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Comfort of two shoulder actuation mechanisms for arm therapy exoskeletons: a comparative study in healthy subjects

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Abstract

Robotic exoskeletons can be used to study and treat patients with neurological impairments. They can guide and support the human limb over a large range of motion, which requires that the movement trajectory of the exoskeleton coincide with the one of the human arm. This is straightforward to achieve for rather simple joints like the elbow, but very challenging for complex joints like the human shoulder, which is comprised by several bones and can exhibit a movement with multiple rotational and translational degrees of freedom. Thus, several research groups have developed different shoulder actuation mechanism. However, there are no experimental studies that directly compare the comfort of two different shoulder actuation mechanisms. In this study, the comfort and the naturalness of the new shoulder actuation mechanism of the ARMin III exoskeleton are compared to a ball-and-socket-type shoulder actuation. The study was conducted in 20 healthy subjects using questionnaires and 3D-motion records to assess comfort and naturalness. The results indicate that the new shoulder actuation is slightly better than a ball-and-socket-type actuation. However, the differences are small, and under the tested conditions, the comfort and the naturalness of the two tested shoulder actuations do not differ a lot.

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References

  1. Nef T, Riener R (2012) Three-dimensional multi-degree-of-freedom arm therapy robot. In: Dietz V, Nef T, Rhymer W (eds) Neurorehabilitation technology. Springer, New York

  2. Kwakkel G, Kollen BJ, Krebs HI (2008) Effects of robot-assisted therapy on upper limb recovery after stroke: a systematic review. Neurorehabil Neural Repair 22:111–121

    PubMed  Google Scholar 

  3. Loureiro RCV, Harwin WS, Nagai K, Johnson M (2011) Advances in upper limb stroke rehabilitation: a technology push. Med Biol Eng Comput 49(10):1–16

    Article  Google Scholar 

  4. Riener R, Nef T, Colombo G (2005) Robot-aided neurorehabilitation of the upper extremities. Med Biol Eng Comput 43:2–10

    Article  PubMed  CAS  Google Scholar 

  5. Krebs HI, Ferraro M, Buerger SP, Newbery MJ, Makiyama A, Sandmann M, Lynch D, Volpe BT, Hogan N (2004) Rehabilitation robotics: pilot trial of a spatial extension for MIT-Manus. J Neuroeng Rehabil 1:5

    Article  PubMed  Google Scholar 

  6. Lum PS, Burgar CG, Shor PC, Majmundar M, Van der Loos M (2002) Robot-assisted movement training compared with conventional therapy techniques for the rehabilitation of upper-limb motor function after stroke. Arch Phys Med Rehabil 83:952–959

    Article  PubMed  Google Scholar 

  7. Hesse S, Werner C, Pohl M, Mehrholz J, Puzich U, Krebs HI (2008) Mechanical arm trainer for the treatment of the severely affected arm after a stroke: a single-blinded randomized trial in two centers. Am J Phys Med Rehabil 87:779–788

    Article  PubMed  CAS  Google Scholar 

  8. Coote S, Murphy B, Harwin W, Stokes E (2008) The effect of the GENTLE/s robot-mediated therapy system on arm function after stroke. Clin Rehabil 22:395–405

    Article  PubMed  Google Scholar 

  9. Dewald J, Ellis M, Holubar B, Sukal T, Acosta A (2004) The robot application in the rehabilitation of stroke patients. Neurol Rehabil 4:S7

    Google Scholar 

  10. Stienen AHA, Hekman EEG, Prange GB, Jannink MJA, Aalsma AMM, van der Helm FCT, van der Kooij H (2009) Dampace: design of an exoskeleton for force-coordination training in upper-extremity rehabilitation. J Med Devices 3:031003

    Article  Google Scholar 

  11. Sanchez RJ, Liu J, Rao S, Shah P, Smith R, Rahman T, Cramer SC, Bobrow JE, Reinkensmeyer DJ (2006) Automating arm movement training following severe stroke: functional exercises with quantitative feedback in a gravity-reduced environment. IEEE Trans Neural Syst Rehabil Eng 14:378–389

    Article  PubMed  Google Scholar 

  12. Carignan C, Tang J, Roderick S, Naylor M (2007) A configuration-space approach to controlling a rehabilitation arm exoskeleton. IEEE 15(3):179–187

    Google Scholar 

  13. Montagner A, Frisoli A, Borelli L, Procopio C, Bergamasco M, Carboncini MC, Rossi B (2007) A pilot clinical study on robotic assisted rehabilitation in VR with an arm exoskeleton device. In: IEEE proceedings on virtual rehabilitation, pp 57–64

  14. Rosen J, Perry JC, Manning N, Burns S, Hannaford B (2005) The human arm kinematics and dynamics during daily activities-toward a 7 DOF upper limb powered exoskeleton. In: IEEE proceedings of the 12th international conference on advanced robotics, pp 532–539

  15. Zhang LQ, Park HS, Ren Y (2007) Developing an intelligent robotic arm for stroke rehabilitation. In: IEEE proceedings of the 10th international conference on rehabilitation robotics, pp 984–993

  16. Nef T, Mihelj M, Riener R (2007) ARMin: a robot for patient-cooperative arm therapy. Med Biol Eng Comput 45:887–900

    Article  PubMed  Google Scholar 

  17. Krebs HI, Volpe BT, Williams D, Celestino J, Charles SK, Lynch D, Hogan N (2007) Robot-aided neurorehabilitation: a robot for wrist rehabilitation. IEEE Trans Neural Syst Rehabil Eng 15:327–335

    Article  PubMed  Google Scholar 

  18. Loureiro R, Amirabdollahian F, Topping M, Driessen B, Harwin W (2003) Upper limb robot mediated stroke therapy—GENTLE/s approach. Auton Robots 15:35–51

    Article  Google Scholar 

  19. Schiele A, Van Der Helm FCT (2006) Kinematic design to improve ergonomics in human machine interaction. IEEE Trans Neural Syst Rehabil Eng 14:456–469

    Article  PubMed  Google Scholar 

  20. Nef T, Guidali M, Riener R (2009) ARMin III–arm therapy exoskeleton with an ergonomic shoulder actuation. Appl Bionics Biomech 6:127–142

    Article  Google Scholar 

  21. Kim YS, Lee J, Lee S, Kim M (2005) A force reflected exoskeleton-type masterarm for human-robot interaction. IEEE Trans Syst Man Cyber Syst Hum 35(2):198–212

    Article  Google Scholar 

  22. He J, Koeneman E, Schultz R, Huang H, Wanberg J, Herring D, Sugar T, Herman R, Koeneman J (2005) Design of a robotic upper extremity repetitive therapy device. In: IEEE proceedings of the 9th international conference on rehabilitation robotics, pp 95–98

  23. Nef T, Quinter G, Müller R, Riener R (2009) Effects of arm training with the robotic device ARMin I in chronic stroke: Three single cases. Neurodegener Dis 6:240–251

    Article  PubMed  Google Scholar 

  24. Sanchez Jr R, Wolbrecht E, Smith R, Liu J, Rao S, Cramer S, Rahman T, Bobrow J, Reinkensmeyer D (2005) A pneumatic robot for re-training arm movement after stroke: Rationale and mechanical design. In: IEEE proceedings of the 9th international conference on rehabilitation robotics, pp 500–504

  25. Housman SJ, Scott KM, Reinkensmeyer DJ (2009) A randomized controlled trial of gravity-supported, computer-enhanced arm exercise for individuals with severe hemiparesis. Neurorehabil Neural Repair 23:505–514

    Article  PubMed  Google Scholar 

  26. Staubli P, Nef T, Klamroth-Marganska V, Riener R (2009) Effects of intensive arm training with the rehabilitation robot ARMin II in chronic stroke patients: four single-cases. J Neuroeng Rehabil 6:46

    Article  PubMed  Google Scholar 

  27. Mihelj M, Nef T, Riener R (2007) ARMin II-7 DoF rehabilitation robot: mechanics and kinematics. In: IEEE proceedings of the international conference on robotics and automation, pp 4120–4125

  28. Bagg SD, Forrest WJ (1988) A biomechanical analysis of scapular rotation during arm abduction in the scapular plane. Am J Phy Med Rehabil Assoc Acad Physiatr 67(6):238–245

    CAS  Google Scholar 

  29. Culham E, Peat M (1993) Functional anatomy of the shoulder complex. J Orthop Sports Phys Ther 18:342

    PubMed  CAS  Google Scholar 

  30. Guidali M, Duschau-Wicke A, Broggi S, Klamroth-Marganska V, Nef T, Riener R (2011) A robotic system to train activities of daily living in a virtual environment. Med Biol Eng Comput 49:1213–1223

    Article  PubMed  Google Scholar 

  31. Wu G, Van der Helm FCT, Veeger H, Makhsous M, Van Roy P, Anglin C, Nagels J, Karduna AR, McQuade K, Wang X (2005) ISB recommendation on definitions of joint coordinate systems of various joints for the reporting of human joint motion—Part II: shoulder, elbow, wrist and hand. J Biomech 38:981–992

    Article  PubMed  CAS  Google Scholar 

  32. Nef T, Riener R (2008) Shoulder actuation mechanisms for arm rehabilitation exoskeletons. In: 2nd IEEE RAS & EMBS international conference on biomedical robotics and biomechatronics, pp 862–868

  33. Christiansen K (1997) Subjective assessment of sitting comfort. Coll Antropol 21:387–396

    PubMed  CAS  Google Scholar 

  34. Hänel SE, Dartman T, Shishoo R (1997) Measuring methods for comfort rating of seats and beds. Int J Ind Ergon 20:163–172

    Article  Google Scholar 

  35. Jansen S, van Welbergen H (2009) Methodologies for the user evaluation of the motion of virtual humans. Springer, Heidelberg, pp 125–131

  36. Guidali M, Duschau-Wicke A, Broggi S, Klamroth-Marganska V, Nef T, Riener R (2011) A robotic system to train activities of daily living in a virtual environment. Med Biol Eng Comput 49:1213–1223

    Article  PubMed  Google Scholar 

  37. Soslowsky LJ, Flatow EL, Bigliani LU, Mow VC (1992) Articular geometry of the glenohumeral joint. Clin Orthop 1992:181–190

    Google Scholar 

  38. Doody S, Freedman L, Waterland J (1970) Shoulder movements during abduction in the scapular plane. Arch Phys Med Rehabil 51:595

    PubMed  CAS  Google Scholar 

  39. Moeslund TB, Madsen CB, Granum E (2005) Modelling the 3D pose of a human arm and the shoulder complex utilising only two parameters. Integr Comput Aid Eng 12:159–176

    Google Scholar 

  40. Tyson SF, Hanley M, Chillala J, Selley AB, Tallis RC (2008) Sensory loss in hospital-admitted people with stroke: characteristics, associated factors, and relationship with function. Neurorehabil Neural Repair 22:166–172

    PubMed  Google Scholar 

  41. Sullivan JE, Hedman LD (2008) Sensory dysfunction following stroke: incidence, significance, examination, and intervention. Topics Stroke Rehabil 15:200–217

    Article  Google Scholar 

  42. Paci M, Nannetti L, Rinaldi LA (2005) Glenohumeral subluxation in hemiplegia: an overview. J Rehabil Res Dev 42:557–568

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We would like to thank Angela DeMarco and Thomas A. Giuliani from the Catholic University of America in Washington, D.C. for supporting the data collection. Also, we thank the participants of this study. Disclaimer: Prof. Dr. –Ing. Robert Riener and Prof. Dr. sc. Tobias Nef are inventors of two patents describing the ARMin shoulder actuation. Owner of the patents is the ETH Zurich and the University of Zurich.

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Authors and Affiliations

  1. Gerontechnology and Rehabilitation Group, University of Bern, Bern, Switzerland

    Tobias Nef, René Müri & Urs P. Mosimann

  2. ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland

    Tobias Nef

  3. Sensory-Motor Systems Lab, Institute of Robotics and Intelligent Systems, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland

    Robert Riener

  4. Spinal Cord Injury Center, University Hospital Balgrist, University of Zurich, Zurich, Switzerland

    Robert Riener

  5. Division of Cognitive and Restorative Neurology, Department of Neurology, Inselspital, University of Bern, Bern, Switzerland

    René Müri

  6. Department of Old Age Psychiatry, University Hospital of Psychiatry, University of Bern, Bern, Switzerland

    Urs P. Mosimann

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  1. Tobias Nef
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  2. Robert Riener
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  3. René Müri
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  4. Urs P. Mosimann
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Correspondence to Tobias Nef.

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Nef, T., Riener, R., Müri, R. et al. Comfort of two shoulder actuation mechanisms for arm therapy exoskeletons: a comparative study in healthy subjects. Med Biol Eng Comput 51, 781–789 (2013). https://doi.org/10.1007/s11517-013-1047-4

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  • DOI: https://doi.org/10.1007/s11517-013-1047-4

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