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research article

Motor improvement estimation and task adaptation for personalized robot-aided therapy: a feasibility study

Giang, Christian
•
Pirondini, Elvira  
•
Kinany, Nawal  
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May 14, 2020
Biomedical Engineering Online

Background In the past years, robotic systems have become increasingly popular in upper limb rehabilitation. Nevertheless, clinical studies have so far not been able to confirm superior efficacy of robotic therapy over conventional methods. The personalization of robot-aided therapy according to the patients' individual motor deficits has been suggested as a pivotal step to improve the clinical outcome of such approaches. Methods Here, we present a model-based approach to personalize robot-aided rehabilitation therapy within training sessions. The proposed method combines the information from different motor performance measures recorded from the robot to continuously estimate patients' motor improvement for a series of point-to-point reaching movements in different directions. Additionally, it comprises a personalization routine to automatically adapt the rehabilitation training. We engineered our approach using an upper-limb exoskeleton. The implementation was tested with 17 healthy subjects, who underwent a motor-adaptation paradigm, and two subacute stroke patients, exhibiting different degrees of motor impairment, who participated in a pilot test undergoing rehabilitative motor training. Results The results of the exploratory study with healthy subjects showed that the participants divided into fast and slow adapters. The model was able to correctly estimate distinct motor improvement progressions between the two groups of participants while proposing individual training protocols. For the two pilot patients, an analysis of the selected motor performance measures showed that both patients were able to retain the improvements gained during training when reaching movements were reintroduced at a later stage. These results suggest that the automated training adaptation was appropriately timed and specifically tailored to the abilities of each individual. Conclusions The results of our exploratory study demonstrated the feasibility of the proposed model-based approach for the personalization of robot-aided rehabilitation therapy. The pilot test with two subacute stroke patients further supported our approach, while providing encouraging results for the applicability in clinical settings.

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Type
research article
DOI
10.1186/s12938-020-00779-y
Web of Science ID

WOS:000536177700003

Author(s)
Giang, Christian
Pirondini, Elvira  
Kinany, Nawal  
Pierella, Camilla  
Panarese, Alessandro
Coscia, Martina
Miehlbradt, Jenifer
Magnin, Cecile
Nicolo, Pierre
Guggisberg, Adrian
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Date Issued

2020-05-14

Published in
Biomedical Engineering Online
Volume

19

Issue

1

Start page

33

Subjects

Engineering, Biomedical

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Engineering

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personalized therapy

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rehabilitation robotics

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stroke rehabilitation

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upper-limb impairment

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assisted therapy

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qualitative-analysis

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stroke recovery

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mechanisms

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plasticity

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brain

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neurorehabilitation

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performance

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motivation

Note

This article is licensed under a Creative Commons Attribution License.

Editorial or Peer reviewed

REVIEWED

Written at

EPFL

EPFL units
TNE  
Available on Infoscience
June 11, 2020
Use this identifier to reference this record
https://infoscience.epfl.ch/handle/20.500.14299/169228
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