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Motor improvement estimation and task adaptation for personalized robot-aided therapy: a feasibility study

Christian Giang, Elvira Pirondini, Nawal Kinany, Camilla Pierella, Alessandro Panarese, Martina Coscia, Jenifer Miehlbradt, Cécile Magnin, Pierre Nicolo, Adrian Guggisberg, Silvestro Micera
doi: https://doi.org/10.1101/728725
Christian Giang
aBertarelli Foundation Chair in Translational Neuroengineering, Center for Neuroprosthetics and Institute of Bioengineering, School of Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, 1015, Switzerland
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  • For correspondence: christian.giang@epfl.ch
Elvira Pirondini
bInstitute of Bioengineering/Center for Neuroprosthetics, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
cDepartment of Radiology and Medical Informatics, University of Geneva, Geneva, Switzerland
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Nawal Kinany
aBertarelli Foundation Chair in Translational Neuroengineering, Center for Neuroprosthetics and Institute of Bioengineering, School of Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, 1015, Switzerland
bInstitute of Bioengineering/Center for Neuroprosthetics, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
cDepartment of Radiology and Medical Informatics, University of Geneva, Geneva, Switzerland
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Camilla Pierella
aBertarelli Foundation Chair in Translational Neuroengineering, Center for Neuroprosthetics and Institute of Bioengineering, School of Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, 1015, Switzerland
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Alessandro Panarese
dTranslational Neural Engineering Area, The Biorobotics Institute, Scuola Superiore Sant’Anna, Pisa, 56025, Italy
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Martina Coscia
eWyss Center for Bio- and Neuro-Engineering, Geneva, 1202, Switzerland
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Jenifer Miehlbradt
aBertarelli Foundation Chair in Translational Neuroengineering, Center for Neuroprosthetics and Institute of Bioengineering, School of Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, 1015, Switzerland
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Cécile Magnin
fDivision of Neurorehabilitation, Department of Clinical Neurosciences, University Hospital Geneva, Geneva, Switzerland
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Pierre Nicolo
fDivision of Neurorehabilitation, Department of Clinical Neurosciences, University Hospital Geneva, Geneva, Switzerland
gLaboratory of Cognitive Neurorehabilitation, Department of Clinical Neurosciences, Medical School, University of Geneva, Geneva, Switzerland
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Adrian Guggisberg
fDivision of Neurorehabilitation, Department of Clinical Neurosciences, University Hospital Geneva, Geneva, Switzerland
gLaboratory of Cognitive Neurorehabilitation, Department of Clinical Neurosciences, Medical School, University of Geneva, Geneva, Switzerland
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Silvestro Micera
aBertarelli Foundation Chair in Translational Neuroengineering, Center for Neuroprosthetics and Institute of Bioengineering, School of Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, 1015, Switzerland
dTranslational Neural Engineering Area, The Biorobotics Institute, Scuola Superiore Sant’Anna, Pisa, 56025, Italy
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Abstract

Background In the past years, robotic systems have become increasingly popular in both upper and lower limb rehabilitation. Nevertheless, clinical studies have so far not been able to confirm superior efficacy of robotic therapy over conventional methods. The personalization of robot-aided therapy according to the patients’ individual motor deficits has been suggested as a pivotal step to improve the clinical outcome of such approaches.

Methods Here, we present a model-based approach to personalize robot-aided rehabilitation therapy within training sessions. The proposed method combines the information from different motor performance measures recorded from the robot to continuously estimate patients’ motor improvement for a series of point-to-point reaching movements in different directions and comprises a personalization routine to automatically adapt the rehabilitation training. We engineered our approach using an upper limb exoskeleton and tested it with seventeen healthy subjects, who underwent a motor-adaptation paradigm, and two subacute stroke patients, exhibiting different degrees of motor impairment, who participated in a pilot test.

Results The experiments illustrated the model’s capability to differentiate distinct motor improvement progressions among subjects and subtasks. The model suggested personalized training schedules based on motor improvement estimations for each movement in different directions. Patients’ motor performances were retained when training movements were reintroduced at a later stage.

Conclusions Our results demonstrated the feasibility of the proposed model-based approach for the personalization of robot-aided rehabilitation therapy. The pilot test with two subacute stroke patients further supported our approach, while providing auspicious results for the applicability in clinical settings.

Trial registration This study is registered in ClinicalTrials.gov (NCT02770300, registered 30 March 2016, https://clinicaltrials.gov/ct2/show/NCT02770300).

Footnotes

  • Co-authors emails: Elvira Pirondini: Elvira.Pirondini{at}unige.ch, Nawal Kinany: nawal.kinany{at}epfl.ch, Camilla Pierella: camilla.pierella{at}epfl.ch, Alessandro Panarese: a.panarese{at}santannapisa.it, Martina Coscia: martina.coscia{at}wysscenter.ch, Jenifer Miehlbradt: jenifer.miehlbradt{at}epfl.ch, Cécile Magnin: Cecile.Magnin{at}hcuge.ch, Pierre Nicolo: Pierre.Nicolo{at}hcuge.ch, Adrian Guggisberg: Adrian.Guggisberg{at}hcuge.ch, Silvestro Micera: silvestro.micera{at}epfl.ch

  • List of abbreviations

    MI
    Motor improvement
    MV
    Movement velocity
    SAL
    Spectral arc length
    SUCC
    Success
    FMA-UE
    Fugl-Meyer assessment for upper extremities
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    Posted August 16, 2019.
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    Motor improvement estimation and task adaptation for personalized robot-aided therapy: a feasibility study
    Christian Giang, Elvira Pirondini, Nawal Kinany, Camilla Pierella, Alessandro Panarese, Martina Coscia, Jenifer Miehlbradt, Cécile Magnin, Pierre Nicolo, Adrian Guggisberg, Silvestro Micera
    bioRxiv 728725; doi: https://doi.org/10.1101/728725
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    Motor improvement estimation and task adaptation for personalized robot-aided therapy: a feasibility study
    Christian Giang, Elvira Pirondini, Nawal Kinany, Camilla Pierella, Alessandro Panarese, Martina Coscia, Jenifer Miehlbradt, Cécile Magnin, Pierre Nicolo, Adrian Guggisberg, Silvestro Micera
    bioRxiv 728725; doi: https://doi.org/10.1101/728725

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