Digital Visits at Intensive Care Units Post-COVID-19: A Mixed-Methods Implementation Evaluation Study.

Due to visiting restrictions at intensive care units during the COVID-19 pandemic, a digital video technology was developed and implemented. This study evaluated the use of digital visits at four intensive care units after COVID-19. Nurses' use of the technology and managerial perspectives on implementation were examined in an explanatory sequential mixed-methods study.

Stimulation of the withdrawal reflex in gait training after stroke: A systematic review and meta-analysis.

Background: After a stroke many people experience hemiparesis, resulting in walking difficulties which affects independence, mobility, and participation in activities of daily living. Activating the nociceptive withdrawal reflex (NWR) during gait training aims to support the initiation and facilitation of the swing phase of the paretic leg. The aim of this review is to investigate the orthotic and therapeutic effects of a NWR stimulation intervention to improve gait in patients after a stroke.

A robot-based hybrid lower limb system for Assist-As-Needed rehabilitation of stroke patients: Technical evaluation and clinical feasibility.

Background: Although early rehabilitation is important following a stroke, severely affected patients have limited options for intensive rehabilitation as they are often bedridden. To create a system for early rehabilitation of lower extremities in these patients, we combined the robotic manipulator ROBERT® with electromyography (EMG)-triggered functional electrical stimulation (FES) and developed a novel user-driven Assist-As-Needed (AAN) control. The method is based on a state machine able to detect user movement capability, assessed by the presence of an EMG-trigger and the movement velocity, and provide different levels of assistance as required by the patient (no support, FES only, and simultaneous FES and mechanical assistance).

The International Functional Electrical Stimulation Society (IFESS): Highlights from the IFESS conference at Rehabweek 2023.

The annual conference of the International Functional Electrical Stimulation Society (IFESS) was held in conjunction with the 7th RehabWeek Congress, from September 24 to 28, 2023 at the Resorts World Convention Centre on Sentosa Island, in Singapore. The Congress was a joint meeting of the International Consortium on Rehabilitation Technology (ICRT) together with 10 other societies in the field of assistive technology and rehabilitation engineering. The conference features comprehensive blend of technical and clinical context of FES, a sustained value the society has offered over many years.

Brain computer interface training with motor imagery and functional electrical stimulation for patients with severe upper limb paresis after stroke: a randomized controlled pilot trial.

Background: Restorative Brain-Computer Interfaces (BCI) that combine motor imagery with visual feedback and functional electrical stimulation (FES) may offer much-needed treatment alternatives for patients with severely impaired upper limb (UL) function after a stroke.

Objectives: This study aimed to examine if BCI-based training, combining motor imagery with FES targeting finger/wrist extensors, is more effective in improving severely impaired UL motor function than conventional therapy in the subacute phase after stroke, and if patients with preserved cortical-spinal tract (CST) integrity benefit more from BCI training.

Methods: Forty patients with severe UL paresis (< 13 on Action Research Arm Test (ARAT) were randomized to either a 12-session BCI training as part of their rehabilitation or conventional UL rehabilitation.

Improving electrotactile communication with a multi-pad electrode under cognitive load.

Background: Electrotactile systems are compact interfaces that can be used to convey information through the skin by producing a range of haptic sensations. In many applications, however, the user needs to perceive and interpret haptic stimulation while being engaged in parallel activities. Developing methods that ensure reliable recognition of electrotactile messages despite additional cognitive load is, therefore, an important step for the practical application of electrotactile displays.

Designing Ecological Auditory Feedback on Lower Limb Kinematics for Hemiparetic Gait Training.

Auditory feedback has earlier been explored as a tool to enhance patient awareness of gait kinematics during rehabilitation. In this study, we devised and tested a novel set of concurrent feedback paradigms on swing phase kinematics in hemiparetic gait training. We adopted a user-centered design approach, where kinematic data recorded from 15 hemiparetic patients was used to design three feedback algorithms (wading sounds, abstract, musical) based on filtered gyroscopic data from four inexpensive wireless inertial units.

Biomimetic Tendon-Based Mechanism for Finger Flexion and Extension in a Soft Hand Exoskeleton: Design and Experimental Assessment.

This study proposes a bioinspired exotendon routing configuration for a tendon-based mechanism to provide finger flexion and extension that utilizes a single motor to reduce the complexity of the system. The configuration was primarily inspired by the extrinsic muscle-tendon units of the human musculoskeletal system. The function of the intrinsic muscle-tendon units was partially compensated by adding a minor modification to the configuration of the extrinsic units.

A Novel Screen-Printed Textile Interface for High-Density Electromyography Recording.

Recording electrical muscle activity using a dense matrix of detection points (high-density electromyography, EMG) is of interest in a range of different applications, from human-machine interfacing to rehabilitation and clinical assessment. The wider application of high-density EMG is, however, limited as the clinical interfaces are not convenient for practical use (e.g.

Electrotactile Communication via Matrix Electrode Placed on the Torso Using Fast Calibration, and Static vs. Dynamic Encoding.

Electrotactile stimulation is a technology that reproducibly elicits tactile sensations and can be used as an alternative channel to communicate information to the user. The presented work is a part of an effort to develop this technology into an unobtrusive communication tool for first responders. In this study, the aim was to compare the success rate (SR) between discriminating stimulation at six spatial locations (static encoding) and recognizing six spatio-temporal patterns where pads are activated sequentially in a predetermined order (dynamic encoding).

Increase and Decrease in Velocity and Force During Exercise with a Hybrid Robotic-FES Rehabilitation System.

Early rehabilitation is beneficial for stroke patients, but it is often delayed since the patients are often bedbound due to their general condition. New robotic rehabilitation devices such as ROBERT® enable patients to exercise even while bedbound. During pilot testing of an automated FES-delivery system combined with ROBERT®, we observed both increased and decreased exerted velocity and interaction force during repetitive exercising with the system.

Evaluation of the implementation of Armeo®Spring in a specialized neurorehabilitation center.

Rehabilitation of the upper extremity (UE) is an essential part of the process following an acquired brain injury, where robot technologies have the potential of making the rehabilitation more intensive and effective. However, the implementation of robot technologies in a clinical setting can be complicated and not always successful. The aim of this study was to evaluate the implementation of the robot technology Armeo®Spring (Hocoma, Volketswil, Switzerland) at a specialized neurorehabilitation center, and to propose a list of actions for further implementation of the technology.

Reducing the number of EMG electrodes during online hand gesture classification with changing wrist positions.

Background: Myoelectric control based on hand gesture classification can be used for effective, contactless human-machine interfacing in general applications (e.g., consumer market) as well as in the clinical context.

An Embodied Sonification Model for Sit-to-Stand Transfers.

Interactive sonification of biomechanical quantities is gaining relevance as a motor learning aid in movement rehabilitation, as well as a monitoring tool. However, existing gaps in sonification research (issues related to meaning, aesthetics, and clinical effects) have prevented its widespread recognition and adoption in such applications. The incorporation of embodied principles and musical structures in sonification design has gradually become popular, particularly in applications related to human movement.

Does feedback based on FES-evoked nociceptive withdrawal reflex condition event-related desynchronization? An exploratory study with brain-computer interfaces.

Event-related desynchronization (ERD) is used in brain-computer interfaces (BCI) to detect the user's motor intention (MI) and convert it into a command for an actuator to provide sensory feedback or mobility, for example by means of functional electrical stimulation (FES). Recent studies have proposed to evoke the nociceptive withdrawal reflex (NWR) using FES, in order to evoke synergistic movements of the lower limb and to facilitate the gait rehabilitation of stroke patients. The use of NWR to provide sensorimotor feedback in ERD-based BCI is novel; thererfore, the conditioning effect that nociceptive stimuli might have on MI is still unknown.

Bio-inspired tendon driven mechanism for simultaneous finger joints flexion using a soft hand exoskeleton.

A new tendon driven mechanism, embedded into a soft hand exoskeleton for rehabilitation and assistance, was proposed in this study. The proposed solution was a pulley flexion mechanism inspired by the human musculoskeletal system to enable a natural and comfortable finger flexion. A biomechanical constraint for the finger flexion motion states that the relation between the proximal interphalangeal joint angle of the finger should always be flexed around 1.

Neurorehabilitation therapy of patients with severe stroke based on functional electrical stimulation commanded by a brain computer interface.

Introduction: Brain computer interface is an emerging technology to treat the sequelae of stroke. The purpose of this study was to explore the motor imagery related desynchronization of sensorimotor rhythms of stroke patients and to assess the efficacy of an upper limb neurorehabilitation therapy based on functional electrical stimulation controlled by a brain computer interface.

Methods: Eight severe chronic stroke patients were recruited.

Toward Standardizing the Classification of Robotic Gait Rehabilitation Systems.

With the existence of numerous rehabilitation systems, classification and comparison becomes difficult, especially due to the many factors involved. Moreover, most current reviews are descriptive and do not provide systematic methods for the visual comparison of systems. This review proposes a method for classifying systems and representing them graphically to easily visualize various characteristics of the different systems at the same time.

A Novel Stimulation Paradigm to Limit the Habituation of the Nociceptive Withdrawal Reflex.

In gait rehabilitation, combining gait therapy with functional electrical stimulation based on the nociceptive withdrawal reflex (NWR) improves walking velocity and gait symmetry of hemiparetic patients. However, habituation of the NWR can affect the efficacy of training. The current study aimed at identifying the stimulation parameters that would limit, in healthy participants, the habituation of the NWR.

Design and test of an automated version of the modified Jebsen test of hand function using Microsoft Kinect.

Background: The present paper describes the design and evaluation of an automated version of the Modified Jebsen Test of Hand Function (MJT) based on the Microsoft Kinect sensor.

Methods: The MJT was administered twice to 11 chronic stroke subjects with varying degrees of hand function deficits. The test times of the MJT were evaluated manually by a therapist using a stopwatch, and automatically using the Microsoft Kinect sensor.

Design and test of a Microsoft Kinect-based system for delivering adaptive visual feedback to stroke patients during training of upper limb movement.

The present paper describes the design and test of a low-cost Microsoft Kinect-based system for delivering adaptive visual feedback to stroke patients during the execution of an upper limb exercise. Eleven sub-acute stroke patients with varying degrees of upper limb function were recruited. Each subject participated in a control session (repeated twice) and a feedback session (repeated twice).