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A Helping Hand: On Innovations for Rehabilitation and Assistive Technology
KTH, School of Technology and Health (STH), Neuronic Engineering (Closed 20130701). (Implantat)
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

This thesis focuses on assistive and rehabilitation technology for restoring the function of the hand. It presents three different approaches to assistive technology: one in the form of an orthosis, one in the form of a brain-computer interface combined with functional electrical stimulation and finally one totally aiming at rehabilitating the nervous system by restoring brain function using the concept of neuroplasticity. The thesis also includes an epidemiological study based on statistics from the Swedish Hospital Discharge Register and a review on different methods for assessment of hand function.

A novel invention of an orthosis in form of a light weight glove, the SEM (Soft Extra Muscle) glove, is introduced and described in detail. The SEM glove is constructed for improving the grasping capability of a human independently of the particular task being performed. A key feature is that a controlling and strengthening effect is achieved without the need for an external mechanical structure in the form of an exoskeleton. The glove is activated by input from tactile sensors in its fingertips and palm. The sensors react when the applied force is larger than 0.2 N and feed a microcontroller of DC motors. These pull lines, which are attached to the fingers of the glove and thus work as artificial tendons.

A clinical study on the feasibility of the SEM glove to improve hand function on a group of patients with varying degree of disability has been made. Assessments included passive and active range of finger motion, flexor muscle strength according to the Medical Research Council (MRC) 0-5 scale, grip strength using the Grippit hand dynamometer, fine motor skills according to the Nine Hole Peg test and hand function in common activities by use of the Sollerman test. Participants rated the potential benefit on a Visual Analogue Scale.

A prototype for a system for combining BCI (Brain-Computer Interface) and FES (Functional Electrical Stimulation) is described. The system is intended to be used during the first period of recovery from a TBI (Traumatic Brain Injury) or stroke that have led to paresis in the hand, before deciding on a permanent system, thus allowing the patients to get a quick start on the motor relearning. The system contains EEG recording electrodes, a control unit and a power unit. Initially the patients will practice controlling the movement of a robotic hand and then move on to controlling pulses being sent to stimulus electrodes placed on the paretic muscle.

An innovative electrophysiological device for rehabilitation of brain lesions is presented, consisting of a portable headset with electrodes on both sides adapted on the localization of treatment area. The purpose is to receive the outgoing signal from the healthy side of the brain and transfer that signal to the injured and surrounding area of the remote side, thereby having the potential to facilitate the reactivation of the injured brain tissue. The device consists of a control unit as well as a power unit to activate the circuit electronics for amplifying, filtering, AD-converting, multiplexing and switching the outgoing electric signals to the most optimal ingoing signal for treatment of the injured and surrounding area.

Place, publisher, year, edition, pages
Stockholm: KTH Royal Institute of Technology, 2013. , viii, 51 p.
Series
TRITA-STH : report, ISSN 1653-3836 ; 2013:2
Keyword [en]
Hand function, Mechatronic system, Orthose, Neurological rehabilitation, Brain-Computer Interface, Functional Electric Stimulation
National Category
Other Medical Engineering
Identifiers
URN: urn:nbn:se:kth:diva-120142ISBN: 978-91-7501-703-7 OAI: oai:DiVA.org:kth-120142DiVA: diva2:613605
Public defence
2013-04-18, Sal 4-221, Alfred Nobels Allé 12, Huddinge, 13:00 (English)
Opponent
Supervisors
Note

QC 20130403

Available from: 2013-04-03 Created: 2013-03-28 Last updated: 2017-02-22Bibliographically approved
List of papers
1. Incidence of traumatic peripheral nerve injuries and amputations in Sweden between 1998 and 2006
Open this publication in new window or tab >>Incidence of traumatic peripheral nerve injuries and amputations in Sweden between 1998 and 2006
2008 (English)In: Neuroepidemiology, ISSN 0251-5350, E-ISSN 1423-0208Article in journal (Refereed) Published
Abstract [en]

Background: To define the epidemiological pattern of nerve injuries and traumatic amputations in Sweden, 1998-2006, and investigate possible targets for emerging neural engineering and neuroprosthetic technologies.

Methods: The Swedish Hospital Discharge Register was used as basis of information, including data from all public in-patient care, excluding out-patient data. ICD-10 codes were screened for nerve injuries and traumatic amputations of high incidence or in-patient care time. Selected codes, causing factors, age and gender distribution were discussed in detail, and potential targets for tailored solutions were identified.

Results: Incidence rate was determined to 13.9 for nerve injuries and 5.21 for amputations per 100 000 person-yrs. The majority of injuries occurred at wrist and hand level although it could be concluded that these are often minor injuries requiring less than a week of hospitalization. The single most care consuming nerve injury was brachial plexus injury constituting, in average, 68 injuries and 960 hospital days annually. When minor amputations of fingers and toes were disregarded, most frequent site of amputation was between knee and ankle (24 patients / year).

Conclusions: Based on analysis of incidence and care time, we find that brachial plexus injuries and lower leg amputations should be primary targets of these new technologies.

Place, publisher, year, edition, pages
Basel: Kargel, AG, 2008
Keyword
Traumatic nerve injury, Traumatic amputations, Epidemiology
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:kth:diva-9844 (URN)10.1159/000197900 (DOI)000263534100010 ()2-s2.0-58649100228 (Scopus ID)
Note
QC 20100623Available from: 2009-01-12 Created: 2009-01-12 Last updated: 2017-12-14Bibliographically approved
2. The Soft Extra Muscle System for Improving the Grasping Capability in Neurological Rehabilitation
Open this publication in new window or tab >>The Soft Extra Muscle System for Improving the Grasping Capability in Neurological Rehabilitation
2012 (English)In: 2012 IEEE-EMBS Conference on Biomedical Engineering and Sciences, IECBES 2012, New York: IEEE , 2012, 412-417 p.Conference paper, Published paper (Refereed)
Abstract [en]

This paper introduces the SEM Glove (Soft Extra Muscle Glove), a comfortable aid which automatically improves the grasping capability of a human independently of the particular task being performed. The technical solution partly mimics a biological solution and at the same time functions in symbiosis with the biological system. The technical invention is also applicable to other parts or regions of the human body that might need supporting forces or torques. A key feature is that a controlling and strengthening effect is achieved without the need for an external mechanical structure in the form of an exoskeleton. The paper includes a description of the physical design, the contents and the system design.

Place, publisher, year, edition, pages
New York: IEEE, 2012
Keyword
mechatronic system, tactile sensors, artificial tendons, underactuated fingers, stroke, neurological rehabilitation, grasping capability
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:kth:diva-120201 (URN)10.1109/IECBES.2012.6498090 (DOI)000321050000084 ()2-s2.0-84876768533 (Scopus ID)978-1-4673-1666-8 (ISBN)
Conference
2012 2nd IEEE-EMBS Conference on Biomedical Engineering and Sciences, IECBES 2012; Langkawi; Malaysia; 17 December 2012 through 19 December 2012
Note

QC 20130816

Available from: 2013-04-02 Created: 2013-04-02 Last updated: 2013-08-16Bibliographically approved
3. Grip strengthening glove to improve hand function in patients with neuromuscular disorders: A feasibility study
Open this publication in new window or tab >>Grip strengthening glove to improve hand function in patients with neuromuscular disorders: A feasibility study
Show others...
(English)In: Journal of NeuroEngineering and Rehabilitation, ISSN 1743-0003, E-ISSN 1743-0003Article in journal (Other academic) Submitted
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:kth:diva-120202 (URN)
Note

QS 2013

Available from: 2013-04-02 Created: 2013-04-02 Last updated: 2017-12-06Bibliographically approved
4. EEG based control of a brain-computer interface for neuromuscular stimulation
Open this publication in new window or tab >>EEG based control of a brain-computer interface for neuromuscular stimulation
(English)Manuscript (preprint) (Other academic)
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:kth:diva-120203 (URN)
Note

QS 2013

Available from: 2013-04-02 Created: 2013-04-02 Last updated: 2013-04-03Bibliographically approved
5. An innovative electrophysiological device for rehabilitation of brain lesions
Open this publication in new window or tab >>An innovative electrophysiological device for rehabilitation of brain lesions
(English)Manuscript (preprint) (Other academic)
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:kth:diva-120204 (URN)
Note

QS 2013

Available from: 2013-04-02 Created: 2013-04-02 Last updated: 2013-04-03Bibliographically approved

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