https://jneuroengrehab.biomedcentral.com/articles/10.1186/s12984-017-0312-4
- F. ResquínEmail author,
- J. Gonzalez-Vargas,
- J. Ibáñez,
- F. Brunetti,
- I. Dimbwadyo,
- L. Carrasco,
- S. Alves,
- C. Gonzalez-Alted,
- A. Gomez-Blanco and
- J. L. Pons
Journal of NeuroEngineering and Rehabilitation201714:104
© The Author(s). 2017
Received: 9 March 2017
Accepted: 27 September 2017
Published: 12 October 2017
Abstract
Background
Brain injury survivors often
present upper-limb motor impairment affecting the execution of
functional activities such as reaching. A currently active research line
seeking to maximize upper-limb motor recovery after a brain injury,
deals with the combined use of functional electrical stimulation (FES)
and mechanical supporting devices, in what has been previously termed
hybrid robotic systems. This study evaluates from the technical and
clinical perspectives the usability of an integrated hybrid robotic
system for the rehabilitation of upper-limb reaching movements after a
brain lesion affecting the motor function.
Methods
The presented system is
comprised of four main components. The hybrid assistance is given by a
passive exoskeleton to support the arm weight against gravity and a
functional electrical stimulation device to assist the execution of the
reaching task. The feedback error learning (FEL) controller was
implemented to adjust the intensity of the electrical stimuli delivered
on target muscles according to the performance of the users. This
control strategy is based on a proportional-integral-derivative feedback
controller and an artificial neural network as the feedforward
controller. Two experiments were carried out in this evaluation. First,
the technical viability and the performance of the implemented FEL
controller was evaluated in healthy subjects (N = 12). Second, a small cohort of patients with a brain injury (N = 4)
participated in two experimental session to evaluate the system
performance. Also, the overall satisfaction and emotional response of
the users after they used the system was assessed.
Results
In the experiment with healthy
subjects, a significant reduction of the tracking error was found
during the execution of reaching movements. In the experiment with
patients, a decreasing trend of the error trajectory was found together
with an increasing trend in the task performance as the movement was
repeated. Brain injury patients expressed a great acceptance in using
the system as a rehabilitation tool.
Conclusions
The study demonstrates the
technical feasibility of using the hybrid robotic system for reaching
rehabilitation. Patients’ reports on the received intervention reveal a
great satisfaction and acceptance of the hybrid robotic system.
Trial registration
Retrospective trial registration in ISRCTN Register with study ID ISRCTN12843006.
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