Robotic aided rehabilitation of hand function using a dynamic model for complex regional pain syndrome (CRPS)
Final Report Abstract
A fundamental scientific advance of the project is the successful development of a biomechanical test bench that allows complex realistic muscle/tendon simulations on human hand specimens using real-time synchronized position and force control. On this basis, new detailed data could be collected, which are essential for improved dynamic hand modeling and can be used for optimization of medical as well as future robotic applications. In this context, the second main goal was successfully achieved and a force-controlled and adaptive exoskeleton system for robotic hand rehabilitation of patients with CRPS syndrome exemplarily for the index finger was developed. Important elements like a generalized modeling of the exoskeleton- finger coupling and differential optimization were implemented. In order to make the rehabilitation process more attractive in the future, new app-based "computer games" were developed to motivate and increase the potential success of the therapy with targeted integration of the exoskeleton functions. A first clinical study on 3 volunteers and 2 patients showed that the concept fulfills both the scientific and the patient-specific requirements. The technical application of the prototypic exoskeleton and the accompanying measurements on the CRPS patients could be performed safely. For longitudinal, objective data acquisition remarkable new functions were implemented by simultaneous measurements of the movement and joint resistance moments of the finger joints by means of a specific quasi-static and dynamic model. To the best of our knowledge - no exoskeleton system has yet been specifically developed or applied for use in CRPS patients, who often suffer from severe movement-dependent pain. Accordingly, the project was challenging - both technically and medically. For example, the technically relatively simple exoskeleton concepts originally planned in the application had to be discarded or modified after initial prototype implementation. In addition, the Corona pandemic posed a very special challenge, which repeatedly caused considerable delays by delivery difficulties or medically due to illnesses or delayed start of studies. In summary, it can be said that the project successfully developed technical solutions for a mobile exoskeleton system for (1) patient-specific robot-assisted movement therapy with simultaneous (2) objective, longitudinal data acquisition of the course of therapy, such as joint movement ranges including stiffness. As a next step, testing on a larger patient population is now planned after appropriate expansion and system integration of the various exoskeleton elements.
Publications
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Evaluation of joint type modelling in the human hand. J Biomech. 2016 Sep 6;49(13):3097-3100
Gustus A, van der Smagt P
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CNN-based segmentation of medical imaging data. Computer Vision and Pattern Recognition. 2017 Jul: 1-24
Kayalibay B, Jensen G, van der Smagt P
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Key Insights into Hand Biomechanics: Human Grip Stiffness Can Be Decoupled from Force by Cocontraction and Predicted from Electromyography. Front Neurorobot. 2017 May 22;11:17
Höppner H, Große-Dunker M, Stillfried G, Bayer J, van der Smagt P
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An Adaptive Mechatronic Exoskeleton for Force-Controlled Finger Rehabilitation. Front Robot AI. 2021 Sep 30;8:716451
Dickmann T, Wilhelm NJ, Glowalla C, Haddadin S, van der Smagt P, Burgkart R
