3D stroke rehabilitation using electrical stimulation and robotics

Abstract

Stroke is the third leading cause of death and foremost cause of adult disability in the UK. A third of the surviving patients suffer from some degree of motor disability and depend on others to undertake daily activities. Conventional rehabilitation can mitigate this disability, but only 5% of the severely paralysed patients regain full upper limb function. Past studies have shown evidence of more effective technologies such as rehabilitation robotics and functional electrical stimulation (FES). Previous collaborative research at the University of Southampton developed a system that pioneered the use of FES with rehabilitation robots to assist planar upper limb stroke rehabilitation. Results from a clinical trial in 2008 have shown significant improvements in 5 stroke patients across a range of clinical outcome measures. Stimulation Assistance through iterative learning (SAIL) is a novel system that builds on this work, combining robotic therapy with the use of FES. This research has been possible through collaboration between engineers, physiotherapists and psychologists. The SAIL platform assists patients in performing 3D arm movements that are presented in a virtual reality setting and resemble daily activities. This assistance is provided through a supportive robotic system, together with FES applied to two muscles in the arm. Iterative learning control (ILC) schemes have been designed for the delivery of precisely-controlled FES to maximise the therapeutic effect of training. Preliminary tests with 9 unimpaired patients and 2 stroke patients have confirmed the control system’s high level of performance in assisting movement. These encouraging results are expected to transfer into effective treatment on 5 stroke patients who have recently started a clinical trial comprising 18 treatment sessions. A range of clinical measures are employed to assess the performance of patients pre- and post-treatment. In addition to the assessment of motor function, the Behavioural Inattention Test is being used to assess level and changes in visual neglect.

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Identifiers

ORCID for Katie Meadmore: orcid.org/0000-0001-5378-8370

ORCID for Anne-Marie Hughes: orcid.org/0000-0002-3958-8206

ORCID for E Rogers: orcid.org/0000-0003-0179-9398

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