from the electromyographic activity of 8 muscles during bilateral movements before and after 4 weeks of non-invasive BMI controlled robot therapy and physiotherapy. We computed the FSRI as well as features quantifying inter-limb structural differences and evaluated the correlation of these synergy-based measures with clinical scores. Main results. Correlation analysis revealed weak relationships between conventional features describing inter-limb synergy structural differences and motor function. In contrast, FSRI values during specific or combined movement data significantly correlated with UL motor function and recovery scores. Additionally, we observed that BMI-based training with contingent positive proprioceptive feedback led to improved FSRI values during the specific trained finger extension movement. Significance. We demonstrated that FSRI can be used as a reliable physiological biomarker of motor function and recovery in stroke, which can be targeted via BMI-based proprioceptive therapies and adjuvant physiotherapy to boost effective rehabilitation.Item HoMEcare aRm rehabiLItatioN (MERLIN): telerehabilitation using an unactuated device based on serious games improves the upper limb function in chronic stroke: telerehabilitation using an unactuated device based on serious games improves the upper limb function in chronic stroke(2021-03) Rozevink, Samantha G.; van der Sluis, Corry K.; Garzo, Ainara; Keller, Thierry; Hijmans, Juha M.; Tecnalia Research & Innovation; Medical TechnologiesHoMEcare aRm rehabiLItatioN (MERLIN) is an unactuated version of the robotic device ArmAssist combined with a telecare platform. Stroke patients are able to train the upper limb function using serious games at home. The aim of this study is to investigate the effect of MERLIN training on the upper limb function of patients with unilateral upper limb paresis in the chronic phase of stroke (> 6 months post stroke). Patients trained task specific serious games for three hours per week during six weeks using an unactuated version of a robotic device. Progress was monitored and game settings were tailored through telerehabilitation. Measurements were performed six weeks pre-intervention (T0), at the start (T1), end (T2) and six weeks post-intervention (T3). Primary outcome was the Wolf Motor Function Test (WMFT). Secondary outcomes were other arm function tests, quality of life, user satisfaction and motivation.Item Interaction force and motion estimators facilitating impedance control of the upper limb rehabilitation robot(IEEE Xplore, 2017-08-15) Mancisidor, Aitziber; Zubizarreta, Asier; Cabanes, Itziar; Bengoa, Pablo; Jung, Je Hyung; Ajoudani, Arash; Artemiadis, Panagiotis; Beckerle, Philipp; Grioli, Giorgio; Lambercy, Olivier; Mombaur, Katja; Novak, Domen; Rauter, Georg; Rodriguez Guerrero, Carlos; Salvietti, Gionata; Amirabdollahian, Farshid; Balasubramanian, Sivakumar; Castellini, Claudio; Di Pino, Giovanni; Guo, Zhao; Hughes, Charmayne; Iida, Fumiya; Lenzi, Tommaso; Ruffaldi, Emanuele; Sergi, Fabrizio; Soh, Gim Song; Caimmi, Marco; Cappello, Leonardo; Carloni, Raffaella; Carlson, Tom; Casadio, Maura; Coscia, Martina; De Santis, Dalia; Forner-Cordero, Arturo; Howard, Matthew; Piovesan, Davide; Siqueira, Adriano; Sup, Frank; Lorenzo, Masia; Catalano, Manuel Giuseppe; Lee, Hyunglae; Menon, Carlo; Raspopovic, Stanisa; Rastgaar, Mo; Ronsse, Renaud; van Asseldonk, Edwin; Vanderborght, Bram; Venkadesan, Madhusudhan; Bianchi, Matteo; Braun, David; Godfrey, Sasha Blue; Mastrogiovanni, Fulvio; McDaid, Andrew; Rossi, Stefano; Zenzeri, Jacopo; Formica, Domenico; Karavas, Nikolaos; Marchal-Crespo, Laura; Reed, Kyle B.; Tagliamonte, Nevio Luigi; Burdet, Etienne; Basteris, Angelo; Campolo, Domenico; Deshpande, Ashish; Dubey, Venketesh; Hussain, Asif; Sanguineti, Vittorio; Unal, Ramazan; Caurin, Glauco Augusto de Paula; Koike, Yasuharu; Mazzoleni, Stefano; Park, Hyung-Soon; Remy, C. David; Saint-Bauzel, Ludovic; Tsagarakis, Nikos; Veneman, Jan; Zhang, Wenlong; Tecnalia Research & Innovation; Medical TechnologiesIn order to enhance the performance of rehabilitation robots, it is imperative to know both force and motion caused by the interaction between user and robot. However, common direct measurement of both signals through force and motion sensors not only increases the complexity of the system but also impedes affordability of the system. As an alternative of the direct measurement, in this work, we present new force and motion estimators for the proper control of the upper-limb rehabilitation Universal Haptic Pantograph (UHP) robot. The estimators are based on the kinematic and dynamic model of the UHP and the use of signals measured by means of common low-cost sensors. In order to demonstrate the effectiveness of the estimators, several experimental tests were carried out. The force and impedance control of the UHP was implemented first by directly measuring the interaction force using accurate extra sensors and the robot performance was compared to the case where the proposed estimators replace the direct measured values. The experimental results reveal that the controller based on the estimators has similar performance to that using direct measurement (less than 1 N difference in root mean square error between two cases), indicating that the proposed force and motion estimators can facilitate implementation of interactive controller for the UHP in robot-mediated rehabilitation trainings.Item Requirements for Upper-Limb Rehabilitation with FES and Exoskeleton(Springer Science and Business Media Deutschland GmbH, 2021-02-06) Kim, Woojin; Joe, Hyunwoo; Kim, Hyun Suk; Lee, Seung Jun; Yoon, Daesub; Jung, Je Hyung; Acuña, Borja Bornail; Lee, Hooman; Raton, Javier Fínez; Isoird, Carlos Fernández; Mariñelarena, Iker; Alonso, Miguel Angel Aldudo; Shin, Myung Jun; Park, Tae Sung; Singh, Madhusudan; Kang, Dae-Ki; Lee, Jong-Ha; Tiwary, Uma Shanker; Singh, Dhananjay; Chung, Wan-Young; Medical Technologies; Tecnalia Research & InnovationIn the last work, we have presented the scope of our project, i.e. use cases of activities of daily living (ADL) for the on-going project a.k.a. iCARE. The project mainly handles the upper-limb rehabilitation in general, however, we have narrowed down the scope and focus on, in terms of the phase of the stroke recovery, the target body area of rehabilitation and the level of muscle function. In this paper, we have drawn the user and system requirements before design the specific functions of the targeted device. First, we have defined the stakeholders for the device and the rehabilitation service scenarios. Next, the user requirements are defined and finally the related system requirements are drawn.Item A Systematic Review of International Clinical Guidelines for Rehabilitation of People With Neurological Conditions: What Recommendations Are Made for Upper Limb Assessment?: What recommendations are made for upperlimb assessment?(2019-06-25) Burridge, Jane; Alt Murphy, Margit; Buurke, Jaap; Feys, Peter; Keller, Thierry; Klamroth-Marganska, Verena; Lamers, Ilse; McNicholas, Lauren; Prange, Gerdienke; Tarkka, Ina; Timmermans, Annick; Hughes, Ann-Marie; Tecnalia Research & InnovationConclusions: We present a comprehensive, critical, and original summary of current recommendations. Defining a core set of measures and agreed protocols requires international consensus between experts representing the diverse and multi-disciplinary field of neurorehabilitation including clinical researchers and practitioners, rehabilitation technology researchers, and commercial developers. Current lack of guidance may hold-back progress in understanding function and recovery. Together with a Delphi consensus study and an overview of systematic reviews of outcome measures it will contribute to the development of international guidelines for upper limb assessment in neurological conditions.