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MUNDUS project: MUltimodal neuroprosthesis for daily upper limb support.

Pedrocchi A, Ferrante S, Ambrosini E, Gandolla M, Casellato C, Schauer T, Klauer C, Pascual J, Vidaurre C, Gföhler M, Reichenfelser W, Karner J, Micera S, Crema A, Molteni F, Rossini M, Palumbo G, Guanziroli E, Jedlitschka A, Hack M, Bulgheroni M, d'Amico E, Schenk P, Zwicker S, Duschau-Wicke A, Miseikis J, Graber L, Ferrigno G - J Neuroeng Rehabil (2013)

Bottom Line: The functionality of all modules has been successfully demonstrated.User's intention was detected with a 100% success.The MUNDUS platform provides functional assistance to daily life activities; the modules integration depends on the user's need, the functionality of the system have been demonstrated for all the possible configurations, and preliminary assessment of usability and acceptance is promising.

View Article: PubMed Central - HTML - PubMed

ABSTRACT

Background: MUNDUS is an assistive framework for recovering direct interaction capability of severely motor impaired people based on arm reaching and hand functions. It aims at achieving personalization, modularity and maximization of the user's direct involvement in assistive systems. To this, MUNDUS exploits any residual control of the end-user and can be adapted to the level of severity or to the progression of the disease allowing the user to voluntarily interact with the environment. MUNDUS target pathologies are high-level spinal cord injury (SCI) and neurodegenerative and genetic neuromuscular diseases, such as amyotrophic lateral sclerosis, Friedreich ataxia, and multiple sclerosis (MS). The system can be alternatively driven by residual voluntary muscular activation, head/eye motion, and brain signals. MUNDUS modularly combines an antigravity lightweight and non-cumbersome exoskeleton, closed-loop controlled Neuromuscular Electrical Stimulation for arm and hand motion, and potentially a motorized hand orthosis, for grasping interactive objects.

Methods: The definition of the requirements and of the interaction tasks were designed by a focus group with experts and a questionnaire with 36 potential end-users.

Results: The functionality of all modules has been successfully demonstrated. User's intention was detected with a 100% success. Averaging all subjects and tasks, the minimum evaluation score obtained was 1.13 ± 0.99 for the release of the handle during the drinking task, whilst all the other sub-actions achieved a mean value above 1.6. All users, but one, subjectively perceived the usefulness of the assistance and could easily control the system. Donning time ranged from 6 to 65 minutes, scaled on the configuration complexity.

Conclusions: The MUNDUS platform provides functional assistance to daily life activities; the modules integration depends on the user's need, the functionality of the system have been demonstrated for all the possible configurations, and preliminary assessment of usability and acceptance is promising.

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Tests on subject GC008. An example of the results obtained by subject GC008 while testing the robotic hand orthosis. MetaCarpoPhalangeal (MCP) and the Proximal InterPhalangeal (PIP) joint angles during the GUI-guided calibration and the subsequent testing phase are shown. The MCP joint reference is the only reference signal controlling the two coupled degrees of freedom.
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Figure 11: Tests on subject GC008. An example of the results obtained by subject GC008 while testing the robotic hand orthosis. MetaCarpoPhalangeal (MCP) and the Proximal InterPhalangeal (PIP) joint angles during the GUI-guided calibration and the subsequent testing phase are shown. The MCP joint reference is the only reference signal controlling the two coupled degrees of freedom.

Mentions: This subject is a quadriplegic male of 33 years old with an incomplete SCI (C7 level) since 2011. The subject is classified as an ASIA Impairment Scale A with right and left motor/sensitive level C7. He has no residual voluntary control of his right arm and hand. Both his arm and hand muscles were completely flaccid, i.e. no muscle tone was present (see MRC scores in Table 1), and he was an NMES-responder only at the arm level. Thus, the selected scenario was Scenario 3, since the instability of his trunk control prevented the possibility to use efficiently the eye tracking module, and he tested the robotic hand orthosis. The subject carried out two experimental sessions. During the first session, the subject visited the rehabilitation centre on three consecutive days. Familiarization with the robotic orthosis, adaptation of the orthotic interface with the subject and adjustments of the orthosis as well as of the exo were the goals of the first day. On the second and third day, the subject was asked to perform two different test cases. The first test case (GC008_test 1 in Table 3, Additional file 9) involved the donning procedure of the orthosis as a stand-alone module, the GUI-guided calibration of an open, a closed and a relaxed hand position and a therapist-triggered grasp and lift movement of the drinking cup to verify the holding of the object. The grasping was not stable in this test. The same steps were performed during the second test case with the robotic orthosis mounted on the exo (GC008_test 2 in Table 3). In this second test the grasping was reliable, while the release was not completely accomplished and required the help of the operator. The arm movement for reaching the object was aided by the operator for both test cases. On the second day, the presence of the exo had no adverse effects on the performance of the tests: the cup could be securely grasped and held while the operator was moving his arm. Figure 11 shows an example of the measured MCP and PIP angles during the calibration and the subsequent grasp&hold phase. To calibrate the three hand postures, the operator incrementally increased or decreased the actuated MCP joint angle by 4° and set the values by clicking on the corresponding button on the GUI screen. The starting points of the blue arrows mark the time and angular values of these clicks. In the subsequent testing phase, the corresponding relax, open and close commands were sent to the controller. The final angles deviate from the reference angle by approximately 6° due to an implemented tolerance band and mechanical clearance. The flexible thumb brace did not always hold the thumb in a position such that it did not interfere with the cup handle. In those cases, the operator had to manually extend the thumb.


MUNDUS project: MUltimodal neuroprosthesis for daily upper limb support.

Pedrocchi A, Ferrante S, Ambrosini E, Gandolla M, Casellato C, Schauer T, Klauer C, Pascual J, Vidaurre C, Gföhler M, Reichenfelser W, Karner J, Micera S, Crema A, Molteni F, Rossini M, Palumbo G, Guanziroli E, Jedlitschka A, Hack M, Bulgheroni M, d'Amico E, Schenk P, Zwicker S, Duschau-Wicke A, Miseikis J, Graber L, Ferrigno G - J Neuroeng Rehabil (2013)

Tests on subject GC008. An example of the results obtained by subject GC008 while testing the robotic hand orthosis. MetaCarpoPhalangeal (MCP) and the Proximal InterPhalangeal (PIP) joint angles during the GUI-guided calibration and the subsequent testing phase are shown. The MCP joint reference is the only reference signal controlling the two coupled degrees of freedom.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
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Figure 11: Tests on subject GC008. An example of the results obtained by subject GC008 while testing the robotic hand orthosis. MetaCarpoPhalangeal (MCP) and the Proximal InterPhalangeal (PIP) joint angles during the GUI-guided calibration and the subsequent testing phase are shown. The MCP joint reference is the only reference signal controlling the two coupled degrees of freedom.
Mentions: This subject is a quadriplegic male of 33 years old with an incomplete SCI (C7 level) since 2011. The subject is classified as an ASIA Impairment Scale A with right and left motor/sensitive level C7. He has no residual voluntary control of his right arm and hand. Both his arm and hand muscles were completely flaccid, i.e. no muscle tone was present (see MRC scores in Table 1), and he was an NMES-responder only at the arm level. Thus, the selected scenario was Scenario 3, since the instability of his trunk control prevented the possibility to use efficiently the eye tracking module, and he tested the robotic hand orthosis. The subject carried out two experimental sessions. During the first session, the subject visited the rehabilitation centre on three consecutive days. Familiarization with the robotic orthosis, adaptation of the orthotic interface with the subject and adjustments of the orthosis as well as of the exo were the goals of the first day. On the second and third day, the subject was asked to perform two different test cases. The first test case (GC008_test 1 in Table 3, Additional file 9) involved the donning procedure of the orthosis as a stand-alone module, the GUI-guided calibration of an open, a closed and a relaxed hand position and a therapist-triggered grasp and lift movement of the drinking cup to verify the holding of the object. The grasping was not stable in this test. The same steps were performed during the second test case with the robotic orthosis mounted on the exo (GC008_test 2 in Table 3). In this second test the grasping was reliable, while the release was not completely accomplished and required the help of the operator. The arm movement for reaching the object was aided by the operator for both test cases. On the second day, the presence of the exo had no adverse effects on the performance of the tests: the cup could be securely grasped and held while the operator was moving his arm. Figure 11 shows an example of the measured MCP and PIP angles during the calibration and the subsequent grasp&hold phase. To calibrate the three hand postures, the operator incrementally increased or decreased the actuated MCP joint angle by 4° and set the values by clicking on the corresponding button on the GUI screen. The starting points of the blue arrows mark the time and angular values of these clicks. In the subsequent testing phase, the corresponding relax, open and close commands were sent to the controller. The final angles deviate from the reference angle by approximately 6° due to an implemented tolerance band and mechanical clearance. The flexible thumb brace did not always hold the thumb in a position such that it did not interfere with the cup handle. In those cases, the operator had to manually extend the thumb.

Bottom Line: The functionality of all modules has been successfully demonstrated.User's intention was detected with a 100% success.The MUNDUS platform provides functional assistance to daily life activities; the modules integration depends on the user's need, the functionality of the system have been demonstrated for all the possible configurations, and preliminary assessment of usability and acceptance is promising.

View Article: PubMed Central - HTML - PubMed

ABSTRACT

Background: MUNDUS is an assistive framework for recovering direct interaction capability of severely motor impaired people based on arm reaching and hand functions. It aims at achieving personalization, modularity and maximization of the user's direct involvement in assistive systems. To this, MUNDUS exploits any residual control of the end-user and can be adapted to the level of severity or to the progression of the disease allowing the user to voluntarily interact with the environment. MUNDUS target pathologies are high-level spinal cord injury (SCI) and neurodegenerative and genetic neuromuscular diseases, such as amyotrophic lateral sclerosis, Friedreich ataxia, and multiple sclerosis (MS). The system can be alternatively driven by residual voluntary muscular activation, head/eye motion, and brain signals. MUNDUS modularly combines an antigravity lightweight and non-cumbersome exoskeleton, closed-loop controlled Neuromuscular Electrical Stimulation for arm and hand motion, and potentially a motorized hand orthosis, for grasping interactive objects.

Methods: The definition of the requirements and of the interaction tasks were designed by a focus group with experts and a questionnaire with 36 potential end-users.

Results: The functionality of all modules has been successfully demonstrated. User's intention was detected with a 100% success. Averaging all subjects and tasks, the minimum evaluation score obtained was 1.13 ± 0.99 for the release of the handle during the drinking task, whilst all the other sub-actions achieved a mean value above 1.6. All users, but one, subjectively perceived the usefulness of the assistance and could easily control the system. Donning time ranged from 6 to 65 minutes, scaled on the configuration complexity.

Conclusions: The MUNDUS platform provides functional assistance to daily life activities; the modules integration depends on the user's need, the functionality of the system have been demonstrated for all the possible configurations, and preliminary assessment of usability and acceptance is promising.

Show MeSH
Related in: MedlinePlus