RoboTrainer: Making effective rehab training available to everyone
Dr Anders Sørensen, University of Southern Denmark
A large amount of trauma victims suffer neurological damage to motor function, that severely inhibit rehabilitative training. Overcome by gravity, they are locked in a viscous circle, risking atrophy, circulatory disease and other physical complications, while depression may further undermine their quality of life. Underwater training, exoskeletons and advanced training machines may break the circle, but their high operational cost is in stark contrast to the high amounts of training needed to make a difference. In the RoboTrainer projects, we explore the design and impact of training robots optimized for simplicity and low cost. Our initial studies show that such devices can easily be operated by physical therapists in simple clinics, and potentially also by patients and their helpers at home. Case tests on the long term robot training made feasible by RoboTrainer show promising results in terms of strength and functional improvement in chronic (abandoned) patients with neurological damage.
The future of human wearable bionics from industry's point of view
Dr Andreas Goppelt, Ottobock
In its 100 years history, Ottobock has been a leader in human mobility: The introduction of C-leg®, the world's first microprocessor controlled knee (MPK), in 1997 has set a new standard for safety of people with transfemoral knee disarticulation and hip disarticulation amputations. Advances in the fields of bionic reconstructive surgery and the use of artificial intelligence in controls allow patients to intuitively move their artificial limbs, and to lead a more active and independent lifestyle.
Clinical evidence provided by us and others has demonstrated that patients with lower mobility grades benefit most from MPKs as evidenced by gains of the health utility score EQ5D.
The translation of these advances in prosthetics into orthotics led to the first knee-ankle foot orthosis (KAFO) with stance and swing phase control: The C-Brace® helps patients suffering from neurological indications such as incomplete spinal cord injury, poliomyelitis and post-polio syndrome to regain a natural gait.
Exoskeletons like the personal assistive device Paexo® help prevent work related disorders of the musculoskeletal system.
As the field of wearable human bionics is rapidly evolving, new opportunities emerge to overcome previously unsolved challenges. This includes the optimization of human comfort, and man-machine interfaces for improved control and somatosensory perception to foster embodiment - make users feel that the device becomes part of them.
Driving neural recovery following Spinal Cord Injury
Professor Jane Burridge, University of Southampton
Recent research both with animals and people with SCI has shown the potential for neural recovery. Some studies have used implanted systems, but we have recently designed and tested an inexpensive non-implanted novel cycling ergometer with a small number of patients. The ‘iCycle’ uses Functional Electrical Stimulation (FES). Electrical stimulation activates the leg muscles during each revolution of the pedals. The position of the crankshaft enables the stimulation to be timed accurately. The amount of effort the person exerts is monitored and used as feedback in a virtual cycle race. We propose that greater neuroplasticity will be achieved by synchronising stimulation with voluntary drive and that the motivation provided by the race will encourage the cyclist to work harder.
In this talk I will explain the neuroscience that underpins the concept, describe the device, how we developed it and report on the effect it had on a small number of people who trained on it for four weeks.
Making direct neural interface therapies a clinical reality
Dr Oliver Armitage, BIOS
Direct neural interfaces for limb control have been used in a variety of research and pilot studies for multiple decades now and clinical practice makes regular use of neuromodulation for pain or other conditions. However, continuous bi-directional connections to the nervous system for treating physical health have so far remained clinically elusive. This is in large part due to the technology required for real-time decoding and encoding being unpractical to put in implantable medical devices. Yet this technology is essential for realising the promise shown by direct neural recording and stimulation for prosthetic control, SCI, neurotrauma or a host of other therapies. BIOS is pioneering AI technologies for long-term direct neural interfaces for lifelong health by continuous decoding and encoding of neural information on small-scale devices for bringing to clinical practice the promise shown over decades of research.
Amputee Biomechanics: it is not just about getting active
Professor Anthony Bull, Centre for Blast Injury Studies, Imperial College London
The ability of young, fit, healthy traumatic amputees to achieve very high levels of performance through their own determination, excellent rehabilitation and advanced prosthetics is one of the features of modern life. Expectations have risen that all should be able to achieve these levels of activity and maintain them through to old age, and yet this seems to be out of reach for so many. Biomechanics is the study of the interaction between forces, motion and deformation and is the underlying science that can shed light on the reasons why such high levels of performance are unsustainable for most, unattainable for many, and detrimental for others. Understanding amputee biomechanics can aid in devising novel rehabilitation, surgery and prosthetics.