Matching Items (6)
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- All Subjects: Rehabilitation
- Creators: Santello, Marco
Description
The generation of walking motion is one of the most vital functions of the human body because it allows us to be mobile in our environment. Unfortunately, numerous individuals suffer from gait impairment as a result of debilitating conditions like stroke, resulting in a serious loss of mobility. Our understanding of human gait is limited by the amount of research we conduct in relation to human walking mechanisms and their characteristics. In order to better understand these characteristics and the systems involved in the generation of human gait, it is necessary to increase the depth and range of research pertaining to walking motion. Specifically, there has been a lack of investigation into a particular area of human gait research that could potentially yield interesting conclusions about gait rehabilitation, which is the effect of surface stiffness on human gait. In order to investigate this idea, a number of studies have been conducted using experimental devices that focus on changing surface stiffness; however, these systems lack certain functionality that would be useful in an experimental scenario. To solve this problem and to investigate the effect of surface stiffness further, a system has been developed called the Variable Stiffness Treadmill system (VST). This treadmill system is a unique investigative tool that allows for the active control of surface stiffness. What is novel about this system is its ability to change the stiffness of the surface quickly, accurately, during the gait cycle, and throughout a large range of possible stiffness values. This type of functionality in an experimental system has never been implemented and constitutes a tremendous opportunity for valuable gait research in regard to the influence of surface stiffness. In this work, the design, development, and implementation of the Variable Stiffness Treadmill system is presented and discussed along with preliminary experimentation. The results from characterization testing demonstrate highly accurate stiffness control and excellent response characteristics for specific configurations. Initial indications from human experimental trials in relation to quantifiable effects from surface stiffness variation using the Variable Stiffness Treadmill system are encouraging.
ContributorsBarkan, Andrew Robert (Author) / Artemiadis, Panagiotis (Thesis director) / Santello, Marco (Committee member) / Barrett, The Honors College (Contributor) / Mechanical and Aerospace Engineering Program (Contributor)
Created2015-05
Description
Repetitive practice of functional movement patterns during motor rehabilitation are known to drive learning (or relearning) of novel motor skills, but the learning process is highly variable between individuals such that responsiveness to task-specific training is often patient-specific. A number of neuroimaging and neurophysiological methods have been proposed to better predict a patient’s responsiveness to a given type or dose of motor therapy. However, these methods are often time- and resource-intensive, and yield results that are not readily interpretable by clinicians. In contrast, standardized visuospatial tests may offer a more feasible solution. The work presented in this dissertation demonstrate that a clinical paper-and-pencil test of visuospatial function may improve predictive models of motor skill learning in older adults and individuals with stroke pathology. To further our understanding of the neuroanatomical correlates underlying this behavioral relationship, I collected diffusion-weighted magnetic resonance images from 19 nondemented older adults to determine if diffusion characteristics of white matter tracts explain shared variance in delayed visuospatial memory test scores and motor skill learning. Consistent with previous work, results indicated that the structural integrity of regions with the bilateral anterior thalamic radiations, corticospinal tracts, and superior longitudinal fasciculi are related to delayed visuospatial memory performance and one-week skill retention. Overall, results of this dissertation suggest that incorporating a clinical paper-and-pencil test of delayed visuospatial memory may prognose motor rehabilitation outcomes and support that personalized variables should be considered in standards of care. Moreover, regions within specific white matter tracts may underlie this behavioral relationship and future work should investigate these regions as potential targets for therapeutic intervention.
ContributorsLingo VanGilder, Jennapher (Author) / Schaefer, Sydney Y (Thesis advisor) / Santello, Marco (Committee member) / Buneo, Christopher (Committee member) / Rogalsky, Corianne (Committee member) / Duff, Kevin (Committee member) / Arizona State University (Publisher)
Created2021
Description
The human hand comprises complex sensorimotor functions that can be impaired by neurological diseases and traumatic injuries. Effective rehabilitation can bring the impaired hand back to a functional state because of the plasticity of the central nervous system to relearn and remodel the lost synapses in the brain. Current rehabilitation therapies focus on strengthening motor skills, such as grasping, employ multiple objects of varying stiffness and devices that are bulky, costly, and have limited range of stiffness due to the rigid mechanisms employed in their variable stiffness actuators. This research project presents a portable cost-effective soft robotic haptic device with a broad stiffness range that is adjustable and can be utilized in both clinical and home settings. The device eliminates the need for multiple objects by employing a pneumatic soft structure made with highly compliant materials that act as the actuator as well as the structure of the haptic interface. It is made with interchangeable soft elastomeric sleeves that can be customized to include materials of varying stiffness to increase or decrease the stiffness range. The device is fabricated using existing 3D printing technologies, and polymer molding and casting techniques, thus keeping the cost low and throughput high. The haptic interface is linked to either an open-loop system that allows for an increased pressure during usage or closed-loop system that provides pressure regulation in accordance with the stiffness the user specifies. A preliminary evaluation is performed to characterize the effective controllable region of variance in stiffness. Results indicate that the region of controllable stiffness was in the center of the device, where the stiffness appeared to plateau with each increase in pressure. The two control systems are tested to derive relationships between internal pressure, grasping force exertion on the surface, and displacement using multiple probing points on the haptic device. Additional quantitative evaluation is performed with study participants and juxtaposed to a qualitative analysis to ensure adequate perception in compliance variance. Finally, a qualitative evaluation showed that greater than 60% of the trials resulted in the correct perception of stiffness in the haptic device.
ContributorsSebastian, Frederick (Author) / Polygerinos, Panagiotis (Thesis advisor) / Santello, Marco (Committee member) / Fu, Qiushi (Committee member) / Arizona State University (Publisher)
Created2018
Description
With an aging population, the number of later in life health related incidents like stroke stand to become more prevalent. Unfortunately, the majority those who are most at risk for debilitating heath episodes are either uninsured or under insured when it comes to long term physical/occupational therapy. As insurance companies lower coverage and/or raise prices of plans with sufficient coverage, it can be expected that the proportion of uninsured/under insured to fully insured people will rise. To address this, lower cost alternative methods of treatment must be developed so people can obtain the treated required for a sufficient recovery. The presented robotic glove employs low cost fabric soft pneumatic actuators which use a closed loop feedback controller based on readings from embedded soft sensors. This provides the device with proprioceptive abilities for the dynamic control of each independent actuator. Force and fatigue tests were performed to determine the viability of the actuator design. A Box and Block test along with a motion capture study was completed to study the performance of the device. This paper presents the design and classification of a soft robotic glove with a feedback controller as a at-home stroke rehabilitation device.
ContributorsAxman, Reed C (Author) / Zhang, Wenlong (Thesis advisor) / Santello, Marco (Committee member) / McDaniel, Troy (Committee member) / Arizona State University (Publisher)
Created2022
Description
The human ankle is a vital joint in the lower limb of the human body. As the point of interaction between the human neuromuscular system and the physical world, the ankle plays important role in lower extremity functions including postural balance and locomotion . Accurate characterization of ankle mechanics in lower extremity function is essential not just to advance the design and control of robots physically interacting with the human lower extremities but also in rehabilitation of humans suffering from neurodegenerative disorders.
In order to characterize the ankle mechanics and understand the underlying mechanisms that influence the neuromuscular properties of the ankle, a novel multi-axial robotic platform was developed. The robotic platform is capable of simulating various haptic environments and transiently perturbing the ankle to analyze the neuromechanics of the ankle, specifically the ankle impedance. Humans modulate ankle impedance to perform various tasks of the lower limb. The robotic platform is used to analyze the modulation of ankle impedance during postural balance and locomotion on various haptic environments. Further, various factors that influence modulation of ankle impedance were identified. Using the factors identified during environment dependent impedance modulation studies, the quantitative relationship between these factors, namely the muscle activation of major ankle muscles, the weight loading on ankle and the torque generation at the ankle was analyzed during postural balance and locomotion. A universal neuromuscular model of the ankle that quantitatively relates ankle stiffness, the major component of ankle impedance, to these factors was developed.
This neuromuscular model is then used as a basis to study the alterations caused in ankle behavior due to neurodegenerative disorders such as Multiple Sclerosis and Stroke. Pilot studies to validate the analysis of altered ankle behavior and demonstrate the effectiveness of robotic rehabilitation protocols in addressing the altered ankle behavior were performed. The pilot studies demonstrate that the altered ankle mechanics can be quantified in the affected populations and correlate with the observed adverse effects of the disability. Further, robotic rehabilitation protocols improve ankle control in affected populations as seen through functional improvements in postural balance and locomotion, validating the neuromuscular approach for rehabilitation.
In order to characterize the ankle mechanics and understand the underlying mechanisms that influence the neuromuscular properties of the ankle, a novel multi-axial robotic platform was developed. The robotic platform is capable of simulating various haptic environments and transiently perturbing the ankle to analyze the neuromechanics of the ankle, specifically the ankle impedance. Humans modulate ankle impedance to perform various tasks of the lower limb. The robotic platform is used to analyze the modulation of ankle impedance during postural balance and locomotion on various haptic environments. Further, various factors that influence modulation of ankle impedance were identified. Using the factors identified during environment dependent impedance modulation studies, the quantitative relationship between these factors, namely the muscle activation of major ankle muscles, the weight loading on ankle and the torque generation at the ankle was analyzed during postural balance and locomotion. A universal neuromuscular model of the ankle that quantitatively relates ankle stiffness, the major component of ankle impedance, to these factors was developed.
This neuromuscular model is then used as a basis to study the alterations caused in ankle behavior due to neurodegenerative disorders such as Multiple Sclerosis and Stroke. Pilot studies to validate the analysis of altered ankle behavior and demonstrate the effectiveness of robotic rehabilitation protocols in addressing the altered ankle behavior were performed. The pilot studies demonstrate that the altered ankle mechanics can be quantified in the affected populations and correlate with the observed adverse effects of the disability. Further, robotic rehabilitation protocols improve ankle control in affected populations as seen through functional improvements in postural balance and locomotion, validating the neuromuscular approach for rehabilitation.
ContributorsNalam, Varun (Author) / Lee, Hyunglae (Thesis advisor) / Artemiadis, Panagiotis (Committee member) / Santello, Marco (Committee member) / Sugar, Thomas (Committee member) / Lockhart, Thurmon (Committee member) / Arizona State University (Publisher)
Created2020
Description
Stroke occurs when the blood supply to part of the brain is interrupted or reduced, preventing brain tissue from getting oxygen and nutrients, thus causing brain cells to die. Stroke is the 5th leading cause of death in the United States and is one of the major causes of disability. Conventional therapy is a form of stroke rehabilitation generally consisting of physical and occupational therapy. It focuses on customized exercises based on the patient’s feedback. Physical therapy includes exercises such as weight bearing (affected arm), vibration of affected muscle and gravity-eliminated movement of affected arm. Overall physical therapy aims at strengthening muscle groups and aides in the relearning process. Occupational aspect of conventional therapy includes activities of daily living (ADL) such as dressing, self-feeding, grooming and toileting. Overall occupational therapy focuses on improving the daily activities performed by individuals. In comparison to conventional therapy, robotic therapy is relatively newer therapy. It uses robotic devices to perform repetitive motions and delivers high dosage and high intensity training to stroke patients. Based on the research studies reviewed, it is known that neuroplasticity in stroke patients is linked to interventions which are high in dosage, intensity, repetition, difficulty, salience. Peer-reviewed literature suggests robotic therapy might be a viable option for recovery in stroke patients. However, the extent to which robotic therapy may provide greater benefits than conventional therapy remains unclear. This thesis addresses the key components of a study design for comparing the efficacy of robotic therapy relative to conventional therapy to improve upper limb sensorimotor function in stroke survivors. The study design is based on an extensive review of the literature of stroke clinical trials and robotic therapy studies, analyses of the capabilities of a robotic therapy device (M2, Fourier Intelligence), and pilot data collected on healthy controls to create a pipeline of tasks and analyses to extract biomarkers of sensorimotor functional changes. This work has laid the foundation for a pilot longitudinal study that will be conducted at the Barrow Neurological Institute, Phoenix, AZ, where conventional and robotic therapy will be compared in a small cohort of stroke survivors.
ContributorsThomas, Lovein (Author) / Santello, Marco (Thesis advisor) / Kleim, Jeffrey (Committee member) / Maruyama, Trent (Committee member) / Arizona State University (Publisher)
Created2021