An online method to monitor hand muscle tone during robot-assisted rehabilitation
Introduction: Robot-assisted neurorehabilitation is becoming an established method to complement conventional therapy after stroke and provide intensive therapy regimes in unsupervised settings (e.g., home rehabilitation). Intensive therapies may temporarily contribute to increasing muscle tone and...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-02-01
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| Series: | Frontiers in Robotics and AI |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/frobt.2023.1093124/full |
| _version_ | 1811170950536757248 |
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| author | Raffaele Ranzani Giorgia Chiriatti Anne Schwarz Giada Devittori Roger Gassert Roger Gassert Olivier Lambercy Olivier Lambercy |
| author_facet | Raffaele Ranzani Giorgia Chiriatti Anne Schwarz Giada Devittori Roger Gassert Roger Gassert Olivier Lambercy Olivier Lambercy |
| author_sort | Raffaele Ranzani |
| collection | DOAJ |
| description | Introduction: Robot-assisted neurorehabilitation is becoming an established method to complement conventional therapy after stroke and provide intensive therapy regimes in unsupervised settings (e.g., home rehabilitation). Intensive therapies may temporarily contribute to increasing muscle tone and spasticity, especially in stroke patients presenting tone alterations. If sustained without supervision, such an increase in muscle tone could have negative effects (e.g., functional disability, pain). We propose an online perturbation-based method that monitors finger muscle tone during unsupervised robot-assisted hand therapy exercises.Methods: We used the ReHandyBot, a novel 2 degrees of freedom (DOF) haptic device to perform robot-assisted therapy exercises training hand grasping (i.e., flexion-extension of the fingers) and forearm pronosupination. The tone estimation method consisted of fast (150 ms) and slow (250 ms) 20 mm ramp-and-hold perturbations on the grasping DOF, which were applied during the exercises to stretch the finger flexors. The perturbation-induced peak force at the finger pads was used to compute tone. In this work, we evaluated the method performance in a stiffness identification experiment with springs (0.97 and 1.57 N/mm), which simulated the stiffness of a human hand, and in a pilot study with subjects with increased muscle tone after stroke and unimpaired, which performed one active sensorimotor exercise embedding the tone monitoring method.Results: The method accurately estimates forces with root mean square percentage errors of 3.8% and 11.3% for the soft and stiff spring, respectively. In the pilot study, six chronic ischemic stroke patients [141.8 (56.7) months after stroke, 64.3 (9.5) years old, expressed as mean (std)] and ten unimpaired subjects [59.9 (6.1) years old] were tested without adverse events. The average reaction force at the level of the fingertip during slow and fast perturbations in the exercise were respectively 10.7 (5.6) N and 13.7 (5.6) N for the patients and 5.8 (4.2) N and 6.8 (5.1) N for the unimpaired subjects.Discussion: The proposed method estimates reaction forces of physical springs accurately, and captures online increased reaction forces in persons with stroke compared to unimpaired subjects within unsupervised human-robot interactions. In the future, the identified range of muscle tone increase after stroke could be used to customize therapy for each subject and maintain safety during intensive robot-assisted rehabilitation. |
| first_indexed | 2024-04-10T17:05:18Z |
| format | Article |
| id | doaj.art-811db6d6b423420aa190e390351a578e |
| institution | Directory Open Access Journal |
| issn | 2296-9144 |
| language | English |
| last_indexed | 2024-04-10T17:05:18Z |
| publishDate | 2023-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Robotics and AI |
| spelling | doaj.art-811db6d6b423420aa190e390351a578e2023-02-06T05:30:25ZengFrontiers Media S.A.Frontiers in Robotics and AI2296-91442023-02-011010.3389/frobt.2023.10931241093124An online method to monitor hand muscle tone during robot-assisted rehabilitationRaffaele Ranzani0Giorgia Chiriatti1Anne Schwarz2Giada Devittori3Roger Gassert4Roger Gassert5Olivier Lambercy6Olivier Lambercy7Rehabilitation Engineering Laboratory, Department of Health Sciences and Technology, ETH Zurich, Zurich, SwitzerlandDepartment of Industrial Engineering and Mathematical Science, Polytechnic University of Marche, Ancona, ItalyVascular Neurology and Neurorehabilitation, Department of Neurology, University Hospital Zurich, University of Zurich, Zurich, SwitzerlandRehabilitation Engineering Laboratory, Department of Health Sciences and Technology, ETH Zurich, Zurich, SwitzerlandRehabilitation Engineering Laboratory, Department of Health Sciences and Technology, ETH Zurich, Zurich, SwitzerlandFuture Health Technologies, Singapore—ETH Centre, Campus for Research Excellence And Technological Enterprise (CREATE), Singapore, SingaporeRehabilitation Engineering Laboratory, Department of Health Sciences and Technology, ETH Zurich, Zurich, SwitzerlandFuture Health Technologies, Singapore—ETH Centre, Campus for Research Excellence And Technological Enterprise (CREATE), Singapore, SingaporeIntroduction: Robot-assisted neurorehabilitation is becoming an established method to complement conventional therapy after stroke and provide intensive therapy regimes in unsupervised settings (e.g., home rehabilitation). Intensive therapies may temporarily contribute to increasing muscle tone and spasticity, especially in stroke patients presenting tone alterations. If sustained without supervision, such an increase in muscle tone could have negative effects (e.g., functional disability, pain). We propose an online perturbation-based method that monitors finger muscle tone during unsupervised robot-assisted hand therapy exercises.Methods: We used the ReHandyBot, a novel 2 degrees of freedom (DOF) haptic device to perform robot-assisted therapy exercises training hand grasping (i.e., flexion-extension of the fingers) and forearm pronosupination. The tone estimation method consisted of fast (150 ms) and slow (250 ms) 20 mm ramp-and-hold perturbations on the grasping DOF, which were applied during the exercises to stretch the finger flexors. The perturbation-induced peak force at the finger pads was used to compute tone. In this work, we evaluated the method performance in a stiffness identification experiment with springs (0.97 and 1.57 N/mm), which simulated the stiffness of a human hand, and in a pilot study with subjects with increased muscle tone after stroke and unimpaired, which performed one active sensorimotor exercise embedding the tone monitoring method.Results: The method accurately estimates forces with root mean square percentage errors of 3.8% and 11.3% for the soft and stiff spring, respectively. In the pilot study, six chronic ischemic stroke patients [141.8 (56.7) months after stroke, 64.3 (9.5) years old, expressed as mean (std)] and ten unimpaired subjects [59.9 (6.1) years old] were tested without adverse events. The average reaction force at the level of the fingertip during slow and fast perturbations in the exercise were respectively 10.7 (5.6) N and 13.7 (5.6) N for the patients and 5.8 (4.2) N and 6.8 (5.1) N for the unimpaired subjects.Discussion: The proposed method estimates reaction forces of physical springs accurately, and captures online increased reaction forces in persons with stroke compared to unimpaired subjects within unsupervised human-robot interactions. In the future, the identified range of muscle tone increase after stroke could be used to customize therapy for each subject and maintain safety during intensive robot-assisted rehabilitation.https://www.frontiersin.org/articles/10.3389/frobt.2023.1093124/fullperturbationrobot-assisted rehabilitationhandstrokesafetyneurorehabilitation |
| spellingShingle | Raffaele Ranzani Giorgia Chiriatti Anne Schwarz Giada Devittori Roger Gassert Roger Gassert Olivier Lambercy Olivier Lambercy An online method to monitor hand muscle tone during robot-assisted rehabilitation Frontiers in Robotics and AI perturbation robot-assisted rehabilitation hand stroke safety neurorehabilitation |
| title | An online method to monitor hand muscle tone during robot-assisted rehabilitation |
| title_full | An online method to monitor hand muscle tone during robot-assisted rehabilitation |
| title_fullStr | An online method to monitor hand muscle tone during robot-assisted rehabilitation |
| title_full_unstemmed | An online method to monitor hand muscle tone during robot-assisted rehabilitation |
| title_short | An online method to monitor hand muscle tone during robot-assisted rehabilitation |
| title_sort | online method to monitor hand muscle tone during robot assisted rehabilitation |
| topic | perturbation robot-assisted rehabilitation hand stroke safety neurorehabilitation |
| url | https://www.frontiersin.org/articles/10.3389/frobt.2023.1093124/full |
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