Summary of the technology supported upper limb rehab lesson given by prof P.Feys of the rehab technology course. It is a summary of the powerpoint slides and additional items noted during the lesson. The slides were in English and my own notes are always in Dutch as much as possible. It is therefor...
What’s in a name?
The term "rehabilitation technology" means the systematic application of technologies, engineering
methodologies, or scientific principles to meet the needs of and address the barriers confronted by
individuals with disabilities in areas which include education, rehabilitation, employment, transportation,
independent living, and recreation.
- Technische visie+ klinische visie
The term includes rehabilitation engineering, assistive technology devices, and assistive technology
services
Robots & Electromechanical Devices/Sensors
Amadeo
- Vingerbewegingen
- /p/;/ap/;/a/;/w/
- Testen spasticitet
Balance board
MIT motion
- 1e robot voor klinische doeleinde
Course content: New Technologies
Robotics
- «Application of robotic devices to assist, enhance and intensify therapy.»
- Gaat BL effectief bewegen
- Heft motor
Non-ActuatorDevices
- «Use of non-actuated devices (no motors) such as body weight support systems to facilitate
rehabilitation.»
- Electromechanische apparatuur
- In latere stages
- Beweegt arm niet meer
Sensor Technology
- «Use of sensors (motion, force etc.) for assessing and enhancing therapy.»
Virtual Reality
- «Use of virtual reality and environments for enhancing movement therapy & providing augmented
feedback»
- Meer FB dan zien in real life
- Augumenting expierence of performance
Key Factors for Recovery
Is technologie een meerwaarde voor behandeling?
Als P niet veel kan= veelvragen van T
- Blijven aanmoedigen etc.
Nog veel moet ontwikkeld worden in technologie
Task segmentation
- Deek van 1 taak oefenen
Variability
- Moeilijkheid; richtingen; bewegingen;…
Nala Melis Pagina 1
, Rehab tech.:Feys: Technology supported upper limb rehab
Advantages of new Technologies
Passive Technologies
Orthoses
- Passive Walking aids.
Functional Electrical Stimulation
- «Application of electrical stimulation to create functional movements and improve recovery.»
Brain Stimulation
- «Application of electrical stimulation to the brain for enhancing recovery.»
FIRST DEVELOPMENTS IN TECHNOLOGY-SUPPORTED TRAINING & REHABILITATION
* The Gustav Zander's institute in Stockholm
- founded in the late nineteenth century (1870)
- featured 27 of the physician's custom-built machines.
Why took (take) it so long before technologysupported training is accepted in rehab?
- Neuro-developmental treatment – Karel en Bertha Bobath
Tone reduction & normal movement quality (selectivity)
Waren tegen technologie
Werken op bewegingskwaliteit
o Attentive voor hoe bewegen segmenten
- wat zijn de principes van bobath
hands on therapy
geen compensatie toegestaan
- apparaat met R= negatief
↑spiermassa & tonus
Niet perse kwaliteit van beweging compensaties
- --> technology zou ervoor kunnen zorgen dat er toch compensaties voorkomen
- --> doel= tonus reductie (met technologie moelijker te controleren)
ACTIVITY-INDUCED NEUROPLASTICITY
! Active training enhances neuroplasticity
- results in reorganization of cortical maps
- Enkel hands on is niet voldoende
- Practicing perfection by 10000 touches
Veel herhaling kan ervoor zorgen dat je een
beweging perfect kan uitvoeren
Sommige apparten kunnen helpen bij BL reva
- Indien begeleid & /a/
Veel herhaling nodig voor automatisatie
- In neuropatienten al blij zijn met kleine
verbeteringen
! Neuroplasticity and learning can be driven by several key factors taken from motor learning theory.
Makkelijk Intensity Psychological factors
met technologie te verwezelijken - Repetitions - Motivation
- Duration
- Distribution/frequency
- Effort
- Difficulty
Kan dit met Manner Information
technologie bereikt worden? - Task segmentation - Instructions
- Specificity/functionality - Feedback
- Variability
- Initiation
- Shaping
Intensity = frequency / duration / repetitions X effort / difficulty of task
- The ‘Black Box’ of traditional neuro-rehabilitation
- Quantify/Measure the dosage delivery
MECHANICAL CLASSIFICATION OF DEVICES
ROBOTS & ELECTROMECHANICAL DEVICES
Exoskeleton / end-effector
- Exoskeleton: er is een mechanica rond het ledemaat, dat zo het ledemaat kan bewegen
buiten lichaam
- End-effector: er is contact met een “endpoint”, dit kan bewogen worden
Enkel vingers bewegen
Distaal deel enkel bewegen
Degree of freedoms (dof) proximal-distal arm
Electromechanical
- Kan bewegen+ is electrisch gecontroleerd
Detective beweging + gebruiken in VR
- Electrisch & mechanisch
- Zelfde als actuator
- Mechanische link
ARMEO SPRING Amadeo BI-MANU TRACK
not a robot, non-actuator Robot Robot
exoskeleton End effector End effector
Exoskeleton End-effector
Zonder motor, met een veer Zowel de P als de robot kan de
- /w/ kan zo aangepast beweging uitvoeren
worden
P maakt alle bew. (/a/, /p/ en /ap/)
Nala Melis Pagina 3
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