Robotics in PT Flashcards by Mind Med

HISTORY

Identify the year:
- Purpose of robotics: for military purposes

1965

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HISTORY

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- Full body exoskeleton

1965

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HISTORY

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- Hardiman by General Electric (US)

1965

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HISTORY

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- First exoskeletons for gait assistance
- Mihajlo Pupin Institute Serbia
- University of Wisconsin-Madison, US

1970’s

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HISTORY

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- RTX manipulator touch-sensitive pad as an end-effector
- Recorded response times, could be compared to previous sessions

1980

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HISTORY

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- MIT-MANUS Project for rehabilitation purposes
- distinct approach to upper-extremity stroke therapy and successfully demonstrated their clinical effectiveness

1990’S

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HISTORY

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- Mechanical control
- Lokomat for stroke and SCI

2001

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One of the earliest devices for locomotion

Lokomat for stroke and SCI

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HISTORY

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World’s first wearable cyborg
Bio-electrical signals (BES)
Birth of the Hybrid Assistive Limb (HAL)

2005

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HISTORY

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Military exoskeletons (Raytheon XOS)
ReWalk, Indego (enables paraplegic patients to get out of their wheelchair)

2010

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HISTORY

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Children’s Healthcare of Atlanta
First Pedia Rehab Program
Ekso Robotic Exoskeleton
Robotic devices to assist factory workers in biomechanics

2015

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HISTORY

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HAL robotic exoskeleton devices were acquired by the city of Manila.

2021 & 2022

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HISTORY

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Cybathlon in Switzerland
Paraplegias using robotic devices compete

2016

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What were the 3 hospitals that acquired HAL robotic exoskeleton devices in 2021 and 2022?

ospital ng maynila, sta ana hospital, san andres hospital

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HISTORY

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Filipinos made upper extremity rehabilitation robot, “AGAPAY Project” received its first international patent.

2023

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Invented in DLSU
Exoskeleton device for UE
Has functions for both passive and active motion

AGAPAY Project

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GIVE 3 OF THE GENERAL CHARACTERISTICS OF PATIENTS WHO ARE ELIGIBLE FOR ROBOTIC REHABILITATION

-WITH MEDICAL CLEARANCE FOR AMBULATION
-GOOD CARDIOPULMONARY HEALTH
-NORMAL BONE DENSITY
-STABLE SPINE / NO UNHEALED FRACTURES
-CONTROLLED AUTONOMIC DYSREFLEXIA AND ORTHOSTATIC HYPOTENSION
-ABSENCE OF UNCONTROLLED LIMB MOVEMENTS
-NORMAL COGNITION
-WITHOUT SEVERE DEFORMITY
-MANAGEABLE SPASTICITY (MAS: GRADE 3 AND BELOW)

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CORE PRINCIPLES OF EXPERIENCE-DEPENDENT NEUROPLASTICITY

Natural networks not actively engaged in training can degrade

USE IT OR LOSE IT

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CORE PRINCIPLES OF EXPERIENCE-DEPENDENT NEUROPLASTICITY

Training can induce dendritic growth and synaptogonesis within specific brain regions that enhance task performance

USE IT & IMPROVE IT

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The nature of training dictates the nature of plasticity

SPECIFICITY

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Repitition is required to induce lasting neural change (skill instantiation)

REPETITION MATTERS

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A sufficient intensity of stimulation is required to induce plasticity

INTENSITY MATTERS

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Different forms of plasticity occur at different times & during training

TIME MATTERS

The training experience must be sufficiently rewarding to induce plasticity

SALIENCE MATTERS

Training-induced plasticity occurs more readily in the younger brain

AGE MATTERS

Plasticity induced by one training experience can enhance the acquisition of similar behaviors

TRANSFERENCE

All are OMTs for the UE except: - Action Research Arm Test - Children’s Hand-use Experience - Canadian Occupational Performance Measure (COPM) - Questionnaire Quality of Upper Extremity Skills Test (QUEST) - Modified Ashworth Scale (MAS)

Canadian Occupational Performance Measure (COPM)

Plasticity induced by one training experience can interfere the acquisition of similar behaviors

INTERFERENCE

Give 3 OMTs for the LE used in robotics for PT

- Walking ability gait speed, step length, cadence - 6-min walking distance (6MD) - Gross Motor Function Measure (GMFM) - Canadian Occupational Performance Measure (COPM) - Pediatric Evaluation of Disability Inventory - Modified Ashworth Scale (MAS)

ELIGIBILITY T/F Manual Ability Classification System (MACS) Level of II-III for UE.

FALSE Manual Ability Classification System (MACS) Level of II-IV for UE.

ELIGIBILITY T/F Gross Motor Function Classification System (GMFCS) levels I–IV

TRUE

ELIGIBILITY T/F - Able to express pain and anxiety through verbal or nonverbal communication or gestures, and facial expressions. - Cooperative and follows instructions. - No significant deformities or contractures. - Sufficient limb length and size.

TRUE

The following are challenges in robotics in PT except: - Difficulty in maintaining patient’s motivation and attention. - Compensatory and involuntary movements such as head turning, and shoulder elevation. - Complains of fatigue. - Available devices specifically designed to fit younger/smaller patients. (e.g. 5 years old)

- Available devices specifically designed to fit younger/smaller patients. (e.g. 5 years old) There is a lack of available devices specifically designed to fit younger/smaller patients. (e.g. 5 years old)

ADVANTAGES OF ROBOTICS IN PT T/F ENHANCE CAPACITY TO PERFORM HIGHLY REPETITIVE TASKS AND INTENSE EXERCISES

TRUE

ADVANTAGES OF ROBOTICS IN PT T/F LESS BURDEN TO THE PATIENT AND THE THERAPIST

TRUE

ADVANTAGES OF ROBOTICS IN PT T/F LESS ACCURATE ASSISTANCE, FEEDBACK AND ASSESSMENT

FALSE MORE ACCURATE ASSISTANCE, FEEDBACK AND ASSESSMENT

ADVANTAGES OF ROBOTICS IN PT T/F ACCURACY AND CONSISTENCY OF MOVEMENT PATTERNS

TRUE

ADVANTAGES OF ROBOTICS IN PT T/F VISUALLY PLEASING

TRUE

ADVANTAGES OF ROBOTICS IN PT T/F Boring for the patient

FALSE. CAPTURES THE PATIENT’S INTEREST

T/F SOME DEVICES ARE HEAVY AND TAKES TIME AND EFFORT TO WEAR

TRUE

T/F ROBOTICS MAY LEAD TO FRUSTRATION FROM PATIENTS WHO TAKES LONGER TO IMPROVE

TRUE

T/F ROBOTICS IS COSTLY. IT MAY LEAD TO MISCONCEPTION THAT THE USE OF A HIGH TECH AND EXPENSIVE DEVICE WILL DEFINITELY “CURE” THEM.

TRUE

What is the goal of robotic rehabilitation?

To serve as an adjunct to conventional therapy to optimize promotion of neuroplasticity and enhance motor re-learning by providing assistance and feedback beyond the capacity of manual techniques.

- Manipulandum (handle) at the distal part of the pt will have the control which will give different controls - Assistive, active-assistive or assist as needed or resisted motion - Can be imbued with haptic technology (different tactile sensations introduced)

End-effector-based

Identification Examples of End-effector-based robotics: - Enables robotically assisted therapy exercises for the paretic fingers. - Taped to the distal phalanges. - Can perform passive, active assistive, and isometric activities. - Real-time biofeedback - Integrated EMG

AMADEO (Trymotion, Austria)

Identification Examples of End-effector-based robotics: -Manipulandum -Patient can draw shapes or move their UE along a specific path. -The kinematic data collected is useful for gauging post-stroke motor recovery.

MIT-MANUS (Interactive Motion Technologies, Cambridge, MA)

- Worn outside of the patient’s body - Divided into stationary (fixed in an area) and mobile (portable; worn in the clinic or for personal use outside)

Exoskeleton-type

Identification Examples of End-effector-based robotics: -Supports motion of finger joints while detecting voluntary active motion. -Multisensory stimulation and a simultaneous 3D animation on the screen to amplifiy the cortical stimulation. -Patient can use his/her healthy hand to reply similar movements on the affected hand through Gloreha robotic glove.

GLOREHA SINFONIA

Identification Examples of End-effector-based robotics: Provides training on all stages of stroke recovery. Has 4 different control modes: -Passive -Assistive -Active -Resistive

ARM MOTUS M2 PRO

Identification Examples of exoskeleton type: -Part of a unique modular therapy concept that covers the whole “Continuum of Rehabilitation”. -Uses a single software platform throughout various devices for a specific stage of rehabilitation from early rehabilitation to long-term recovery.

ARMEO SPRING (Hocoma)

Identification Examples of exoskeleton type: Amplify patient's weak bioelectrical signals. Detects signals by using different sensors attached to the patient's skin.

MYOMO ROBOTIC ARM (Massachusetts Institute of Technology)

Identification Examples of exoskeleton type: Fourier Intelligence Amplify patient's weak bioelectrical signals. Detects signals by using different sensors attached to the patient's skin.

HANDY REHAB

CONTROL STRATEGIES FOR ROBOT-ASSISTED THERAPY EMG, ground reaction force, counterbalance

Assistance Strategies

CONTROL STRATEGIES FOR ROBOT-ASSISTED THERAPY Resistive, constraint-induced

Challenge-based strategies

CONTROL STRATEGIES FOR ROBOT-ASSISTED THERAPY Providing different sensations - Proprioceptive, tactile, etc Particularly, for UE with virtual reality - Teaches skill to the patient

Haptic Simulation Strategies

CONTROL STRATEGIES FOR ROBOT-ASSISTED THERAPY Type of devices that does not have contact with patients; just coaching E.g., Assess form/posture then provide feedback and motivation

Embodied Coaching Strategies