The Biomechanical Engineering group at the University of Twente (UT), The Netherlands wishes to bring affordable hand and arm rehabilitation to the homes of stroke survivors. Recent development in robot—mediated rehabilitation has shown the potential of robotic devices for delivering repetitive training thus allowing for a large number of repetitions to be delivered during acute and chronic phases of stroke rehabilitation. There is growing evidence that such technologies are beneficial to patient’s recovery of functional and motor outcome.
In a consortium of eight institutions and companies from four European countries called SCRIPT and funded by the European Union, our goals are:
To use such technologies at patient’s home would enable better management of chronic stroke as it allows to administer larger repetitions and frequent exercise which can in turn increase the recovery gains.
To focus on hand and wrist exercise that present the least researched area with the most functional relevance, and potential for contribution to personal independence.
To look at differences between passive and active actuated devices. Inherent safe nature of these devices make them an ideal choice for home use.
To provide an educational, motivational and engaging interaction, which makes a therapy session more enjoyable while having the capabilities to provide feedback to patients and health professional. The provided feedback will be based on heterogeneous data collected during interaction as well as comparisons with models such as minimum jerk model as a performance indicator.
To focus on remote management and support of the patient. It creates a communication platform that will support the remote management allowing to adjust the therapy program remotely thus reducing hospital or home visits frequency. This is facilitated by incorporating the clinical workflows into user interfaces used by patients and clinicians while maintaining a customizable and easy to operate front-end for users. The two-fold objective here enables us to look at aspects of acceptability and compliance as well as data security and confidentiality. 6. To infer from summative evaluation in this project, impact on health and recovery and its potential cost implications.
The PhD student at the UT will focus on the development of the passive and active wrist, hand and finger orthosis via multiple smaller design stages. The student will cooperate strongly with MOOG Robotics in Nieuw_Vennep (NL), who are highly experienced in developing and building human interaction (haptic) devices for the hand and arm. The hand orthosis will be coupled to anavailable arm support device and used by other collaborating groups for patient evaluations. The PhD student will be supervised by dr.ir. Arno Stienen (UT) and ir. Piet Lammertse (MOOG), with prof.dr.ir. Herman van der Kooij (UT) as promotor. Bachelor and master students will also be involved in the project and the PhD student will have an important role in the daily supervision of these.
The HandTutor and ArmTutor have already been developed and are in use in major U.S. and European hospitals as well as clinics. The devices together with their sisters (LegTutor and 3DTutor) are easily adaptable to home use through the use of telerehabilitation.
The HandTutor uses a unique ergonomic glove that is easy to wear for patients with neuromuscular problems. It is designed to detect finger and wrist motion. The HandTutor is tailored to a range of motion, accuracy and speed of movement, cognitive function and isolated or combined movement ability. The glove is attached to a computer that includes dedicated and powerful evaluation software giving the therapist objective and quantitative information on the impairment. The therapist is then able to customize a program specifically for the patient’s ability level. The software consists of a series of games that encourage the patient to initiate movement and enjoy the treatment simultaneously. The software contains a complete set of Clinic/Patient management records.
The devices have shown success as well with patients suffering from brain and spinal injury, CP, MS, post surgery disorders, Parkinson’s disease and more.
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