Results Of Automating A Photolithography Cell In A Clean Tunnel

NASA Astrophysics Data System (ADS)

June, David H.

1987-01-01

A prototype automated photobay was installed in an existing fab area utilizing flexible material handling techniques within a clean tunnel. The project objective was to prove design concepts of automated cassette-to-cassette handling within a clean tunnel that isolated operators from the wafers being processed. Material handling was by monorail track transport system to feed cassettes to pick and place robots. The robots loaded and unloaded cassettes of wafers to each of the various pieces of process equipment. The material handling algorithms, recipe downloading and statistical process control functions were all performed by custom software on the photobay cell controller.

Training and learning robotic surgery, time for a more structured approach: a systematic review.

PubMed

Schreuder, H W R; Wolswijk, R; Zweemer, R P; Schijven, M P; Verheijen, R H M

2012-01-01

Robotic assisted laparoscopic surgery is growing rapidly and there is an increasing need for a structured approach to train future robotic surgeons. To review the literature on training and learning strategies for robotic assisted laparoscopic surgery. A systematic search of MEDLINE, EMBASE, the Cochrane Library and the Journal of Robotic Surgery was performed. We included articles concerning training, learning, education and teaching of robotic assisted laparoscopic surgery in any specialism. Two authors independently selected articles to be included. We categorised the included articles into: training modalities, learning curve, training future surgeons, curriculum design and implementation. We included 114 full text articles. Training modalities such as didactic training, skills training (dry lab, virtual reality, animal or cadaver models), case observation, bedside assisting, proctoring and the mentoring console can be used for training in robotic assisted laparoscopic surgery. Several training programmes in general and specific programmes designed for residents, fellows and surgeons are described in the literature. We provide guidelines for development of a structured training programme. Robotic surgical training consists of system training and procedural training. System training should be formally organised and should be competence based, instead of time based. Virtual reality training will play an import role in the near future. Procedural training should be organised in a stepwise approach with objective assessment of each step. This review aims to facilitate and improve the implementation of structured robotic surgical training programmes. © 2011 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2011 RCOG.

Current status of robotic simulators in acquisition of robotic surgical skills.

PubMed

Kumar, Anup; Smith, Roger; Patel, Vipul R

2015-03-01

This article provides an overview of the current status of simulator systems in robotic surgery training curriculum, focusing on available simulators for training, their comparison, new technologies introduced in simulation focusing on concepts of training along with existing challenges and future perspectives of simulator training in robotic surgery. The different virtual reality simulators available in the market like dVSS, dVT, RoSS, ProMIS and SEP have shown face, content and construct validity in robotic skills training for novices outside the operating room. Recently, augmented reality simulators like HoST, Maestro AR and RobotiX Mentor have been introduced in robotic training providing a more realistic operating environment, emphasizing more on procedure-specific robotic training . Further, the Xperience Team Trainer, which provides training to console surgeon and bed-side assistant simultaneously, has been recently introduced to emphasize the importance of teamwork and proper coordination. Simulator training holds an important place in current robotic training curriculum of future robotic surgeons. There is a need for more procedure-specific augmented reality simulator training, utilizing advancements in computing and graphical capabilities for new innovations in simulator technology. Further studies are required to establish its cost-benefit ratio along with concurrent and predictive validity.

Robotic Surgical Training in an Academic Institution

PubMed Central

Chitwood, W. Randolph; Nifong, L. Wiley; Chapman, William H. H.; Felger, Jason E.; Bailey, B. Marcus; Ballint, Tara; Mendleson, Kim G.; Kim, Victor B.; Young, James A.; Albrecht, Robert A.

2001-01-01

Objective To detail robotic procedure development and clinical applications for mitral valve, biliary, and gastric reflux operations, and to implement a multispecialty robotic surgery training curriculum for both surgeons and surgical teams. Summary Background Data Remote, accurate telemanipulation of intracavitary instruments by general and cardiac surgeons is now possible. Complex technologic advancements in surgical robotics require well-designed training programs. Moreover, efficient robotic surgical procedures must be developed methodically and safely implemented clinically. Methods Advanced training on robotic systems provides surgeon confidence when operating in tiny intracavitary spaces. Three-dimensional vision and articulated instrument control are essential. The authors’ two da Vinci robotic systems have been dedicated to procedure development, clinical surgery, and training of surgical specialists. Their center has been the first United States site to train surgeons formally in clinical robotics. Results Established surgeons and residents have been trained using a defined robotic surgical educational curriculum. Also, 30 multispecialty teams have been trained in robotic mechanics and electronics. Initially, robotic procedures were developed experimentally and are described. In the past year the authors have performed 52 robotic-assisted clinical operations: 18 mitral valve repairs, 20 cholecystectomies, and 14 Nissen fundoplications. These respective operations required 108, 28, and 73 minutes of robotic telemanipulation to complete. Procedure times for the last half of the abdominal operations decreased significantly, as did the knot-tying time in mitral operations. There have been no deaths and few complications. One mitral patient had postoperative bleeding. Conclusion Robotic surgery can be performed safely with excellent results. The authors have developed an effective curriculum for training teams in robotic surgery. After training, surgeons have applied these methods effectively and safely. PMID:11573041

General surgery residents' perception of robot-assisted procedures during surgical training.

PubMed

Farivar, Behzad S; Flannagan, Molly; Leitman, I Michael

2015-01-01

With the continued expansion of robotically assisted procedures, general surgery residents continue to receive more exposure to this new technology as part of their training. There are currently no guidelines or standardized training requirements for robot-assisted procedures during general surgical residency. The aim of this study was to assess the effect of this new technology on general surgery training from the residents' perspective. An anonymous, national, web-based survey was conducted on residents enrolled in general surgery training in 2013. The survey was sent to 240 Accreditation Council for Graduate Medical Education-approved general surgery training programs. Overall, 64% of the responding residents were men and had an average age of 29 years. Half of the responses were from postgraduate year 1 (PGY1) and PGY2 residents, and the remainder was from the PGY3 level and above. Overall, 50% of the responses were from university training programs, 32% from university-affiliated programs, and 18% from community-based programs. More than 96% of residents noted the availability of the surgical robot system at their training institution. Overall, 63% of residents indicated that they had participated in robotic surgical cases. Most responded that they had assisted in 10 or fewer robotic cases with the most frequent activities being assisting with robotic trocar placement and docking and undocking the robot. Only 18% reported experience with operating the robotic console. More senior residents (PGY3 and above) were involved in robotic cases compared with junior residents (78% vs 48%, p < 0.001). Overall, 60% of residents indicated that they received no prior education or training before their first robotic case. Approximately 64% of residents reported that formal training in robotic surgery was important in residency training and 46% of residents indicated that robotic-assisted cases interfered with resident learning. Only 11% felt that robotic-assisted cases would replace conventional laparoscopic surgery in the future. This study illustrates that although the most residents have a robot at their institution and have participated in robotic surgery cases, very few residents received formal training before participating in a robotic case. Copyright © 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Robotic Surgery Training in an OB/GYN Residency Program: A Survey Investigating the Optimal Training and Credentialing of OB/GYN Residents.

PubMed

Peterson, Shannon; Mayer, Allan; Nelson, Beth; Roland, Phillip

2015-08-01

Many community hospital gynecologic surgery training programs now include robotics.At St. Francis Hospital and Medical Center, we have integrated robotic surgical training since 2006. This study is designed to assess the success in training gynecology residents in robotic surgery. An anonymous web-based survey tool (www. survey monkey. com) was sent to all Ob/Gyn residency graduates from 2007-2010 (n = 17). From 2011-2014, we emailed three reevaluation questions to all 2007-2014 graduates (N = 32). Design Classification: II-3. The response rate was 95%, and 11 of 17 initial graduates (65%) indicated that they had received adequate robotic training. Currently, 24 of 32 (75%) graduates practice in hospitals with robotic availability. Twenty of the 32 graduates (63%) are using robotics in their surgical practices. Nine of these 20 graduates (45%) were fully credentialed following their residency. The other 11 graduates (55%)required further proctoring to obtain full robotic credentials. Robotic surgical training is a component of modern gynecologic surgical training. Postresidency robotic credentialing is a realistic graduation goal for residents who plan to practice gynecologic surgery.

Space Robotics: AWIMR an Overview

NASA Technical Reports Server (NTRS)

Wagner, Rick

2006-01-01

This viewgraph presentation reviews the usages of Autonomous Walking Inspection and Maintenance Robots (AWIMR) in space. Some of the uses that these robots in support of space exploration can have are: inspection of a space craft, cleaning, astronaut assistance, assembly of a structure, repair of structures, and replenishment of supplies.

Raven surgical robot training in preparation for da vinci.

PubMed

Glassman, Deanna; White, Lee; Lewis, Andrew; King, Hawkeye; Clarke, Alicia; Glassman, Thomas; Comstock, Bryan; Hannaford, Blake; Lendvay, Thomas S

2014-01-01

The rapid adoption of robotic assisted surgery challenges the pace at which adequate robotic training can occur due to access limitations to the da Vinci robot. Thirty medical students completed a randomized controlled trial evaluating whether the Raven robot could be used as an alternative training tool for the Fundamentals of Laparoscopic Surgery (FLS) block transfer task on the da Vinci robot. Two groups, one trained on the da Vinci and one trained on the Raven, were tested on a criterion FLS block transfer task on the da Vinci. After robotic FLS block transfer proficiency training there was no statistically significant difference between path length (p=0.39) and economy of motion scores (p=0.06) between the two groups, but those trained on the da Vinci did have faster task times (p=0.01). These results provide evidence for the value of using the Raven robot for training prior to using the da Vinci surgical system for similar tasks.

Physiological and Behavioral Responses of Dairy Cattle to the Introduction of Robot Scrapers.

PubMed

Doerfler, Renate L; Lehermeier, Christina; Kliem, Heike; Möstl, Erich; Bernhardt, Heinz

2016-01-01

Autonomous mobile robot scrapers are increasingly used in order to clean the floors on dairy farms. Given the complexity of robot scraper operation, stress may occur in cows due to unpredictability of the situation. Experiencing stress can impair animal welfare and, in the long term, the health and milk production of the cows. Therefore, this study addressed potential stress responses of dairy cattle to the robot scraper after introducing the autonomous mobile machine. Thirty-six cows in total were studied on three different farms to explore possible modifications in cardiac function, behavior, and adrenocortical activity. The research protocol on each farm consisted of four experimental periods including one baseline measurement without robot scraper operation followed by three test measurements, in which cows interacted with the robotic cleaning system. Interbeat intervals were recorded in order to calculate the heart rate variability (HRV) parameter RMSSD; behavior was observed to determine time budgets; and fecal samples were collected for analysis of the cortisol metabolites concentration. A statistical analysis was carried out using linear mixed-effects models. HRV decline immediately after the introduction of the robot scraper and modified behavior in the subsequent experimental periods indicated a stress response. The cortisol metabolites concentration remained constant. It is hypothesized that after the initial phase of decrease, HRV stabilized through the behavioral adjustments of the cows in the second part of the study. Persistent alterations in behavior gave rise to the assumption that the animals' habituation process to the robot scraper was not yet completed. In summary, the present study illustrated that the cows showed minor signs of disturbance toward the robotic cleaning system. Thus, our findings suggest that dairy cattle can largely adjust their behavior to avoid aversive effects on animal welfare. Additional research can provide further insight into the development of the animal-machine interaction beyond the initial phase of robot scraper operation considered in this study.

Outcomes from the Delphi process of the Thoracic Robotic Curriculum Development Committee.

PubMed

Veronesi, Giulia; Dorn, Patrick; Dunning, Joel; Cardillo, Giuseppe; Schmid, Ralph A; Collins, Justin; Baste, Jean-Marc; Limmer, Stefan; Shahin, Ghada M M; Egberts, Jan-Hendrik; Pardolesi, Alessandro; Meacci, Elisa; Stamenkovic, Sasha; Casali, Gianluca; Rueckert, Jens C; Taurchini, Mauro; Santelmo, Nicola; Melfi, Franca; Toker, Alper

2018-06-01

As the adoption of robotic procedures becomes more widespread, additional risk related to the learning curve can be expected. This article reports the results of a Delphi process to define procedures to optimize robotic training of thoracic surgeons and to promote safe performance of established robotic interventions as, for example, lung cancer and thymoma surgery. In June 2016, a working panel was spontaneously created by members of the European Society of Thoracic Surgeons (ESTS) and European Association for Cardio-Thoracic Surgery (EACTS) with a specialist interest in robotic thoracic surgery and/or surgical training. An e-consensus-finding exercise using the Delphi methodology was applied requiring 80% agreement to reach consensus on each question. Repeated iterations of anonymous voting continued over 3 rounds. Agreement was reached on many points: a standardized robotic training curriculum for robotic thoracic surgery should be divided into clearly defined sections as a staged learning pathway; the basic robotic curriculum should include a baseline evaluation, an e-learning module, a simulation-based training (including virtual reality simulation, Dry lab and Wet lab) and a robotic theatre (bedside) observation. Advanced robotic training should include e-learning on index procedures (right upper lobe) with video demonstration, access to video library of robotic procedures, simulation training, modular console training to index procedure, transition to full-procedure training with a proctor and final evaluation of the submitted video to certified independent examiners. Agreement was reached on a large number of questions to optimize and standardize training and education of thoracic surgeons in robotic activity. The production of the content of the learning material is ongoing.

Survey of robotic surgery training in obstetrics and gynecology residency.

PubMed

Gobern, Joseph M; Novak, Christopher M; Lockrow, Ernest G

2011-01-01

To examine the status of resident training in robotic surgery in obstetrics and gynecology programs in the United States, an online survey was emailed to residency program directors of 247 accredited programs identified through the Accreditation Council for Graduate Medical Education website. Eighty-three of 247 program directors responded, representing a 34% response rate. Robotic surgical systems for gynecologic procedures were used at 65 (78%) institutions. Robotic surgery training was part of residency curriculum at 48 (58%) residency programs. Half of respondents were undecided on training effectiveness. Most program directors believed the role of robotic surgery would increase and play a more integral role in gynecologic surgery. Robotic surgery was widely reported in residency training hospitals with limited availability of effective resident training. Robotic surgery training in obstetrics and gynecology residency needs further assessment and may benefit from a structured curriculum. Published by Elsevier Inc.

Reducing robotic guidance during robot-assisted gait training improves gait function: a case report on a stroke survivor.

PubMed

Krishnan, Chandramouli; Kotsapouikis, Despina; Dhaher, Yasin Y; Rymer, William Z

2013-06-01

To test the feasibility of patient-cooperative robotic gait training for improving locomotor function of a chronic stroke survivor with severe lower-extremity motor impairments. Single-subject crossover design. Performed in a controlled laboratory setting. A 62-year-old man with right temporal lobe ischemic stroke was recruited for this study. The baseline lower-extremity Fugl-Meyer score of the subject was 10 on a scale of 34, which represented severe impairment in the paretic leg. However, the subject had a good ambulation level (community walker with the aid of a stick cane and ankle-foot orthosis) and showed no signs of sensory or cognitive impairments. The subject underwent 12 sessions (3 times per week for 4wk) of conventional robotic training with the Lokomat, where the robot provided full assistance to leg movements while walking, followed by 12 sessions (3 times per week for 4wk) of patient-cooperative robotic control training, where the robot provided minimal guidance to leg movements during walking. Clinical outcomes were evaluated before the start of the intervention, immediately after 4 weeks of conventional robotic training, and immediately after 4 weeks of cooperative control robotic training. These included: (1) self-selected and fast walking speed, (2) 6-minute walk test, (3) Timed Up & Go test, and (4) lower-extremity Fugl-Meyer score. Results showed that clinical outcomes changed minimally after full guidance robotic training, but improved considerably after 4 weeks of reduced guidance robotic training. The findings from this case study suggest that cooperative control robotic training is superior to conventional robotic training and is a feasible option to restoring locomotor function in ambulatory stroke survivors with severe motor impairments. A larger trial is needed to verify the efficacy of this advanced robotic control strategy in facilitating gait recovery after stroke. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Basic Operational Robotics Instructional System

NASA Technical Reports Server (NTRS)

Todd, Brian Keith; Fischer, James; Falgout, Jane; Schweers, John

2013-01-01

The Basic Operational Robotics Instructional System (BORIS) is a six-degree-of-freedom rotational robotic manipulator system simulation used for training of fundamental robotics concepts, with in-line shoulder, offset elbow, and offset wrist. BORIS is used to provide generic robotics training to aerospace professionals including flight crews, flight controllers, and robotics instructors. It uses forward kinematic and inverse kinematic algorithms to simulate joint and end-effector motion, combined with a multibody dynamics model, moving-object contact model, and X-Windows based graphical user interfaces, coordinated in the Trick Simulation modeling environment. The motivation for development of BORIS was the need for a generic system for basic robotics training. Before BORIS, introductory robotics training was done with either the SRMS (Shuttle Remote Manipulator System) or SSRMS (Space Station Remote Manipulator System) simulations. The unique construction of each of these systems required some specialized training that distracted students from the ideas and goals of the basic robotics instruction.

Survey on Robot-Assisted Surgical Techniques Utilization in US Pediatric Surgery Fellowships.

PubMed

Maizlin, Ilan I; Shroyer, Michelle C; Yu, David C; Martin, Colin A; Chen, Mike K; Russell, Robert T

2017-02-01

Robotic technology has transformed both practice and education in many adult surgical specialties; no standardized training guidelines in pediatric surgery currently exist. The purpose of our study was to assess the prevalence of robotic procedures and extent of robotic surgery education in US pediatric surgery fellowships. A deidentified survey measured utilization of the robot, perception on the utility of the robot, and its incorporation in training among the program directors of Accreditation Council for Graduate Medical Education (ACGME) pediatric surgery fellowships in the United States. Forty-one of the 47 fellowship programs (87%) responded to the survey. While 67% of respondents indicated the presence of a robot in their facility, only 26% reported its utilizing in their surgical practice. Among programs not utilizing the robot, most common reasons provided were lack of clear supportive evidence, increased intraoperative time, and incompatibility of instrument size to pediatric patients. While 58% of program directors believe that there is a future role for robotic surgery in children, only 18% indicated that robotic training should play a part in pediatric surgery education. Consequently, while over 66% of survey respondents received training in robot-assisted surgical technique, only 29% of fellows receive robot-assisted training during their fellowship. A majority of fellowships have access to a robot, but few utilize the technology in their current practice or as part of training. Further investigation is required into both the technology's potential benefits in the pediatric population and its role in pediatric surgery training.

Robot-assisted laparoscopic skills development: formal versus informal training.

PubMed

Benson, Aaron D; Kramer, Brandan A; Boehler, Margaret; Schwind, Cathy J; Schwartz, Bradley F

2010-08-01

The learning curve for robotic surgery is not completely defined, and ideal training components have not yet been identified. We attempted to determine whether skill development would be accelerated with formal, organized instruction in robotic surgical techniques versus informal practice alone. Forty-three medical students naive to robotic surgery were randomized into two groups and tested on three tasks using the robotic platform. Between the testing sessions, the students were given equally timed practice sessions. The formal training group participated in an organized, formal training session with instruction from an attending robotic surgeon, whereas the informal training group participated in an equally timed unstructured practice session with the robot. The results were compared based on technical score and time to completion of each task. There was no difference between groups in prepractice testing for any task. In postpractice testing, there was no difference between groups for the ring transfer tasks. However, for the suture placement and knot-tying task, the technical score of the formal training group was significantly better than that of the informal training group (p < 0.001), yet time to completion was not different. Although formal training may not be necessary for basic skills, formal instruction for more advanced skills, such as suture placement and knot tying, is important in developing skills needed for effective robotic surgery. These findings may be important in formulating potential skills labs or training courses for robotic surgery.

Sozzy: a hormone-driven autonomous vacuum cleaner

NASA Astrophysics Data System (ADS)

Yamamoto, Masaki

1994-02-01

Domestic robots are promising examples of the application of robotics to personal life. There have been many approaches in this field, but no successful results exist. The problem is that domestic environments are more difficult for robots than other environments, such as factory floors or office floors. Consequently, conventional approaches using a model of human intelligence to design robots have not been successful. In this paper, we report on a prototyped domestic vacuum-cleaning robot that is designed to be able to handle complex environments. The control software is composed of two layers, both of which are generally inspired by behaviors of living creatures. The first layer corresponds to a dynamically reconfigurable system of behaviors implemented in the subsumption architecture. The ability of the robot to support alternate configurations of its behaviors provides the robot with increased robustness. We have conveniently labeled particular configurations as specific `emotions' according to the interpretation of observers of the robot's behavior. The second layer simulates the hormone system. The hormone system is modeled using state variables, increased or decreased by stimuli from the environment. The hormone condition selects the robot's most suitable emotion, according to the changing environments. The robot hardware is built of off-the-shelf parts, such as an embedded CPU, inexpensive home-appliance sensors, and small motors. These parts keep the total building cost to a minimum. The robot also has a vacuum cleaning function to demonstrate its capability to perform useful tasks. We tested the robot in our laboratory, and successfully videotaped its robust behaviors. We also confirmed the hormone system to enhance the robot's plasticity and lifelike quality.

The Complex Challenges of Remotely Removing Redundant Pipework and Cleaning/Remediation of Aging Civil Structures at Sellafield - 12446

DOE Office of Scientific and Technical Information (OSTI.GOV)

Farran, Paul

This paper identifies how a joint Sellafield Ltd/Nuclear Management Partners Tactical Review Team and main contractor, SA Robotics, developed and successfully deployed a solution to clean and coat the wall surface of an aging structure on the Sellafield Site. This involved removal of redundant pipework from the wall, cleaning and coating of the surface using a bespoke designed robotic manipulator with various end effectors. This system was able to safely and in a controlled manner remove the pipework, clean down the wall and prime and coat it within the required programme duration which was 5 months earlier than a previousmore » shielding only option. This was done in a high radiation field and in the challenging conditions of winter in Northern England. (authors)« less

Feasibility and effects of patient-cooperative robot-aided gait training applied in a 4-week pilot trial

PubMed Central

2012-01-01

Background Functional training is becoming the state-of-the-art therapy approach for rehabilitation of individuals after stroke and spinal cord injury. Robot-aided treadmill training reduces personnel effort, especially when treating severely affected patients. Improving rehabilitation robots towards more patient-cooperative behavior may further increase the effects of robot-aided training. This pilot study aims at investigating the feasibility of applying patient-cooperative robot-aided gait rehabilitation to stroke and incomplete spinal cord injury during a therapy period of four weeks. Short-term effects within one training session as well as the effects of the training on walking function are evaluated. Methods Two individuals with chronic incomplete spinal cord injury and two with chronic stroke trained with the Lokomat gait rehabilitation robot which was operated in a new, patient-cooperative mode for a period of four weeks with four training sessions of 45 min per week. At baseline, after two and after four weeks, walking function was assessed with the ten meter walking test. Additionally, muscle activity of the major leg muscles, heart rate and the Borg scale were measured under different walking conditions including a non-cooperative position control mode to investigate the short-term effects of patient-cooperative versus non-cooperative robot-aided gait training. Results Patient-cooperative robot-aided gait training was tolerated well by all subjects and performed without difficulties. The subjects trained more actively and with more physiological muscle activity than in a non-cooperative position-control mode. One subject showed a significant and relevant increase of gait speed after the therapy, the three remaining subjects did not show significant changes. Conclusions Patient-cooperative robot-aided gait training is feasible in clinical practice and overcomes the main points of criticism against robot-aided gait training: It enables patients to train in an active, variable and more natural way. The limited number of subjects in this pilot trial does not permit valid conclusions on the effect of patient-cooperative robot-aided gait training on walking function. A large, possibly multi-center randomized controlled clinical trial is required to shed more light on this question. PMID:22650320

Sports Training Support Method by Self-Coaching with Humanoid Robot

NASA Astrophysics Data System (ADS)

Toyama, S.; Ikeda, F.; Yasaka, T.

2016-09-01

This paper proposes a new training support method called self-coaching with humanoid robots. In the proposed method, two small size inexpensive humanoid robots are used because of their availability. One robot called target robot reproduces motion of a target player and another robot called reference robot reproduces motion of an expert player. The target player can recognize a target technique from the reference robot and his/her inadequate skill from the target robot. Modifying the motion of the target robot as self-coaching, the target player could get advanced cognition. Some experimental results show some possibility as the new training method and some issues of the self-coaching interface program as a future work.

Residency Training in Robotic General Surgery: A Survey of Program Directors

PubMed Central

George, Lea C.; O'Neill, Rebecca

2018-01-01

Objective Robotic surgery continues to expand in minimally invasive surgery; however, the literature is insufficient to understand the current training process for general surgery residents. Therefore, the objectives of this study were to identify the current approach to and perspectives on robotic surgery training. Methods An electronic survey was distributed to general surgery program directors identified by the Accreditation Council for Graduate Medical Education website. Multiple choice and open-ended questions regarding current practices and opinions on robotic surgery training in general surgery residency programs were used. Results 20 program directors were surveyed, a majority being from medium-sized programs (4–7 graduating residents per year). Most respondents (73.68%) had a formal robotic surgery curriculum at their institution, with 63.16% incorporating simulation training. Approximately half of the respondents believe that more time should be dedicated to robotic surgery training (52.63%), with simulation training prior to console use (84.21%). About two-thirds of the respondents (63.16%) believe that a formal robotic surgery curriculum should be established as a part of general surgery residency, with more than half believing that exposure should occur in postgraduate year one (55%). Conclusion A formal robotics curriculum with simulation training and early surgical exposure for general surgery residents should be given consideration in surgical residency training. PMID:29854454

Residency Training in Robotic General Surgery: A Survey of Program Directors.

PubMed

George, Lea C; O'Neill, Rebecca; Merchant, Aziz M

2018-01-01

Robotic surgery continues to expand in minimally invasive surgery; however, the literature is insufficient to understand the current training process for general surgery residents. Therefore, the objectives of this study were to identify the current approach to and perspectives on robotic surgery training. An electronic survey was distributed to general surgery program directors identified by the Accreditation Council for Graduate Medical Education website. Multiple choice and open-ended questions regarding current practices and opinions on robotic surgery training in general surgery residency programs were used. 20 program directors were surveyed, a majority being from medium-sized programs (4-7 graduating residents per year). Most respondents (73.68%) had a formal robotic surgery curriculum at their institution, with 63.16% incorporating simulation training. Approximately half of the respondents believe that more time should be dedicated to robotic surgery training (52.63%), with simulation training prior to console use (84.21%). About two-thirds of the respondents (63.16%) believe that a formal robotic surgery curriculum should be established as a part of general surgery residency, with more than half believing that exposure should occur in postgraduate year one (55%). A formal robotics curriculum with simulation training and early surgical exposure for general surgery residents should be given consideration in surgical residency training.

Task-specific ankle robotics gait training after stroke: a randomized pilot study.

PubMed

Forrester, Larry W; Roy, Anindo; Hafer-Macko, Charlene; Krebs, Hermano I; Macko, Richard F

2016-06-02

An unsettled question in the use of robotics for post-stroke gait rehabilitation is whether task-specific locomotor training is more effective than targeting individual joint impairments to improve walking function. The paretic ankle is implicated in gait instability and fall risk, but is difficult to therapeutically isolate and refractory to recovery. We hypothesize that in chronic stroke, treadmill-integrated ankle robotics training is more effective to improve gait function than robotics focused on paretic ankle impairments. Participants with chronic hemiparetic gait were randomized to either six weeks of treadmill-integrated ankle robotics (n = 14) or dose-matched seated ankle robotics (n = 12) videogame training. Selected gait measures were collected at baseline, post-training, and six-week retention. Friedman, and Wilcoxon Sign Rank and Fisher's exact tests evaluated within and between group differences across time, respectively. Six weeks post-training, treadmill robotics proved more effective than seated robotics to increase walking velocity, paretic single support, paretic push-off impulse, and active dorsiflexion range of motion. Treadmill robotics durably improved gait dorsiflexion swing angle leading 6/7 initially requiring ankle braces to self-discarded them, while their unassisted paretic heel-first contacts increased from 44 % to 99.6 %, versus no change in assistive device usage (0/9) following seated robotics. Treadmill-integrated, but not seated ankle robotics training, durably improves gait biomechanics, reversing foot drop, restoring walking propulsion, and establishing safer foot landing in chronic stroke that may reduce reliance on assistive devices. These findings support a task-specific approach integrating adaptive ankle robotics with locomotor training to optimize mobility recovery. NCT01337960. https://clinicaltrials.gov/ct2/show/NCT01337960?term=NCT01337960&rank=1.

Comparison of two simulation systems to support robotic-assisted surgical training: a pilot study (Swine model).

PubMed

Whitehurst, Sabrina V; Lockrow, Ernest G; Lendvay, Thomas S; Propst, Anthony M; Dunlow, Susan G; Rosemeyer, Christopher J; Gobern, Joseph M; White, Lee W; Skinner, Anna; Buller, Jerome L

2015-01-01

To compare the efficacy of simulation-based training between the Mimic dV- Trainer and traditional dry lab da Vinci robot training. A prospective randomized study analyzing the performance of 20 robotics-naive participants. Participants were enrolled in an online da Vinci Intuitive Surgical didactic training module, followed by training in use of the da Vinci standard surgical robot. Spatial ability tests were performed as well. Participants were randomly assigned to 1 of 2 training conditions: performance of 3 Fundamentals of Laparoscopic Surgery dry lab tasks using the da Vinci or performance of 4 dV-Trainer tasks. Participants in both groups performed all tasks to empirically establish proficiency criterion. Participants then performed the transfer task, a cystotomy closure using the daVinci robot on a live animal (swine) model. The performance of robotic tasks was blindly assessed by a panel of experienced surgeons using objective tracking data and using the validated Global Evaluative Assessment of Robotic Surgery (GEARS), a structured assessment tool. No statistically significant difference in surgeon performance was found between the 2 training conditions, dV-Trainer and da Vinci robot. Analysis of a 95% confidence interval for the difference in means (-0.803 to 0.543) indicated that the 2 methods are unlikely to differ to an extent that would be clinically meaningful. Based on the results of this study, a curriculum on the dV- Trainer was shown to be comparable to traditional da Vinci robot training. Therefore, we have identified that training on a virtual reality system may be an alternative to live animal training for future robotic surgeons. Published by Elsevier Inc.

Retention of laparoscopic and robotic skills among medical students: a randomized controlled trial.

PubMed

Orlando, Megan S; Thomaier, Lauren; Abernethy, Melinda G; Chen, Chi Chiung Grace

2017-08-01

Although simulation training beneficially contributes to traditional surgical training, there are less objective data on simulation skills retention. To investigate the retention of laparoscopic and robotic skills after simulation training. We present the second stage of a randomized single-blinded controlled trial in which 40 simulation-naïve medical students were randomly assigned to practice peg transfer tasks on either laparoscopic (N = 20, Fundamentals of Laparoscopic Surgery, Venture Technologies Inc., Waltham, MA) or robotic (N = 20, dV-Trainer, Mimic, Seattle, WA) platforms. In the first stage, two expert surgeons evaluated participants on both tasks before (Stage 1: Baseline) and immediately after training (Stage 1: Post-training) using a modified validated global rating scale of laparoscopic and robotic operative performance. In Stage 2, participants were evaluated on both tasks 11-20 weeks after training. Of the 40 students who participated in Stage 1, 23 (11 laparoscopic and 12 robotic) underwent repeat evaluation. During Stage 2, there were no significant differences between groups in objective or subjective measures for the laparoscopic task. Laparoscopic-trained participants' performances on the laparoscopic task were improved during Stage 2 compared to baseline measured by time to task completion, but not by the modified global rating scale. During the robotic task, the robotic-trained group demonstrated superior economy of motion (p = .017), Tissue Handling (p = .020), and fewer errors (p = .018) compared to the laparoscopic-trained group. Robotic skills acquisition from baseline with no significant deterioration as measured by modified global rating scale scores was observed among robotic-trained participants during Stage 2. Robotic skills acquired through simulation appear to be better maintained than laparoscopic simulation skills. This study is registered on ClinicalTrials.gov (NCT02370407).

Cleaning-resistant Cupriavidus and Ralstonia bacteria contaminating spacecrafts and the ultra clean rooms they are assembled in.

NASA Astrophysics Data System (ADS)

Leys, N.; Dams, A.; Bossus, A.; Provoost, A.; Venkateswaran, K.; Mergeay, M.

Background Planetary Protection is preventing microbial contamination of both the target planet and the Earth when sending spacecrafts on interplanetary space mission It is important to preserve the natural conditions of other planets and to not bring with robots earthly microbes forward contamination when looking for spores of extra terrestrial life Spacecrafts and the ultra clean rooms they are assembled in are routinely monitored for microbial contamination It was shown that the floor air and surfaces of such spacecraft assembly rooms often contain Cupriavidu s and Ralstonia bacteria These bacteria not only contaminated the clean rooms but have also been found prior-to-flight on surfaces of space robots such as the Mars Odyssey Orbiter La Duc et al 2003 and even in-flight in ISS cooling water and Shuttle drinking water unpublished Aim In this study several Cupriavidus and Ralstonia strains isolated from space craft assembling rooms and spacecrafts were characterized and analysed in detail Results The analysis showed that all the Cupriavidus and Ralstonia clean-room isolates are able to use a wide variety of substrates as carbon sources including ethanol and acetone In addition they all have accumulated moderate resistances to an extraordinary collection of physical and chemical antimicrobial agents Some of the test strains were able to form biofilms on plastic and metal materials used for space robots a nutritional and

A Lower Limb Rehabilitation Robot in Sitting Position with a Review of Training Activities.

PubMed

Eiammanussakul, Trinnachoke; Sangveraphunsiri, Viboon

2018-01-01

Robots for stroke rehabilitation at the lower limbs in sitting/lying position have been developed extensively. Some of them have been applied in clinics and shown the potential of the recovery of poststroke patients who suffer from hemiparesis. These robots were developed to provide training at different joints of lower limbs with various activities and modalities. This article reviews the training activities that were realized by rehabilitation robots in literature, in order to offer insights for developing a novel robot suitable for stroke rehabilitation. The control system of the lower limb rehabilitation robot in sitting position that was introduced in the previous work is discussed in detail to demonstrate the behavior of the robot while training a subject. The nonlinear impedance control law, based on active assistive control strategy, is able to define the response of the robot with more specifications while the passivity property and the robustness of the system is verified. A preliminary experiment is conducted on a healthy subject to show that the robot is able to perform active assistive exercises with various training activities and assist the subject to complete the training with desired level of assistance.

Outcomes of a virtual-reality simulator-training programme on basic surgical skills in robot-assisted laparoscopic surgery.

PubMed

Phé, Véronique; Cattarino, Susanna; Parra, Jérôme; Bitker, Marc-Olivier; Ambrogi, Vanina; Vaessen, Christophe; Rouprêt, Morgan

2017-06-01

The utility of the virtual-reality robotic simulator in training programmes has not been clearly evaluated. Our aim was to evaluate the impact of a virtual-reality robotic simulator-training programme on basic surgical skills. A simulator-training programme in robotic surgery, using the da Vinci Skills Simulator, was evaluated in a population including junior and seasoned surgeons, and non-physicians. Their performances on robotic dots and suturing-skin pod platforms before and after virtual-simulation training were rated anonymously by surgeons experienced in robotics. 39 participants were enrolled: 14 medical students and residents in surgery, 14 seasoned surgeons, 11 non-physicians. Junior and seasoned surgeons' performances on platforms were not significantly improved after virtual-reality robotic simulation in any of the skill domains, in contrast to non-physicians. The benefits of virtual-reality simulator training on several tasks to basic skills in robotic surgery were not obvious among surgeons in our initial and early experience with the simulator. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Curiosity Mars Rover Flexes its Robotic Arm

NASA Image and Video Library

2010-09-16

Test operators in a clean room at NASA Jet Propulsion Laboratory monitor some of the first motions by the robotic arm on the Mars rover Curiosity after installation in August 2010. The arm is shown in a partially extended position.

Prior experience in micro-surgery may improve the surgeon's performance in robotic surgical training.

PubMed

Perez, Manuela; Perrenot, Cyril; Tran, Nguyen; Hossu, Gabriela; Felblinger, Jacques; Hubert, Jacques

2013-09-01

Robotic surgery has witnessed a huge expansion. Robotic simulators have proved to be of major interest in training. Some authors have suggested that prior experience in micro-surgery could improve robotic surgery training. To test micro-surgery as a new approach in training, we proposed a prospective study comparing the surgical performance of micro-surgeons with that of general surgeons on a robotic simulator. 49 surgeons were enrolled; 11 in the micro-surgery group (MSG); 38 n the control group (CG). Performance was evaluated based on five dV-Trainer® exercises. MSG achieved better results for all exercises including exercises requiring visual evaluation of force feed-back, economy of motion, instrument force and position. These results show that experience in micro-surgery could significantly improve surgeons' abilities and their performance in robotic training. So, as micro-surgery practice is relatively cheap, it could be easily included in basic robotic surgery training. Copyright © 2013 John Wiley & Sons, Ltd.

Analysis, design and testing of high pressure waterjet nozzles

NASA Technical Reports Server (NTRS)

Mazzoleni, Andre P.

1996-01-01

The Hydroblast Research Cell at MSFC is both a research and a processing facility. The cell is used to investigate fundamental phenomena associated with waterjets as well as to clean hardware for various NASA and contractor projects. In the area of research, investigations are made regarding the use of high pressure waterjets to strip paint, grease, adhesive and thermal spray coatings from various substrates. Current industrial methods of cleaning often use ozone depleting chemicals (ODC) such as chlorinated solvents, and high pressure waterjet cleaning has proven to be a viable alternative. Standard methods of waterjet cleaning use hand held or robotically controlled nozzles. The nozzles used can be single-stream or multijet nozzles, and the multijet nozzles may be mounted in a rotating head or arranged in a fan-type shape. We consider in this paper the use of a rotating, multijet, high pressure water nozzle which is robotically controlled. This method enables rapid cleaning of a large area, but problems such as incomplete coverage (e.g. the formation of 'islands' of material not cleaned) and damage to the substrate from the waterjet have been observed. In addition, current stripping operations require the nozzle to be placed at a standoff distance of approximately 2 inches in order to achieve adequate performance. This close proximity of the nozzle to the target to be cleaned poses risks to the nozzle and the target in the event of robot error or the striking of unanticipated extrusions on the target surface as the nozzle sweeps past. Two key motivations of this research are to eliminate the formation of 'coating islands' and to increase the allowable standoff distance of the nozzle.

Proficiency training on a virtual reality robotic surgical skills curriculum.

PubMed

Bric, Justin; Connolly, Michael; Kastenmeier, Andrew; Goldblatt, Matthew; Gould, Jon C

2014-12-01

The clinical application of robotic surgery is increasing. The skills necessary to perform robotic surgery are unique from those required in open and laparoscopic surgery. A validated laparoscopic surgical skills curriculum (Fundamentals of Laparoscopic Surgery or FLS™) has transformed the way surgeons acquire laparoscopic skills. There is a need for a similar skills training and assessment tool for robotic surgery. Our research group previously developed and validated a robotic training curriculum in a virtual reality (VR) simulator. We hypothesized that novice robotic surgeons could achieve proficiency levels defined by more experienced robotic surgeons on the VR robotic curriculum, and that this would result in improved performance on the actual daVinci Surgical System™. 25 medical students with no prior robotic surgery experience were recruited. Prior to VR training, subjects performed 2 FLS tasks 3 times each (Peg Transfer, Intracorporeal Knot Tying) using the daVinci Surgical System™ docked to a video trainer box. Task performance for the FLS tasks was scored objectively. Subjects then practiced on the VR simulator (daVinci Skills Simulator) until proficiency levels on all 5 tasks were achieved before completing a post-training assessment of the 2 FLS tasks on the daVinci Surgical System™ in the video trainer box. All subjects to complete the study (1 dropped out) reached proficiency levels on all VR tasks in an average of 71 (± 21.7) attempts, accumulating 164.3 (± 55.7) minutes of console training time. There was a significant improvement in performance on the robotic FLS tasks following completion of the VR training curriculum. Novice robotic surgeons are able to attain proficiency levels on a VR simulator. This leads to improved performance in the daVinci surgical platform on simulated tasks. Training to proficiency on a VR robotic surgery simulator is an efficient and viable method for acquiring robotic surgical skills.

A Force-Controllable Macro-Micro Manipulator and its Application to Medical Robotics

NASA Technical Reports Server (NTRS)

Marzwell, Neville I.; Uecker, Darrin R.; Wang, Yulun

1993-01-01

This paper describes an 8-degrees-of-freedom macro-micro robot. This robot is capable of performing tasks that require accurate force control, such as polishing, finishing, grinding, deburring, and cleaning. The design of the macro-micro mechanism, the control algorithms, and the hardware/sofware implemtation of the algotithms are described in this paper. Initial experimental results are reported.

Enhancement Of Water-Jet Stripping Of Foam

NASA Technical Reports Server (NTRS)

Cosby, Steven A.; Shockney, Charles H.; Bates, Keith E.; Shalala, John P.; Daniels, Larry S.

1995-01-01

Improved robotic high-pressure-water-jet system strips foam insulation from parts without removing adjacent coating materials like paints, primers, and sealants. Even injects water into crevices and blind holes to clean out foam, without harming adjacent areas. Eliminates both cost of full stripping and recoating and problem of disposing of toxic solutions used in preparation for coating. Developed for postflight refurbishing of aft skirts of booster rockets. System includes six-axis robot provided with special end effector and specially written control software, called Aftfoam. Adaptable to cleaning and stripping in other industrial settings.

Robotics Technician Training at Macomb Community College.

ERIC Educational Resources Information Center

Lynch, Edward J.

Approved in 1979, the robotics technician training program at Macomb County Community College (MCC) in Warren (Michigan) provides students with training in hydraulics and electronics as well as with hands-on training in the area of robotics. Furthermore, the program faculty includes individuals with work experience in electronics, fluid power, and…

Portable and Reconfigurable Wrist Robot Improves Hand Function for Post-Stroke Subjects.

PubMed

Khor, Kang Xiang; Chin, Patrick Jun Hua; Yeong, Che Fai; Su, Eileen Lee Ming; Narayanan, Aqilah Leela T; Abdul Rahman, Hisyam; Khan, Qamer Iqbal

2017-10-01

Rehabilitation robots have become increasingly popular for stroke rehabilitation. However, the high cost of robots hampers their implementation on a large scale. This paper implements the concept of a modular and reconfigurable robot, reducing its cost and size by adopting different therapeutic end effectors for different training movements using a single robot. The challenge is to increase the robot's portability and identify appropriate kinds of modular tools and configurations. Because literature on the effectiveness of this kind of rehabilitation robot is still scarce, this paper presents the design of a portable and reconfigurable rehabilitation robot and describes its use with a group of post-stroke patients for wrist and forearm training. Seven stroke subjects received training using a reconfigurable robot for 30 sessions, lasting 30 min per session. Post-training, statistical analysis showed significant improvement of 3.29 points (16.20%, p = 0.027) on the Fugl-Meyer assessment scale for forearm and wrist components. Significant improvement of active range of motion was detected in both pronation-supination (75.59%, p = 0.018) and wrist flexion-extension (56.12%, p = 0.018) after the training. These preliminary results demonstrate that the developed reconfigurable robot could improve subjects' wrist and forearm movement.

A cable-driven locomotor training system for restoration of gait in human SCI.

PubMed

Wu, Ming; Hornby, T George; Landry, Jill M; Roth, Heidi; Schmit, Brian D

2011-02-01

A novel cable-driven robotic locomotor training system was developed to provide compliant assistance/resistance forces to the legs during treadmill training in patients with incomplete spinal cord injury (SCI). Eleven subjects with incomplete SCI were recruited to participate in two experiments to test the feasibility of the robotic gait training system. Specifically, 10 subjects participated in one experimental session to test the characteristics of the robotic gait training system and one subject participated in repeated testing sessions over 8 weeks with the robotic device to test improvements in locomotor function. Limb kinematics were recorded in one experiment to evaluate the system characteristics of the cable-driven locomotor trainer and the overground gait speed and 6 min walking distance were evaluated at pre, 4 and 8 weeks post treadmill training of a single subject as well. The results indicated that the cable driven robotic gait training system improved the kinematic performance of the leg during treadmill walking and had no significant impact on the variability of lower leg trajectory, suggesting a high backdrivability of the cable system. In addition, results from a patient with incomplete SCI indicated that prolonged robotic gait training using the cable robot improved overground gait speed. Results from this study suggested that a cable driven robotic gait training system is effective in improving leg kinematic performance, yet allows variability of gait kinematics. Thus, it seems feasible to improve the locomotor function in human SCI using this cable driven robotic system, warranting testing with a larger group of patients. Copyright © 2010 Elsevier B.V. All rights reserved.

Corticospinal excitability as a predictor of functional gains at the affected upper limb following robotic training in chronic stroke survivors

PubMed Central

Milot, Marie-Hélène; Spencer, Steven J.; Chan, Vicky; Allington, James P.; Klein, Julius; Chou, Cathy; Pearson-Fuhrhop, Kristin; Bobrow, James E.; Reinkensmeyer, David J.; Cramer, Steven C.

2014-01-01

Background Robotic training can help improve function of a paretic limb following a stroke, but individuals respond differently to the training. A predictor of functional gains might improve the ability to select those individuals more likely to benefit from robot based therapy. Studies evaluating predictors of functional improvement after a robotic training are scarce. One study has found that white matter tract integrity predicts functional gains following a robotic training of the hand and wrist. Objective Determine the predictive ability of behavioral and brain measures to improve selection of individuals for robotic training. Methods Twenty subjects with chronic stroke participated in an 8-week course of robotic exoskeletal training for the arm. Before training, a clinical evaluation, fMRI, diffusion tensor imaging, and transcranial magnetic stimulation (TMS) were each measured as predictors. Final functional gain was defined as change in the Box and Block Test (BBT). Measures significant in bivariate analysis were fed into a multivariate linear regression model. Results Training was associated with an average gain of 6±5 blocks on the BBT (p<0.0001). Bivariate analysis revealed that lower baseline motor evoked potential (MEP) amplitude on TMS, and lower laterality M1 index on fMRI each significantly correlated with greater BBT change. In the multivariate linear regression analysis, baseline MEP magnitude was the only measure that remained significant. Conclusion Subjects with lower baseline MEP magnitude benefited the most from robotic training of the affected arm. These subjects might have reserve remaining for the training to boost corticospinal excitability, translating into functional gains. PMID:24642382

Brush head composition, wear profile, and cleaning efficacy: an assessment of three electric brush heads using in vitro methods.

PubMed

Kaiser, Eva; Meyners, Michael; Markgraf, Dirk; Stoerkel, Ulrich; von Koppenfels, Roxana; Adam, Ralf; Soukup, Martin; Wehrbein, Heinrich; Erbe, Christina

2014-01-01

The objective of this research was to evaluate a current store brand (SB) brush head for composition/physical characteristics, Wear Index (WI), and cleaning efficacy versus the previous SB brush head refill design (SB control) and the Oral-B Precision Clean brush head (positive control, PC). This research consisted of three parts: 1) Analytical analysis using Fourier Transform Infrared (FT-IR) spectrometry to evaluate the chemical composition of the current SB brush head bristles relative to the SB control. In addition, physical parameters such as bristle count and diameter were determined. 2) Wear Index (WI) investigation to determine the Wear Index scores of in vitro-aged brush heads at four weeks (one month) and 13 weeks (three months) by a trained investigator. To "age" the brush heads, a robot system was used as a new alternative in vitro method to simulate aging by consumer use. 3) Robot testing to determine the cleaning performance of in vitro-aged brush heads, comparing one month-aged current SB brush heads with the SB control (one and three months-aged) and the PC brush heads (three months-aged) in a standardized fashion. 1) FT-IR analysis revealed that the chemical composition of the current and control SB refill brush heads is identical. In terms of physical parameters, the current SB brush head has 12% more bristles and a slightly oval brush head compared to the round brush head of the SB control. 2) Wear Index analysis showed there was no difference in the one month-aged current SB brush head versus the one month-aged SB control (1.67 vs. 1.50, p = 0.65) or versus the three months-aged PC brush head (1.67 vs. 1.50, p = 0.65). The one month-aged current SB brush head demonstrated statistically significantly less wear than the three months-aged SB control (1.67 vs. 2.67, p = 0.01). 3) Analysis of cleaning efficacy shows that the one month-aged current SB brush head had improved cleaning performance over the one month-aged SB control brush head (p < 0.05), despite no statistically significant difference in wear. Both the one month-aged current and control SB brush heads showed statistically significantly lower cleaning performance compared to the three months-aged PC brush heads (p < 0.01). While the current SB brush head showed improved cleaning over the SB control, it demonstrated significantly lower durability and cleaning in comparison to the PC brush head. Dental professionals should be aware of these differences, both in durability and in cleaning performance, when recommending brush heads to their patients.

Development and Implementation of an End-Effector Upper Limb Rehabilitation Robot for Hemiplegic Patients with Line and Circle Tracking Training

PubMed Central

Li, Chong; Bi, Sheng; Zhang, Xuemin; Huo, Jianfei

2017-01-01

Numerous robots have been widely used to deliver rehabilitative training for hemiplegic patients to improve their functional ability. Because of the complexity and diversity of upper limb motion, customization of training patterns is one key factor during upper limb rehabilitation training. Most of the current rehabilitation robots cannot intelligently provide adaptive training parameters, and they have not been widely used in clinical rehabilitation. This article proposes a new end-effector upper limb rehabilitation robot, which is a two-link robotic arm with two active degrees of freedom. This work investigated the kinematics and dynamics of the robot system, the control system, and the realization of different rehabilitation therapies. We also explored the influence of constraint in rehabilitation therapies on interaction force and muscle activation. The deviation of the trajectory of the end effector and the required trajectory was less than 1 mm during the tasks, which demonstrated the movement accuracy of the robot. Besides, results also demonstrated the constraint exerted by the robot provided benefits for hemiplegic patients by changing muscle activation in the way similar to the movement pattern of the healthy subjects, which indicated that the robot can improve the patient's functional ability by training the normal movement pattern. PMID:29065614

Development and Implementation of an End-Effector Upper Limb Rehabilitation Robot for Hemiplegic Patients with Line and Circle Tracking Training.

PubMed

Liu, Yali; Li, Chong; Ji, Linhong; Bi, Sheng; Zhang, Xuemin; Huo, Jianfei; Ji, Run

2017-01-01

Numerous robots have been widely used to deliver rehabilitative training for hemiplegic patients to improve their functional ability. Because of the complexity and diversity of upper limb motion, customization of training patterns is one key factor during upper limb rehabilitation training. Most of the current rehabilitation robots cannot intelligently provide adaptive training parameters, and they have not been widely used in clinical rehabilitation. This article proposes a new end-effector upper limb rehabilitation robot, which is a two-link robotic arm with two active degrees of freedom. This work investigated the kinematics and dynamics of the robot system, the control system, and the realization of different rehabilitation therapies. We also explored the influence of constraint in rehabilitation therapies on interaction force and muscle activation. The deviation of the trajectory of the end effector and the required trajectory was less than 1 mm during the tasks, which demonstrated the movement accuracy of the robot. Besides, results also demonstrated the constraint exerted by the robot provided benefits for hemiplegic patients by changing muscle activation in the way similar to the movement pattern of the healthy subjects, which indicated that the robot can improve the patient's functional ability by training the normal movement pattern.

Effect of Caregiver Driven Robot-Assisted In-Ward Training in Subacute Stroke Patients: A Case Series

PubMed Central

2018-01-01

Objective To evaluate the effect of caregiver driven robot-assisted in-ward training in subacute stroke patients. Methods A retrospective evaluation was performed for patients treated with caregiver driven robot-assisted in-ward training to retain gait function from June 2014 and December 2016. All patients received more than 2 weeks of caregiver driven robot-assisted in-ward training after undergoing conventional programs. The robot was used as a sitting device, a standing frame, or a high-walker depending on functional status of the patient. Patients were evaluated before and after robot training. Patient records were assessed by Korean version of Modified Barthel Index (K-MBI), Functional Independence Measure (FIM), and Functional Ambulation Category (FAC). Results Initially, patients used the robot as a sitting device (n=6), a standing frame (n=7), or a partial body-weight support high-walker (n=2). As patient functions were improved, usage level of the robot was changed to the next level. At the end of the treatment, the robot was used as a sitting device (n=1), a standing frame (n=6), or high-walker (n=8). Scores of K-MBI (Δ17.47±10.72) and FIM (Δ19.80±12.34) were improved in all patients. Conclusion Patients' usage level of the robot and functional scores were improved. Therefore, performing additional caregiver driven robot-assisted in-ward training is feasible and beneficial for subacute stroke patients. PMID:29765872

Effect of Caregiver Driven Robot-Assisted In-Ward Training in Subacute Stroke Patients: A Case Series.

PubMed

Kim, Sang Beom; Lee, Kyeong Woo; Lee, Jong Hwa; Lee, Sook Joung; Park, Jin Gee; Park, Joo Won

2018-04-01

To evaluate the effect of caregiver driven robot-assisted in-ward training in subacute stroke patients. A retrospective evaluation was performed for patients treated with caregiver driven robot-assisted in-ward training to retain gait function from June 2014 and December 2016. All patients received more than 2 weeks of caregiver driven robot-assisted in-ward training after undergoing conventional programs. The robot was used as a sitting device, a standing frame, or a high-walker depending on functional status of the patient. Patients were evaluated before and after robot training. Patient records were assessed by Korean version of Modified Barthel Index (K-MBI), Functional Independence Measure (FIM), and Functional Ambulation Category (FAC). Initially, patients used the robot as a sitting device (n=6), a standing frame (n=7), or a partial body-weight support high-walker (n=2). As patient functions were improved, usage level of the robot was changed to the next level. At the end of the treatment, the robot was used as a sitting device (n=1), a standing frame (n=6), or high-walker (n=8). Scores of K-MBI (Δ17.47±10.72) and FIM (Δ19.80±12.34) were improved in all patients. Patients' usage level of the robot and functional scores were improved. Therefore, performing additional caregiver driven robot-assisted in-ward training is feasible and beneficial for subacute stroke patients.

Predicting space telerobotic operator training performance from human spatial ability assessment

NASA Astrophysics Data System (ADS)

Liu, Andrew M.; Oman, Charles M.; Galvan, Raquel; Natapoff, Alan

2013-11-01

Our goal was to determine whether existing tests of spatial ability can predict an astronaut's qualification test performance after robotic training. Because training astronauts to be qualified robotics operators is so long and expensive, NASA is interested in tools that can predict robotics performance before training begins. Currently, the Astronaut Office does not have a validated tool to predict robotics ability as part of its astronaut selection or training process. Commonly used tests of human spatial ability may provide such a tool to predict robotics ability. We tested the spatial ability of 50 active astronauts who had completed at least one robotics training course, then used logistic regression models to analyze the correlation between spatial ability test scores and the astronauts' performance in their evaluation test at the end of the training course. The fit of the logistic function to our data is statistically significant for several spatial tests. However, the prediction performance of the logistic model depends on the criterion threshold assumed. To clarify the critical selection issues, we show how the probability of correct classification vs. misclassification varies as a function of the mental rotation test criterion level. Since the costs of misclassification are low, the logistic models of spatial ability and robotic performance are reliable enough only to be used to customize regular and remedial training. We suggest several changes in tracking performance throughout robotics training that could improve the range and reliability of predictive models.

Evaluation of Surface Sampling for Bacillus Spores Using ...

EPA Pesticide Factsheets

Journal Article In this study, commercially-available domestic cleaning robots were evaluated for spore surface sampling efficiency on common indoor surfaces. The current study determined the sampling efficiency of each robot, without modifying the sensors, algorithms, or logics set by the manufacturers.

Does assist-as-needed upper limb robotic therapy promote participation in repetitive activity-based motor training in sub-acute stroke patients with severe paresis?

PubMed

Grosmaire, Anne-Gaëlle; Duret, Christophe

2017-01-01

Repetitive, active movement-based training promotes brain plasticity and motor recovery after stroke. Robotic therapy provides highly repetitive therapy that reduces motor impairment. However, the effect of assist-as-needed algorithms on patient participation and movement quality is not known. To analyze patient participation and motor performance during highly repetitive assist-as-needed upper limb robotic therapy in a retrospective study. Sixteen patients with sub-acute stroke carried out a 16-session upper limb robotic training program combined with usual care. The Fugl-Meyer Assessment (FMA) score was evaluated pre and post training. Robotic assistance parameters and Performance measures were compared within and across sessions. Robotic assistance did not change within-session and decreased between sessions during the training program. Motor performance did not decrease within-session and improved between sessions. Velocity-related assistance parameters improved more quickly than accuracy-related parameters. An assist-as-needed-based upper limb robotic training provided intense and repetitive rehabilitation and promoted patient participation and motor performance, facilitating motor recovery.

Corticospinal excitability as a predictor of functional gains at the affected upper limb following robotic training in chronic stroke survivors.

PubMed

Milot, Marie-Hélène; Spencer, Steven J; Chan, Vicky; Allington, James P; Klein, Julius; Chou, Cathy; Pearson-Fuhrhop, Kristin; Bobrow, James E; Reinkensmeyer, David J; Cramer, Steven C

2014-01-01

Robotic training can help improve function of a paretic limb following a stroke, but individuals respond differently to the training. A predictor of functional gains might improve the ability to select those individuals more likely to benefit from robot-based therapy. Studies evaluating predictors of functional improvement after a robotic training are scarce. One study has found that white matter tract integrity predicts functional gains following a robotic training of the hand and wrist. Objective. To determine the predictive ability of behavioral and brain measures in order to improve selection of individuals for robotic training. Twenty subjects with chronic stroke participated in an 8-week course of robotic exoskeletal training for the arm. Before training, a clinical evaluation, functional magnetic resonance imaging (fMRI), diffusion tensor imaging, and transcranial magnetic stimulation (TMS) were each measured as predictors. Final functional gain was defined as change in the Box and Block Test (BBT). Measures significant in bivariate analysis were fed into a multivariate linear regression model. Training was associated with an average gain of 6 ± 5 blocks on the BBT (P < .0001). Bivariate analysis revealed that lower baseline motor-evoked potential (MEP) amplitude on TMS, and lower laterality M1 index on fMRI each significantly correlated with greater BBT change. In the multivariate linear regression analysis, baseline MEP magnitude was the only measure that remained significant. Subjects with lower baseline MEP magnitude benefited the most from robotic training of the affected arm. These subjects might have reserve remaining for the training to boost corticospinal excitability, translating into functional gains. © The Author(s) 2014.

Mobile Robot Designed with Autonomous Navigation System

NASA Astrophysics Data System (ADS)

An, Feng; Chen, Qiang; Zha, Yanfang; Tao, Wenyin

2017-10-01

With the rapid development of robot technology, robots appear more and more in all aspects of life and social production, people also ask more requirements for the robot, one is that robot capable of autonomous navigation, can recognize the road. Take the common household sweeping robot as an example, which could avoid obstacles, clean the ground and automatically find the charging place; Another example is AGV tracking car, which can following the route and reach the destination successfully. This paper introduces a new type of robot navigation scheme: SLAM, which can build the environment map in a totally strange environment, and at the same time, locate its own position, so as to achieve autonomous navigation function.

Automated processing of forensic casework samples using robotic workstations equipped with nondisposable tips: contamination prevention.

PubMed

Frégeau, Chantal J; Lett, C Marc; Elliott, Jim; Yensen, Craig; Fourney, Ron M

2008-05-01

An automated process has been developed for the analysis of forensic casework samples using TECAN Genesis RSP 150/8 or Freedom EVO liquid handling workstations equipped exclusively with nondisposable tips. Robot tip cleaning routines have been incorporated strategically within the DNA extraction process as well as at the end of each session. Alternative options were examined for cleaning the tips and different strategies were employed to verify cross-contamination. A 2% sodium hypochlorite wash (1/5th dilution of the 10.8% commercial bleach stock) proved to be the best overall approach for preventing cross-contamination of samples processed using our automated protocol. The bleach wash steps do not adversely impact the short tandem repeat (STR) profiles developed from DNA extracted robotically and allow for major cost savings through the implementation of fixed tips. We have demonstrated that robotic workstations equipped with fixed pipette tips can be used with confidence with properly designed tip washing routines to process casework samples using an adapted magnetic bead extraction protocol.

Virtual Reality Simulator Systems in Robotic Surgical Training.

PubMed

Mangano, Alberto; Gheza, Federico; Giulianotti, Pier Cristoforo

2018-06-01

The number of robotic surgical procedures has been increasing worldwide. It is important to maximize the cost-effectiveness of robotic surgical training and safely reduce the time needed for trainees to reach proficiency. The use of preliminary lab training in robotic skills is a good strategy for the rapid acquisition of further, standardized robotic skills. Such training can be done either by using a simulator or by exercises in a dry or wet lab. While the use of an actual robotic surgical system for training may be problematic (high cost, lack of availability), virtual reality (VR) simulators can overcome many of these obstacles. However, there is still a lack of standardization. Although VR training systems have improved, they cannot yet replace experience in a wet lab. In particular, simulated scenarios are not yet close enough to a real operative experience. Indeed, there is a difference between technical skills (i.e., mechanical ability to perform a simulated task) and surgical competence (i.e., ability to perform a real surgical operation). Thus, while a VR simulator can replace a dry lab, it cannot yet replace training in a wet lab or operative training in actual patients. However, in the near future, it is expected that VR surgical simulators will be able to provide total reality simulation and replace training in a wet lab. More research is needed to produce more wide-ranging, trans-specialty robotic curricula.

A crossover pilot study evaluating the functional outcomes of two different types of robotic movement training in chronic stroke survivors using the arm exoskeleton BONES.

PubMed

Milot, Marie-Hélène; Spencer, Steven J; Chan, Vicky; Allington, James P; Klein, Julius; Chou, Cathy; Bobrow, James E; Cramer, Steven C; Reinkensmeyer, David J

2013-12-19

To date, the limited degrees of freedom (DOF) of most robotic training devices hinders them from providing functional training following stroke. We developed a 6-DOF exoskeleton ("BONES") that allows movement of the upper limb to assist in rehabilitation. The objectives of this pilot study were to evaluate the impact of training with BONES on function of the affected upper limb, and to assess whether multijoint functional robotic training would translate into greater gains in arm function than single joint robotic training also conducted with BONES. Twenty subjects with mild to moderate chronic stroke participated in this crossover study. Each subject experienced multijoint functional training and single joint training three sessions per week, for four weeks, with the order of presentation randomized. The primary outcome measure was the change in Box and Block Test (BBT). The secondary outcome measures were the changes in Fugl-Meyer Arm Motor Scale (FMA), Wolf Motor Function Test (WMFT), Motor Activity Log (MAL), and quantitative measures of strength and speed of reaching. These measures were assessed at baseline, after each training period, and at a 3-month follow-up evaluation session. Training with the robotic exoskeleton resulted in significant improvements in the BBT, FMA, WMFT, MAL, shoulder and elbow strength, and reaching speed (p < 0.05); these improvements were sustained at the 3 month follow-up. When comparing the effect of type of training on the gains obtained, no significant difference was noted between multijoint functional and single joint robotic training programs. However, for the BBT, WMFT and MAL, inequality of carryover effects were noted; subsequent analysis on the change in score between the baseline and first period of training again revealed no difference in the gains obtained between the types of training. Training with the 6 DOF arm exoskeleton improved motor function after chronic stroke, challenging the idea that robotic therapy is only useful for impairment reduction. The pilot results presented here also suggest that multijoint functional robotic training is not decisively superior to single joint robotic training. This challenges the idea that functionally-oriented games during training is a key element for improving behavioral outcomes. NCT01050231.

Retention of fundamental surgical skills learned in robot-assisted surgery.

PubMed

Suh, Irene H; Mukherjee, Mukul; Shah, Bhavin C; Oleynikov, Dmitry; Siu, Ka-Chun

2012-12-01

Evaluation of the learning curve for robotic surgery has shown reduced errors and decreased task completion and training times compared with regular laparoscopic surgery. However, most training evaluations of robotic surgery have only addressed short-term retention after the completion of training. Our goal was to investigate the amount of surgical skills retained after 3 months of training with the da Vinci™ Surgical System. Seven medical students without any surgical experience were recruited. Participants were trained with a 4-day training program of robotic surgical skills and underwent a series of retention tests at 1 day, 1 week, 1 month, and 3 months post-training. Data analysis included time to task completion, speed, distance traveled, and movement curvature by the instrument tip. Performance of the participants was graded using the modified Objective Structured Assessment of Technical Skills (OSATS) for robotic surgery. Participants filled out a survey after each training session by answering a set of questions. Time to task completion and the movement curvature was decreased from pre- to post-training and the performance was retained at all the corresponding retention periods: 1 day, 1 week, 1 month, and 3 months. The modified OSATS showed improvement from pre-test to post-test and this improvement was maintained during all the retention periods. Participants increased in self-confidence and mastery in performing robotic surgical tasks after training. Our novel comprehensive training program improved robot-assisted surgical performance and learning. All trainees retained their fundamental surgical skills for 3 months after receiving the training program.

Robotic technology results in faster and more robust surgical skill acquisition than traditional laparoscopy.

PubMed

Moore, Lee J; Wilson, Mark R; Waine, Elizabeth; Masters, Rich S W; McGrath, John S; Vine, Samuel J

2015-03-01

Technical surgical skills are said to be acquired quicker on a robotic rather than laparoscopic platform. However, research examining this proposition is scarce. Thus, this study aimed to compare the performance and learning curves of novices acquiring skills using a robotic or laparoscopic system, and to examine if any learning advantages were maintained over time and transferred to more difficult and stressful tasks. Forty novice participants were randomly assigned to either a robotic- or laparoscopic-trained group. Following one baseline trial on a ball pick-and-drop task, participants performed 50 learning trials. Participants then completed an immediate retention trial and a transfer trial on a two-instrument rope-threading task. One month later, participants performed a delayed retention trial and a stressful multi-tasking trial. The results revealed that the robotic-trained group completed the ball pick-and-drop task more quickly and accurately than the laparoscopic-trained group across baseline, immediate retention, and delayed retention trials. Furthermore, the robotic-trained group displayed a shorter learning curve for accuracy. The robotic-trained group also performed the more complex rope-threading and stressful multi-tasking transfer trials better. Finally, in the multi-tasking trial, the robotic-trained group made fewer tone counting errors. The results highlight the benefits of using robotic technology for the acquisition of technical surgical skills.

Robotic colorectal surgery: previous laparoscopic colorectal experience is not essential.

PubMed

Sian, Tanvir Singh; Tierney, G M; Park, H; Lund, J N; Speake, W J; Hurst, N G; Al Chalabi, H; Smith, K J; Tou, S

2018-06-01

A background in minimally invasive colorectal surgery (MICS) has been thought to be essential prior to robotic-assisted colorectal surgery (RACS). Our aim was to determine whether MICS is essential prior to starting RACS training based on results from our initial experience with RACS. Two surgeons from our centre received robotic training through the European Academy of Robotic Colorectal Surgery (EARCS). One surgeon had no prior formal MICS training. We reviewed the first 30 consecutive robotic colorectal procedures from a prospectively maintained database between November 2014 and January 2016 at our institution. Fourteen patients were male. Median age was 64.5 years (range 36-82) and BMI was 27.5 (range 20-32.5). Twelve procedures (40%) were performed by the non-MICS-trained surgeon: ten high anterior resections (one conversion), one low anterior resection and one abdomino-perineal resection of rectum (APER). The MICS-trained surgeon performed nine high and four low anterior resections, one APER and in addition three right hemicolectomies and one abdominal suture rectopexy. There were no intra-operative complications and two patients required re-operation. Median post-operative stay was five days (range 1-26). There were two 30-day re-admissions. All oncological resections had clear margins and median node harvest was 18 (range 9-39). Our case series demonstrates that a background in MICS is not essential prior to starting RACS training. Not having prior MICS training should not discourage surgeons from considering applying for a robotic training programme. Safe and successful robotic colorectal services can be established after completing a formal structured robotic training programme.

Patient-cooperative control increases active participation of individuals with SCI during robot-aided gait training

PubMed Central

2010-01-01

Background Manual body weight supported treadmill training and robot-aided treadmill training are frequently used techniques for the gait rehabilitation of individuals after stroke and spinal cord injury. Current evidence suggests that robot-aided gait training may be improved by making robotic behavior more patient-cooperative. In this study, we have investigated the immediate effects of patient-cooperative versus non-cooperative robot-aided gait training on individuals with incomplete spinal cord injury (iSCI). Methods Eleven patients with iSCI participated in a single training session with the gait rehabilitation robot Lokomat. The patients were exposed to four different training modes in random order: During both non-cooperative position control and compliant impedance control, fixed timing of movements was provided. During two variants of the patient-cooperative path control approach, free timing of movements was enabled and the robot provided only spatial guidance. The two variants of the path control approach differed in the amount of additional support, which was either individually adjusted or exaggerated. Joint angles and torques of the robot as well as muscle activity and heart rate of the patients were recorded. Kinematic variability, interaction torques, heart rate and muscle activity were compared between the different conditions. Results Patients showed more spatial and temporal kinematic variability, reduced interaction torques, a higher increase of heart rate and more muscle activity in the patient-cooperative path control mode with individually adjusted support than in the non-cooperative position control mode. In the compliant impedance control mode, spatial kinematic variability was increased and interaction torques were reduced, but temporal kinematic variability, heart rate and muscle activity were not significantly higher than in the position control mode. Conclusions Patient-cooperative robot-aided gait training with free timing of movements made individuals with iSCI participate more actively and with larger kinematic variability than non-cooperative, position-controlled robot-aided gait training. PMID:20828422

Development of wrist rehabilitation robot and interface system.

PubMed

Yamamoto, Ikuo; Matsui, Miki; Inagawa, Naohiro; Hachisuka, Kenji; Wada, Futoshi; Hachisuka, Akiko; Saeki, Satoru

2015-01-01

The authors have developed a practical wrist rehabilitation robot for hemiplegic patients. It consists of a mechanical rotation unit, sensor, grip, and computer system. A myoelectric sensor is used to monitor the extensor carpi radialis longus/brevis muscle and flexor carpi radialis muscle activity during training. The training robot can provoke training through myoelectric sensors, a biological signal detector and processor in advance, so that patients can undergo effective training of extention and flexion in an excited condition. In addition, both-wrist system has been developed for mirror effect training, which is the most effective function of the system, so that autonomous training using both wrists is possible. Furthermore, a user-friendly screen interface with easily recognizable touch panels has been developed to give effective training for patients. The developed robot is small size and easy to carry. The developed aspiring interface system is effective to motivate the training of patients. The effectiveness of the robot system has been verified in hospital trails.

Robot-Aided Neurorehabilitation: A Robot for Wrist Rehabilitation

PubMed Central

Krebs, Hermano Igo; Volpe, Bruce T.; Williams, Dustin; Celestino, James; Charles, Steven K.; Lynch, Daniel; Hogan, Neville

2009-01-01

In 1991, a novel robot, MIT-MANUS, was introduced to study the potential that robots might assist in and quantify the neuro-rehabilitation of motor function. MIT-MANUS proved an excellent tool for shoulder and elbow rehabilitation in stroke patients, showing in clinical trials a reduction of impairment in movements confined to the exercised joints. This successful proof of principle as to additional targeted and intensive movement treatment prompted a test of robot training examining other limb segments. This paper focuses on a robot for wrist rehabilitation designed to provide three rotational degrees-of-freedom. The first clinical trial of the device will enroll 200 stroke survivors. Ultimately 160 stroke survivors will train with both the proximal shoulder and elbow MIT-MANUS robot, as well as with the novel distal wrist robot, in addition to 40 stroke survivor controls. So far 52 stroke patients have completed the robot training (ongoing protocol). Here, we report on the initial results on 36 of these volunteers. These results demonstrate that further improvement should be expected by adding additional training to other limb segments. PMID:17894265

Robot-aided neurorehabilitation: a robot for wrist rehabilitation.

PubMed

Krebs, Hermano Igo; Volpe, Bruce T; Williams, Dustin; Celestino, James; Charles, Steven K; Lynch, Daniel; Hogan, Neville

2007-09-01

In 1991, a novel robot, MIT-MANUS, was introduced to study the potential that robots might assist in and quantify the neuro-rehabilitation of motor function. MIT-MANUS proved an excellent tool for shoulder and elbow rehabilitation in stroke patients, showing in clinical trials a reduction of impairment in movements confined to the exercised joints. This successful proof of principle as to additional targeted and intensive movement treatment prompted a test of robot training examining other limb segments. This paper focuses on a robot for wrist rehabilitation designed to provide three rotational degrees-of-freedom. The first clinical trial of the device will enroll 200 stroke survivors. Ultimately 160 stroke survivors will train with both the proximal shoulder and elbow MIT-MANUS robot, as well as with the novel distal wrist robot, in addition to 40 stroke survivor controls. So far 52 stroke patients have completed the robot training (ongoing protocol). Here, we report on the initial results on 36 of these volunteers. These results demonstrate that further improvement should be expected by adding additional training to other limb segments.

Pilot study of a robotic protocol to treat shoulder subluxation in patients with chronic stroke

PubMed Central

2013-01-01

Background Shoulder subluxation is a frequent complication of motor impairment after stroke, leading to soft tissue damage, stretching of the joint capsule, rotator cuff injury, and in some cases pain, thus limiting use of the affected extremity beyond weakness. In this pilot study, we determined whether robotic treatment of chronic shoulder subluxation can lead to functional improvement and whether any improvement was robust. Methods 18 patients with chronic stroke (3.9 ± 2.9 years from acute stroke), completed 6 weeks of robotic training using the linear shoulder robot. Training was performed 3 times per week on alternate days. Each session consisted of 3 sets of 320 repetitions of the affected arm, and the robotic protocol alternated between training vertical arm movements, shoulder flexion and extension, in an anti-gravity plane, and training horizontal arm movements, scapular protraction and retraction, in a gravity eliminated plane. Results Training with the linear robot improved shoulder stability, motor power, and resulted in improved functional outcomes that were robust 3 months after training. Conclusion In this uncontrolled pilot study, the robotic protocol effectively treated shoulder subluxation in chronic stroke patients. Treatment of subluxation can lead to improved functional use of the affected arm, likely by increasing motor power in the trained muscles. PMID:23914834

Pilot study of a robotic protocol to treat shoulder subluxation in patients with chronic stroke.

PubMed

Dohle, Carolin I; Rykman, Avrielle; Chang, Johanna; Volpe, Bruce T

2013-08-05

Shoulder subluxation is a frequent complication of motor impairment after stroke, leading to soft tissue damage, stretching of the joint capsule, rotator cuff injury, and in some cases pain, thus limiting use of the affected extremity beyond weakness. In this pilot study, we determined whether robotic treatment of chronic shoulder subluxation can lead to functional improvement and whether any improvement was robust. 18 patients with chronic stroke (3.9 ± 2.9 years from acute stroke), completed 6 weeks of robotic training using the linear shoulder robot. Training was performed 3 times per week on alternate days. Each session consisted of 3 sets of 320 repetitions of the affected arm, and the robotic protocol alternated between training vertical arm movements, shoulder flexion and extension, in an anti-gravity plane, and training horizontal arm movements, scapular protraction and retraction, in a gravity eliminated plane. Training with the linear robot improved shoulder stability, motor power, and resulted in improved functional outcomes that were robust 3 months after training. In this uncontrolled pilot study, the robotic protocol effectively treated shoulder subluxation in chronic stroke patients. Treatment of subluxation can lead to improved functional use of the affected arm, likely by increasing motor power in the trained muscles.

Robotic Surgical Education: a Collaborative Approach to Training Postgraduate Urologists and Endourology Fellows

PubMed Central

Mirheydar, Hossein; Jones, Marklyn; Koeneman, Kenneth S.

2009-01-01

Objective: Currently, robotic training for inexperienced, practicing surgeons is primarily done vis-à-vis industry and/or society-sponsored day or weekend courses, with limited proctorship opportunities. The objective of this study was to assess the impact of an extended-proctorship program at up to 32 months of follow-up. Methods: An extended-proctorship program for robotic-assisted laparoscopic radical prostatectomy was established at our institution. The curriculum consisted of 3 phases: (1) completing an Intuitive Surgical 2-day robotic training course with company representatives; (2) serving as assistant to a trained proctor on 5 to 6 cases; and (3) performing proctored cases up to 1 year until confidence was achieved. Participants were surveyed and asked to evaluate on a 5-point Likert scale their operative experience in robotics and satisfaction regarding their training Results: Nine of 9 participants are currently performing robotic-assisted laparoscopic radical prostatectomy (RALP) independently. Graduates of our program have performed 477 RALP cases. The mean number of cases performed within phase 3 was 20.1 (range, 5 to 40) prior to independent practice. The program received a rating of 4.2/5 for effectiveness in teaching robotic surgery skills. Conclusion: Our robotic program, with extended proctoring, has led to an outstanding take-rate for disseminating robotic skills in a metropolitan community. PMID:19793464

Robotic surgical education: a collaborative approach to training postgraduate urologists and endourology fellows.

PubMed

Mirheydar, Hossein; Jones, Marklyn; Koeneman, Kenneth S; Sweet, Robert M

2009-01-01

Currently, robotic training for inexperienced, practicing surgeons is primarily done vis-à-vis industry and/or society-sponsored day or weekend courses, with limited proctorship opportunities. The objective of this study was to assess the impact of an extended-proctorship program at up to 32 months of follow-up. An extended-proctorship program for robotic-assisted laparoscopic radical prostatectomy was established at our institution. The curriculum consisted of 3 phases: (1) completing an Intuitive Surgical 2-day robotic training course with company representatives; (2) serving as assistant to a trained proctor on 5 to 6 cases; and (3) performing proctored cases up to 1 year until confidence was achieved. Participants were surveyed and asked to evaluate on a 5-point Likert scale their operative experience in robotics and satisfaction regarding their training. Nine of 9 participants are currently performing robotic-assisted laparoscopic radical prostatectomy (RALP) independently. Graduates of our program have performed 477 RALP cases. The mean number of cases performed within phase 3 was 20.1 (range, 5 to 40) prior to independent practice. The program received a rating of 4.2/5 for effectiveness in teaching robotic surgery skills. Our robotic program, with extended proctoring, has led to an outstanding take-rate for disseminating robotic skills in a metropolitan community.

Robotics Programs: Automation Training in Disguise.

ERIC Educational Resources Information Center

Rehg, James A.

1985-01-01

Questions and answers from the book "Guidelines for Robotics Program Development" are presented, addressing some of the major issues confronted by the person setting the direction for a robotics training program. (CT)

The University of Pennsylvania curriculum for training otorhinolaryngology residents in transoral robotic surgery.

PubMed

Sperry, Steven M; O'Malley, Bert W; Weinstein, Gregory S

2014-01-01

To define a curriculum for the development of robotic surgical skills in otorhinolaryngology residency training. A systematic review of the current literature on robotic surgery training was performed. Based on prior reports in other specialties, a curriculum for otorhinolaryngology residents was created that progresses through several modules, including didactics, inanimate skills laboratory, and operative experience. The curriculum for residents in otorhinolaryngology was designed as follows: didactics include an overview of the robotic device and instruments, a tutorial in basic controls and function, and a room setup and positioning. The anatomy and steps of transoral procedures are taught through books, videos, operative observations, and cadaver dissections. Skills are developed with a virtual reality robotic simulator and robotics labs. The operative experience progresses from case observation to bedside assistant to console surgeon. The role of the console surgeon progresses in a stepwise fashion, and the procedures of radical tonsillectomy, supraglottic partial laryngectomy, and base of tongue resection have been organized as a series of steps. A structured curriculum for training residents in transoral robotic surgery was developed. This training is important for otorhinolaryngology residents to acquire the knowledge and skills to perform robotic surgery safely. © 2015 S. Karger AG, Basel.

Development and feasibility study of a sensory-enhanced robot-aided motor training in stroke rehabilitation.

PubMed

Liu, W; Mukherjee, M; Tsaur, Y; Kim, S H; Liu, H; Natarajan, P; Agah, A

2009-01-01

Functional impairment of the upper limb is a major challenge faced by many stroke survivors. The present study aimed at developing a novel sensory-enhanced robot-aided motor training program and testing its feasibility in stroke rehabilitation. A specially designed robot handle was developed as an attachment to the Inmotion2 robotic system. This handle provided sensory stimulation through pins connected to small servo motors inside the handle. Vibration of the pins was activated during motor training once pressure on the handle reached a certain threshold indicating an active motion of the study subject. Nine chronic stroke survivors were randomly assigned to either a sensory-enhanced robot-aided motor training group (SERMT) or robot-aided motor training only group (RMT). All participants underwent a 6-week motor training program, performing target reaching movements with the specialized handle with or without vibration stimulation during training. Motor Status (MS) scores were measured for functional outcome prior to and after training. The results showed significant improvement in the total MS scores after training in both experimental groups. However, MS sub-scores for the shoulder/elbow and the wrist/hand increased significantly only in the SERMT group (p<0.05). Future studies are required to confirm these preliminary findings.

Center of Cardiac Surgery Robotic Computerized Telemanipulation as Part of a Comprehensive Approach to Advanced Heart Care

DTIC Science & Technology

2011-10-01

performance metrics; and development of Robotic OR Team training including crisis management. Q3: During the third quarter of this project, the...literature review for robot-assisted surgical skill training/performance metrics; development of Robotic OR Team training materials including crisis ... crisis management situations. Q2: Contract negotiations for the purchase of the da Vinci Skills Simulator are completed and we anticipate the

Robot-assisted gait training for stroke patients: current state of the art and perspectives of robotics.

PubMed

Morone, Giovanni; Paolucci, Stefano; Cherubini, Andrea; De Angelis, Domenico; Venturiero, Vincenzo; Coiro, Paola; Iosa, Marco

2017-01-01

In this review, we give a brief outline of robot-mediated gait training for stroke patients, as an important emerging field in rehabilitation. Technological innovations are allowing rehabilitation to move toward more integrated processes, with improved efficiency and less long-term impairments. In particular, robot-mediated neurorehabilitation is a rapidly advancing field, which uses robotic systems to define new methods for treating neurological injuries, especially stroke. The use of robots in gait training can enhance rehabilitation, but it needs to be used according to well-defined neuroscientific principles. The field of robot-mediated neurorehabilitation brings challenges to both bioengineering and clinical practice. This article reviews the state of the art (including commercially available systems) and perspectives of robotics in poststroke rehabilitation for walking recovery. A critical revision, including the problems at stake regarding robotic clinical use, is also presented.

Robot-assisted gait training for stroke patients: current state of the art and perspectives of robotics

PubMed Central

Morone, Giovanni; Paolucci, Stefano; Cherubini, Andrea; De Angelis, Domenico; Venturiero, Vincenzo; Coiro, Paola; Iosa, Marco

2017-01-01

In this review, we give a brief outline of robot-mediated gait training for stroke patients, as an important emerging field in rehabilitation. Technological innovations are allowing rehabilitation to move toward more integrated processes, with improved efficiency and less long-term impairments. In particular, robot-mediated neurorehabilitation is a rapidly advancing field, which uses robotic systems to define new methods for treating neurological injuries, especially stroke. The use of robots in gait training can enhance rehabilitation, but it needs to be used according to well-defined neuroscientific principles. The field of robot-mediated neurorehabilitation brings challenges to both bioengineering and clinical practice. This article reviews the state of the art (including commercially available systems) and perspectives of robotics in poststroke rehabilitation for walking recovery. A critical revision, including the problems at stake regarding robotic clinical use, is also presented. PMID:28553117

Robotic surgery basic skills training: Evaluation of a pilot multidisciplinary simulation-based curriculum

PubMed Central

Foell, Kirsten; Finelli, Antonio; Yasufuku, Kazuhiro; Bernardini, Marcus Q.; Waddell, Thomas K.; Pace, Kenneth T.; Honey, R. John D.’A.; Lee, Jason Y.

2013-01-01

Purpose: Simulation-based training improves clinical skills, while minimizing the impact of the educational process on patient care. We present results of a pilot multidisciplinary, simulation-based robotic surgery basic skills training curriculum (BSTC) for robotic novices. Methods: A 4-week, simulation-based, robotic surgery BSTC was offered to the Departments of Surgery and Obstetrics & Gynecology (ObGyn) at the University of Toronto. The course consisted of various instructional strategies: didactic lecture, self-directed online-training modules, introductory hands-on training with the da Vinci robot (dVR) (Intuitive Surgical Inc., Sunnyvale, CA), and dedicated training on the da Vinci Skills Simulator (Intuitive Surgical Inc., Sunnyvale, CA) (dVSS). A third of trainees participated in competency-based dVSS training, all others engaged in traditional time-based training. Pre- and post-course skill testing was conducted on the dVR using 2 standardized skill tasks: ring transfer (RT) and needle passing (NP). Retention of skills was assessed at 5 months post-BSTC. Results: A total of 37 participants completed training. The mean task completion time and number of errors improved significantly post-course on both RT (180.6 vs. 107.4 sec, p < 0.01 and 3.5 vs. 1.3 sec, p < 0.01, respectively) and NP (197.1 vs. 154.1 sec, p < 0.01 and 4.5 vs. 1.8 sec, p = 0.04, respectively) tasks. No significant difference in performance was seen between specialties. Competency-based training was associated with significantly better post-course performance. The dVSS demonstrated excellent face validity. Conclusions: The implementation of a pilot multidisciplinary, simulation-based robotic surgery BSTC revealed significantly improved basic robotic skills among novice trainees, regardless of specialty or level of training. Competency-based training was associated with significantly better acquisition of basic robotic skills. PMID:24381662

Structural Brain Changes after Traditional and Robot-Assisted Multi-Domain Cognitive Training in Community-Dwelling Healthy Elderly

PubMed Central

Kim, Geon Ha; Jeon, Seun; Im, Kiho; Kwon, Hunki; Lee, Byung Hwa; Kim, Ga Young; Jeong, Hana; Han, Noh Eul; Seo, Sang Won; Cho, Hanna; Noh, Young; Park, Sang Eon; Kim, Hojeong; Hwang, Jung Won; Yoon, Cindy W.; Kim, Hee Jin; Ye, Byoung Seok; Chin, Ju Hee; Kim, Jung-Hyun; Suh, Mee Kyung; Lee, Jong Min; Kim, Sung Tae; Choi, Mun-Taek; Kim, Mun Sang; Heilman, Kenneth M; Jeong, Jee Hyang; Na, Duk L.

2015-01-01

The purpose of this study was to investigate if multi-domain cognitive training, especially robot-assisted training, alters cortical thickness in the brains of elderly participants. A controlled trial was conducted with 85 volunteers without cognitive impairment who were 60 years old or older. Participants were first randomized into two groups. One group consisted of 48 participants who would receive cognitive training and 37 who would not receive training. The cognitive training group was randomly divided into two groups, 24 who received traditional cognitive training and 24 who received robot-assisted cognitive training. The training for both groups consisted of daily 90-min-session, five days a week for a total of 12 weeks. The primary outcome was the changes in cortical thickness. When compared to the control group, both groups who underwent cognitive training demonstrated attenuation of age related cortical thinning in the frontotemporal association cortices. When the robot and the traditional interventions were directly compared, the robot group showed less cortical thinning in the anterior cingulate cortices. Our results suggest that cognitive training can mitigate age-associated structural brain changes in the elderly. Trial Registration ClnicalTrials.gov NCT01596205 PMID:25898367

Savannah River Site Robotics

ScienceCinema

None

2018-04-16

Meet Sandmantis and Frankie, two advanced robotic devices that are key to cleanup at Savannah River Site. Sandmantis cleans hard, residual waste off huge underground storage tanks. Frankie is equipped with unique satellite capabilities and sensing abilties that can determine what chemicals still reside in the tanks in a cost effective manner.

Savannah River Site Robotics

DOE Office of Scientific and Technical Information (OSTI.GOV)

None

Meet Sandmantis and Frankie, two advanced robotic devices that are key to cleanup at Savannah River Site. Sandmantis cleans hard, residual waste off huge underground storage tanks. Frankie is equipped with unique satellite capabilities and sensing abilties that can determine what chemicals still reside in the tanks in a cost effective manner.

Current state of virtual reality simulation in robotic surgery training: a review.

PubMed

Bric, Justin D; Lumbard, Derek C; Frelich, Matthew J; Gould, Jon C

2016-06-01

Worldwide, the annual number of robotic surgical procedures continues to increase. Robotic surgical skills are unique from those used in either open or laparoscopic surgery. The acquisition of a basic robotic surgical skill set may be best accomplished in the simulation laboratory. We sought to review the current literature pertaining to the use of virtual reality (VR) simulation in the acquisition of robotic surgical skills on the da Vinci Surgical System. A PubMed search was conducted between December 2014 and January 2015 utilizing the following keywords: virtual reality, robotic surgery, da Vinci, da Vinci skills simulator, SimSurgery Educational Platform, Mimic dV-Trainer, and Robotic Surgery Simulator. Articles were included if they were published between 2007 and 2015, utilized VR simulation for the da Vinci Surgical System, and utilized a commercially available VR platform. The initial search criteria returned 227 published articles. After all inclusion and exclusion criteria were applied, a total of 47 peer-reviewed manuscripts were included in the final review. There are many benefits to utilizing VR simulation for robotic skills acquisition. Four commercially available simulators have been demonstrated to be capable of assessing robotic skill. Three of the four simulators demonstrate the ability of a VR training curriculum to improve basic robotic skills, with proficiency-based training being the most effective training style. The skills obtained on a VR training curriculum are comparable with those obtained on dry laboratory simulation. The future of VR simulation includes utilization in assessment for re-credentialing purposes, advanced procedural-based training, and as a warm-up tool prior to surgery.

Does robotic gait training improve balance in Parkinson's disease? A randomized controlled trial.

PubMed

Picelli, Alessandro; Melotti, Camilla; Origano, Francesca; Waldner, Andreas; Gimigliano, Raffaele; Smania, Nicola

2012-09-01

Treadmill training (with or without robotic assistance) has been reported to improve balance skills in patients with Parkinson's disease (PD). However, its effectiveness on postural instability has been evaluated mainly in patients with mild to moderate PD (Hoehn & Yahr stage ≤3). Patients with more severe disease may benefit from robot-assisted gait training performed by the Gait-Trainer GT1, as a harness supports them with their feet placed on motor-driven footplates. The aim of this study was to determine whether robot-assisted gait training could have a positive influence on postural stability in patients with PD at Hoehn & Yahr stage 3-4. Thirty-four patients with PD at Hoehn & Yahr stage 3-4 were randomly assigned into two groups. All patients received twelve, 40-min treatment sessions, three days/week, for four consecutive weeks. The Robotic Training group (n = 17) underwent robot-assisted gait training, while the Physical Therapy group (n = 17) underwent a training program not specifically aimed at improving postural stability. Patients were evaluated before, immediately after and 1-month post-treatment. Primary outcomes were: Berg Balance scale; Nutt's rating. A significant improvement was found after treatment on the Berg Balance Scale and the Nutt's rating in favor of the Robotic Training group (Berg: 43.44 ± 2.73; Nutt: 1.38 ± 0.50) compared to the Physical Therapy group (Berg: 37.27 ± 5.68; Nutt: 2.07 ± 0.59). All improvements were maintained at the 1-month follow-up evaluation. Robot-assisted gait training may improve postural instability in patients with PD at Hoehn & Yahr stage 3-4. Copyright © 2012 Elsevier Ltd. All rights reserved.

A robotic voice simulator and the interactive training for hearing-impaired people.

PubMed

Sawada, Hideyuki; Kitani, Mitsuki; Hayashi, Yasumori

2008-01-01

A talking and singing robot which adaptively learns the vocalization skill by means of an auditory feedback learning algorithm is being developed. The robot consists of motor-controlled vocal organs such as vocal cords, a vocal tract and a nasal cavity to generate a natural voice imitating a human vocalization. In this study, the robot is applied to the training system of speech articulation for the hearing-impaired, because the robot is able to reproduce their vocalization and to teach them how it is to be improved to generate clear speech. The paper briefly introduces the mechanical construction of the robot and how it autonomously acquires the vocalization skill in the auditory feedback learning by listening to human speech. Then the training system is described, together with the evaluation of the speech training by auditory impaired people.

An integrated gait rehabilitation training based on Functional Electrical Stimulation cycling and overground robotic exoskeleton in complete spinal cord injury patients: Preliminary results.

PubMed

Mazzoleni, S; Battini, E; Rustici, A; Stampacchia, G

2017-07-01

The aim of this study is to investigate the effects of an integrated gait rehabilitation training based on Functional Electrical Stimulation (FES)-cycling and overground robotic exoskeleton in a group of seven complete spinal cord injury patients on spasticity and patient-robot interaction. They underwent a robot-assisted rehabilitation training based on two phases: n=20 sessions of FES-cycling followed by n= 20 sessions of robot-assisted gait training based on an overground robotic exoskeleton. The following clinical outcome measures were used: Modified Ashworth Scale (MAS), Numerical Rating Scale (NRS) on spasticity, Penn Spasm Frequency Scale (PSFS), Spinal Cord Independence Measure Scale (SCIM), NRS on pain and International Spinal Cord Injury Pain Data Set (ISCI). Clinical outcome measures were assessed before (T0) after (T1) the FES-cycling training and after (T2) the powered overground gait training. The ability to walk when using exoskeleton was assessed by means of 10 Meter Walk Test (10MWT), 6 Minute Walk Test (6MWT), Timed Up and Go test (TUG), standing time, walking time and number of steps. Statistically significant changes were found on the MAS score, NRS-spasticity, 6MWT, TUG, standing time and number of steps. The preliminary results of this study show that an integrated gait rehabilitation training based on FES-cycling and overground robotic exoskeleton in complete SCI patients can provide a significant reduction of spasticity and improvements in terms of patient-robot interaction.

Robot-supported upper limb training in a virtual learning environment : a pilot randomized controlled trial in persons with MS.

PubMed

Feys, Peter; Coninx, Karin; Kerkhofs, Lore; De Weyer, Tom; Truyens, Veronik; Maris, Anneleen; Lamers, Ilse

2015-07-23

Despite the functional impact of upper limb dysfunction in multiple sclerosis (MS), effects of intensive exercise programs and specifically robot-supported training have been rarely investigated in persons with advanced MS. To investigate the effects of additional robot-supported upper limb training in persons with MS compared to conventional treatment only. Seventeen persons with MS (pwMS) (median Expanded Disability Status Scale of 8, range 3.5-8.5) were included in a pilot RCT comparing the effects of additional robot-supported training to conventional treatment only. Additional training consisted of 3 weekly sessions of 30 min interacting with the HapticMaster robot within an individualised virtual learning environment (I-TRAVLE). Clinical measures at body function (Hand grip strength, Motricity Index, Fugl-Meyer) and activity (Action Research Arm test, Motor Activity Log) level were administered before and after an intervention period of 8 weeks. The intervention group were also evaluated on robot-mediated movement tasks in three dimensions, providing active range of motion, movement duration and speed and hand-path ratio as indication of movement efficiency in the spatial domain. Non-parametric statistics were applied. PwMS commented favourably on the robot-supported virtual learning environment and reported functional training effects in daily life. Movement tasks in three dimensions, measured with the robot, were performed in less time and for the transporting and reaching movement tasks more efficiently. There were however no significant changes for any clinical measure in neither intervention nor control group although observational analyses of the included cases indicated large improvements on the Fugl-Meyer in persons with more marked upper limb dysfunction. Robot-supported training lead to more efficient movement execution which was however, on group level, not reflected by significant changes on standard clinical tests. Persons with more marked upper limb dysfunction may benefit most from additional robot-supported training, but larger studies are needed. This trial is registered within the registry Clinical Trials GOV ( NCT02257606 ).

Robot design for a vacuum environment

NASA Technical Reports Server (NTRS)

Belinski, S.; Trento, W.; Imani-Shikhabadi, R.; Hackwood, S.

1987-01-01

The cleanliness requirements for many processing and manufacturing tasks are becoming ever stricter, resulting in a greater interest in the vacuum environment. Researchers discuss the importance of this special environment, and the development of robots which are physically and functionally suited to vacuum processing tasks. Work is in progress at the Center for robotic Systems in Microelectronics (CRSM) to provide a robot for the manufacture of a revolutionary new gyroscope in high vacuum. The need for vacuum in this and other processes is discussed as well as the requirements for a vacuum-compatible robot. Finally, researchers present details on work done at the CRSM to modify an existing clean-room compatible robot for use at high vacuum.

Effects of robot-guided passive stretching and active movement training of ankle and mobility impairments in stroke.

PubMed

Waldman, Genna; Yang, Chung-Yong; Ren, Yupeng; Liu, Lin; Guo, Xin; Harvey, Richard L; Roth, Elliot J; Zhang, Li-Qun

2013-01-01

To investigate the effects of controlled passive stretching and active movement training using a portable rehabilitation robot on stroke survivors with ankle and mobility impairment. Twenty-four patients at least 3 months post stroke were assigned to receive 6 week training using the portable robot in a research laboratory (robot group) or an instructed exercise program at home (control group). All patients underwent clinical and biomechanical evaluations in the laboratory at pre-evaluation, post-evaluation, and 6-week follow-up. Subjects in the robot group improved significantly more than that in the control group in reduction in spasticity measured by modified Ashworth scale, mobility by Stroke Rehabilitation Assessment of Movement (STREAM), the balance by Berg balance score, dorsiflexion passive range of motion, dorsiflexion strength, and load bearing on the affected limb during gait after 6-week training. Both groups improved in the STREAM, dorsiflexion active range of motion and dorsiflexor strength after the training, which were retained in the follow-up evaluation. Robot-assisted passive stretching and active movement training is effective in improving motor function and mobility post stroke.

Laparoscopic and robotic skills are transferable in a simulation setting: a randomized controlled trial.

PubMed

Thomaier, Lauren; Orlando, Megan; Abernethy, Melinda; Paka, Chandhana; Chen, Chi Chiung Grace

2017-08-01

Although surgical simulation provides an effective supplement to traditional training, it is not known whether skills are transferable between minimally invasive surgical modalities. The purpose of this study was to assess the transferability of skills between minimally invasive surgical simulation platforms among simulation-naïve participants. Forty simulation-naïve medical students were enrolled in this randomized single-blinded controlled trial. Participants completed a baseline evaluation on laparoscopic (Fundamentals of Laparoscopic Surgery Program, Los Angeles, CA) and robotic (dV-Trainer, Mimic, Seattle, WA) simulation peg transfer tasks. Participants were then randomized to perform a practice session on either the robotic (N = 20) or laparoscopic (N = 20) simulator. Two blinded, expert minimally invasive surgeons evaluated participants before and after training using a modified previously validated subjective global rating scale. Objective measures including time to task completion and Mimic dV-Trainer motion metrics were also recorded. At baseline, there were no significant differences between the training groups as measured by objective and subjective measures for either simulation task. After training, participants randomized to the laparoscopic practice group completed the laparoscopic task faster (p < 0.003) and with higher global rating scale scores (p < 0.001) than the robotic group. Robotic-trained participants performed the robotic task faster (p < 0.001), with improved economy of motion (p < 0.001), and with higher global rating scale scores (p = 0.006) than the laparoscopic group. The robotic practice group also demonstrated significantly improved performance on the laparoscopic task (p = 0.02). Laparoscopic-trained participants also improved their robotic performance (p = 0.02), though the robotic group had a higher percent improvement on the robotic task (p = 0.037). Skills acquired through practice on either laparoscopic or robotic simulation platforms appear to be transferable between modalities. However, participants demonstrate superior skill in the modality in which they specifically train.

Biofeedback for robotic gait rehabilitation.

PubMed

Lünenburger, Lars; Colombo, Gery; Riener, Robert

2007-01-23

Development and increasing acceptance of rehabilitation robots as well as advances in technology allow new forms of therapy for patients with neurological disorders. Robot-assisted gait therapy can increase the training duration and the intensity for the patients while reducing the physical strain for the therapist. Optimal training effects during gait therapy generally depend on appropriate feedback about performance. Compared to manual treadmill therapy, there is a loss of physical interaction between therapist and patient with robotic gait retraining. Thus, it is difficult for the therapist to assess the necessary feedback and instructions. The aim of this study was to define a biofeedback system for a gait training robot and test its usability in subjects without neurological disorders. To provide an overview of biofeedback and motivation methods applied in gait rehabilitation, previous publications and results from our own research are reviewed. A biofeedback method is presented showing how a rehabilitation robot can assess the patients' performance and deliver augmented feedback. For validation, three subjects without neurological disorders walked in a rehabilitation robot for treadmill training. Several training parameters, such as body weight support and treadmill speed, were varied to assess the robustness of the biofeedback calculation to confounding factors. The biofeedback values correlated well with the different activity levels of the subjects. Changes in body weight support and treadmill velocity had a minor effect on the biofeedback values. The synchronization of the robot and the treadmill affected the biofeedback values describing the stance phase. Robot-aided assessment and feedback can extend and improve robot-aided training devices. The presented method estimates the patients' gait performance with the use of the robot's existing sensors, and displays the resulting biofeedback values to the patients and therapists. The therapists can adapt the therapy and give further instructions to the patients. The feedback might help the patients to adapt their movement patterns and to improve their motivation. While it is assumed that these novel methods also improve training efficacy, the proof will only be possible with future in-depth clinical studies.

Developing a successful robotics program.

PubMed

Luthringer, Tyler; Aleksic, Ilija; Caire, Arthur; Albala, David M

2012-01-01

Advancements in the robotic surgical technology have revolutionized the standard of care for many surgical procedures. The purpose of this review is to evaluate the important considerations in developing a new robotics program at a given healthcare institution. Patients' interest in robotic-assisted surgery has and continues to grow because of improved outcomes and decreased periods of hospitalization. Resulting market forces have created a solid foundation for the implementation of robotic surgery into surgical practice. Given proper surgeon experience and an efficient system, robotic-assisted procedures have been cost comparable to open surgical alternatives. Surgeon training and experience is closely linked to the efficiency of a new robotics program. Formally trained robotic surgeons have better patient outcomes and shorter operative times. Training in robotics has shown no negative impact on patient outcomes or mentor learning curves. Individual economic factors of local healthcare settings must be evaluated when planning for a new robotics program. The high cost of the robotic surgical platform is best offset with a large surgical volume. A mature, experienced surgeon is integral to the success of a new robotics program.

Robotic kidney autotransplantation in a porcine model: a procedure-specific training platform for the simulation of robotic intracorporeal vascular anastomosis.

PubMed

Tiong, Ho Yee; Goh, Benjamin Yen Seow; Chiong, Edmund; Tan, Lincoln Guan Lim; Vathsala, Anatharaman

2018-03-31

Robotic-assisted kidney transplantation (RKT) with the Da Vinci (Intuitive, USA) platform has been recently developed to improve outcomes by decreasing surgical site complications and morbidity, especially in obese patients. This potential paradigm shift in the surgical technique of kidney transplantation is performed in only a few centers. For wider adoption of this high stake complex operation, we aimed to develop a procedure-specific simulation platform in a porcine model for the training of robotic intracorporeal vascular anastomosis and evaluating vascular anastomoses patency. This paper describes the requirements and steps developed for the above training purpose. Over a series of four animal ethics' approved experiments, the technique of robotic-assisted laparoscopic autotransplantation of the kidney was developed in Amsterdam live pigs (60-70 kg). The surgery was based around the vascular anastomosis technique described by Menon et al. This non-survival porcine training model is targeted at transplant surgeons with robotic surgery experience. Under general anesthesia, each pig was placed in lateral decubitus position with the placement of one robotic camera port, two robotic 8 mm ports and one assistant port. Robotic docking over the pig posteriorly was performed. The training platform involved the following procedural steps. First, ipsilateral iliac vessel dissection was performed. Second, robotic-assisted laparoscopic donor nephrectomy was performed with in situ perfusion of the kidney with cold Hartmann's solution prior to complete division of the hilar vessels, ureter and kidney mobilization. Thirdly, the kidney was either kept in situ for orthotopic autotransplantation or mobilized to the pelvis and orientated for the vascular anastomosis, which was performed end to end or end to side after vessel loop clamping of the iliac vessels, respectively, using 6/0 Gore-Tex sutures. Following autotransplantation and release of vessel loops, perfusion of the graft was assessed using intraoperative indocyanine green imaging and monitoring urine output after unclamping. This training platform demonstrates adequate face and content validity. With practice, arterial anastomotic time could be improved, showing its construct validity. This porcine training model can be useful in providing training for robotic intracorporeal vascular anastomosis and may facilitate confident translation into a transplant human recipient.

Current status of validation for robotic surgery simulators - a systematic review.

PubMed

Abboudi, Hamid; Khan, Mohammed S; Aboumarzouk, Omar; Guru, Khurshid A; Challacombe, Ben; Dasgupta, Prokar; Ahmed, Kamran

2013-02-01

To analyse studies validating the effectiveness of robotic surgery simulators. The MEDLINE(®), EMBASE(®) and PsycINFO(®) databases were systematically searched until September 2011. References from retrieved articles were reviewed to broaden the search. The simulator name, training tasks, participant level, training duration and evaluation scoring were extracted from each study. We also extracted data on feasibility, validity, cost-effectiveness, reliability and educational impact. We identified 19 studies investigating simulation options in robotic surgery. There are five different robotic surgery simulation platforms available on the market. In all, 11 studies sought opinion and compared performance between two different groups; 'expert' and 'novice'. Experts ranged in experience from 21-2200 robotic cases. The novice groups consisted of participants with no prior experience on a robotic platform and were often medical students or junior doctors. The Mimic dV-Trainer(®), ProMIS(®), SimSurgery Educational Platform(®) (SEP) and Intuitive systems have shown face, content and construct validity. The Robotic Surgical SimulatorTM system has only been face and content validated. All of the simulators except SEP have shown educational impact. Feasibility and cost-effectiveness of simulation systems was not evaluated in any trial. Virtual reality simulators were shown to be effective training tools for junior trainees. Simulation training holds the greatest potential to be used as an adjunct to traditional training methods to equip the next generation of robotic surgeons with the skills required to operate safely. However, current simulation models have only been validated in small studies. There is no evidence to suggest one type of simulator provides more effective training than any other. More research is needed to validate simulated environments further and investigate the effectiveness of animal and cadaveric training in robotic surgery. © 2012 BJU International.

Robotic thyroidectomy learning curve for beginning surgeons with little or no experience of endoscopic surgery.

PubMed

Park, Jae Hyun; Lee, Jandee; Hakim, Nor Azham; Kim, Ha Yan; Kang, Sang-Wook; Jeong, Jong Ju; Nam, Kee-Hyun; Bae, Keum-Seok; Kang, Seong Joon; Chung, Woong Youn

2015-12-01

This study assessed the results of robotic thyroidectomy by fellowship-trained surgeons in their initial independent practice, and whether standard fellowship training for robotic surgery shortens the learning curve. This prospective cohort study evaluated outcomes in 125 patients who underwent robotic thyroidectomy using gasless transaxillary single-incision technique by 2 recently graduated fellowship-trained surgeons. Learning curves were analyzed by operation time, with proficiency defined as the point at which the slope of the time curve became less steep. Of the 125 patients, 113 underwent robotic less-than-total thyroidectomy, 9 underwent robotic total thyroidectomy and 3 underwent robotic total thyroidectomy with modified radical neck dissection. Mean total times for these 3 operations were 100.8 ± 20.6 minutes, 134.2 ± 38.7 minutes, and 284.7 ± 60.4 minutes, respectively. For both surgeons, the operation times gradually decreased, reaching a plateau after 20 robotic less-than-total thyroidectomies. The surgical learning curve for robotic thyroidectomy performed by recently graduated fellowship-trained surgeons with little or no experience in endoscopic surgery showed excellent results compared with those in a large series of more experienced surgeons. © 2014 Wiley Periodicals, Inc.

Effects of robot-assisted training on upper limb functional recovery during the rehabilitation of poststroke patients.

PubMed

Daunoraviciene, Kristina; Adomaviciene, Ausra; Grigonyte, Agne; Griškevičius, Julius; Juocevicius, Alvydas

2018-05-18

The study aims to determine the effectiveness of robot-assisted training in the recovery of stroke-affected arms using an exoskeleton robot Armeo Spring. To identify the effect of robot training on functional recovery of the arm. A total of 34 stroke patients were divided into either an experimental group (EG; n= 17) or a control group (n= 17). EG was also trained to use the Armeo Spring during occupational therapy. Both groups were clinically assessed before and after treatment. Statistical comparison methods (i.e. one-tailed t-tests for differences between two independent means and the simplest test) were conducted to compare motor recovery using robot-assisted training or conventional therapy. Patients assigned to the EG showed a statistically significant improvement in upper extremity motor function when compared to the CG by FIM (P< 0.05) and ACER (P< 0.05). The calculated treatment effect in the EG and CG was meaningful for shoulder and elbow kinematic parameters. The findings show the benefits of robot therapy in two areas of functional recovery. Task-oriented robotic training in rehabilitation setting facilitates recovery not only of the motor function of the paretic arm but also of the cognitive abilities in stroke patients.

Robotic Technologies and Rehabilitation: New Tools for Stroke Patients' Therapy

PubMed Central

Poli, Patrizia; Morone, Giovanni; Rosati, Giulio; Masiero, Stefano

2013-01-01

Introduction. The role of robotics in poststroke patients' rehabilitation has been investigated intensively. This paper presents the state-of-the-art and the possible future role of robotics in poststroke rehabilitation, for both upper and lower limbs. Materials and Methods. We performed a comprehensive search of PubMed, Cochrane, and PeDRO databases using as keywords “robot AND stroke AND rehabilitation.” Results and Discussion. In upper limb robotic rehabilitation, training seems to improve arm function in activities of daily living. In addition, electromechanical gait training after stroke seems to be effective. It is still unclear whether robot-assisted arm training may improve muscle strength, and which electromechanical gait-training device may be the most effective for walking training implementation. Conclusions. In the field of robotic technologies for stroke patients' rehabilitation we identified currently relevant growing points and areas timely for developing research. Among the growing points there is the development of new easily transportable, wearable devices that could improve rehabilitation also after discharge, in an outpatient or home-based setting. For developing research, efforts are being made to establish the ideal type of treatment, the length and amount of training protocol, and the patient's characteristics to be successfully enrolled to this treatment. PMID:24350244

Design and Development Issues for Educational Robotics Training Camps

ERIC Educational Resources Information Center

Ucgul, Memet; Cagiltay, Kursat

2014-01-01

The aim of this study is to explore critical design issues for educational robotics training camps and to describe how these factors should be implemented in the development of such camps. For this purpose, two robotics training camps were organized for elementary school students. The first camp had 30 children attendees, and the second had 22. As…

Road-Cleaning Device

ERIC Educational Resources Information Center

Roman, Harry T.

2014-01-01

Roadways are literally soaked with petrochemical byproducts, oils, gasoline, and other volatile substances that eventually run off into sewers and end up in rivers, waterways, and other undesirable places. Can the roads be cleaned of these wastes, with their proper disposal? Can vehicles, robots, or other devices be designed that could be driven…

A Comparison of Robotic, Body Weight Supported Locomotor Training and Aquatic Therapy in Chronic Motor Incomplete Spinal Cord Injury Subjects

DTIC Science & Technology

2015-06-01

Award Number: W81XWH-10-1-0981 TITLE: "A Comparison of Robotic , Body Weight-Supported Locomotor Training and Aquatic Therapy in Chronic Motor...ABSTRACT U c. THIS PAGE U 19b. TELEPHONE NUMBER (include area code) email: pgorman@umm.edu "A Comparison of Robotic , Body Weight-Supported...months, three times a week aquatic therapy with similar intensity robotically assisted, body weight supported locomotor training (RABWSLT) upon

Effort, performance, and motivation: insights from robot-assisted training of human golf putting and rat grip strength.

PubMed

Duarte, Jaime E; Gebrekristos, Berkenesh; Perez, Sergi; Rowe, Justin B; Sharp, Kelli; Reinkensmeyer, David J

2013-06-01

Robotic devices can modulate success rates and required effort levels during motor training, but it is unclear how this affects performance gains and motivation. Here we present results from training unimpaired humans in a virtual golf-putting task, and training spinal cord injured (SCI) rats in a grip strength task using robotically modulated success rates and effort levels. Robotic assistance in golf practice increased trainees feelings of competence, and, paradoxically, increased their sense effort, even though it had mixed effects on learning. Reducing effort during a grip strength training task led rats with SCI to practice the task more frequently. However, the more frequent practice of these rats did not cause them to exceed the strength gains achieved by rats that exercised less often at higher required effort levels. These results show that increasing success and decreasing effort with robots increases motivation, but has mixed effects on performance gains.

Robotic Water Blast Cleaner

NASA Technical Reports Server (NTRS)

Sharpe, M. H.; Roberts, M. L.; Hill, W. E.; Jackson, C. H.

1983-01-01

Water blasting system under development removes hard, dense, extraneous material from surfaces. High pressure pump forces water at supersonic speed through nozzle manipulated by robot. Impact of water blasts away unwanted material from workpiece rotated on air bearing turntable. Designed for removing thermal-protection material, system is adaptable to such industrial processes as cleaning iron or steel castings.

Comparison of haptic guidance and error amplification robotic trainings for the learning of a timing-based motor task by healthy seniors.

PubMed

Bouchard, Amy E; Corriveau, Hélène; Milot, Marie-Hélène

2015-01-01

With age, a decline in the temporal aspect of movement is observed such as a longer movement execution time and a decreased timing accuracy. Robotic training can represent an interesting approach to help improve movement timing among the elderly. Two types of robotic training-haptic guidance (HG; demonstrating the correct movement for a better movement planning and improved execution of movement) and error amplification (EA; exaggerating movement errors to have a more rapid and complete learning) have been positively used in young healthy subjects to boost timing accuracy. For healthy seniors, only HG training has been used so far where significant and positive timing gains have been obtained. The goal of the study was to evaluate and compare the impact of both HG and EA robotic trainings on the improvement of seniors' movement timing. Thirty-two healthy seniors (mean age 68 ± 4 years) learned to play a pinball-like game by triggering a one-degree-of-freedom hand robot at the proper time to make a flipper move and direct a falling ball toward a randomly positioned target. During HG and EA robotic trainings, the subjects' timing errors were decreased and increased, respectively, based on the subjects' timing errors in initiating a movement. Results showed that only HG training benefited learning, but the improvement did not generalize to untrained targets. Also, age had no influence on the efficacy of HG robotic training, meaning that the oldest subjects did not benefit more from HG training than the younger senior subjects. Using HG to teach the correct timing of movement seems to be a good strategy to improve motor learning for the elderly as for younger people. However, more studies are needed to assess the long-term impact of HG robotic training on improvement in movement timing.

Robot-Assisted Training for People With Spinal Cord Injury: A Meta-Analysis.

PubMed

Cheung, Eddy Y Y; Ng, Thomas K W; Yu, Kevin K K; Kwan, Rachel L C; Cheing, Gladys L Y

2017-11-01

To investigate the effects of robot-assisted training on the recovery of people with spinal cord injury (SCI). Randomized controlled trials (RCTs) or quasi-RCTs involving people with SCI that compared robot-assisted upper limbs or lower limbs training with a control of other treatment approach or no treatment. We included studies involving people with complete or incomplete SCIs. We searched MEDLINE, CINAHL, Cochrane Central Register of Controlled Trials (Cochrane Library), and Embase to August 2016. Bibliographies of relevant articles on the effect of body-weight-supported treadmill training on subjects with SCI were screened to avoid missing relevant articles from the search of databases. All kinds of objective assessments concerning physical ability, mobility, and/or functional ability were included. Assessments could be clinical tests (ie, 6-minute walk test, FIM) or laboratory tests (ie, gait analysis). Subjective outcome measures were excluded from this review. Eleven RCT studies involving 443 subjects were included in the study. Meta-analysis was performed on the included studies. Walking independence (3.73; 95% confidence interval [CI], -4.92 to -2.53; P<.00001; I 2 =38%) and endurance (53.32m; 95% CI, -73.15 to -33.48; P<.00001; I 2 =0%) were found to have better improvement in robot-assisted training groups. Lower limb robot-assisted training was also found to be as effective as other types of body-weight-supported training. There is a lack of upper limb robot-assisted training studies; therefore, performing a meta-analysis was not possible. Robot-assisted training is an adjunct therapy for physical and functional recovery for patients with SCI. Future high-quality studies are warranted to investigate the effects of robot-assisted training on functional and cardiopulmonary recovery of patients with SCI. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Method for neural network control of motion using real-time environmental feedback

NASA Technical Reports Server (NTRS)

Buckley, Theresa M. (Inventor)

1997-01-01

A method of motion control for robotics and other automatically controlled machinery using a neural network controller with real-time environmental feedback. The method is illustrated with a two-finger robotic hand having proximity sensors and force sensors that provide environmental feedback signals. The neural network controller is taught to control the robotic hand through training sets using back- propagation methods. The training sets are created by recording the control signals and the feedback signal as the robotic hand or a simulation of the robotic hand is moved through a representative grasping motion. The data recorded is divided into discrete increments of time and the feedback data is shifted out of phase with the control signal data so that the feedback signal data lag one time increment behind the control signal data. The modified data is presented to the neural network controller as a training set. The time lag introduced into the data allows the neural network controller to account for the temporal component of the robotic motion. Thus trained, the neural network controlled robotic hand is able to grasp a wide variety of different objects by generalizing from the training sets.

[Study on the center-driven multiple degrees of freedom upper limb rehabilitation training robot].

PubMed

Huang, Xiaohai; Yu, Hongliu; Wang, Jinchao; Dong, Qi; Zhang, Linling; Meng, Qiaoling; Li, Sujiao; Wang, Duojin

2018-03-01

With the aging of the society, the number of stroke patients has been increasing year by year. Compared with the traditional rehabilitation therapy, the application of upper limb rehabilitation robot has higher efficiency and better rehabilitation effect, and has become an important development direction in the field of rehabilitation. In view of the current development status and the deficiency of upper limb rehabilitation robot system, combined with the development trend of all kinds of products of the upper limb rehabilitation robot, this paper designed a center-driven upper limb rehabilitation training robot for cable transmission which can help the patients complete 6 degrees of freedom (3 are driven, 3 are underactuated) training. Combined the structure of robot with more joints rehabilitation training, the paper choosed a cubic polynomial trajectory planning method in the joint space planning to design two trajectories of eating and lifting arm. According to the trajectory equation, the movement trajectory of each joint of the robot was drawn in MATLAB. It laid a foundation for scientific and effective rehabilitation training. Finally, the experimental prototype is built, and the mechanical structure and design trajectories are verified.

Accelerometry Measuring the Outcome of Robot-Supported Upper Limb Training in Chronic Stroke: A Randomized Controlled Trial

PubMed Central

Lemmens, Ryanne J. M.; Timmermans, Annick A. A.; Janssen-Potten, Yvonne J. M.; Pulles, Sanne A. N. T. D.; Geers, Richard P. J.; Bakx, Wilbert G. M.; Smeets, Rob J. E. M.; Seelen, Henk A. M.

2014-01-01

Purpose This study aims to assess the extent to which accelerometers can be used to determine the effect of robot-supported task-oriented arm-hand training, relative to task-oriented arm-hand training alone, on the actual amount of arm-hand use of chronic stroke patients in their home situation. Methods This single-blind randomized controlled trial included 16 chronic stroke patients, randomly allocated using blocked randomization (n = 2) to receive task-oriented robot-supported arm-hand training or task-oriented (unsupported) arm-hand training. Training lasted 8 weeks, 4 times/week, 2×30 min/day using the (T-)TOAT ((Technology-supported)-Task-Oriented-Arm-Training) method. The actual amount of arm-hand use, was assessed at baseline, after 8 weeks training and 6 months after training cessation. Duration of use and intensity of use of the affected arm-hand during unimanual and bimanual activities were calculated. Results Duration and intensity of use of the affected arm-hand did not change significantly during and after training, with or without robot-support (i.e. duration of use of unimanual use of the affected arm-hand: median difference of −0.17% in the robot-group and −0.08% in the control group between baseline and after training cessation; intensity of the affected arm-hand: median difference of 3.95% in the robot-group and 3.32% in the control group between baseline and after training cessation). No significant between-group differences were found. Conclusions Accelerometer data did not show significant changes in actual amount of arm-hand use after task-oriented training, with or without robot-support. Next to the amount of use, discrimination between activities performed and information about quality of use of the affected arm-hand are essential to determine actual arm-hand performance. Trial Registration Controlled-trials.com ISRCTN82787126 PMID:24823925

Assessment of hindlimb locomotor strength in spinal cord transected rats through animal-robot contact force.

PubMed

Nessler, Jeff A; Moustafa-Bayoumi, Moustafa; Soto, Dalziel; Duhon, Jessica; Schmitt, Ryan

2011-12-01

Robotic locomotor training devices have gained popularity in recent years, yet little has been reported regarding contact forces experienced by the subject performing automated locomotor training, particularly in animal models of neurological injury. The purpose of this study was to develop a means for acquiring contact forces between a robotic device and a rodent model of spinal cord injury through instrumentation of a robotic gait training device (the rat stepper) with miniature force/torque sensors. Sensors were placed at each interface between the robot arm and animal's hindlimb and underneath the stepping surface of both hindpaws (four sensors total). Twenty four female, Sprague-Dawley rats received mid-thoracic spinal cord transections as neonates and were included in the study. Of these 24 animals, training began for 18 animals at 21 days of age and continued for four weeks at five min/day, five days/week. The remaining six animals were untrained. Animal-robot contact forces were acquired for trained animals weekly and untrained animals every two weeks while stepping in the robotic device with both 60 and 90% of their body weight supported (BWS). Animals that received training significantly increased the number of weight supported steps over the four week training period. Analysis of raw contact forces revealed significant increases in forward swing and ground reaction forces during this time, and multiple aspects of animal-robot contact forces were significantly correlated with weight bearing stepping. However, when contact forces were normalized to animal body weight, these increasing trends were no longer present. Comparison of trained and untrained animals revealed significant differences in normalized ground reaction forces (both horizontal and vertical) and normalized forward swing force. Finally, both forward swing and ground reaction forces were significantly reduced at 90% BWS when compared to the 60% condition. These results suggest that measurement of animal-robot contact forces using the instrumented rat stepper can provide a sensitive and reliable measure of hindlimb locomotor strength and control of flexor and extensor muscle activity in neurologically impaired animals. Additionally, these measures may be useful as a means to quantify training intensity or dose-related functional outcomes of automated training.

Task-oriented rehabilitation robotics.

PubMed

Schweighofer, Nicolas; Choi, Younggeun; Winstein, Carolee; Gordon, James

2012-11-01

Task-oriented training is emerging as the dominant and most effective approach to motor rehabilitation of upper extremity function after stroke. Here, the authors propose that the task-oriented training framework provides an evidence-based blueprint for the design of task-oriented robots for the rehabilitation of upper extremity function in the form of three design principles: skill acquisition of functional tasks, active participation training, and individualized adaptive training. The previous robotic systems that incorporate elements of task-oriented trainings are then reviewed. Finally, the authors critically analyze their own attempt to design and test the feasibility of a TOR robot, ADAPT (Adaptive and Automatic Presentation of Tasks), which incorporates the three design principles. Because of its task-oriented training-based design, ADAPT departs from most other current rehabilitation robotic systems: it presents realistic functional tasks in which the task goal is constantly adapted, so that the individual actively performs doable but challenging tasks without physical assistance. To maximize efficacy for a large clinical population, the authors propose that future task-oriented robots need to incorporate yet-to-be developed adaptive task presentation algorithms that emphasize acquisition of fine motor coordination skills while minimizing compensatory movements.

Effects of robotic treadmill training on functional mobility, walking capacity, motor symptoms and quality of life in ambulatory patients with Parkinson's disease: a preliminary prospective longitudinal study.

PubMed

Paker, Nurdan; Bugdayci, Derya; Goksenoglu, Goksen; Sen, Aysu; Kesiktas, Nur

2013-01-01

Decreased mobility and walking capacity occur frequently in Parkinson's disease (PD). Robotic treadmill training is a novel method to improve the walking capacity in rehabilitation. The primary aim of this study was to investigate the effects of robotic treadmill training on functional mobility and walking capacity in PD. Secondly, we aimed to assess the effects of the robotic treadmill training the motor symptoms and quality of life in patients with PD. Seventy patients with idiopathic Parkinson's disease who admitted to the outpatient clinic of the rehabilitation hospital were screened and 12 ambulatory volenteers who met the study criteria were included in this study. Patients were evaluated by Hoehn Yahr (HY) scale clinically. Two sessions robotic treadmill training per week during 5 weeks was planned for every patient. Patients were evaluated by the Timed Up and Go (TUG) test, 10 meter walking test (10 MWT), Unified Parkinson's Disease Rating Scale (UPDRS) motor section and Parkinson's Disease Questionnaire-39 (PDQ-39) at the baseline, at the 5 and 12 weeks. Cognitive and emotional states of the patients were assessed by Mini Mental State Examination (MMSE) test and Hospital Anxiety and Depression Scale (HADS) at the baseline. All patients were under medical treatment for the PD in this study and drug treatment was not changed during the study. Ten patients completed the study. The mean age was 65.6 ± 6.6 years. Five patients (50%) were women. Disease severity was between the HY stage 1-3. Two patients did not continue the robotic treadmill training after 7 sessions. They also did not want to come for control visits. TUG test, 10 MWT and UPDRS motor subscale scores showed statistically significant improvement after robotic treadmill training (p = 0.02, p = 0.001, p = 0.016). PDQ-39 scores improved significantly after robotic treadmill training (p = 0.03), however, the scores turned back to the baseline level at the 12. week control. As a result of this preliminary study, robotic treadmill training was useful to improve the functional mobility, walking capacity and motor symptoms in mild to moderate PD. Robotic treadmill training provided a transient improvement in the quality of life during the treatment.

Randomized controlled trial of robot-assisted gait training with dorsiflexion assistance on chronic stroke patients wearing ankle-foot-orthosis.

PubMed

Yeung, Ling-Fung; Ockenfeld, Corinna; Pang, Man-Kit; Wai, Hon-Wah; Soo, Oi-Yan; Li, Sheung-Wai; Tong, Kai-Yu

2018-06-19

Robot-assisted ankle-foot-orthosis (AFO) can provide immediate powered ankle assistance in post-stroke gait training. Our research team has developed a novel lightweight portable robot-assisted AFO which is capable of detecting walking intentions using sensor feedback of wearer's gait pattern. This study aims to investigate the therapeutic effects of robot-assisted gait training with ankle dorsiflexion assistance. This was a double-blinded randomized controlled trial. Nineteen chronic stroke patients with motor impairment at ankle participated in 20-session robot-assisted gait training for about five weeks, with 30-min over-ground walking and stair ambulation practices. Robot-assisted AFO either provided active powered ankle assistance during swing phase in Robotic Group (n = 9), or torque impedance at ankle joint as passive AFO in Sham Group (n = 10). Functional assessments were performed before and after the 20-session gait training with 3-month Follow-up. Primary outcome measure was gait independency assessed by Functional Ambulatory Category (FAC). Secondary outcome measures were clinical scores including Fugl-Meyer Assessment (FMA), Modified Ashworth Scale (MAS), Berg Balance Scale (BBS), Timed 10-Meter Walk Test (10MWT), Six-minute Walk Test (SMWT), supplemented by gait analysis. All outcome measures were performed in unassisted gait after patients had taken off the robot-assisted AFO. Repeated-measures analysis of covariance was conducted to test the group differences referenced to clinical scores before training. After 20-session robot-assisted gait training with ankle dorsiflexion assistance, the active ankle assistance in Robotic Group induced changes in gait pattern with improved gait independency (all patients FAC ≥ 5 post-training and 3-month follow-up), motor recovery, walking speed, and greater confidence in affected side loading response (vertical ground reaction force + 1.49 N/kg, peak braking force + 0.24 N/kg) with heel strike instead of flat foot touch-down at initial contact (foot tilting + 1.91°). Sham Group reported reduction in affected leg range of motion (ankle dorsiflexion - 2.36° and knee flexion - 8.48°) during swing. Robot-assisted gait training with ankle dorsiflexion assistance could improve gait independency and help stroke patients developing confidence in weight acceptance, but future development of robot-assisted AFO should consider more lightweight and custom-fit design. ClinicalTrials.gov NCT02471248 . Registered 15 June 2015 retrospectively registered.

Rehabilitation robotics: pilot trial of a spatial extension for MIT-Manus

PubMed Central

Krebs, Hermano I; Ferraro, Mark; Buerger, Stephen P; Newbery, Miranda J; Makiyama, Antonio; Sandmann, Michael; Lynch, Daniel; Volpe, Bruce T; Hogan, Neville

2004-01-01

Background Previous results with the planar robot MIT-MANUS demonstrated positive benefits in trials with over 250 stroke patients. Consistent with motor learning, the positive effects did not generalize to other muscle groups or limb segments. Therefore we are designing a new class of robots to exercise other muscle groups or limb segments. This paper presents basic engineering aspects of a novel robotic module that extends our approach to anti-gravity movements out of the horizontal plane and a pilot study with 10 outpatients. Patients were trained during the initial six-weeks with the planar module (i.e., performance-based training limited to horizontal movements with gravity compensation). This training was followed by six-weeks of robotic therapy that focused on performing vertical arm movements against gravity. The 12-week protocol includes three one-hour robot therapy sessions per week (total 36 robot treatment sessions). Results Pilot study demonstrated that the protocol was safe and well tolerated with no patient presenting any adverse effect. Consistent with our past experience with persons with chronic strokes, there was a statistically significant reduction in tone measurement from admission to discharge of performance-based planar robot therapy and we have not observed increases in muscle tone or spasticity during the anti-gravity training protocol. Pilot results showed also a reduction in shoulder-elbow impairment following planar horizontal training. Furthermore, it suggested an additional reduction in shoulder-elbow impairment following the anti-gravity training. Conclusion Our clinical experiments have focused on a fundamental question of whether task specific robotic training influences brain recovery. To date several studies demonstrate that in mature and damaged nervous systems, nurture indeed has an effect on nature. The improved recovery is most pronounced in the trained limb segments. We have now embarked on experiments that test whether we can continue to influence recovery, long after the acute insult, with a novel class of spatial robotic devices. This pilot results support the pursuit of further clinical trials to test efficacy and the pursuit of optimal therapy following brain injury. PMID:15679916

Rehabilitation robotics: pilot trial of a spatial extension for MIT-Manus.

PubMed

Krebs, Hermano I; Ferraro, Mark; Buerger, Stephen P; Newbery, Miranda J; Makiyama, Antonio; Sandmann, Michael; Lynch, Daniel; Volpe, Bruce T; Hogan, Neville

2004-10-26

BACKGROUND: Previous results with the planar robot MIT-MANUS demonstrated positive benefits in trials with over 250 stroke patients. Consistent with motor learning, the positive effects did not generalize to other muscle groups or limb segments. Therefore we are designing a new class of robots to exercise other muscle groups or limb segments. This paper presents basic engineering aspects of a novel robotic module that extends our approach to anti-gravity movements out of the horizontal plane and a pilot study with 10 outpatients. Patients were trained during the initial six-weeks with the planar module (i.e., performance-based training limited to horizontal movements with gravity compensation). This training was followed by six-weeks of robotic therapy that focused on performing vertical arm movements against gravity. The 12-week protocol includes three one-hour robot therapy sessions per week (total 36 robot treatment sessions). RESULTS: Pilot study demonstrated that the protocol was safe and well tolerated with no patient presenting any adverse effect. Consistent with our past experience with persons with chronic strokes, there was a statistically significant reduction in tone measurement from admission to discharge of performance-based planar robot therapy and we have not observed increases in muscle tone or spasticity during the anti-gravity training protocol. Pilot results showed also a reduction in shoulder-elbow impairment following planar horizontal training. Furthermore, it suggested an additional reduction in shoulder-elbow impairment following the anti-gravity training. CONCLUSION: Our clinical experiments have focused on a fundamental question of whether task specific robotic training influences brain recovery. To date several studies demonstrate that in mature and damaged nervous systems, nurture indeed has an effect on nature. The improved recovery is most pronounced in the trained limb segments. We have now embarked on experiments that test whether we can continue to influence recovery, long after the acute insult, with a novel class of spatial robotic devices. This pilot results support the pursuit of further clinical trials to test efficacy and the pursuit of optimal therapy following brain injury.

The decisive role of the patient-side surgeon in robotic surgery.

PubMed

Sgarbura, Olivia; Vasilescu, Catalin

2010-12-01

Minimally invasive technology literature is mainly concerned about the feasibility of the robotic procedures and the performance of the console surgeon. However, few of these technologies could be applied without a well-trained team. Our goal was to demonstrate that robotic surgery depends more on the patient-side assistant surgeon's abilities than has been previously reported. In our department, 280 interventions in digestive, thoracic, and gynecological surgery were performed since the acquisition of the robotic equipment. There are three teams trained in robotic surgery with three console surgeons and four certified patient-side surgeons. Four more patient-side assistants were trained at our center. Trocar placement, docking and undocking of the robot, insertion of the laparoscopic instruments, and hemostatic maneuvers with various devices were quantified and compared. Assistants trained by using animal or cadaver surgery are more comfortable with the robotic instruments handling and with docking and undocking of the robot. Assistants who finalized their residency or attend their final year are more accurate with the insertion of the laparoscopic instrument to the targeted organ and more skillful with LigaSure or clip applier devices. Interventions that require vivid participation of the assistants have shorter assistant-depending time intervals at the end of the learning curve than at the beginning. Robotic surgery is a team effort and is greatly dependant on the performance of assistant surgeons. Interventions that have the benefit of a trained team are more rapid and secure.

Bilateral robots for upper-limb stroke rehabilitation: State of the art and future prospects.

PubMed

Sheng, Bo; Zhang, Yanxin; Meng, Wei; Deng, Chao; Xie, Shengquan

2016-07-01

Robot-assisted bilateral upper-limb training grows abundantly for stroke rehabilitation in recent years and an increasing number of devices and robots have been developed. This paper aims to provide a systematic overview and evaluation of existing bilateral upper-limb rehabilitation devices and robots based on their mechanisms and clinical-outcomes. Most of the articles studied here were searched from nine online databases and the China National Knowledge Infrastructure (CNKI) from year 1993 to 2015. Devices and robots were categorized as end-effectors, exoskeletons and industrial robots. Totally ten end-effectors, one exoskeleton and one industrial robot were evaluated in terms of their mechanical characteristics, degrees of freedom (DOF), supported control modes, clinical applicability and outcomes. Preliminary clinical results of these studies showed that all participants could gain certain improvements in terms of range of motion, strength or physical function after training. Only four studies supported that bilateral training was better than unilateral training. However, most of clinical results cannot definitely verify the effectiveness of mechanisms and clinical protocols used in robotic therapies. To explore the actual value of these robots and devices, further research on ingenious mechanisms, dose-matched clinical protocols and universal evaluation criteria should be conducted in the future. Copyright © 2016 IPEM. Published by Elsevier Ltd. All rights reserved.

[Human-robot global Simulink modeling and analysis for an end-effector upper limb rehabilitation robot].

PubMed

Liu, Yali; Ji, Linhong

2018-02-01

Robot rehabilitation has been a primary therapy method for the urgent rehabilitation demands of paralyzed patients after a stroke. The parameters in rehabilitation training such as the range of the training, which should be adjustable according to each participant's functional ability, are the key factors influencing the effectiveness of rehabilitation therapy. Therapists design rehabilitation projects based on the semiquantitative functional assessment scales and their experience. But these therapies based on therapists' experience cannot be implemented in robot rehabilitation therapy. This paper modeled the global human-robot by Simulink in order to analyze the relationship between the parameters in robot rehabilitation therapy and the patients' movement functional abilities. We compared the shoulder and elbow angles calculated by simulation with the angles recorded by motion capture system while the healthy subjects completed the simulated action. Results showed there was a remarkable correlation between the simulation data and the experiment data, which verified the validity of the human-robot global Simulink model. Besides, the relationship between the circle radius in the drawing tasks in robot rehabilitation training and the active movement degrees of shoulder as well as elbow was also matched by a linear, which also had a remarkable fitting coefficient. The matched linear can be a quantitative reference for the robot rehabilitation training parameters.

Biofeedback for robotic gait rehabilitation

PubMed Central

Lünenburger, Lars; Colombo, Gery; Riener, Robert

2007-01-01

Background Development and increasing acceptance of rehabilitation robots as well as advances in technology allow new forms of therapy for patients with neurological disorders. Robot-assisted gait therapy can increase the training duration and the intensity for the patients while reducing the physical strain for the therapist. Optimal training effects during gait therapy generally depend on appropriate feedback about performance. Compared to manual treadmill therapy, there is a loss of physical interaction between therapist and patient with robotic gait retraining. Thus, it is difficult for the therapist to assess the necessary feedback and instructions. The aim of this study was to define a biofeedback system for a gait training robot and test its usability in subjects without neurological disorders. Methods To provide an overview of biofeedback and motivation methods applied in gait rehabilitation, previous publications and results from our own research are reviewed. A biofeedback method is presented showing how a rehabilitation robot can assess the patients' performance and deliver augmented feedback. For validation, three subjects without neurological disorders walked in a rehabilitation robot for treadmill training. Several training parameters, such as body weight support and treadmill speed, were varied to assess the robustness of the biofeedback calculation to confounding factors. Results The biofeedback values correlated well with the different activity levels of the subjects. Changes in body weight support and treadmill velocity had a minor effect on the biofeedback values. The synchronization of the robot and the treadmill affected the biofeedback values describing the stance phase. Conclusion Robot-aided assessment and feedback can extend and improve robot-aided training devices. The presented method estimates the patients' gait performance with the use of the robot's existing sensors, and displays the resulting biofeedback values to the patients and therapists. The therapists can adapt the therapy and give further instructions to the patients. The feedback might help the patients to adapt their movement patterns and to improve their motivation. While it is assumed that these novel methods also improve training efficacy, the proof will only be possible with future in-depth clinical studies. PMID:17244363

Timing of intermittent torque control with wire-driven gait training robot lifting toe trajectory for trip avoidance.

PubMed

Miyake, Tamon; Kobayashi, Yo; Fujie, Masakatsu G; Sugano, Shigeki

2017-07-01

Gait training robots are useful for changing gait patterns and decreasing risk of trip. Previous research has reported that decreasing duration of the assistance or guidance of the robot is beneficial for efficient gait training. Although robotic intermittent control method for assisting joint motion has been established, the effect of the robot intervention timing on change of toe clearance is unclear. In this paper, we tested different timings of applying torque to the knee, employing the intermittent control of a gait training robot to increase toe clearance throughout the swing phase. We focused on knee flexion motion and designed a gait training robot that can apply flexion torque to the knee with a wire-driven system. We used a method of timing detecting for the robot conducting torque control based on information from the hip, knee, and ankle angles to establish a non-time dependent parameter that can be used to adapt to gait change, such as gait speed. We carried out an experiment in which the conditions were four time points: starting the swing phase, lifting the foot, maintaining knee flexion, and finishing knee flexion. The results show that applying flexion torque to the knee at the time point when people start lifting their toe is effective for increasing toe clearance in the whole swing phase.

The effect of impedance-controlled robotic gait training on walking ability and quality in individuals with chronic incomplete spinal cord injury: an explorative study.

PubMed

Fleerkotte, Bertine M; Koopman, Bram; Buurke, Jaap H; van Asseldonk, Edwin H F; van der Kooij, Herman; Rietman, Johan S

2014-03-04

There is increasing interest in the use of robotic gait-training devices in walking rehabilitation of incomplete spinal cord injured (iSCI) individuals. These devices provide promising opportunities to increase the intensity of training and reduce physical demands on therapists. Despite these potential benefits, robotic gait-training devices have not yet demonstrated clear advantages over conventional gait-training approaches, in terms of functional outcomes. This might be due to the reduced active participation and step-to-step variability in most robotic gait-training strategies, when compared to manually assisted therapy. Impedance-controlled devices can increase active participation and step-to-step variability. The aim of this study was to assess the effect of impedance-controlled robotic gait training on walking ability and quality in chronic iSCI individuals. A group of 10 individuals with chronic iSCI participated in an explorative clinical trial. Participants trained three times a week for eight weeks using an impedance-controlled robotic gait trainer (LOPES: LOwer extremity Powered ExoSkeleton). Primary outcomes were the 10-meter walking test (10 MWT), the Walking Index for Spinal Cord Injury (WISCI II), the six-meter walking test (6 MWT), the Timed Up and Go test (TUG) and the Lower Extremity Motor Scores (LEMS). Secondary outcomes were spatiotemporal and kinematics measures. All participants were tested before, during, and after training and at 8 weeks follow-up. Participants experienced significant improvements in walking speed (0.06 m/s, p = 0.008), distance (29 m, p = 0.005), TUG (3.4 s, p = 0.012), LEMS (3.4, p = 0.017) and WISCI after eight weeks of training with LOPES. At the eight-week follow-up, participants retained the improvements measured at the end of the training period. Significant improvements were also found in spatiotemporal measures and hip range of motion. Robotic gait training using an impedance-controlled robot is feasible in gait rehabilitation of chronic iSCI individuals. It leads to improvements in walking ability, muscle strength, and quality of walking. Improvements observed at the end of the training period persisted at the eight-week follow-up. Slower walkers benefit the most from the training protocol and achieve the greatest relative improvement in speed and walking distance.

The effect of impedance-controlled robotic gait training on walking ability and quality in individuals with chronic incomplete spinal cord injury: an explorative study

PubMed Central

2014-01-01

Background There is increasing interest in the use of robotic gait-training devices in walking rehabilitation of incomplete spinal cord injured (iSCI) individuals. These devices provide promising opportunities to increase the intensity of training and reduce physical demands on therapists. Despite these potential benefits, robotic gait-training devices have not yet demonstrated clear advantages over conventional gait-training approaches, in terms of functional outcomes. This might be due to the reduced active participation and step-to-step variability in most robotic gait-training strategies, when compared to manually assisted therapy. Impedance-controlled devices can increase active participation and step-to-step variability. The aim of this study was to assess the effect of impedance-controlled robotic gait training on walking ability and quality in chronic iSCI individuals. Methods A group of 10 individuals with chronic iSCI participated in an explorative clinical trial. Participants trained three times a week for eight weeks using an impedance-controlled robotic gait trainer (LOPES: LOwer extremity Powered ExoSkeleton). Primary outcomes were the 10-meter walking test (10MWT), the Walking Index for Spinal Cord Injury (WISCI II), the six-meter walking test (6MWT), the Timed Up and Go test (TUG) and the Lower Extremity Motor Scores (LEMS). Secondary outcomes were spatiotemporal and kinematics measures. All participants were tested before, during, and after training and at 8 weeks follow-up. Results Participants experienced significant improvements in walking speed (0.06 m/s, p = 0.008), distance (29 m, p = 0.005), TUG (3.4 s, p = 0.012), LEMS (3.4, p = 0.017) and WISCI after eight weeks of training with LOPES. At the eight-week follow-up, participants retained the improvements measured at the end of the training period. Significant improvements were also found in spatiotemporal measures and hip range of motion. Conclusion Robotic gait training using an impedance-controlled robot is feasible in gait rehabilitation of chronic iSCI individuals. It leads to improvements in walking ability, muscle strength, and quality of walking. Improvements observed at the end of the training period persisted at the eight-week follow-up. Slower walkers benefit the most from the training protocol and achieve the greatest relative improvement in speed and walking distance. PMID:24594284

Is body-weight-supported treadmill training or robotic-assisted gait training superior to overground gait training and other forms of physiotherapy in people with spinal cord injury? A systematic review.

PubMed

Mehrholz, J; Harvey, L A; Thomas, S; Elsner, B

2017-08-01

Systematic review about randomised trials comparing different training strategies to improve gait in people with spinal cord injuries (SCI). The aim of this systematic review was to compare the effectiveness of body-weight-supported treadmill training (BWSTT) and robotic-assisted gait training with overground gait training and other forms of physiotherapy in people with traumatic SCI. Systematic review conducted by researchers from Germany and Australia. An extensive search was conducted for randomised controlled trials involving people with traumatic SCI that compared either BWSTT or robotic-assisted gait training with overground gait training and other forms of physiotherapy. The two outcomes of interest were walking speed (m s -1 ) and walking distance (m). BWSTT and robotic-assisted gait training were analysed separately, and data were pooled across trials to derive mean between-group differences using a random-effects model. Thirteen randomised controlled trials involving 586 people were identified. Ten trials involving 462 participants compared BWSTT to overground gait training and other forms of physiotherapy, but only nine trials provided useable data. The pooled mean (95% confidence interval (CI)) between-group differences for walking speed and walking distance were -0.03 m s -1 (-0.10 to 0.04) and -7 m (-45 to 31), respectively, favouring overground gait training. Five trials involving 344 participants compared robotic-assisted gait training to overground gait training and other forms of physiotherapy but only three provided useable data. The pooled mean (95% CI) between-group differences for walking speed and walking distance were -0.04 m s -1 (95% CI -0.21 to 0.13) and -6 m (95% CI -86 to 74), respectively, favouring overground gait training. BWSTT and robotic-assisted gait training do not increase walking speed more than overground gait training and other forms of physiotherapy do, but their effects on walking distance are not clear.

Initial validation of a virtual-reality robotic simulator.

PubMed

Lendvay, Thomas S; Casale, Pasquale; Sweet, Robert; Peters, Craig

2008-09-01

Robotic surgery is an accepted adjunct to minimally invasive surgery, but training is restricted to console time. Virtual-reality (VR) simulation has been shown to be effective for laparoscopic training and so we seek to validate a novel VR robotic simulator. The American Urological Association (AUA) Office of Education approved this study. Subjects enrolled in a robotics training course at the 2007 AUA annual meeting underwent skills training in a da Vinci dry-lab module and a virtual-reality robotics module which included a three-dimensional (3D) VR robotic simulator. Demographic and acceptability data were obtained, and performance metrics from the simulator were compared between experienced and nonexperienced roboticists for a ring transfer task. Fifteen subjects-four with previous robotic surgery experience and 11 without-participated. Nine subjects were still in urology training and nearly half of the group had reported playing video games. Overall performance of the da Vinci system and the simulator were deemed acceptable by a Likert scale (0-6) rating of 5.23 versus 4.69, respectively. Experienced subjects outperformed nonexperienced subjects on the simulator on three metrics: total task time (96 s versus 159 s, P < 0.02), economy of motion (1,301 mm versus 2,095 mm, P < 0.04), and time the telemanipulators spent outside of the center of the platform's workspace (4 s versus 35 s, P < 0.02). This is the first demonstration of face and construct validity of a virtual-reality robotic simulator. Further studies assessing predictive validity are ultimately required to support incorporation of VR robotic simulation into training curricula.

Effect of Gravity on Robot-Assisted Motor Training After Chronic Stroke: A Randomized Trial

PubMed Central

Conroy, Susan S.; Whitall, Jill; Dipietro, Laura; Jones-Lush, Lauren M.; Zhan, Min; Finley, Margaret A.; Wittenberg, George F.; Krebs, Hermano I.; Bever, Christopher T.

2015-01-01

Objectives To determine the efficacy of 2 distinct 6-week robot-assisted reaching programs compared with an intensive conventional arm exercise program (ICAE) for chronic, stroke-related upper-extremity (UE) impairment. To examine whether the addition of robot-assisted training out of the horizontal plane leads to improved outcomes. Design Randomized controlled trial, single-blinded, with 12-week follow-up. Setting Research setting in a large medical center. Participants Adults (N=62) with chronic, stroke-related arm weakness stratified by impairment severity using baseline UE motor assessments. Interventions Sixty minutes, 3 times a week for 6 weeks of robot-assisted planar reaching (gravity compensated), combined planar with vertical robot-assisted reaching, or intensive conventional arm exercise program. Main Outcome Measure UE Fugl-Meyer Assessment (FMA) mean change from baseline to final training. Results All groups showed modest gains in the FMA from baseline to final with no significant between group differences. Most change occurred in the planar robot group (mean change ± SD, 2.94± 0.77; 95% confidence interval [CI], 1.40 – 4.47). Participants with greater motor impairment (n=41) demonstrated a larger difference in response (mean change ± SD, 2.29±0.72; 95% CI, 0.85–3.72) for planar robot-assisted exercise compared with the intensive conventional arm exercise program (mean change ± SD, 0.43±0.72; 95% CI, −1.00 to 1.86). Conclusions Chronic UE deficits because of stroke are responsive to intensive motor task training. However, training outside the horizontal plane in a gravity present environment using a combination of vertical with planar robots was not superior to training with the planar robot alone. PMID:21849168

Training with a balance exercise assist robot is more effective than conventional training for frail older adults.

PubMed

Ozaki, Kenichi; Kondo, Izumi; Hirano, Satoshi; Kagaya, Hitoshi; Saitoh, Eiichi; Osawa, Aiko; Fujinori, Yoichi

2017-11-01

To examine the efficacy of postural strategy training using a balance exercise assist robot (BEAR) as compared with conventional balance training for frail older adults. The present study was designed as a cross-over trial without a washout term. A total of 27 community-dwelling frail or prefrail elderly residents (7 men, 20 women; age range 65-85 years) were selected from a volunteer sample. Two exercises were prepared for interventions: robotic exercise moving the center of gravity by the balance exercise assist robot system; and conventional balance training combining muscle-strengthening exercise, postural strategy training and applied motion exercise. Each exercise was carried out twice a week for 6 weeks. Participants were allocated randomly to either the robotic exercise first group or the conventional balance exercise first group. preferred and maximal gait speeds, tandem gait speeds, timed up-and-go test, functional reach test, functional base of support, center of pressure, and muscle strength of the lower extremities were assessed before and after completion of each exercise program. Robotic exercise achieved significant improvements for tandem gait speed (P = 0.012), functional reach test (P = 0.002), timed up-and-go test (P = 0.023) and muscle strength of the lower extremities (P = 0.001-0.030) compared with conventional exercise. In frail or prefrail older adults, robotic exercise was more effective for improving dynamic balance and lower extremity muscle strength than conventional exercise. These findings suggest that postural strategy training with the balance exercise assist robot is effective to improve the gait instability and muscle weakness often seen in frail older adults. Geriatr Gerontol Int 2017; 17: 1982-1990. © 2017 The Authors. Geriatrics & Gerontology International published by John Wiley & Sons Australia, Ltd on behalf of Japan Geriatrics Society.

Trunk Robot Rehabilitation Training with Active Stepping Reorganizes and Enriches Trunk Motor Cortex Representations in Spinal Transected Rats

PubMed Central

Oza, Chintan S.

2015-01-01

Trunk motor control is crucial for postural stability and propulsion after low thoracic spinal cord injury (SCI) in animals and humans. Robotic rehabilitation aimed at trunk shows promise in SCI animal models and patients. However, little is known about the effect of SCI and robot rehabilitation of trunk on cortical motor representations. We previously showed reorganization of trunk motor cortex after adult SCI. Non-stepping training also exacerbated some SCI-driven plastic changes. Here we examine effects of robot rehabilitation that promotes recovery of hindlimb weight support functions on trunk motor cortex representations. Adult rats spinal transected as neonates (NTX rats) at the T9/10 level significantly improve function with our robot rehabilitation paradigm, whereas treadmill-only trained do not. We used intracortical microstimulation to map motor cortex in two NTX groups: (1) treadmill trained (control group); and (2) robot-assisted treadmill trained (improved function group). We found significant robot rehabilitation-driven changes in motor cortex: (1) caudal trunk motor areas expanded; (2) trunk coactivation at cortex sites increased; (3) richness of trunk cortex motor representations, as examined by cumulative entropy and mutual information for different trunk representations, increased; (4) trunk motor representations in the cortex moved toward more normal topography; and (5) trunk and forelimb motor representations that SCI-driven plasticity and compensations had caused to overlap were segregated. We conclude that effective robot rehabilitation training induces significant reorganization of trunk motor cortex and partially reverses some plastic changes that may be adaptive in non-stepping paraplegia after SCI. PMID:25948267

Pilot Validation Study of the European Association of Urology Robotic Training Curriculum.

PubMed

Volpe, Alessandro; Ahmed, Kamran; Dasgupta, Prokar; Ficarra, Vincenzo; Novara, Giacomo; van der Poel, Henk; Mottrie, Alexandre

2015-08-01

The development of structured and validated training curricula is one of the current priorities in robot-assisted urological surgery. To establish the feasibility, acceptability, face validity, and educational impact of a structured training curriculum for robot-assisted radical prostatectomy (RARP), and to assess improvements in performance and ability to perform RARP after completion of the curriculum. A 12-wk training curriculum was developed based on an expert panel discussion and used to train ten fellows from major European teaching institutions. The curriculum included: (1) e-learning, (2) 1 wk of structured simulation-based training (virtual reality synthetic, animal, and cadaveric platforms), and (3) supervised modular training for RARP. The feasibility, acceptability, face validity, and educational impact were assessed using quantitative surveys. Improvement in the technical skills of participants over the training period was evaluated using the inbuilt validated assessment metrics on the da Vinci surgical simulator (dVSS). A final RARP performed by fellows on completion of their training was assessed using the Global Evaluative Assessment of Robotic Skills (GEARS) score and generic and procedure-specific scoring criteria. The median baseline experience of participants as console surgeon was 4 mo (interquartile range [IQR] 0-6.5 mo). All participants completed the curriculum and were involved in a median of 18 RARPs (IQR 14-36) during modular training. The overall score for dVSS tasks significantly increased over the training period (p<0.001-0.005). At the end of the curriculum, eight fellows (80%) were deemed able by their mentors to perform a RARP independently, safely, and effectively. At assessment of the final RARP, the participants achieved an average score ≥4 (scale 1-5) for all domains using the GEARS scale and an average score >10 (scale 4-16) for all procedural steps using a generic dedicated scoring tool. In performance comparison using this scoring tool, the experts significantly outperformed the fellows (mean score for all steps 13.6 vs 11). The European robot-assisted urologic training curriculum is acceptable, valid, and effective for training in RARP. This study shows that a 12-wk structured training program including simulation-based training and mentored training in the operating room allows surgeons with limited robotic experience to increase their robotic skills and their ability to perform the surgical steps of robot-assisted radical prostatectomy. Copyright © 2014 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Effect of Robot-Assisted Game Training on Upper Extremity Function in Stroke Patients

PubMed Central

2017-01-01

Objective To determine the effects of combining robot-assisted game training with conventional upper extremity rehabilitation training (RCT) on motor and daily functions in comparison with conventional upper extremity rehabilitation training (OCT) in stroke patients. Methods Subjects were eligible if they were able to perform the robot-assisted game training and were divided randomly into a RCT and an OCT group. The RCT group performed one daily session of 30 minutes of robot-assisted game training with a rehabilitation robot, plus one daily session of 30 minutes of conventional rehabilitation training, 5 days a week for 2 weeks. The OCT group performed two daily sessions of 30 minutes of conventional rehabilitation training. The effects of training were measured by a Manual Function Test (MFT), Manual Muscle Test (MMT), Korean version of the Modified Barthel Index (K-MBI) and a questionnaire about satisfaction with training. These measurements were taken before and after the 2-week training. Results Both groups contained 25 subjects. After training, both groups showed significant improvements in motor and daily functions measured by MFT, MMT, and K-MBI compared to the baseline. Both groups demonstrated similar training effects, except motor power of wrist flexion. Patients in the RCT group were more satisfied than those in the OCT group. Conclusion There were no significant differences in changes in most of the motor and daily functions between the two types of training. However, patients in the RCT group were more satisfied than those in the OCT group. Therefore, RCT could be a useful upper extremity rehabilitation training method. PMID:28971037

From dV-Trainer to Real Robotic Console: The Limitations of Robotic Skill Training.

PubMed

Yang, Kun; Zhen, Hang; Hubert, Nicolas; Perez, Manuela; Wang, Xing Huan; Hubert, Jacques

To investigate operators' performance quality, mental stress, and ergonomic habits through a training curriculum on robotic simulators. Forty volunteers without robotic surgery experience were recruited to practice 2 exercises on a dV-Trainer (dVT) for 14 hours. The simulator software (M-score a ) provided an automatic evaluation of the overall score for the surgeons' performance. Each participant provided a subjective difficulty score (validity to be proven) for each exercise. Their ergonomic habits were evaluated based on the workspace range and armrest load-validated criteria for evaluating the proficiency of using the armrest. They then repeated the same tasks on a da Vinci Surgical Skill Simulator for a final-level test. Their final scores were compared with their initial scores and the scores of 5 experts on the da Vinci Surgical Skill Simulator. A total of 14 hours of training on the dVT significantly improved the surgeons' performance scores to the expert level with a significantly reduced workload, but their ergonomic score was still far from the expert level. Sufficient training on the dVT improves novices' performance, reduces psychological stress, and inculcates better ergonomic habits. Among the evaluated criteria, novices had the most difficulty in achieving expert levels of ergonomic skills. The training benefits of robotic surgery simulators should be determined with quantified variables. The detection of the limitations during robotic training curricula could guide the targeted training and improve the training effect. Copyright © 2017. Published by Elsevier Inc.

Robotics, motor learning, and neurologic recovery.

PubMed

Reinkensmeyer, David J; Emken, Jeremy L; Cramer, Steven C

2004-01-01

Robotic devices are helping shed light on human motor control in health and injury. By using robots to apply novel force fields to the arm, investigators are gaining insight into how the nervous system models its external dynamic environment. The nervous system builds internal models gradually by experience and uses them in combination with impedance and feedback control strategies. Internal models are robust to environmental and neural noise, generalized across space, implemented in multiple brain regions, and developed in childhood. Robots are also being used to assist in repetitive movement practice following neurologic injury, providing insight into movement recovery. Robots can haptically assess sensorimotor performance, administer training, quantify amount of training, and improve motor recovery. In addition to providing insight into motor control, robotic paradigms may eventually enhance motor learning and rehabilitation beyond the levels possible with conventional training techniques.

The value of haptic feedback in conventional and robot-assisted minimal invasive surgery and virtual reality training: a current review.

PubMed

van der Meijden, O A J; Schijven, M P

2009-06-01

Virtual reality (VR) as surgical training tool has become a state-of-the-art technique in training and teaching skills for minimally invasive surgery (MIS). Although intuitively appealing, the true benefits of haptic (VR training) platforms are unknown. Many questions about haptic feedback in the different areas of surgical skills (training) need to be answered before adding costly haptic feedback in VR simulation for MIS training. This study was designed to review the current status and value of haptic feedback in conventional and robot-assisted MIS and training by using virtual reality simulation. A systematic review of the literature was undertaken using PubMed and MEDLINE. The following search terms were used: Haptic feedback OR Haptics OR Force feedback AND/OR Minimal Invasive Surgery AND/OR Minimal Access Surgery AND/OR Robotics AND/OR Robotic Surgery AND/OR Endoscopic Surgery AND/OR Virtual Reality AND/OR Simulation OR Surgical Training/Education. The results were assessed according to level of evidence as reflected by the Oxford Centre of Evidence-based Medicine Levels of Evidence. In the current literature, no firm consensus exists on the importance of haptic feedback in performing minimally invasive surgery. Although the majority of the results show positive assessment of the benefits of force feedback, results are ambivalent and not unanimous on the subject. Benefits are least disputed when related to surgery using robotics, because there is no haptic feedback in currently used robotics. The addition of haptics is believed to reduce surgical errors resulting from a lack of it, especially in knot tying. Little research has been performed in the area of robot-assisted endoscopic surgical training, but results seem promising. Concerning VR training, results indicate that haptic feedback is important during the early phase of psychomotor skill acquisition.

Research on Safety and Compliance of a New Lower Limb Rehabilitation Robot

PubMed

Feng, Yongfei; Wang, Hongbo; Yan, Hao; Wang, Xincheng; Jin, Zhennan; Vladareanu, Luige

2017-01-01

The lower limb rehabilitation robot is an application of robotic technology for stroke people with lower limb disabilities. A new applicable and effective sitting/lying lower limb rehabilitation robot (LLR-Ro) is proposed, which has the mechanical limit protection, the electrical limit protection, and the software protection to prevent the patient from the secondary damage. Meanwhile, as a new type of the rehabilitation robots, its hip joint rotation ranges are different in the patient sitting training posture and lying training posture. The mechanical leg of the robot has a variable workspace to work in both training postures. So, if the traditional mechanical limit and the electrical limit cannot be used in the hip joint mechanism design, a follow-up limit is first proposed to improve the compatibility of human-machine motion. Besides, to eliminate the accident interaction force between the patient and LLR-Ro in the process of the passive training, an amendment impedance control strategy based on the position control is proposed to improve the compliance of the LLR-Ro. A simulation experiment and an experiment with a participant show that the passive training of LLR-Ro has compliance. © 2017 Yongfei Feng et al.

Training and outcome monitoring in robotic urologic surgery.

PubMed

Liberman, Daniel; Trinh, Quoc-Dien; Jeldres, Claudio; Valiquette, Luc; Zorn, Kevin C

2011-11-08

The use of robot-assisted laparoscopic technology is rapidly expanding, with applicability in numerous disciplines of surgery. Training to perform robot-assisted laparoscopic urological procedures requires a motivated learner, a motivated teacher or proctor, a curriculum with stepwise learning objectives, and regular access to a training robot. In light of the many constraints that limit surgical training, animal models should be utilized to quantifiably improve the surgical skills of residents and surgical fellows, before these skills are put into practice on patients. A system based on appropriate supervision, graduated responsibility, real-time feedback, and objective measure of progress has proven to be safe and effective. Surgical team education directed towards cohesion is perhaps the most important aspect of training. At present, there are very few published guidelines for the safe introduction of robotic urologic surgery at an institution. Increasing evidence demonstrates the effects of learning curve and surgical volume on oncological and functional outcomes in robotic surgery (RS). This necessitates the introduction of mechanisms and guidelines by which trainee surgeons can attain a sufficient level of skill, without compromising the safety of patients. Guidelines for outcome monitoring following RS should be developed, to ensure patient safety and sufficient baseline surgeon skill.

Research on Safety and Compliance of a New Lower Limb Rehabilitation Robot

PubMed Central

Yan, Hao; Wang, Xincheng; Jin, Zhennan; Vladareanu, Luige

2017-01-01

The lower limb rehabilitation robot is an application of robotic technology for stroke people with lower limb disabilities. A new applicable and effective sitting/lying lower limb rehabilitation robot (LLR-Ro) is proposed, which has the mechanical limit protection, the electrical limit protection, and the software protection to prevent the patient from the secondary damage. Meanwhile, as a new type of the rehabilitation robots, its hip joint rotation ranges are different in the patient sitting training posture and lying training posture. The mechanical leg of the robot has a variable workspace to work in both training postures. So, if the traditional mechanical limit and the electrical limit cannot be used in the hip joint mechanism design, a follow-up limit is first proposed to improve the compatibility of human-machine motion. Besides, to eliminate the accident interaction force between the patient and LLR-Ro in the process of the passive training, an amendment impedance control strategy based on the position control is proposed to improve the compliance of the LLR-Ro. A simulation experiment and an experiment with a participant show that the passive training of LLR-Ro has compliance. PMID:29065571

Effects of robot assisted gait training in progressive supranuclear palsy (PSP): a preliminary report

PubMed Central

Sale, Patrizio; Stocchi, Fabrizio; Galafate, Daniele; De Pandis, Maria Francesca; Le Pera, Domenica; Sova, Ivan; Galli, Manuela; Foti, Calogero; Franceschini, Marco

2014-01-01

Background and Purpose: Progressive supranuclear palsy (PSP) is a rare neurodegenerative disease clinically characterized by prominent axial extrapyramidal motor symptoms with frequent falls. Over the last years the introduction of robotic technologies to recover lower limb function has been greatly employed in the rehabilitative practice. This observational trial is aimed at investigating the changes in the main spatiotemporal following end-effector robot training in people with PSP. Method: Pilot observational trial. Participants: Five cognitively intact participants with PSP and gait disorders. Interventions: Patients were submitted to a rehabilitative program of robot-assisted walking sessions for 45 min, 5 times a week for 4 weeks. Main outcome measures: The spatiotemporal parameters at the beginning (T0) and at the end of treatment (T1) were recorded by a gait analysis laboratory. Results: Robot training was feasible, acceptable and safe and all participants completed the prescribed training sessions. All patients showed an improvement in the gait spatiotemporal index (Mean velocity, Cadence, Step length, and Step width) (T0 vs. T1). Conclusions: Robot training is a feasible and safe form of rehabilitation for cognitively intact people with PSP. The lack of side effects and the positive results in the gait parameter index in all patients support the recommendation to extend the trials of this treatment. Further investigation regarding the effectiveness of robot training in time is necessary. Trial registration: ClinicalTrials.gov NCT01668407. PMID:24860459

Robot training of upper limb in multiple sclerosis: comparing protocols with or without manipulative task components.

PubMed

Carpinella, Ilaria; Cattaneo, Davide; Bertoni, Rita; Ferrarin, Maurizio

2012-05-01

In this pilot study, we compared two protocols for robot-based rehabilitation of upper limb in multiple sclerosis (MS): a protocol involving reaching tasks (RT) requiring arm transport only and a protocol requiring both objects' reaching and manipulation (RMT). Twenty-two MS subjects were assigned to RT or RMT group. Both protocols consisted of eight sessions. During RT training, subjects moved the handle of a planar robotic manipulandum toward circular targets displayed on a screen. RMT protocol required patients to reach and manipulate real objects, by moving the robotic arm equipped with a handle which left the hand free for distal tasks. In both trainings, the robot generated resistive and perturbing forces. Subjects were evaluated with clinical and instrumental tests. The results confirmed that MS patients maintained the ability to adapt to the robot-generated forces and that the rate of motor learning increased across sessions. Robot-therapy significantly reduced arm tremor and improved arm kinematics and functional ability. Compared to RT, RMT protocol induced a significantly larger improvement in movements involving grasp (improvement in Grasp ARAT sub-score: RMT 77.4%, RT 29.5%, p=0.035) but not precision grip. Future studies are needed to evaluate if longer trainings and the use of robotic handles would significantly improve also fine manipulation.

Robotic Mining Competition - Activities

NASA Image and Video Library

2018-05-16

On the third day of NASA's 9th Robotic Mining Competition, May 16, a university team cleans their robot miner after its turn in the mining arena at NASA's Kennedy Space Center Visitor Complex in Florida. More than 40 student teams from colleges and universities around the U.S. will use their mining robots to dig in a supersized sandbox filled with BP-1, or simulated Lunar soil, gravel and rocks, and participate in other competition requirements. The Robotic Mining Competition is a NASA Human Exploration and Operations Mission Directorate project designed to encourage students in science, technology, engineering and math, or STEM fields. The project provides a competitive environment to foster innovative ideas and solutions that could be used on NASA's deep space missions.

Trunk robot rehabilitation training with active stepping reorganizes and enriches trunk motor cortex representations in spinal transected rats.

PubMed

Oza, Chintan S; Giszter, Simon F

2015-05-06

Trunk motor control is crucial for postural stability and propulsion after low thoracic spinal cord injury (SCI) in animals and humans. Robotic rehabilitation aimed at trunk shows promise in SCI animal models and patients. However, little is known about the effect of SCI and robot rehabilitation of trunk on cortical motor representations. We previously showed reorganization of trunk motor cortex after adult SCI. Non-stepping training also exacerbated some SCI-driven plastic changes. Here we examine effects of robot rehabilitation that promotes recovery of hindlimb weight support functions on trunk motor cortex representations. Adult rats spinal transected as neonates (NTX rats) at the T9/10 level significantly improve function with our robot rehabilitation paradigm, whereas treadmill-only trained do not. We used intracortical microstimulation to map motor cortex in two NTX groups: (1) treadmill trained (control group); and (2) robot-assisted treadmill trained (improved function group). We found significant robot rehabilitation-driven changes in motor cortex: (1) caudal trunk motor areas expanded; (2) trunk coactivation at cortex sites increased; (3) richness of trunk cortex motor representations, as examined by cumulative entropy and mutual information for different trunk representations, increased; (4) trunk motor representations in the cortex moved toward more normal topography; and (5) trunk and forelimb motor representations that SCI-driven plasticity and compensations had caused to overlap were segregated. We conclude that effective robot rehabilitation training induces significant reorganization of trunk motor cortex and partially reverses some plastic changes that may be adaptive in non-stepping paraplegia after SCI. Copyright © 2015 the authors 0270-6474/15/357174-16$15.00/0.

Improved motor performance in chronic spinal cord injury following upper-limb robotic training.

PubMed

Cortes, Mar; Elder, Jessica; Rykman, Avrielle; Murray, Lynda; Avedissian, Manuel; Stampas, Argyrios; Thickbroom, Gary W; Pascual-Leone, Alvaro; Krebs, Hermano Igo; Valls-Sole, Josep; Edwards, Dylan J

2013-01-01

Recovering upper-limb motor function has important implications for improving independence of patients with tetraplegia after traumatic spinal cord injury (SCI). To evaluate the feasibility, safety and effectiveness of robotic-assisted training of upper limb in a chronic SCI population. A total of 10 chronic tetraplegic SCI patients (C4 to C6 level of injury, American Spinal Injury Association Impairment Scale, A to D) participated in a 6-week wrist-robot training protocol (1 hour/day 3 times/week). The following outcome measures were recorded at baseline and after the robotic training: a) motor performance, assessed by robot-measured kinematics, b) corticospinal excitability measured by transcranial magnetic stimulation (TMS), and c) changes in clinical scales: motor strength (Upper extremity motor score), pain level (Visual Analog Scale) and spasticity (Modified Ashworth scale). No adverse effects were observed during or after the robotic training. Statistically significant improvements were found in motor performance kinematics: aim (pre 1.17 ± 0.11 raduans, post 1.03 ± 0.08 raduans, p = 0.03) and smoothness of movement (pre 0.26 ± 0.03, post 0.31 ± 0.02, p = 0.03). These changes were not accompanied by changes in upper-extremity muscle strength or corticospinal excitability. No changes in pain or spasticity were found. Robotic-assisted training of the upper limb over six weeks is a feasible and safe intervention that can enhance movement kinematics without negatively affecting pain or spasticity in chronic SCI. In addition, robot-assisted devices are an excellent tool to quantify motor performance (kinematics) and can be used to sensitively measure changes after a given rehabilitative intervention.

[Service robots in elderly care. Possible application areas and current state of developments].

PubMed

Graf, B; Heyer, T; Klein, B; Wallhoff, F

2013-08-01

The term "Service robotics" describes semi- or fully autonomous technical systems able to perform services useful to the well-being of humans. Service robots have the potential to support and disburden both persons in need of care as well as nursing care staff. In addition, they can be used in prevention and rehabilitation in order to reduce or avoid the need for help. Products currently available to support people in domestic environments are mainly cleaning or remote-controlled communication robots. Examples of current research activities are the (further) development of mobile robots as advanced communication assistants or the development of (semi) autonomous manipulation aids and multifunctional household assistants. Transport robots are commonly used in many hospitals. In nursing care facilities, the first evaluations have already been made. So-called emotional robots are now sold as products and can be used for therapeutic, occupational, or entertainment activities.

Evaluation of robotic cardiac surgery simulation training: A randomized controlled trial.

PubMed

Valdis, Matthew; Chu, Michael W A; Schlachta, Christopher; Kiaii, Bob

2016-06-01

To compare the currently available simulation training modalities used to teach robotic surgery. Forty surgical trainees completed a standardized robotic 10-cm dissection of the internal thoracic artery and placed 3 sutures of a mitral valve annuloplasty in porcine models and were then randomized to a wet lab, a dry lab, a virtual reality lab, or a control group that received no additional training. All groups trained to a level of proficiency determined by 2 expert robotic cardiac surgeons. All assessments were evaluated using the Global Evaluative Assessment of Robotic Skills in a blinded fashion. Wet lab trainees showed the greatest improvement in time-based scoring and the objective scoring tool compared with the experts (mean, 24.9 ± 1.7 vs 24.9 ± 2.6; P = .704). The virtual reality lab improved their scores and met the level of proficiency set by our experts for all primary outcomes (mean, 24.9 ± 1.7 vs 22.8 ± 3.7; P = .103). Only the control group trainees were not able to meet the expert level of proficiency for both time-based scores and the objective scoring tool (mean, 24.9 ± 1.7 vs 11.0 ± 4.5; P < .001). The average duration of training was shortest for the dry lab and longest for the virtual reality simulation (1.6 hours vs 9.3 hours; P < .001). We have completed the first randomized controlled trial to objectively compare the different training modalities of robotic surgery. Our data demonstrate the significant benefits of wet lab and virtual reality robotic simulation training and highlight key differences in current training methods. This study can help guide training programs in investing resources in cost-effective, high-yield simulation exercises. Copyright © 2016 The American Association for Thoracic Surgery. All rights reserved.

Content and face validity of a comprehensive robotic skills training program for general surgery, urology, and gynecology.

PubMed

Dulan, Genevieve; Rege, Robert V; Hogg, Deborah C; Gilberg-Fisher, Kristine K; Tesfay, Seifu T; Scott, Daniel J

2012-04-01

The authors previously developed a comprehensive, proficiency-based robotic training curriculum that aimed to address 23 unique skills identified via task deconstruction of robotic operations. The purpose of this study was to determine the content and face validity of this curriculum. Expert robotic surgeons (n = 12) rated each deconstructed skill regarding relevance to robotic operations, were oriented to the curricular components, performed 3 to 5 repetitions on the 9 exercises, and rated each exercise. In terms of content validity, experts rated all 23 deconstructed skills as highly relevant (4.5 on a 5-point scale). Ratings for the 9 inanimate exercises indicated moderate to thorough measurement of designated skills. For face validity, experts indicated that each exercise effectively measured relevant skills (100% agreement) and was highly effective for training and assessment (4.5 on a 5-point scale). These data indicate that the 23 deconstructed skills accurately represent the appropriate content for robotic skills training and strongly support content and face validity for this curriculum. Copyright © 2012. Published by Elsevier Inc.

Real-time augmented feedback benefits robotic laparoscopic training.

PubMed

Judkins, Timothy N; Oleynikov, Dmitry; Stergiou, Nick

2006-01-01

Robotic laparoscopic surgery has revolutionized minimally invasive surgery for treatment of abdominal pathologies. However, current training techniques rely on subjective evaluation. There is a lack of research on the type of tasks that should be used for training. Robotic surgical systems also do not currently have the ability to provide feedback to the surgeon regarding success of performing tasks. We trained medical students on three laparoscopic tasks and provided real-time feedback of performance during training. We found that real-time feedback can benefit training if the feedback provides information that is not available through other means (grip force). Subjects that received grip force feedback applied less force when the feedback was removed. Other forms of feedback (speed and relative phase) did not aid or impede training. Secondly, a relatively short training period (10 trials for each task) significantly improved most objective measures of performance. We also showed that robotic surgical performance can be quantitatively measured and evaluated. Providing grip force feedback can make the surgeon more aware of the forces being applied to delicate tissue during surgery.

Robot-assisted walking training for individuals with Parkinson's disease: a pilot randomized controlled trial.

PubMed

Sale, Patrizio; De Pandis, Maria Francesca; Le Pera, Domenica; Sova, Ivan; Cimolin, Veronica; Ancillao, Andrea; Albertini, Giorgio; Galli, Manuela; Stocchi, Fabrizio; Franceschini, Marco

2013-05-24

Over the last years, the introduction of robotic technologies into Parkinson's disease rehabilitation settings has progressed from concept to reality. However, the benefit of robotic training remains elusive. This pilot randomized controlled observer trial is aimed at investigating the feasibility, the effectiveness and the efficacy of new end-effector robot training in people with mild Parkinson's disease. Design. Pilot randomized controlled trial. Robot training was feasible, acceptable, safe, and the participants completed 100% of the prescribed training sessions. A statistically significant improvement in gait index was found in favour of the EG (T0 versus T1). In particular, the statistical analysis of primary outcome (gait speed) using the Friedman test showed statistically significant improvements for the EG (p = 0,0195). The statistical analysis performed by Friedman test of Step length left (p = 0,0195) and right (p = 0,0195) and Stride length left (p = 0,0078) and right (p = 0,0195) showed a significant statistical gain. No statistically significant improvements on the CG were found. Robot training is a feasible and safe form of rehabilitative exercise for cognitively intact people with mild PD. This original approach can contribute to increase a short time lower limb motor recovery in idiopathic PD patients. The focus on the gait recovery is a further characteristic that makes this research relevant to clinical practice. On the whole, the simplicity of treatment, the lack of side effects, and the positive results from patients support the recommendation to extend the use of this treatment. Further investigation regarding the long-time effectiveness of robot training is warranted. ClinicalTrials.gov NCT01668407.

Construction of a Urologic Robotic Surgery Training Curriculum: How Many Simulator Sessions Are Required for Residents to Achieve Proficiency?

PubMed

Wiener, Scott; Haddock, Peter; Shichman, Steven; Dorin, Ryan

2015-11-01

To define the time needed by urology residents to attain proficiency in computer-aided robotic surgery to aid in the refinement of a robotic surgery simulation curriculum. We undertook a retrospective review of robotic skills training data acquired during January 2012 to December 2014 from junior (postgraduate year [PGY] 2-3) and senior (PGY4-5) urology residents using the da Vinci Skills Simulator. We determined the number of training sessions attended and the level of proficiency achieved by junior and senior residents in attempting 11 basic or 6 advanced tasks, respectively. Junior residents successfully completed 9.9 ± 1.8 tasks, with 62.5% completing all 11 basic tasks. The maximal cumulative success rate of junior residents completing basic tasks was 89.8%, which was achieved within 7.0 ± 1.5 hours of training. Of senior residents, 75% successfully completed all six advanced tasks. Senior residents attended 6.3 ± 3.5 hours of training during which 5.1 ± 1.6 tasks were completed. The maximal cumulative success rate of senior residents completing advanced tasks was 85.4%. When designing and implementing an effective robotic surgical training curriculum, an allocation of 10 hours of training may be optimal to allow junior and senior residents to achieve an acceptable level of surgical proficiency in basic and advanced robotic surgical skills, respectively. These data help guide the design and scheduling of a residents training curriculum within the time constraints of a resident's workload.

A pilot study of surgical training using a virtual robotic surgery simulator.

PubMed

Tergas, Ana I; Sheth, Sangini B; Green, Isabel C; Giuntoli, Robert L; Winder, Abigail D; Fader, Amanda N

2013-01-01

Our objectives were to compare the utility of learning a suturing task on the virtual reality da Vinci Skills Simulator versus the da Vinci Surgical System dry laboratory platform and to assess user satisfaction among novice robotic surgeons. Medical trainees were enrolled prospectively; one group trained on the virtual reality simulator, and the other group trained on the da Vinci dry laboratory platform. Trainees received pretesting and post-testing on the dry laboratory platform. Participants then completed an anonymous online user experience and satisfaction survey. We enrolled 20 participants. Mean pretest completion times did not significantly differ between the 2 groups. Training with either platform was associated with a similar decrease in mean time to completion (simulator platform group, 64.9 seconds [P = .04]; dry laboratory platform group, 63.9 seconds [P < .01]). Most participants (58%) preferred the virtual reality platform. The majority found the training "definitely useful" in improving robotic surgical skills (mean, 4.6) and would attend future training sessions (mean, 4.5). Training on the virtual reality robotic simulator or the dry laboratory robotic surgery platform resulted in significant improvements in time to completion and economy of motion for novice robotic surgeons. Although there was a perception that both simulators improved performance, there was a preference for the virtual reality simulator. Benefits unique to the simulator platform include autonomy of use, computerized performance feedback, and ease of setup. These features may facilitate more efficient and sophisticated simulation training above that of the conventional dry laboratory platform, without loss of efficacy.

A Comparison of Robotic, Body Weight-Supported Locomotor Training and Aquatic Therapy in Chronic Motor Incomplete Spinal Cord Injury Subjects

DTIC Science & Technology

2014-10-01

Award Number:W81XWH-10-1-0981 TITLE:“A Comparison of Robotic, Body Weight-Supported Locomotor Training and Aquatic Therapy in Chronic Motor...three months, three times a week aquatic therapy with similar intensity robotically assisted, body weight supported aerobic treadmill training upon...incomplete spinal cord injury (MISCI). Thirty-seven individuals with chronic MISCI enrolled in this study. We hypothesized aquatic therapy would be

Development of rehabilitation training support system for occupational therapy of upper limb motor function

NASA Astrophysics Data System (ADS)

Morita, Yoshifumi; Hirose, Akinori; Uno, Takashi; Uchid, Masaki; Ukai, Hiroyuki; Matsui, Nobuyuki

2007-12-01

In this paper we propose a new rehabilitation training support system for upper limbs. The proposed system enables therapists to quantitatively evaluate the therapeutic effect of upper limb motor function during training, to easily change the load of resistance of training and to easily develop a new training program suitable for the subjects. For this purpose we develop control algorithms of training programs in the 3D force display robot. The 3D force display robot has parallel link mechanism with three motors. The control algorithm simulating sanding training is developed for the 3D force display robot. Moreover the teaching/training function algorithm is developed. It enables the therapists to easily make training trajectory suitable for subject's condition. The effectiveness of the developed control algorithms is verified by experiments.

Effects of Robot-assisted Gait Training Combined with Functional Electrical Stimulation on Recovery of Locomotor Mobility in Chronic Stroke Patients: A Randomized Controlled Trial.

PubMed

Bae, Young-Hyeon; Ko, Young Jun; Chang, Won Hyuk; Lee, Ju Hyeok; Lee, Kyeong Bong; Park, Yoo Jung; Ha, Hyun Geun; Kim, Yun-Hee

2014-12-01

[Purpose] The purpose of the present study was to investigate the effects of robot-assisted gait training combined with functional electrical stimulation on locomotor recovery in patients with chronic stroke. [Subjects] The 20 subjects were randomly assigned into either an experimental group (n = 10) that received a combination of robot-assisted gait training and functional electrical stimulation on the ankle dorsiflexor of the affected side or a control group (n = 10) that received robot-assisted gait training only. [Methods] Both groups received the respective therapies for 30 min/day, 3 days/week for 5 weeks. The outcome was measured using the Modified Motor Assessment Scale (MMAS), Timed Up-and-Go Test (TUG), Berg Balance Scale (BBS), and gait parameters through gait analysis (Vicon 370 motion analysis system, Oxford Metrics Ltd., Oxford, UK). All the variables were measured before and after training. [Results] Step length and maximal knee extension were significantly greater than those before training in the experimental group only. Maximal Knee flexion showed a significant difference between the experimental and control groups. The MMAS, BBS, and TUG scores improved significantly after training compared with before training in both groups. [Conclusion] We suggest that the combination of robot-assisted gait training and functional electrical stimulation encourages patients to actively participate in training because it facilitates locomotor recovery without the risk of adverse effects.

Automation, robotics, and inflight training for manned Mars missions

NASA Technical Reports Server (NTRS)

Holt, Alan C.

1986-01-01

The automation, robotics, and inflight training requirements of manned Mars missions will be supported by similar capabilities developed for the space station program. Evolutionary space station onboard training facilities will allow the crewmembers to minimize the amount of training received on the ground by providing extensive onboard access to system and experiment malfunction procedures, maintenance procedures, repair procedures, and associated video sequences. Considerable on-the-job training will also be conducted for space station management, mobile remote manipulator operations, proximity operations with the Orbital Maneuvering Vehicle (and later the Orbit Transfer Vehicle), and telerobotics and mobile robots. A similar approach could be used for manned Mars mission training with significant additions such as high fidelity image generation and simulation systems such as holographic projection systems for Mars landing, ascent, and rendezvous training. In addition, a substantial increase in the use of automation and robotics for hazardous and tedious tasks would be expected for Mars mission. Mobile robots may be used to assist in the assembly, test and checkout of the Mars spacecraft, in the handling of nuclear components and hazardous chemical propellent transfer operations, in major spacecraft repair tasks which might be needed (repair of a micrometeroid penetration, for example), in the construction of a Mars base, and for routine maintenance of the base when unmanned.

General surgery training and robotics: Are residents improving their skills?

PubMed

Finnerty, Brendan M; Afaneh, Cheguevara; Aronova, Anna; Fahey, Thomas J; Zarnegar, Rasa

2016-02-01

While robotic-assisted operations have become more prevalent, many general surgery residencies do not have a formal robotic training curriculum. We sought to ascertain how well current general surgery training permits acquisition of robotic skills by comparing robotic simulation performance across various training levels. Thirty-six participants were categorized by level of surgical training: eight medical students (MS), ten junior residents (JR), ten mid-level residents (MLR), and eight senior residents (SR). Participants performed three simulation tasks on the da Vinci (®) Skills Simulator (MatchBoard, EnergyDissection, SutureSponge). Each task's scores (0-100) and cumulative scores (0-300) were compared between groups. There were no differences in sex, hand dominance, video gaming history, or prior robotic experience between groups; however, SR was the oldest (p < 0.001). The median overall scores did not differ: 188 (84-201) for MS, 183 (91-234) for JR, 197 (153-218) for MLR, and 205 (169-229) for SR (p = 0.14). The median SutureSponge score was highest for SR (61, range 39-81) compared to MS (43, range 26-61), JR (43, range 11-72), and MLR (55, range 36-68) (p = 0.039). However, there were no significant differences in MatchBoard (p = 0.27) or EnergyDissection (p = 0.99) scores between groups. There was a positive correlation between SutureSponge score and number of laparoscopic cases logged (p = 0.005, r(2) = 0.21), but this correlation did not exist for the MatchBoard or EnergyDissection tasks. Lastly, there was no correlation between total lifetime hours of video gaming and overall score (p = 0.89, R(2) = 0.0006). Robotic skillsets acquired during general surgery residency show minimal improvement during the course of training, although laparoscopic experience is correlated with advanced robotic task performance. Changes in residency curricula or pursuit of fellowship training may be warranted for surgeons seeking proficiency.

Current robotic curricula for surgery residents: A need for additional cognitive and psychomotor focus.

PubMed

Green, Courtney A; Chern, Hueylan; O'Sullivan, Patricia S

2018-02-01

Current robot surgery curricula developed by industry were designed for expert surgeons. We sought to identify the robotic curricula that currently exist in general surgery residencies and describe their components. We identified 12 residency programs with robotic curricula. Using a structured coding form to identify themes including sequence, duration, emphasis and assessment, we generated a descriptive summary. Curricula followed a similar sequence: learners started with online modules and simulation exercises, followed by bedside experience during R2-R3 training years, and then operative opportunities on the console in the final years of training. Consistent portions of the curricula reflect a device-dependent training paradigm; they defined the sequence of instruction. Most curricula lacked specifics on duration and content of training activities. None clearly described cognitive or psychomotor skills needed by residents and none required a proficiency assessment before graduation. Resident-specific robotic curricula remain grounded in initial industrial efforts to train experienced surgeons, are non-specific regarding the type and nature of hands on experience, and do not include discussion of operative technique and surgical concepts. Copyright © 2017 Elsevier Inc. All rights reserved.

Functional impacts of exoskeleton-based rehabilitation in chronic stroke: multi-joint versus single-joint robotic training

PubMed Central

2013-01-01

Stroke is a major cause of disability in the world. The activities of upper limb segments are often compromised following a stroke, impairing most daily tasks. Robotic training is now considered amongst the rehabilitation methods applied to promote functional recovery. However, the implementation of robotic devices remains a major challenge for the bioengineering and clinical community. Latest exoskeletons with multiple degrees of freedom (DOF) may become particularly attractive, because of their low apparent inertia, the multiple actuators generating large torques, and the fact that patients can move the arm in the normal wide workspace. A recent study published in JNER by Milot and colleagues underlines that training with a 6-DOF exoskeleton impacts positively on motor function in patients being in stable phase of recovery after a stroke. Also, multi-joint robotic training was not found to be superior to single-joint robotic training. Although it is often considered that rehabilitation should start from simple movements to complex functional movements as the recovery evolves, this study challenges this widespread notion whose scientific basis has remained uncertain. PMID:24354518

Intensive Sensorimotor Arm Training Mediated by Therapist or Robot Improves Hemiparesis in Patients With Chronic Stroke

PubMed Central

Volpe, Bruce T.; Lynch, Daniel; Rykman-Berland, Avrielle; Ferraro, Mark; Galgano, Michael; Hogan, Neville; Krebs, Hermano I.

2016-01-01

Investigators have demonstrated that a variety of intensive movement training protocols for persistent upper limb paralysis in patients with chronic stroke (6 months or more after stroke) improve motor outcome. This randomized controlled study determined in patients with upper limb motor impairment after chronic stroke whether movement therapy delivered by a robot or by a therapist using an intensive training protocol was superior. Robotic training (n = 11) and an intensive movement protocol (n = 10) improved the impairment measures of motor outcome significantly and comparably; there were no significant changes in disability measures. Motor gains were maintained at the 3-month evaluation after training. These data contribute to the growing awareness that persistent impairments in those with chronic stroke may not reflect exhausted capacity for improvement. These new protocols, rendered by either therapist or robot, can be standardized, tested, and replicated, and potentially will contribute to rational activity-based programs. PMID:18184932

Training a Network of Electronic Neurons for Control of a Mobile Robot

NASA Astrophysics Data System (ADS)

Vromen, T. G. M.; Steur, E.; Nijmeijer, H.

An adaptive training procedure is developed for a network of electronic neurons, which controls a mobile robot driving around in an unknown environment while avoiding obstacles. The neuronal network controls the angular velocity of the wheels of the robot based on the sensor readings. The nodes in the neuronal network controller are clusters of neurons rather than single neurons. The adaptive training procedure ensures that the input-output behavior of the clusters is identical, even though the constituting neurons are nonidentical and have, in isolation, nonidentical responses to the same input. In particular, we let the neurons interact via a diffusive coupling, and the proposed training procedure modifies the diffusion interaction weights such that the neurons behave synchronously with a predefined response. The working principle of the training procedure is experimentally validated and results of an experiment with a mobile robot that is completely autonomously driving in an unknown environment with obstacles are presented.

Virtual reality-assisted robotic surgery simulation.

PubMed

Albani, Justin M; Lee, David I

2007-03-01

For more than a decade, advancing computer technologies have allowed incorporation of virtual reality (VR) into surgical training. This has become especially important in training for laparoscopic procedures, which often are complex and leave little room for error. With the advent of robotic surgery and the development and prevalence of a commercial surgical system (da Vinci robot; Intuitive Surgical, Sunnyvale, CA), a valid VR-assisted robotic surgery simulator could minimize the steep learning curve associated with many of these complex procedures and thus enable better outcomes. To date, such simulation does not exist; however, several agencies and corporations are involved in making this dream a reality. We review the history and progress of VR simulation in surgical training, its promising applications in robotic-assisted surgery, and the remaining challenges to implementation.

Early poststroke rehabilitation using a robotic tilt-table stepper and functional electrical stimulation.

PubMed

Kuznetsov, Alexey N; Rybalko, Natalia V; Daminov, Vadim D; Luft, Andreas R

2013-01-01

Background. Stroke frequently leaves survivors with hemiparesis. To prevent persistent deficits, rehabilitation may be more effective if started early. Early training is often limited because of orthostatic reactions. Tilt-table stepping robots and functional electrical stimulation (FES) may prevent these reactions. Objective. This controlled convenience sample study compares safety and feasibility of robotic tilt-table training plus FES (ROBO-FES) and robotic tilt-table training (ROBO) against tilt-table training alone (control). A preliminary assessment of efficacy is performed. Methods. Hemiparetic ischemic stroke survivors (age 58.3 ± 1.2 years, 4.6 ± 1.2 days after stroke) were assigned to 30 days of ROBO-FES (n = 38), ROBO (n = 35), or control (n = 31) in addition to conventional physical therapy. Impedance cardiography and transcranial doppler sonography were performed before, during, and after training. Hemiparesis was assessed using the British Medical Research Council (MRC) strength scale. Results. No serious adverse events occurred; 8 patients in the tilt-table group prematurely quit the study because of orthostatic reactions. Blood pressure and CBFV dipped <10% during robot training. In 52% of controls mean arterial pressure decreased by ≥20%. ROBO-FES increased leg strength by 1.97 ± 0.88 points, ROBO by 1.50 ± 0.85 more than control (1.03 ± 0.61, P < 0.05). CBFV increased in both robotic groups more than in controls (P < 0.05). Conclusions. Robotic tilt-table exercise with or without FES is safe and may be more effective in improving leg strength and cerebral blood flow than tilt table alone.

Early Poststroke Rehabilitation Using a Robotic Tilt-Table Stepper and Functional Electrical Stimulation

PubMed Central

Kuznetsov, Alexey N.; Rybalko, Natalia V.; Daminov, Vadim D.; Luft, Andreas R.

2013-01-01

Background. Stroke frequently leaves survivors with hemiparesis. To prevent persistent deficits, rehabilitation may be more effective if started early. Early training is often limited because of orthostatic reactions. Tilt-table stepping robots and functional electrical stimulation (FES) may prevent these reactions. Objective. This controlled convenience sample study compares safety and feasibility of robotic tilt-table training plus FES (ROBO-FES) and robotic tilt-table training (ROBO) against tilt-table training alone (control). A preliminary assessment of efficacy is performed. Methods. Hemiparetic ischemic stroke survivors (age 58.3 ± 1.2 years, 4.6 ± 1.2 days after stroke) were assigned to 30 days of ROBO-FES (n = 38), ROBO (n = 35), or control (n = 31) in addition to conventional physical therapy. Impedance cardiography and transcranial doppler sonography were performed before, during, and after training. Hemiparesis was assessed using the British Medical Research Council (MRC) strength scale. Results. No serious adverse events occurred; 8 patients in the tilt-table group prematurely quit the study because of orthostatic reactions. Blood pressure and CBFV dipped <10% during robot training. In 52% of controls mean arterial pressure decreased by ≥20%. ROBO-FES increased leg strength by 1.97 ± 0.88 points, ROBO by 1.50 ± 0.85 more than control (1.03 ± 0.61, P < 0.05). CBFV increased in both robotic groups more than in controls (P < 0.05). Conclusions. Robotic tilt-table exercise with or without FES is safe and may be more effective in improving leg strength and cerebral blood flow than tilt table alone. PMID:23691432

Robotic Assistance for Training Finger Movement Using a Hebbian Model: A Randomized Controlled Trial.

PubMed

Rowe, Justin B; Chan, Vicky; Ingemanson, Morgan L; Cramer, Steven C; Wolbrecht, Eric T; Reinkensmeyer, David J

2017-08-01

Robots that physically assist movement are increasingly used in rehabilitation therapy after stroke, yet some studies suggest robotic assistance discourages effort and reduces motor learning. To determine the therapeutic effects of high and low levels of robotic assistance during finger training. We designed a protocol that varied the amount of robotic assistance while controlling the number, amplitude, and exerted effort of training movements. Participants (n = 30) with a chronic stroke and moderate hemiparesis (average Box and Blocks Test 32 ± 18 and upper extremity Fugl-Meyer score 46 ± 12) actively moved their index and middle fingers to targets to play a musical game similar to GuitarHero 3 h/wk for 3 weeks. The participants were randomized to receive high assistance (causing 82% success at hitting targets) or low assistance (55% success). Participants performed ~8000 movements during 9 training sessions. Both groups improved significantly at the 1-month follow-up on functional and impairment-based motor outcomes, on depression scores, and on self-efficacy of hand function, with no difference between groups in the primary endpoint (change in Box and Blocks). High assistance boosted motivation, as well as secondary motor outcomes (Fugl-Meyer and Lateral Pinch Strength)-particularly for individuals with more severe finger motor deficits. Individuals with impaired finger proprioception at baseline benefited less from the training. Robot-assisted training can promote key psychological outcomes known to modulate motor learning and retention. Furthermore, the therapeutic effectiveness of robotic assistance appears to derive at least in part from proprioceptive stimulation, consistent with a Hebbian plasticity model.

Validation of a novel virtual reality simulator for robotic surgery.

PubMed

Schreuder, Henk W R; Persson, Jan E U; Wolswijk, Richard G H; Ihse, Ingmar; Schijven, Marlies P; Verheijen, René H M

2014-01-01

With the increase in robotic-assisted laparoscopic surgery there is a concomitant rising demand for training methods. The objective was to establish face and construct validity of a novel virtual reality simulator (dV-Trainer, Mimic Technologies, Seattle, WA) for the use in training of robot-assisted surgery. A comparative cohort study was performed. Participants (n = 42) were divided into three groups according to their robotic experience. To determine construct validity, participants performed three different exercises twice. Performance parameters were measured. To determine face validity, participants filled in a questionnaire after completion of the exercises. Experts outperformed novices in most of the measured parameters. The most discriminative parameters were "time to complete" and "economy of motion" (P < 0.001). The training capacity of the simulator was rated 4.6 ± 0.5 SD on a 5-point Likert scale. The realism of the simulator in general, visual graphics, movements of instruments, interaction with objects, and the depth perception were all rated as being realistic. The simulator is considered to be a very useful training tool for residents and medical specialist starting with robotic surgery. Face and construct validity for the dV-Trainer could be established. The virtual reality simulator is a useful tool for training robotic surgery.

Validation of a Novel Virtual Reality Simulator for Robotic Surgery

PubMed Central

Schreuder, Henk W. R.; Persson, Jan E. U.; Wolswijk, Richard G. H.; Ihse, Ingmar; Schijven, Marlies P.; Verheijen, René H. M.

2014-01-01

Objective. With the increase in robotic-assisted laparoscopic surgery there is a concomitant rising demand for training methods. The objective was to establish face and construct validity of a novel virtual reality simulator (dV-Trainer, Mimic Technologies, Seattle, WA) for the use in training of robot-assisted surgery. Methods. A comparative cohort study was performed. Participants (n = 42) were divided into three groups according to their robotic experience. To determine construct validity, participants performed three different exercises twice. Performance parameters were measured. To determine face validity, participants filled in a questionnaire after completion of the exercises. Results. Experts outperformed novices in most of the measured parameters. The most discriminative parameters were “time to complete” and “economy of motion” (P < 0.001). The training capacity of the simulator was rated 4.6 ± 0.5 SD on a 5-point Likert scale. The realism of the simulator in general, visual graphics, movements of instruments, interaction with objects, and the depth perception were all rated as being realistic. The simulator is considered to be a very useful training tool for residents and medical specialist starting with robotic surgery. Conclusions. Face and construct validity for the dV-Trainer could be established. The virtual reality simulator is a useful tool for training robotic surgery. PMID:24600328

Manual cleaning of hospital mattresses: an observational study comparing high- and low-resource settings.

PubMed

Hopman, J; Hakizimana, B; Meintjes, W A J; Nillessen, M; de Both, E; Voss, A; Mehtar, S

2016-01-01

Hospital-associated infections (HAIs) are more frequently encountered in low- than in high-resource settings. There is a need to identify and implement feasible and sustainable approaches to strengthen HAI prevention in low-resource settings. To evaluate the biological contamination of routinely cleaned mattresses in both high- and low-resource settings. In this two-stage observational study, routine manual bed cleaning was evaluated at two university hospitals using adenosine triphosphate (ATP). Standardized training of cleaning personnel was achieved in both high- and low-resource settings. Qualitative analysis of the cleaning process was performed to identify predictors of cleaning outcome in low-resource settings. Mattresses in low-resource settings were highly contaminated prior to cleaning. Cleaning significantly reduced biological contamination of mattresses in low-resource settings (P < 0.0001). After training, the contamination observed after cleaning in both the high- and low-resource settings seemed comparable. Cleaning with appropriate type of cleaning materials reduced the contamination of mattresses adequately. Predictors for mattresses that remained contaminated in a low-resource setting included: type of product used, type of ward, training, and the level of contamination prior to cleaning. In low-resource settings mattresses were highly contaminated as noted by ATP levels. Routine manual cleaning by trained staff can be as effective in a low-resource setting as in a high-resource setting. We recommend a multi-modal cleaning strategy that consists of training of domestic services staff, availability of adequate time to clean beds between patients, and application of the correct type of cleaning products. Copyright © 2015 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

All-Metal Tires

NASA Technical Reports Server (NTRS)

Bickler, Donald B.; Sword, Lee F.; Lindemann, Randel A.

1994-01-01

Tires used where elastomeric and pneumatic tires would not function. Metal tires withstand extreme temperatures. Used on Earth for vehicles and robots that fight fires or clean up dangerous chemicals.

Robot-assisted walking training for individuals with Parkinson’s disease: a pilot randomized controlled trial

PubMed Central

2013-01-01

Background Over the last years, the introduction of robotic technologies into Parkinson’s disease rehabilitation settings has progressed from concept to reality. However, the benefit of robotic training remains elusive. This pilot randomized controlled observer trial is aimed at investigating the feasibility, the effectiveness and the efficacy of new end-effector robot training in people with mild Parkinson’s disease. Methods Design. Pilot randomized controlled trial. Setting. Robot assisted gait training (EG) compared to treadmill training (CG). Participants. Twenty cognitively intact participants with mild Parkinson’s disease and gait disturbance. Interventions. The EG underwent a rehabilitation programme of robot assisted walking for 40 minutes, 5 times a week for 4 weeks. The CG received a treadmill training programme for 40 minutes, 5 times a week for 4 weeks. Main outcome measures. The outcome measure of efficacy was recorded by gait analysis laboratory. The assessments were performed at the beginning (T0) and at the end of the treatment (T1). The main outcome was the change in velocity. The feasibility of the intervention was assessed by recording exercise adherence and acceptability by specific test. Results Robot training was feasible, acceptable, safe, and the participants completed 100% of the prescribed training sessions. A statistically significant improvement in gait index was found in favour of the EG (T0 versus T1). In particular, the statistical analysis of primary outcome (gait speed) using the Friedman test showed statistically significant improvements for the EG (p = 0,0195). The statistical analysis performed by Friedman test of Step length left (p = 0,0195) and right (p = 0,0195) and Stride length left (p = 0,0078) and right (p = 0,0195) showed a significant statistical gain. No statistically significant improvements on the CG were found. Conclusions Robot training is a feasible and safe form of rehabilitative exercise for cognitively intact people with mild PD. This original approach can contribute to increase a short time lower limb motor recovery in idiopathic PD patients. The focus on the gait recovery is a further characteristic that makes this research relevant to clinical practice. On the whole, the simplicity of treatment, the lack of side effects, and the positive results from patients support the recommendation to extend the use of this treatment. Further investigation regarding the long-time effectiveness of robot training is warranted. Trial registration ClinicalTrials.gov NCT01668407 PMID:23706025

Troubleshooting of an Electromechanical System (Westinghouse PLC Controlling a Pneumatic Robot). High-Technology Training Module.

ERIC Educational Resources Information Center

Tucker, James D.

This training module on the troubleshooting of an electromechanical system, The Westinghouse Programmable Logic Controller (PLC) controlling a pneumatic robot, is used for a troubleshooting unit in an electromechanical systems/robotics and automation systems course. In this unit, students locate and repair a defect in a PLC-operated machine. The…

Effects of electromyography-driven robot-aided hand training with neuromuscular electrical stimulation on hand control performance after chronic stroke.

PubMed

Rong, Wei; Tong, Kai Yu; Hu, Xiao Ling; Ho, Sze Kit

2015-03-01

An electromyography-driven robot system integrated with neuromuscular electrical stimulation (NMES) was developed to investigate its effectiveness on post-stroke rehabilitation. The performance of this system in assisting finger flexion/extension with different assistance combinations was evaluated in five stroke subjects. Then, a pilot study with 20-sessions training was conducted to evaluate the training's effectiveness. The results showed that combined assistance from the NMES-robot could improve finger movement accuracy, encourage muscle activation of the finger muscles and suppress excessive muscular activities in the elbow joint. When assistances from both NMES and the robot were 50% of their maximum assistances, finger-tracking performance had the best results, with the lowest root mean square error, greater range of motion, higher voluntary muscle activations of the finger joints and lower muscle co-contraction in the finger and elbow joints. Upper limb function improved after the 20-session training, indicated by the increased clinical scores of Fugl-Meyer Assessment, Action Research Arm Test and Wolf Motor Function Test. Muscle co-contraction was reduced in the finger and elbow joints reflected by the Modified Ashworth Scale. The findings demonstrated that an electromyography-driven NMES-robot used for chronic stroke improved hand function and tracking performance. Further research is warranted to validate the method on a larger scale. Implications for Rehabilitation The hand robotics and neuromuscular electrical stimulation (NMES) techniques are still separate systems in current post-stroke hand rehabilitation. This is the first study to investigate the combined effects of the NMES and robot on hand rehabilitation. The finger tracking performance was improved with the combined assistance from the EMG-driven NMES-robot hand system. The assistance from the robot could improve the finger movement accuracy and the assistance from the NMES could reduce the muscle co-contraction on finger and elbow joints. The upper limb functions were improved on chronic stroke patients after the pilot study of 20-session hand training with the combined assistance from the EMG-driven NMES-robot. The muscle spasticity on finger and elbow joints was reduced after the training.

`An observational report of intensive robotic and manual gait training in sub-acute stroke

PubMed Central

2012-01-01

Background The use of automated electromechanical devices for gait training in neurological patients is increasing, yet the functional outcomes of well-defined training programs using these devices and the characteristics of patients that would most benefit are seldom reported in the literature. In an observational study of functional outcomes, we aimed to provide a benchmark for expected change in gait function in early stroke patients, from an intensive inpatient rehabilitation program including both robotic and manual gait training. Methods We followed 103 sub-acute stroke patients who met the clinical inclusion criteria for Body Weight Supported Robotic Gait Training (BWSRGT). Patients completed an intensive 8-week gait-training program comprising robotic gait training (weeks 0-4) followed by manual gait training (weeks 4-8). A change in clinical function was determined by the following assessments taken at 0, 4 and 8 weeks (baseline, mid-point and end-point respectively): Functional Ambulatory Categories (FAC), 10 m Walking Test (10 MWT), and Tinetti Gait and Balance Scales. Results Over half of the patients made a clinically meaningful improvement on the Tinetti Gait Scale (> 3 points) and Tinetti Balance Scale (> 5 points), while over 80% of the patients increased at least 1 point on the FAC scale (0-5) and improved walking speed by more than 0.2 m/s. Patients responded positively in gait function regardless of variables gender, age, aetiology (hemorrhagic/ischemic), and affected hemisphere. The most robust and significant change was observed for patients in the FAC categories two and three. The therapy was well tolerated and no patients withdrew for factors related to the type or intensity of training. Conclusions Eight-weeks of intensive rehabilitation including robotic and manual gait training was well tolerated by early stroke patients, and was associated with significant gains in function. Patients with mid-level gait dysfunction showed the most robust improvement following robotic training. PMID:22329866

Implementing a robotics curriculum at an academic general surgery training program: our initial experience.

PubMed

Winder, Joshua S; Juza, Ryan M; Sasaki, Jennifer; Rogers, Ann M; Pauli, Eric M; Haluck, Randy S; Estes, Stephanie J; Lyn-Sue, Jerome R

2016-09-01

The robotic surgical platform is being utilized by a growing number of hospitals across the country, including academic medical centers. Training programs are tasked with teaching their residents how to utilize this technology. To this end, we have developed and implemented a robotic surgical curriculum, and share our initial experience here. Our curriculum was implemented for all General Surgical residents for the academic year 2014-2015. The curriculum consisted of online training, readings, bedside training, console simulation, participating in ten cases as bedside first assistant, and operating at the console. 20 surgical residents were included. Residents were provided the curriculum and notified the department upon completion. Bedside assistance and operative console training were completed in the operating room through a mix of biliary, foregut, and colorectal cases. During the fiscal years of 2014 and 2015, there were 164 and 263 robot-assisted surgeries performed within the General Surgery Department, respectively. All 20 residents completed the online and bedside instruction portions of the curriculum. Of the 20 residents trained, 13/20 (65 %) sat at the Surgeon console during at least one case. Utilizing this curriculum, we have trained and incorporated residents into robot-assisted cases in an efficient manner. A successful curriculum must be based on didactic learning, reading, bedside training, simulation, and training in the operating room. Each program must examine their caseload and resident class to ensure proper exposure to this platform.

Satisfaction and perceptions of long-term manual wheelchair users with a spinal cord injury upon completion of a locomotor training program with an overground robotic exoskeleton.

PubMed

Gagnon, Dany H; Vermette, Martin; Duclos, Cyril; Aubertin-Leheudre, Mylène; Ahmed, Sara; Kairy, Dahlia

2017-12-19

The main objectives of this study were to quantify clients' satisfaction and perception upon completion of a locomotor training program with an overground robotic exoskeleton. A group of 14 wheelchair users with a spinal cord injury, who finished a 6-8-week locomotor training program with the robotic exoskeleton (18 training sessions), were invited to complete a web-based electronic questionnaire. This questionnaire encompassed 41 statements organized around seven key domains: overall satisfaction related to the training program, satisfaction related to the overground robotic exoskeleton, satisfaction related to the program attributes, perceived learnability, perceived health benefits and risks and perceived motivation to engage in physical activity. Each statement was rated using a visual analogue scale ranging from "0 = totally disagree" to "100 = completely agree". Overall, respondents unanimously considered themselves satisfied with the locomotor training program with the robotic exoskeleton (95.7 ± 0.7%) and provided positive feedback about the robotic exoskeleton itself (82.3 ± 6.9%), the attributes of the locomotor training program (84.5 ± 6.9%) and their ability to learn to perform sit-stand transfers and walk with the robotic exoskeleton (79.6 ± 17%). Respondents perceived some health benefits (67.9 ± 16.7%) and have reported no fear of developing secondary complications or of potential risk for themselves linked to the use of the robotic exoskeleton (16.7 ± 8.2%). At the end of the program, respondents felt motivated to engage in a regular physical activity program (91.3 ± 0.1%). This study provides new insights on satisfaction and perceptions of wheelchair users while also confirming the relevance to continue to improve such technologies, and informing the development of future clinical trials. Implications for Rehabilitation All long-term manual wheelchair users with a spinal cord injury who participated in the study are unanimously satisfied upon completion of a 6-8-week locomotor training program with the robotic exoskeleton and would recommend the program to their peers. All long-term manual wheelchair users with a spinal cord injury who participated in the study offered positive feedback about the robotic exoskeleton itself and feel it is easy to learn to perform sit-stand transfers and walk with the robotic exoskeleton. All long-term manual wheelchair users with a spinal cord injury who participated in the study predominantly perceived improvements in their overall health status, upper limb strength and endurance as well as in their sleep and psychological well-being upon completion of a 6-8-week locomotor training program with the robotic exoskeleton. All long-term manual wheelchair users with a spinal cord injury who participated in the study unanimously felt motivated to engage in a regular physical activity program adapted to their condition and most of them do plan to continue to participate in moderate-to-strenuous physical exercise. Additional research on clients' perspectives, especially satisfaction with the overground exoskeleton and locomotor training program attributes, is needed.

Control strategies for effective robot assisted gait rehabilitation: the state of art and future prospects.

PubMed

Cao, Jinghui; Xie, Sheng Quan; Das, Raj; Zhu, Guo L

2014-12-01

A large number of gait rehabilitation robots, together with a variety of control strategies, have been developed and evaluated during the last decade. Initially, control strategies applied to rehabilitation robots were adapted from those applied to traditional industrial robots. However, these strategies cannot optimise effectiveness of gait rehabilitation. As a result, researchers have been investigating control strategies tailored for the needs of rehabilitation. Among these control strategies, assisted-as-needed (AAN) control is one of the most popular research topics in this field. AAN training strategies have gained the theoretical and practical evidence based backup from motor learning principles and clinical studies. Various approaches to AAN training have been proposed and investigated by research groups all around the world. This article presents a review on control algorithms of gait rehabilitation robots to summarise related knowledge and investigate potential trends of development. There are existing review papers on control strategies of rehabilitation robots. The review by Marchal-Crespo and Reinkensmeyer (2009) had a broad cover of control strategies of all kinds of rehabilitation robots. Hussain et al. (2011) had specifically focused on treadmill gait training robots and covered a limited number of control implementations on them. This review article encompasses more detailed information on control strategies for robot assisted gait rehabilitation, but is not limited to treadmill based training. It also investigates the potential to further develop assist-as-needed gait training based on assessments of patients' ability. In this paper, control strategies are generally divided into the trajectory tracking control and AAN control. The review covers these two basic categories, as well as other control algorithm and technologies derived from them, such as biofeedback control. Assessments on human gait ability are also included to investigate how to further develop implementations based on assist-as-needed concept. For the consideration of effectiveness, clinical studies on robotic gait rehabilitation are reviewed and analysed from the viewpoint of control algorithm. Copyright © 2014 IPEM. Published by Elsevier Ltd. All rights reserved.

Structured training on the da Vinci Skills Simulator leads to improvement in technical performance of robotic novices.

PubMed

Walliczek-Dworschak, U; Mandapathil, M; Förtsch, A; Teymoortash, A; Dworschak, P; Werner, J A; Güldner, C

2017-02-01

The increasing use of minimally invasive techniques such as robotic-assisted devices raises the question of how to acquire robotic surgery skills. The da Vinci Skills Simulator has been demonstrated to be an effective training tool in previous reports. To date, little data are available on how to acquire proficiency through simulator training. We investigated the outcome of a structured training programme for robotic surgical skills by robotic novices. This prospective study was conducted from January to December 2013 using the da Vinci Skills Simulator. Twenty participants, all robotic novices, were enrolled in a 4-week training curriculum. After a brief introduction to the simulator system, three consecutive repetitions of five selected exercises (Match Board 1, 2, 3 and Ring and Rail 1, 2) were performed in a defined order on days 1, 8, 15 and 22. On day 22, one repetition of a previously unpractised more advanced module (Needle Targeting) was also performed. After completion of each study day, the overall performance, time to completion, economy in motion, instrument collisions, excessive instrument force, instruments out of view, master workspace range and number of drops were analysed. Comparing the first and final repetition, overall score and time needed to complete all exercises, economy of motion and instrument collisions were significantly improved in nearly all exercises. Regarding the new exercise, a positive training effect could be demonstrated. While its overall entry score was significantly higher, the time to completion and economy of motion were significantly lower than the scores on the first repetition of the previous 5 exercises. It could be shown that training on the da Vinci Skills Simulator led to an improvement in technical performance of robotic novices. With regard to a new exercise, the training had a positive effect on the technical performance. © 2016 John Wiley & Sons Ltd.

Particulate Removal Using a CO2 Composite Spray Cleaning System

NASA Technical Reports Server (NTRS)

Chen, Nicole; Lin, Ying; Jackson, David; Chung, Shirley

2016-01-01

The Planetary Protection surface cleanliness requirements for potential Mars Sample Return hardware that would come in contact with Martian samples may be stricter than previous missions. The Jet Propulsion Laboratory has developed a new technology that will enable us to remove sub-micron size particles from critical hardware surfaces. A hand-held CO2 composite cleaning system was tested to verify its cleaning capabilities. This convenient, portable device can be used in cleanrooms for cleaning after rework or during spacecraft integration and assembly. It is environmentally safe and easy to use. This cleaning concept has the potential to be further developed into a robotic cleaning device on a Mars Lander to be used to clean sample acquisition or sample handling devices in situ. Contaminants of known sizes and concentrations, such as fluorescent microspheres and spores were deposited on common spacecraft material surfaces. The cleaning efficiency results will be presented and discussed.

Combined functional electrical stimulation (FES) and robotic system for wrist rehabiliation after stroke.

PubMed

Hu, Xiaoling; Tong, K Y; Li, R; Chen, M; Xue, J J; Ho, S K; Chen, P N

2010-01-01

Functional electrical stimulation (FES) and rehabilitation robots are techniques used to assist in post-stroke rehabilitation. However, FES and rehabilitation robots are still separate systems currently; and their combined training effects on persons after experiencing a stroke have not been well studied yet. In this work, a new combined FES-robot system driven by user's voluntary intention was developed for wrist joint training after stroke. The performance of the FES-robot assisted wrist tracking was evaluated on five subjects with chronic stroke. With simultaneous assistance from both the FES and robot parts of the system, the motion accuracy was improved and excessive activation in elbow flexor was reduced during wrist tracking.

Robotics in Lower-Limb Rehabilitation after Stroke

PubMed Central

2017-01-01

With the increase in the elderly, stroke has become a common disease, often leading to motor dysfunction and even permanent disability. Lower-limb rehabilitation robots can help patients to carry out reasonable and effective training to improve the motor function of paralyzed extremity. In this paper, the developments of lower-limb rehabilitation robots in the past decades are reviewed. Specifically, we provide a classification, a comparison, and a design overview of the driving modes, training paradigm, and control strategy of the lower-limb rehabilitation robots in the reviewed literature. A brief review on the gait detection technology of lower-limb rehabilitation robots is also presented. Finally, we discuss the future directions of the lower-limb rehabilitation robots. PMID:28659660

Robotics in Lower-Limb Rehabilitation after Stroke.

PubMed

Zhang, Xue; Yue, Zan; Wang, Jing

2017-01-01

With the increase in the elderly, stroke has become a common disease, often leading to motor dysfunction and even permanent disability. Lower-limb rehabilitation robots can help patients to carry out reasonable and effective training to improve the motor function of paralyzed extremity. In this paper, the developments of lower-limb rehabilitation robots in the past decades are reviewed. Specifically, we provide a classification, a comparison, and a design overview of the driving modes, training paradigm, and control strategy of the lower-limb rehabilitation robots in the reviewed literature. A brief review on the gait detection technology of lower-limb rehabilitation robots is also presented. Finally, we discuss the future directions of the lower-limb rehabilitation robots.

Robotically facilitated virtual rehabilitation of arm transport integrated with finger movement in persons with hemiparesis.

PubMed

Merians, Alma S; Fluet, Gerard G; Qiu, Qinyin; Saleh, Soha; Lafond, Ian; Davidow, Amy; Adamovich, Sergei V

2011-05-16

Recovery of upper extremity function is particularly recalcitrant to successful rehabilitation. Robotic-assisted arm training devices integrated with virtual targets or complex virtual reality gaming simulations are being developed to deal with this problem. Neural control mechanisms indicate that reaching and hand-object manipulation are interdependent, suggesting that training on tasks requiring coordinated effort of both the upper arm and hand may be a more effective method for improving recovery of real world function. However, most robotic therapies have focused on training the proximal, rather than distal effectors of the upper extremity. This paper describes the effects of robotically-assisted, integrated upper extremity training. Twelve subjects post-stroke were trained for eight days on four upper extremity gaming simulations using adaptive robots during 2-3 hour sessions. The subjects demonstrated improved proximal stability, smoothness and efficiency of the movement path. This was in concert with improvement in the distal kinematic measures of finger individuation and improved speed. Importantly, these changes were accompanied by a robust 16-second decrease in overall time in the Wolf Motor Function Test and a 24-second decrease in the Jebsen Test of Hand Function. Complex gaming simulations interfaced with adaptive robots requiring integrated control of shoulder, elbow, forearm, wrist and finger movements appear to have a substantial effect on improving hemiparetic hand function. We believe that the magnitude of the changes and the stability of the patient's function prior to training, along with maintenance of several aspects of the gains demonstrated at retention make a compelling argument for this approach to training.

Robotically facilitated virtual rehabilitation of arm transport integrated with finger movement in persons with hemiparesis

PubMed Central

2011-01-01

Background Recovery of upper extremity function is particularly recalcitrant to successful rehabilitation. Robotic-assisted arm training devices integrated with virtual targets or complex virtual reality gaming simulations are being developed to deal with this problem. Neural control mechanisms indicate that reaching and hand-object manipulation are interdependent, suggesting that training on tasks requiring coordinated effort of both the upper arm and hand may be a more effective method for improving recovery of real world function. However, most robotic therapies have focused on training the proximal, rather than distal effectors of the upper extremity. This paper describes the effects of robotically-assisted, integrated upper extremity training. Methods Twelve subjects post-stroke were trained for eight days on four upper extremity gaming simulations using adaptive robots during 2-3 hour sessions. Results The subjects demonstrated improved proximal stability, smoothness and efficiency of the movement path. This was in concert with improvement in the distal kinematic measures of finger individuation and improved speed. Importantly, these changes were accompanied by a robust 16-second decrease in overall time in the Wolf Motor Function Test and a 24-second decrease in the Jebsen Test of Hand Function. Conclusions Complex gaming simulations interfaced with adaptive robots requiring integrated control of shoulder, elbow, forearm, wrist and finger movements appear to have a substantial effect on improving hemiparetic hand function. We believe that the magnitude of the changes and the stability of the patient's function prior to training, along with maintenance of several aspects of the gains demonstrated at retention make a compelling argument for this approach to training. PMID:21575185

Cognitive training for technical and non-technical skills in robotic surgery: a randomised controlled trial.

PubMed

Raison, Nicholas; Ahmed, Kamran; Abe, Takashige; Brunckhorst, Oliver; Novara, Giacomo; Buffi, Nicolò; McIlhenny, Craig; van der Poel, Henk; van Hemelrijck, Mieke; Gavazzi, Andrea; Dasgupta, Prokar

2018-05-07

To investigate the effectiveness of motor imagery (MI) for technical skill and non-technical skill (NTS) training in minimally invasive surgery (MIS). A single-blind, parallel-group randomised controlled trial was conducted at the Vattikuti Institute of Robotic Surgery, King's College London. Novice surgeons were recruited by open invitation in 2015. After basic robotic skills training, participants underwent simple randomisation to either MI training or standard training. All participants completed a robotic urethrovesical anastomosis task within a simulated operating room. In addition to the technical task, participants were required to manage three scripted NTS scenarios. Assessment was performed by five blinded expert surgeons and a NTS expert using validated tools for evaluating technical skills [Global Evaluative Assessment of Robotic Skills (GEARS)] and NTS [Non-Technical Skills for Surgeons (NOTSS)]. Quality of MI was assessed using a revised Movement Imagery Questionnaire (MIQ). In all, 33 participants underwent MI training and 29 underwent standard training. Interrater reliability was high, Krippendorff's α = 0.85. After MI training, the mean (sd) GEARS score was significantly higher than after standard training, at 13.1 (3.25) vs 11.4 (2.97) (P = 0.03). There was no difference in mean NOTSS scores, at 25.8 vs 26.4 (P = 0.77). MI training was successful with significantly higher imagery scores than standard training (mean MIQ score 5.1 vs 4.5, P = 0.04). Motor imagery is an effective training tool for improving technical skill in MIS even in novice participants. No beneficial effect for NTS was found. © 2018 The Authors BJU International © 2018 BJU International Published by John Wiley & Sons Ltd.

Improving proprioceptive deficits after stroke through robot-assisted training of the upper limb: a pilot case report study.

PubMed

Colombo, R; Sterpi, I; Mazzone, A; Delconte, C; Pisano, F

2016-01-01

The purpose of this study was to determine whether a conventional robot-assisted therapy of the upper limb was able to improve proprioception and motor recovery of an individual after stroke who exhibited proprioceptive deficits. After robotic sensorimotor training, significant changes were observed in kinematic performance variables. Two quantitative parameters evaluating position sense improved after training. Range of motion during shoulder and wrist flexion improved, but only wrist flexion remained improved at 3-month follow-up. These preliminary results suggest that intensive robot-aided rehabilitation may play an important role in the recovery of sensory function. However, further studies are required to confirm these data.

Develop a wearable ankle robot for in-bed acute stroke rehabilitation.

PubMed

Ren, Yupeng; Xu, Tao; Wang, Liang; Yang, Chung Yong; Guo, Xin; Harvey, Richard L; Zhang, Li-Qun

2011-01-01

Movement training is important in motor recovery post stroke and early intervention is critical to stroke rehabilitation. However, acute stroke survivors are actively trained with activities helpful for recovery of mobility in only 13% of the time in the acute phase. Considering the first few months post stroke is critical in stroke recovery (neuroplasticity), there is a strong need for movement therapy and manipulate/mobilize the joints. There is a lack of in-bed robotic rehabilitation in acute stroke. This study seeks to meet the clinic need and deliver intensive passive and active movement therapy using a wearable robot to enhance motor function in acute stroke. Passively, the wearable robot stretches the joint to its extreme positions safely and forcefully. Actively, movement training is conducted and game playing is used to guide and motivate the patient in movement training.

Reviewing Clinical Effectiveness of Active Training Strategies of Platform-Based Ankle Rehabilitation Robots.

PubMed

Zeng, Xiangfeng; Zhu, Guoli; Zhang, Mingming; Xie, Sheng Q

2018-01-01

This review aims to provide a systematical investigation of clinical effectiveness of active training strategies applied in platform-based ankle robots. English-language studies published from Jan 1980 to Aug 2017 were searched from four databases using key words of "Ankle ∗ " AND "Robot ∗ " AND "Effect ∗ OR Improv ∗ OR Increas ∗ ." Following an initial screening, three rounds of discrimination were successively conducted based on the title, the abstract, and the full paper. A total of 21 studies were selected with 311 patients involved; of them, 13 studies applied a single group while another eight studies used different groups for comparison to verify the therapeutic effect. Virtual-reality (VR) game training was applied in 19 studies, while two studies used proprioceptive neuromuscular facilitation (PNF) training. Active training techniques delivered by platform ankle rehabilitation robots have been demonstrated with great potential for clinical applications. Training strategies are mostly combined with one another by considering rehabilitation schemes and motion ability of ankle joints. VR game environment has been commonly used with active ankle training. Bioelectrical signals integrated with VR game training can implement intelligent identification of movement intention and assessment. These further provide the foundation for advanced interactive training strategies that can lead to enhanced training safety and confidence for patients and better treatment efficacy.

Development of monitoring and diagnostic methods for robots used in remediation of waste sites. 1997 annual progress report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tecza, J.

1998-06-01

'Safe and efficient clean up of hazardous and radioactive waste sites throughout the DOE complex will require extensive use of robots. This research effort focuses on developing Monitoring and Diagnostic (M and D) methods for robots that will provide early detection, isolation, and tracking of impending faults before they result in serious failure. The utility and effectiveness of applying M and D methods to hydraulic robots has never been proven. The present research program is utilizing seeded faults in a laboratory test rig that is representative of an existing hydraulically-powered remediation robot. This report summarizes activity conducted in the firstmore » 9 months of the project. The research team has analyzed the Rosie Mobile Worksystem as a representative hydraulic robot, developed a test rig for implanted fault testing, developed a test plan and agenda, and established methods for acquiring and analyzing the test data.'« less

Effects of task-oriented robot training on arm function, activity, and quality of life in chronic stroke patients: a randomized controlled trial.

PubMed

Timmermans, Annick A A; Lemmens, Ryanne J M; Monfrance, Maurice; Geers, Richard P J; Bakx, Wilbert; Smeets, Rob J E M; Seelen, Henk A M

2014-03-31

Over fifty percent of stroke patients experience chronic arm hand performance problems, compromising independence in daily life activities and quality of life. Task-oriented training may improve arm hand performance after stroke, whereby augmented therapy may lead to a better treatment outcome. Technology-supported training holds opportunities for increasing training intensity. However, the effects of robot-supported task-oriented training with real life objects in stroke patients are not known to date. The aim of the present study was to investigate the effectiveness and added value of the Haptic Master robot combined with task-oriented arm hand training in chronic stroke patients. In a single-blind randomized controlled trial, 22 chronic stroke patients were randomly allocated to receive either task-oriented robot-assisted arm-hand training (experimental group) or task-oriented non-robotic arm-hand training (control group). For training, the T-TOAT (Technology-supported Task-Oriented Arm Training) method was applied. Training was provided during 8 weeks, 4 times/week, 2 × 30 min/day. A significant improvement after training on the Action Research Arm Test (ARAT) was demonstrated in the experimental group (p = 0.008). Results were maintained until 6 months after cessation of the training. On the perceived performance measure (Motor Activity Log (MAL)), both, the experimental and control group improved significantly after training (control group p = 0.008; experimental group p = 0.013). The improvements on MAL in both groups were maintained until 6 months after cessation of the training. With regard to quality of life, only in the control group a significant improvement after training was found (EuroQol-5D p = 0.015, SF-36 physical p = 0.01). However, the improvement on SF-36 in the control group was not maintained (p = 0.012). No between-group differences could be demonstrated on any of the outcome measures. Arm hand performance improved in chronic stroke patients, after eight weeks of task oriented training. The use of a Haptic Master robot in support of task-oriented arm training did not show additional value over the video-instructed task-oriented exercises in highly functional stroke patients. Current Controlled Trials ISRCTN82787126.

State-of-the-art robotic devices for ankle rehabilitation: Mechanism and control review.

PubMed

Hussain, Shahid; Jamwal, Prashant K; Ghayesh, Mergen H

2017-12-01

There is an increasing research interest in exploring use of robotic devices for the physical therapy of patients suffering from stroke and spinal cord injuries. Rehabilitation of patients suffering from ankle joint dysfunctions such as drop foot is vital and therefore has called for the development of newer robotic devices. Several robotic orthoses and parallel ankle robots have been developed during the last two decades to augment the conventional ankle physical therapy of patients. A comprehensive review of these robotic ankle rehabilitation devices is presented in this article. Recent developments in the mechanism design, actuation and control are discussed. The study encompasses robotic devices for treadmill and over-ground training as well as platform-based parallel ankle robots. Control strategies for these robotic devices are deliberated in detail with an emphasis on the assist-as-needed training strategies. Experimental evaluations of the mechanism designs and various control strategies of these robotic ankle rehabilitation devices are also presented.

Versatile robotic interface to evaluate, enable and train locomotion and balance after neuromotor disorders.

PubMed

Dominici, Nadia; Keller, Urs; Vallery, Heike; Friedli, Lucia; van den Brand, Rubia; Starkey, Michelle L; Musienko, Pavel; Riener, Robert; Courtine, Grégoire

2012-07-01

Central nervous system (CNS) disorders distinctly impair locomotor pattern generation and balance, but technical limitations prevent independent assessment and rehabilitation of these subfunctions. Here we introduce a versatile robotic interface to evaluate, enable and train pattern generation and balance independently during natural walking behaviors in rats. In evaluation mode, the robotic interface affords detailed assessments of pattern generation and dynamic equilibrium after spinal cord injury (SCI) and stroke. In enabling mode,the robot acts as a propulsive or postural neuroprosthesis that instantly promotes unexpected locomotor capacities including overground walking after complete SCI, stair climbing following partial SCI and precise paw placement shortly after stroke. In training mode, robot-enabled rehabilitation, epidural electrical stimulation and monoamine agonists reestablish weight-supported locomotion, coordinated steering and balance in rats with a paralyzing SCI. This new robotic technology and associated concepts have broad implications for both assessing and restoring motor functions after CNS disorders, both in animals and in humans.

Development of an in vivo visual robot system with a magnetic anchoring mechanism and a lens cleaning mechanism for laparoendoscopic single-site surgery (LESS).

PubMed

Feng, Haibo; Dong, Dinghui; Ma, Tengfei; Zhuang, Jinlei; Fu, Yili; Lv, Yi; Li, Liyi

2017-12-01

Surgical robot systems which can significantly improve surgical procedures have been widely used in laparoendoscopic single-site surgery (LESS). For a relative complex surgical procedure, the development of an in vivo visual robot system for LESS can effectively improve the visualization for surgical robot systems. In this work, an in vivo visual robot system with a new mechanism for LESS was investigated. A finite element method (FEM) analysis was carried out to ensure the safety of the in vivo visual robot during the movement, which was the most important concern for surgical purposes. A master-slave control strategy was adopted, in which the control model was established by off-line experiments. The in vivo visual robot system was verified by using a phantom box. The experiment results show that the robot system can successfully realize the expected functionalities and meet the demands of LESS. The experiment results indicate that the in vivo visual robot with high manipulability has great potential in clinical application. Copyright © 2017 John Wiley & Sons, Ltd.

Variety Wins: Soccer-Playing Robots and Infant Walking.

PubMed

Ossmy, Ori; Hoch, Justine E; MacAlpine, Patrick; Hasan, Shohan; Stone, Peter; Adolph, Karen E

2018-01-01

Although both infancy and artificial intelligence (AI) researchers are interested in developing systems that produce adaptive, functional behavior, the two disciplines rarely capitalize on their complementary expertise. Here, we used soccer-playing robots to test a central question about the development of infant walking. During natural activity, infants' locomotor paths are immensely varied. They walk along curved, multi-directional paths with frequent starts and stops. Is the variability observed in spontaneous infant walking a "feature" or a "bug?" In other words, is variability beneficial for functional walking performance? To address this question, we trained soccer-playing robots on walking paths generated by infants during free play and tested them in simulated games of "RoboCup." In Tournament 1, we compared the functional performance of a simulated robot soccer team trained on infants' natural paths with teams trained on less varied, geometric paths-straight lines, circles, and squares. Across 1,000 head-to-head simulated soccer matches, the infant-trained team consistently beat all teams trained with less varied walking paths. In Tournament 2, we compared teams trained on different clusters of infant walking paths. The team trained with the most varied combination of path shape, step direction, number of steps, and number of starts and stops outperformed teams trained with less varied paths. This evidence indicates that variety is a crucial feature supporting functional walking performance. More generally, we propose that robotics provides a fruitful avenue for testing hypotheses about infant development; reciprocally, observations of infant behavior may inform research on artificial intelligence.

Robotic virtual reality simulation plus standard robotic orientation versus standard robotic orientation alone: a randomized controlled trial.

PubMed

Vaccaro, Christine M; Crisp, Catrina C; Fellner, Angela N; Jackson, Christopher; Kleeman, Steven D; Pavelka, James

2013-01-01

The objective of this study was to compare the effect of virtual reality simulation training plus robotic orientation versus robotic orientation alone on performance of surgical tasks using an inanimate model. Surgical resident physicians were enrolled in this assessor-blinded randomized controlled trial. Residents were randomized to receive either (1) robotic virtual reality simulation training plus standard robotic orientation or (2) standard robotic orientation alone. Performance of surgical tasks was assessed at baseline and after the intervention. Nine of 33 modules from the da Vinci Skills Simulator were chosen. Experts in robotic surgery evaluated each resident's videotaped performance of the inanimate model using the Global Rating Scale (GRS) and Objective Structured Assessment of Technical Skills-modified for robotic-assisted surgery (rOSATS). Nine resident physicians were enrolled in the simulation group and 9 in the control group. As a whole, participants improved their total time, time to incision, and suture time from baseline to repeat testing on the inanimate model (P = 0.001, 0.003, <0.001, respectively). Both groups improved their GRS and rOSATS scores significantly (both P < 0.001); however, the GRS overall pass rate was higher in the simulation group compared with the control group (89% vs 44%, P = 0.066). Standard robotic orientation and/or robotic virtual reality simulation improve surgical skills on an inanimate model, although this may be a function of the initial "practice" on the inanimate model and repeat testing of a known task. However, robotic virtual reality simulation training increases GRS pass rates consistent with improved robotic technical skills learned in a virtual reality environment.

Motor learning characterizes habilitation of children with hemiplegic cerebral palsy.

PubMed

Krebs, Hermano I; Fasoli, Susan E; Dipietro, Laura; Fragala-Pinkham, Maria; Hughes, Richard; Stein, Joel; Hogan, Neville

2012-09-01

This study tested in children with cerebral palsy (CP) whether motor habilitation resembles motor learning. Twelve children with hemiplegic CP ages 5 to 12 years with moderate to severe motor impairments underwent a 16-session robot-mediated planar therapy program to improve upper limb reach, with a focus on shoulder and elbow movements. Participants were trained to execute point-to-point movements (with robot assistance) with the affected arm and were evaluated (without robot assistance) in trained (point-to-point) and untrained (circle-drawing) conditions. Outcomes were measured at baseline, midpoint, immediately after the program, and 1 month postcompletion. Outcome measures were the Fugl-Meyer (FM), Quality of Upper Extremity Skills Test (QUEST), and Modified Ashworth Scale (MAS) scores; parent questionnaire; and robot-based kinematic metrics. To assess whether learning best characterizes motor habilitation in CP, the authors quantified (a) improvement on trained tasks at completion of training (acquisition) and 1 month following completion (retention) and (b) quantified generalization of improvement to untrained tasks. After robotic intervention, the authors found significant gains in the FM, QUEST, and parent questionnaire. Robot-based evaluations demonstrated significant improvement in trained movements and that improvement was sustained at follow-up. Furthermore, children improved their performance in untrained movements indicating generalization. Motor habilitation in CP exhibits some traits of motor learning. Optimal treatment may not require an extensive repertoire of tasks but rather a select set to promote generalization.

Tinning/Trimming Robot System

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fureigh, M.L.

In a new surface mount assembly area at AlliedSignal Inc., Kansas City Division (KCD), a tinning/trimming robot system tins and trims the gold-plated leads of surface mount technology (SMT) transistors. The KCD-designed system uses a Unimation PUMA 260 robot, a General Production Devices SP-2000 solder pot; water-soluble Blackstone No. 2508 flux; and a Virtual Industries high-temperature, ESD-conductive, miniature suction cup. After the manual cleaning operation, the processed SMT transistors go to the QUADSTAR Automated Component Placement System for a Radar Logic Assembly. The benefits are reductions in the cost of nonconformance, worker fatigue, and standard hours.

Robot-assisted gait training versus treadmill training in patients with Parkinson's disease: a kinematic evaluation with gait profile score.

PubMed

Galli, M; Cimolin, V; De Pandis, M F; Le Pera, D; Sova, I; Albertini, G; Stocchi, F; Franceschini, M

2016-01-01

The purpose of this study was to quantitatively compare the effects, on walking performance, of end-effector robotic rehabilitation locomotor training versus intensive training with a treadmill in Parkinson's disease (PD). Fifty patients with PD were randomly divided into two groups: 25 were assigned to the robot-assisted therapy group (RG) and 25 to the intensive treadmill therapy group (IG). They were evaluated with clinical examination and 3D quantitative gait analysis [gait profile score (GPS) and its constituent gait variable scores (GVSs) were calculated from gait analysis data] at the beginning (T0) and at the end (T1) of the treatment. In the RG no differences were found in the GPS, but there were significant improvements in some GVSs (Pelvic Obl and Hip Ab-Add). The IG showed no statistically significant changes in either GPS or GVSs. The end-effector robotic rehabilitation locomotor training improved gait kinematics and seems to be effective for rehabilitation in patients with mild PD.

"You gotta try it all": Parents' Experiences with Robotic Gait Training for their Children with Cerebral Palsy.

PubMed

Beveridge, Briony; Feltracco, Deanna; Struyf, Jillian; Strauss, Emily; Dang, Saniya; Phelan, Shanon; Wright, F Virginia; Gibson, Barbara E

2015-01-01

Innovative robotic technologies hold strong promise for improving walking abilities of children with cerebral palsy (CP), but may create expectations for parents pursuing the "newest thing" in treatment. The aim of this qualitative study was to explore parents' values about walking in relation to their experiences with robotic gait training for their children. Semi-structured interviews were conducted with parents of five ambulatory children with CP participating in a randomized trial investigating robotic gait training effectiveness. Parents valued walking, especially "correct" walking, as a key component of their children's present and future well-being. They continually sought the "next best thing" in therapy and viewed the robotic gait trainer as a potentially revolutionary technology despite mixed experiences. The results can help inform rehabilitation therapists' knowledge of parents' values and perspectives, and guide effective collaborations toward meeting the therapeutic needs of children with CP.

Robotic surgical skill acquisition: What one needs to know?

PubMed Central

Sood, Akshay; Jeong, Wooju; Ahlawat, Rajesh; Campbell, Logan; Aggarwal, Shruti; Menon, Mani; Bhandari, Mahendra

2015-01-01

Robotic surgery has been eagerly adopted by patients and surgeons alike in the field of urology, over the last decade. However, there is a lack of standardization in training curricula and accreditation guidelines to ensure surgeon competence and patient safety. Accordingly, in this review, we aim to highlight ‘who’ needs to learn ‘what’ and ‘how’, to become competent in robotic surgery. We demonstrate that both novice and experienced open surgeons require supervision and mentoring during the initial phases of robotic surgery skill acquisition. The experienced open surgeons possess domain knowledge, however, need to acquire technical knowledge under supervision (either in simulated or clinical environment) to successfully transition to robotic surgery, whereas, novice surgeons need to acquire both domain as well as technical knowledge to become competent in robotic surgery. With regard to training curricula, a variety of training programs such as academic fellowships, mini-fellowships, and mentored skill courses exist, and cater to the needs and expectations of postgraduate surgeons adequately. Fellowships provide the most comprehensive training, however, may not be suitable to all surgeon-learners secondary to the long-term time commitment. For these surgeon-learners short-term courses such as the mini-fellowships or mentored skill courses might be more apt. Lastly, with regards to credentialing uniformity in criteria regarding accreditation is lacking but earnest efforts are underway. Currently, accreditation for competence in robotic surgery is institutional specific. PMID:25598593

Robotic surgical skill acquisition: What one needs to know?

PubMed

Sood, Akshay; Jeong, Wooju; Ahlawat, Rajesh; Campbell, Logan; Aggarwal, Shruti; Menon, Mani; Bhandari, Mahendra

2015-01-01

Robotic surgery has been eagerly adopted by patients and surgeons alike in the field of urology, over the last decade. However, there is a lack of standardization in training curricula and accreditation guidelines to ensure surgeon competence and patient safety. Accordingly, in this review, we aim to highlight 'who' needs to learn 'what' and 'how', to become competent in robotic surgery. We demonstrate that both novice and experienced open surgeons require supervision and mentoring during the initial phases of robotic surgery skill acquisition. The experienced open surgeons possess domain knowledge, however, need to acquire technical knowledge under supervision (either in simulated or clinical environment) to successfully transition to robotic surgery, whereas, novice surgeons need to acquire both domain as well as technical knowledge to become competent in robotic surgery. With regard to training curricula, a variety of training programs such as academic fellowships, mini-fellowships, and mentored skill courses exist, and cater to the needs and expectations of postgraduate surgeons adequately. Fellowships provide the most comprehensive training, however, may not be suitable to all surgeon-learners secondary to the long-term time commitment. For these surgeon-learners short-term courses such as the mini-fellowships or mentored skill courses might be more apt. Lastly, with regards to credentialing uniformity in criteria regarding accreditation is lacking but earnest efforts are underway. Currently, accreditation for competence in robotic surgery is institutional specific.

Robot-assisted upper extremity rehabilitation for cervical spinal cord injuries: a systematic scoping review.

PubMed

Singh, Hardeep; Unger, Janelle; Zariffa, José; Pakosh, Maureen; Jaglal, Susan; Craven, B Catharine; Musselman, Kristin E

2018-01-15

Abstact Purpose: To provide an overview of the feasibility and outcomes of robotic-assisted upper extremity training for individuals with cervical spinal cord injury (SCI), and to identify gaps in current research and articulate future research directions. A systematic search was conducted using Medline, Embase, PsycINFO, CCTR, CDSR, CINAHL and PubMed on June 7, 2017. Search terms included 3 themes: (1) robotics; (2) SCI; (3) upper extremity. Studies using robots for upper extremity rehabilitation among individuals with cervical SCI were included. Identified articles were independently reviewed by two researchers and compared to pre-specified criteria. Disagreements regarding article inclusion were resolved through discussion. The modified Downs and Black checklist was used to assess article quality. Participant characteristics, study and intervention details, training outcomes, robot features, study limitations and recommendations for future studies were abstracted from included articles. Twelve articles (one randomized clinical trial, six case series, five case studies) met the inclusion criteria. Five robots were exoskeletons and three were end-effectors. Sample sizes ranged from 1 to 17 subjects. Articles had variable quality, with quality scores ranging from 8 to 20. Studies had a low internal validity primarily from lack of blinding or a control group. Individuals with mild-moderate impairments showed the greatest improvements on body structure/function and performance-level measures. This review is limited by the small number of articles, low-sample sizes and the diversity of devices and their associated training protocols, and outcome measures. Preliminary evidence suggests robot-assisted interventions are safe, feasible and can reduce active assistance provided by therapists. Implications for rehabilitation Robot-assisted upper extremity training for individuals with cervical spinal cord injury is safe, feasible and can reduce hands-on assistance provided by therapists. Future research in robotics rehabilitation with individuals with spinal cord injury is needed to determine the optimal device and training protocol as well as effectiveness.

An over-view of robot assisted surgery curricula and the status of their validation.

PubMed

Fisher, Rebecca A; Dasgupta, Prokar; Mottrie, Alex; Volpe, Alessandro; Khan, Mohammed S; Challacombe, Ben; Ahmed, Kamran

2015-01-01

Robotic surgery is a rapidly expanding field. Thus far training for robotic techniques has been unstructured and the requirements are variable across various regions. Several projects are currently underway to develop a robotic surgery curriculum and are in various stages of validation. We aimed to outline the structures of available curricula, their process of development, validation status and current utilization. We undertook a literature review of papers including the MeSH terms "Robotics" and "Education". When we had an overview of curricula in development, we searched recent conference abstracts to gain up to date information. The main curricula are the FRS, the FSRS, the Canadian BSTC and the ERUS initiative. They are in various stages of validation and offer a mixture of theoretical and practical training, using both physical and simulated models. Whilst the FSRS is based on tasks on the RoSS virtual reality simulator, FRS and BSTC are designed for use on simulators and the robot itself. The ERUS curricula benefits from a combination of dry lab, wet lab and virtual reality components, which may allow skills to be more transferable to the OR as tasks are completed in several formats. Finally, the ERUS curricula includes the OR modular training programme as table assistant and console surgeon. Curricula are a crucial step in global standardisation of training and certification of surgeons for robotic surgical procedures. Many curricula are in early stages of development and more work is needed in development and validation of these programmes before training can be standardised. Copyright © 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

75 FR 38125 - Fanuc Robotics America, Inc. Including On-Site Leased Workers From Right Angle Staffing, Inc...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-01

... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-70,749] Fanuc Robotics America... period, Fanuc Robotics America neither imported articles like or directly competitive with the robotic.... Furthermore, the Department surveyed Fanuc Robotics America's major declining customers regarding purchases of...

Robotic Arms. A Contribution to the Curriculum. An Occasional Paper.

ERIC Educational Resources Information Center

Arnold, W. F.; Carpenter, C. J.

This report examines ways of providing technician training in the operating principles of robotic devices. The terms "robotics" and "robotic arms" are first defined. Some background information on the principal features of robotic arms is given, including their geometric arrangement, type of actuator used, control method, and…

Media-fill simulation tests in manual and robotic aseptic preparation of injection solutions in syringes.

PubMed

Krämer, Irene; Federici, Matteo; Kaiser, Vanessa; Thiesen, Judith

2016-04-01

The purpose of this study was to evaluate the contamination rate of media-fill products either prepared automated with a robotic system (APOTECAchemo™) or prepared manually at cytotoxic workbenches in the same cleanroom environment and by experienced operators. Media fills were completed by microbiological environmental control in the critical zones and used to validate the cleaning and disinfection procedures of the robotic system. The aseptic preparation of patient individual ready-to-use injection solutions was simulated by using double concentrated tryptic soy broth as growth medium, water for injection and plastic syringes as primary packaging materials. Media fills were either prepared automated (500 units) in the robot or manually (500 units) in cytotoxic workbenches in the same cleanroom over a period of 18 working days. The test solutions were incubated at room temperature (22℃) over 4 weeks. Products were visually inspected for turbidity after a 2-week and 4-week period. Following incubation, growth promotion tests were performed with Staphylococcus epidermidis. During the media-fill procedures, passive air monitoring was performed with settle plates and surface monitoring with contact plates on predefined locations as well as fingerprints. The plates got incubated for 5-7 days at room temperature, followed by 2-3 days at 30-35℃ and the colony forming units (cfu) counted after both periods. The robot was cleaned and disinfected according to the established standard operating procedure on two working days prior to the media-fill session, while on six other working days only six critical components were sanitized at the end of the media-fill sessions. Every day UV irradiation was operated for 4 h after finishing work. None of the 1000 media-fill products prepared in the two different settings showed turbidity after the incubation period thereby indicating no contamination with microorganisms. All products remained uniform, clear, and light-amber solutions. In addition, the reliability of the nutrient medium and the process was demonstrated by positive growth promotion tests with S. epidermidis. During automated preparation the recommended limits < 1 cfu per settle/contact plate set for cleanroom Grade A zones were not succeeded in the carousel and working area, but in the loading area of the robot. During manual preparation, the number of cfus detected on settle/contact plates inside the workbenches lay far below the limits. The number of cfus detected on fingertips succeeded several times the limit during manual preparation but not during automated preparation. There was no difference in the microbial contamination rate depending on the extent of cleaning and disinfection of the robot. Extensive media-fill tests simulating manual and automated preparation of ready-to-use cytotoxic injection solutions revealed the same level of sterility for both procedures. The results of supplemental environmental controls confirmed that the aseptic procedures are well controlled. As there was no difference in the microbial contamination rates of the media preparations depending on the extent of cleaning and disinfection of the robot, the results were used to adapt the respective standard operating procedures. © The Author(s) 2014.

Feasibility and safety of early lower limb robot-assisted training in sub-acute stroke patients: a pilot study.

PubMed

Gandolfi, Marialuisa; Geroin, Christian; Tomelleri, Christopher; Maddalena, Isacco; Kirilova Dimitrova, Eleonora; Picelli, Alessandro; Smania, Nicola; Waldner, Andreas

2017-12-01

So far, the development of robotic devices for the early lower limb mobilization in the sub-acute phase after stroke has received limited attention. To explore the feasibility of a newly robotic-stationary gait training in sub-acute stroke patients. To report the training effects on lower limb function and muscle activation. A pilot study. Rehabilitation ward. Two sub-acute stroke inpatients and ten age-matched healthy controls were enrolled. Healthy controls served as normative data. Patients underwent 10 robot-assisted training sessions (20 minutes, 5 days/week) in alternating stepping movements (500 repetitions/session) on a hospital bed in addition to conventional rehabilitation. Feasibility outcome measures were compliance, physiotherapist time, and responses to self-report questionnaires. Efficacy outcomes were bilateral lower limb muscle activation pattern as measured by surface electromyography (sEMG), Motricity Index (MI), Medical Research Council (MRC) grade, and Ashworth Scale (AS) scores before and after training. No adverse events occurred. No significant differences in sEMG activity between patients and healthy controls were observed. Post-training improvement in MI and MRC scores, but no significant changes in AS scores, were recorded. Post-treatment sEMG analysis of muscle activation patterns showed a significant delay in rectus femoris offset (P=0.02) and prolonged duration of biceps femoris (P=0.04) compared to pretreatment. The robot-assisted training with our device was feasible and safe. It induced physiological muscle activations pattern in both stroke patients and healthy controls. Full-scale studies are needed to explore its potential role in post-stroke recovery. This robotic device may enrich early rehabilitation in subacute stroke patients by inducing physiological muscle activation patterns. Future studies are warranted to evaluate its effects on promoting restorative mechanisms involved in lower limb recovery after stroke.

Positive effects of robotic exoskeleton training of upper limb reaching movements after stroke

PubMed Central

2012-01-01

This study, conducted in a group of nine chronic patients with right-side hemiparesis after stroke, investigated the effects of a robotic-assisted rehabilitation training with an upper limb robotic exoskeleton for the restoration of motor function in spatial reaching movements. The robotic assisted rehabilitation training was administered for a period of 6 weeks including reaching and spatial antigravity movements. To assess the carry-over of the observed improvements in movement during training into improved function, a kinesiologic assessment of the effects of the training was performed by means of motion and dynamic electromyographic analysis of reaching movements performed before and after training. The same kinesiologic measurements were performed in a healthy control group of seven volunteers, to determine a benchmark for the experimental observations in the patients’ group. Moreover degree of functional impairment at the enrolment and discharge was measured by clinical evaluation with upper limb Fugl-Meyer Assessment scale (FMA, 0–66 points), Modified Ashworth scale (MA, 0–60 pts) and active ranges of motion. The robot aided training induced, independently by time of stroke, statistical significant improvements of kinesiologic (movement time, smoothness of motion) and clinical (4.6 ± 4.2 increase in FMA, 3.2 ± 2.1 decrease in MA) parameters, as a result of the increased active ranges of motion and improved co-contraction index for shoulder extension/flexion. Kinesiologic parameters correlated significantly with clinical assessment values, and their changes after the training were affected by the direction of motion (inward vs. outward movement) and position of target to be reached (ipsilateral, central and contralateral peripersonal space). These changes can be explained as a result of the motor recovery induced by the robotic training, in terms of regained ability to execute single joint movements and of improved interjoint coordination of elbow and shoulder joints. PMID:22681653

Robot-Assisted Training Early After Cardiac Surgery.

PubMed

Schoenrath, Felix; Markendorf, Susanne; Brauchlin, Andreas E; Seifert, Burkhardt; Wilhelm, Markus J; Czerny, Martin; Riener, Robert; Falk, Volkmar; Schmied, Christian M

2015-07-01

To assess feasibility and safety of a robot-assisted gait therapy with the Lokomat® system in patients early after open heart surgery. Within days after open heart surgery 10 patients were subjected to postoperative Lokomat® training (Intervention group, IG) whereas 20 patients served as controls undergoing standard postoperative physiotherapy (Control group, CG). All patients underwent six-minute walk test and evaluation of the muscular strength of the lower limbs by measuring quadriceps peak force. The primary safety end-point was freedom from any device-related wound healing disturbance. Patients underwent clinical follow-up after one month. Both training methods resulted in an improvement of walking distance (IG [median, interquartile range, p-value]: +119 m, 70-201 m, p = 0.005; CG: 105 m, 57-152.5m, p < 0.001) and quadriceps peak force (IG left: +5 N, 3.8 7 N, p = 0.005; IG right: +3.5 N, 1.5-8.8 N, p = 0.011; CG left: +5.5 N, 4-9 N, p < 0.001; CG right: +6 N, 4.3-9.8 N, p < 0.001) in all participants. Results with robot-assisted training were comparable to early postoperative standard in hospital training (median changes in walking distance in percent, p = 0.81; median changes in quadriceps peak force in percent, left: p = 0.97, right p = 0.61). No deep sternal wound infection or any adverse event occurred in the robot-assisted training group. Robot-assisted gait therapy with the Lokomat® system is feasible and safe in patients early after median sternotomy. Results with robot-assisted training were comparable to standard in hospital training. An adapted and combined aerobic and resistance training intervention with augmented feedback may result in benefits in walking distance and lower limb muscle strength (ClinicalTrials.gov number, NCT 02146196). © 2015 Wiley Periodicals, Inc.

Atypical autonomic dysreflexia during robotic-assisted body weight supported treadmill training in an individual with motor incomplete spinal cord injury.

PubMed

Geigle, Paula R; Frye, Sara Kate; Perreault, John; Scott, William H; Gorman, Peter H

2013-03-01

A 41-year-old man with a history of C6 American Spinal Injury Association (ASIA) Impairment Scale (AIS) C spinal cord injury (SCI), enrolled in an Institutional Review Board (IRB)-approved, robotic-assisted body weight-supported treadmill training (BWSTT), and aquatic exercise research protocol developed asymptomatic autonomic dysreflexia (AD) during training. Little information is available regarding the relationship of robotic-assisted BWSTT and AD. After successfully completing 36 sessions of aquatic exercise, he reported exertional fatigue during his 10th Lokomat intervention and exhibited asymptomatic or silent AD during this and the three subsequent BWSTT sessions. Standard facilitators of AD were assessed and no obvious irritant identified other than the actual physical exertion and positioning required during robotic-assisted BWSTT. Increased awareness of potential silent AD presenting during robotic assisted BWSTT training for individuals with motor incomplete SCI is required as in this case AD clinical signs were not concurrent with occurrence. Frequent vital sign assessment before, during, and at conclusion of each BWSTT session is strongly recommended.

European Association of Endoscopic Surgeons (EAES) consensus statement on the use of robotics in general surgery.

PubMed

Szold, Amir; Bergamaschi, Roberto; Broeders, Ivo; Dankelman, Jenny; Forgione, Antonello; Langø, Thomas; Melzer, Andreas; Mintz, Yoav; Morales-Conde, Salvador; Rhodes, Michael; Satava, Richard; Tang, Chung-Ngai; Vilallonga, Ramon

2015-02-01

Following an extensive literature search and a consensus conference with subject matter experts the following conclusions can be drawn: 1. Robotic surgery is still at its infancy, and there is a great potential in sophisticated electromechanical systems to perform complex surgical tasks when these systems evolve. 2. To date, in the vast majority of clinical settings, there is little or no advantage in using robotic systems in general surgery in terms of clinical outcome. Dedicated parameters should be addressed, and high quality research should focus on quality of care instead of routine parameters, where a clear advantage is not to be expected. 3. Preliminary data demonstrates that robotic system have a clinical benefit in performing complex procedures in confined spaces, especially in those that are located in unfavorable anatomical locations. 4. There is a severe lack of high quality data on robotic surgery, and there is a great need for rigorously controlled, unbiased clinical trials. These trials should be urged to address the cost-effectiveness issues as well. 5. Specific areas of research should include complex hepatobiliary surgery, surgery for gastric and esophageal cancer, revisional surgery in bariatric and upper GI surgery, surgery for large adrenal masses, and rectal surgery. All these fields show some potential for a true benefit of using current robotic systems. 6. Robotic surgery requires a specific set of skills, and needs to be trained using a dedicated, structured training program that addresses the specific knowledge, safety issues and skills essential to perform this type of surgery safely and with good outcomes. It is the responsibility of the corresponding professional organizations, not the industry, to define the training and credentialing of robotic basic skills and specific procedures. 7. Due to the special economic environment in which robotic surgery is currently employed special care should be taken in the decision making process when deciding on the purchase, use and training of robotic systems in general surgery. 8. Professional organizations in the sub-specialties of general surgery should review these statements and issue detailed, specialty-specific guidelines on the use of specific robotic surgery procedures in addition to outlining the advanced robotic surgery training required to safely perform such procedures.

The immediate effects of robot-assistance on energy consumption and cardiorespiratory load during walking compared to walking without robot-assistance: a systematic review.

PubMed

Lefeber, Nina; Swinnen, Eva; Kerckhofs, Eric

2017-10-01

The integration of sufficient cardiovascular stress into robot-assisted gait (RAG) training could combine the benefits of both RAG and aerobic training. The aim was to summarize literature data on the immediate effects of RAG compared to walking without robot-assistance on metabolic-, cardiorespiratory- and fatigue-related parameters. PubMed and Web of Science were searched for eligible articles till February 2016. Means, SDs and significance values were extracted. Effect sizes were calculated. Fourteen studies were included, concerning 155 participants (85 healthy subjects, 39 stroke and 31 spinal cord injury patients), 9 robots (2 end-effectors, 1 treadmill-based and 6 wearable exoskeletons), and 7 outcome parameters (mostly oxygen consumption and heart rate). Overall, metabolic and cardiorespiratory parameters were lower during RAG compared to walking without robot-assistance (moderate to large effect sizes). In healthy subjects, when no body-weight support (BWS) was provided, RAG with an end-effector device was more energy demanding than walking overground (p > .05, large effect sizes). Generally, results suggest that RAG is less energy-consuming and cardiorespiratory stressful than walking without robot-assistance, but results depend on factors such as robot type, walking speed, BWS and effort. Additional research is needed to draw firm conclusions. Implications for Rehabilitation Awareness of the energy consumption and cardiorespiratory load of robot-assisted gait (RAG) training is important in the rehabilitation of (neurological) patients with impaired cardiorespiratory fitness and patients who are at risk of cardiovascular diseases. On the other hand, the integration of sufficient cardiometabolic stress in RAG training could combine the effects of both RAG and aerobic training. Energy consumption and cardiorespiratory load during walking with robot-assistance seems to depend on factors such as robot type, walking speed, body-weight support or amount of effort. These parameters could be adjusted in RAG rehabilitation to make RAG more or less energy-consuming and cardiorespiratory stressful. Overall, short duration exoskeleton walking seems less energy-consuming and cardiorespiratory stressful than walking without robot-assistance. This might implicate that the exercise intensity is safe for (neurological) patients at risk of cardiovascular diseases. How this changes in extended walking time is unclear.

Everyday robotic action: lessons from human action control

PubMed Central

de Kleijn, Roy; Kachergis, George; Hommel, Bernhard

2014-01-01

Robots are increasingly capable of performing everyday human activities such as cooking, cleaning, and doing the laundry. This requires the real-time planning and execution of complex, temporally extended sequential actions under high degrees of uncertainty, which provides many challenges to traditional approaches to robot action control. We argue that important lessons in this respect can be learned from research on human action control. We provide a brief overview of available psychological insights into this issue and focus on four principles that we think could be particularly beneficial for robot control: the integration of symbolic and subsymbolic planning of action sequences, the integration of feedforward and feedback control, the clustering of complex actions into subcomponents, and the contextualization of action-control structures through goal representations. PMID:24672474

Clinical Characteristics of Proper Robot-Assisted Gait Training Group in Non-ambulatory Subacute Stroke Patients

PubMed Central

Kim, Soo Jeong; Lee, Hye Jin; Hwang, Seung Won; Pyo, Hannah; Yang, Sung Phil; Lim, Mun-Hee; Park, Gyu Lee

2016-01-01

Objective To identify the clinical characteristics of proper robot-assisted gait training group using exoskeletal locomotor devices in non-ambulatory subacute stroke patients. Methods A total of 38 stroke patients were enrolled in a 4-week robotic training protocol (2 sessions/day, 5 times/week). All subjects were evaluated for their general characteristics, Functional Ambulatory Classification (FAC), Fugl-Meyer Scale (FMS), Berg Balance Scale (BBS), Modified Rankin Scale (MRS), Modified Barthel Index (MBI), and Mini-Mental Status Examination (MMSE) at 0, 2, and 4 weeks. Statistical analysis were performed to determine significant clinical characteristics for improvement of gait function after robot-assisted gait training. Results Paired t-test showed that all functional parameters except MMSE were improved significantly (p<0.05). The duration of disease and baseline BBS score were significantly (p<0.05) correlated with FAC score in multiple regression models. Receiver operating characteristic (ROC) curve showed that a baseline BBS score of '9' was a cutoff value (AUC, 0.966; sensitivity, 91%–100%; specificity, 85%). By repeated-measures ANOVA, the differences in improved walking ability according to time were significant between group of patients who had baseline BBS score of '9' and those who did not have baseline BBS score of '9' Conclusion Our results showed that a baseline BBS score above '9' and a short duration of disease were highly correlated with improved walking ability after robot-assisted gait training. Therefore, baseline BBS and duration of disease should be considered clinically for gaining walking ability in robot-assisted training group. PMID:27152266

Validity evidence for procedural competency in virtual reality robotic simulation, establishing a credible pass/fail standard for the vaginal cuff closure procedure.

PubMed

Hovgaard, Lisette Hvid; Andersen, Steven Arild Wuyts; Konge, Lars; Dalsgaard, Torur; Larsen, Christian Rifbjerg

2018-03-30

The use of robotic surgery for minimally invasive procedures has increased considerably over the last decade. Robotic surgery has potential advantages compared to laparoscopic surgery but also requires new skills. Using virtual reality (VR) simulation to facilitate the acquisition of these new skills could potentially benefit training of robotic surgical skills and also be a crucial step in developing a robotic surgical training curriculum. The study's objective was to establish validity evidence for a simulation-based test for procedural competency for the vaginal cuff closure procedure that can be used in a future simulation-based, mastery learning training curriculum. Eleven novice gynaecological surgeons without prior robotic experience and 11 experienced gynaecological robotic surgeons (> 30 robotic procedures) were recruited. After familiarization with the VR simulator, participants completed the module 'Guided Vaginal Cuff Closure' six times. Validity evidence was investigated for 18 preselected simulator metrics. The internal consistency was assessed using Cronbach's alpha and a composite score was calculated based on metrics with significant discriminative ability between the two groups. Finally, a pass/fail standard was established using the contrasting groups' method. The experienced surgeons significantly outperformed the novice surgeons on 6 of the 18 metrics. The internal consistency was 0.58 (Cronbach's alpha). The experienced surgeons' mean composite score for all six repetitions were significantly better than the novice surgeons' (76.1 vs. 63.0, respectively, p < 0.001). A pass/fail standard of 75/100 was established. Four novice surgeons passed this standard (false positives) and three experienced surgeons failed (false negatives). Our study has gathered validity evidence for a simulation-based test for procedural robotic surgical competency in the vaginal cuff closure procedure and established a credible pass/fail standard for future proficiency-based training.

Inducing self-selected human engagement in robotic locomotion training.

PubMed

Collins, Steven H; Jackson, Rachel W

2013-06-01

Stroke leads to severe mobility impairments for millions of individuals each year. Functional outcomes can be improved through manual treadmill therapy, but high costs limit patient exposure and, thereby, outcomes. Robotic gait training could increase the viable duration and frequency of training sessions, but robotic approaches employed thus far have been less effective than manual therapy. These shortcomings may relate to subconscious energy-minimizing drives, which might cause patients to engage less actively in therapy when provided with corrective robotic assistance. We have devised a new method for gait rehabilitation that harnesses, rather than fights, least-effort tendencies. Therapeutic goals, such as increased use of the paretic limb, are made easier than the patient's nominal gait through selective assistance from a robotic platform. We performed a pilot test on a healthy subject (N = 1) in which altered self-selected stride length was induced using a tethered robotic ankle-foot orthosis. The subject first walked on a treadmill while wearing the orthosis with and without assistance at unaltered and voluntarily altered stride length. Voluntarily increasing stride length by 5% increased metabolic energy cost by 4%. Robotic assistance decreased energy cost at both unaltered and voluntarily increased stride lengths, by 6% and 8% respectively. We then performed a test in which the robotic system continually monitored stride length and provided more assistance if the subject's stride length approached a target increase. This adaptive assistance protocol caused the subject to slowly adjust their gait patterns towards the target, leading to a 4% increase in stride length. Metabolic energy consumption was simultaneously reduced by 5%. These results suggest that selective-assistance protocols based on targets relevant to rehabilitation might lead patients to self-select desirable gait patterns during robotic gait training sessions, possibly facilitating better adherence and outcomes.

A Search-and-Rescue Robot System for Remotely Sensing the Underground Coal Mine Environment

PubMed Central

Gao, Junyao; Zhao, Fangzhou; Liu, Yi

2017-01-01

This paper introduces a search-and-rescue robot system used for remote sensing of the underground coal mine environment, which is composed of an operating control unit and two mobile robots with explosion-proof and waterproof function. This robot system is designed to observe and collect information of the coal mine environment through remote control. Thus, this system can be regarded as a multifunction sensor, which realizes remote sensing. When the robot system detects danger, it will send out signals to warn rescuers to keep away. The robot consists of two gas sensors, two cameras, a two-way audio, a 1 km-long fiber-optic cable for communication and a mechanical explosion-proof manipulator. Especially, the manipulator is a novel explosion-proof manipulator for cleaning obstacles, which has 3-degree-of-freedom, but is driven by two motors. Furthermore, the two robots can communicate in series for 2 km with the operating control unit. The development of the robot system may provide a reference for developing future search-and-rescue systems. PMID:29065560

Review of control strategies for robotic movement training after neurologic injury.

PubMed

Marchal-Crespo, Laura; Reinkensmeyer, David J

2009-06-16

There is increasing interest in using robotic devices to assist in movement training following neurologic injuries such as stroke and spinal cord injury. This paper reviews control strategies for robotic therapy devices. Several categories of strategies have been proposed, including, assistive, challenge-based, haptic simulation, and coaching. The greatest amount of work has been done on developing assistive strategies, and thus the majority of this review summarizes techniques for implementing assistive strategies, including impedance-, counterbalance-, and EMG- based controllers, as well as adaptive controllers that modify control parameters based on ongoing participant performance. Clinical evidence regarding the relative effectiveness of different types of robotic therapy controllers is limited, but there is initial evidence that some control strategies are more effective than others. It is also now apparent there may be mechanisms by which some robotic control approaches might actually decrease the recovery possible with comparable, non-robotic forms of training. In future research, there is a need for head-to-head comparison of control algorithms in randomized, controlled clinical trials, and for improved models of human motor recovery to provide a more rational framework for designing robotic therapy control strategies.

Model of a training program in robotic surgery and its initial results.

PubMed

Madureira, Fernando Athayde Veloso; Varela, José Luís Souza; Madureira, Delta; D'Almeida, Luis Alfredo Vieira; Madureira, Fábio Athayde Veloso; Duarte, Alexandre Miranda; Vaz, Otávio Pires; Ramos, José Reinan

2017-01-01

to describe the implementation of a training program in robotic surgery and to point the General Surgery procedures that can be performed with advantages using the robotic platform. we conducted a retrospective analysis of data collected prospectively from the robotic surgery group in General and Colo-Retal Surgery at the Samaritan Hospital (Rio de Janeiro, Brazil), from October 2012 to December 2015. We describe the training stages and particularities. two hundred and ninety three robotic operations were performed in general surgery: 108 procedures for morbid obesity, 59 colorectal surgeries, 55 procedures in the esophago-gastric transition area, 16 cholecystectomies, 27 abdominal wall hernioplasties, 13 inguinal hernioplasties, two gastrectomies with D2 lymphadenectomy, one vagotomy, two diaphragmatic hernioplasties, four liver surgeries, two adrenalectomies, two splenectomies, one pancreatectomy and one bilio-digestive anastomosis. The complication rate was 2.4%, with no major complications. the robotic surgery program of the Samaritan Hospital was safely implemented and with initial results better than the ones described in the current literature. There seems to be benefits in using the robotic platform in super-obese patients, re-operations of obesity surgery and hiatus hernias, giant and paraesophageal hiatus hernias, ventral hernias with multiple defects and rectal resections.

Review of control strategies for robotic movement training after neurologic injury

PubMed Central

Marchal-Crespo, Laura; Reinkensmeyer, David J

2009-01-01

There is increasing interest in using robotic devices to assist in movement training following neurologic injuries such as stroke and spinal cord injury. This paper reviews control strategies for robotic therapy devices. Several categories of strategies have been proposed, including, assistive, challenge-based, haptic simulation, and coaching. The greatest amount of work has been done on developing assistive strategies, and thus the majority of this review summarizes techniques for implementing assistive strategies, including impedance-, counterbalance-, and EMG- based controllers, as well as adaptive controllers that modify control parameters based on ongoing participant performance. Clinical evidence regarding the relative effectiveness of different types of robotic therapy controllers is limited, but there is initial evidence that some control strategies are more effective than others. It is also now apparent there may be mechanisms by which some robotic control approaches might actually decrease the recovery possible with comparable, non-robotic forms of training. In future research, there is a need for head-to-head comparison of control algorithms in randomized, controlled clinical trials, and for improved models of human motor recovery to provide a more rational framework for designing robotic therapy control strategies. PMID:19531254

Robot-Assisted Body-Weight-Supported Treadmill Training in Gait Impairment in Multiple Sclerosis Patients: A Pilot Study.

PubMed

Łyp, Marek; Stanisławska, Iwona; Witek, Bożena; Olszewska-Żaczek, Ewelina; Czarny-Działak, Małgorzata; Kaczor, Ryszard

2018-02-13

This study deals with the use of a robot-assisted body-weight-supported treadmill training in multiple sclerosis (MS) patients with gait dysfunction. Twenty MS patients (10 men and 10 women) of the mean of 46.3 ± 8.5 years were assigned to a six-week-long training period with the use of robot-assisted treadmill training of increasing intensity of the Lokomat type. The outcome measure consisted of the difference in motion-dependent torque of lower extremity joint muscles after training compared with baseline before training. We found that the training uniformly and significantly augmented the torque of both extensors and flexors of the hip and knee joints. The muscle power in the lower limbs of SM patients was improved, leading to corrective changes of disordered walking movements, which enabled the patients to walk with less effort and less assistance of care givers. The torque augmentation could have its role in affecting the function of the lower extremity muscle groups during walking. The results of this pilot study suggest that the robot-assisted body-weight-supported treadmill training may be a potential adjunct measure in the rehabilitation paradigm of 'gait reeducation' in peripheral neuropathies.

POINTER: Portable Intelligent Trainer for External Robotics

NASA Technical Reports Server (NTRS)

Kuiper, Hilbert; Rikken, Patrick J.

1994-01-01

Intelligent tutoring systems (ITS's) play an increasing role in training and education of people with different levels of skill and knowledge. As compared to conventional computer based training (CBT) an ITS provides more tailored instruction by trying to mimic the teaching behavior of a human instructor as much as possible and is therefore much more flexible. This paper starts with an introduction to ITS's, followed by the description of an ITS for training of an (astronaut) operator in monitoring and controlling robotic arm procedures. The robotic arm will be used for exchange of equipment between a space station and a space plane involving critical and accurate movements of the robotic arm. The ITS for this application, called Pointer, is developed by TNO Physics and Electronics Laboratory and is based upon an existing ITS that includes procedural training. Pointer has been developed on a workstation whereas the target platform was a portable computer. Therefore, a lot of attention had to be paid to scaling effects and keeping up with user friendliness of the much smaller user interface. Although the learning domain was the control of a robotic arm, it is clear that use of intelligent training technologies on a portable computer has many other applications (payload operations, operation control rooms, etc.). Training can occur at any time and place in an attractive and cost effective way.

Competency based training in robotic surgery: benchmark scores for virtual reality robotic simulation.

PubMed

Raison, Nicholas; Ahmed, Kamran; Fossati, Nicola; Buffi, Nicolò; Mottrie, Alexandre; Dasgupta, Prokar; Van Der Poel, Henk

2017-05-01

To develop benchmark scores of competency for use within a competency based virtual reality (VR) robotic training curriculum. This longitudinal, observational study analysed results from nine European Association of Urology hands-on-training courses in VR simulation. In all, 223 participants ranging from novice to expert robotic surgeons completed 1565 exercises. Competency was set at 75% of the mean expert score. Benchmark scores for all general performance metrics generated by the simulator were calculated. Assessment exercises were selected by expert consensus and through learning-curve analysis. Three basic skill and two advanced skill exercises were identified. Benchmark scores based on expert performance offered viable targets for novice and intermediate trainees in robotic surgery. Novice participants met the competency standards for most basic skill exercises; however, advanced exercises were significantly more challenging. Intermediate participants performed better across the seven metrics but still did not achieve the benchmark standard in the more difficult exercises. Benchmark scores derived from expert performances offer relevant and challenging scores for trainees to achieve during VR simulation training. Objective feedback allows both participants and trainers to monitor educational progress and ensures that training remains effective. Furthermore, the well-defined goals set through benchmarking offer clear targets for trainees and enable training to move to a more efficient competency based curriculum. © 2016 The Authors BJU International © 2016 BJU International Published by John Wiley & Sons Ltd.

Variety Wins: Soccer-Playing Robots and Infant Walking

PubMed Central

Ossmy, Ori; Hoch, Justine E.; MacAlpine, Patrick; Hasan, Shohan; Stone, Peter; Adolph, Karen E.

2018-01-01

Although both infancy and artificial intelligence (AI) researchers are interested in developing systems that produce adaptive, functional behavior, the two disciplines rarely capitalize on their complementary expertise. Here, we used soccer-playing robots to test a central question about the development of infant walking. During natural activity, infants' locomotor paths are immensely varied. They walk along curved, multi-directional paths with frequent starts and stops. Is the variability observed in spontaneous infant walking a “feature” or a “bug?” In other words, is variability beneficial for functional walking performance? To address this question, we trained soccer-playing robots on walking paths generated by infants during free play and tested them in simulated games of “RoboCup.” In Tournament 1, we compared the functional performance of a simulated robot soccer team trained on infants' natural paths with teams trained on less varied, geometric paths—straight lines, circles, and squares. Across 1,000 head-to-head simulated soccer matches, the infant-trained team consistently beat all teams trained with less varied walking paths. In Tournament 2, we compared teams trained on different clusters of infant walking paths. The team trained with the most varied combination of path shape, step direction, number of steps, and number of starts and stops outperformed teams trained with less varied paths. This evidence indicates that variety is a crucial feature supporting functional walking performance. More generally, we propose that robotics provides a fruitful avenue for testing hypotheses about infant development; reciprocally, observations of infant behavior may inform research on artificial intelligence. PMID:29867427

Safety, efficiency and learning curves in robotic surgery: a human factors analysis.

PubMed

Catchpole, Ken; Perkins, Colby; Bresee, Catherine; Solnik, M Jonathon; Sherman, Benjamin; Fritch, John; Gross, Bruno; Jagannathan, Samantha; Hakami-Majd, Niv; Avenido, Raymund; Anger, Jennifer T

2016-09-01

Expense, efficiency of use, learning curves, workflow integration and an increased prevalence of serious incidents can all be barriers to adoption. We explored an observational approach and initial diagnostics to enhance total system performance in robotic surgery. Eighty-nine robotic surgical cases were observed in multiple operating rooms using two different surgical robots (the S and Si), across several specialties (Urology, Gynecology, and Cardiac Surgery). The main measures were operative duration and rate of flow disruptions-described as 'deviations from the natural progression of an operation thereby potentially compromising safety or efficiency.' Contextual parameters collected were surgeon experience level and training, type of surgery, the model of robot and patient factors. Observations were conducted across four operative phases (operating room pre-incision; robot docking; main surgical intervention; post-console). A mean of 9.62 flow disruptions per hour (95 % CI 8.78-10.46) were predominantly caused by coordination, communication, equipment and training problems. Operative duration and flow disruption rate varied with surgeon experience (p = 0.039; p < 0.001, respectively), training cases (p = 0.012; p = 0.007) and surgical type (both p < 0.001). Flow disruption rates in some phases were also sensitive to the robot model and patient characteristics. Flow disruption rate is sensitive to system context and generates improvement diagnostics. Complex surgical robotic equipment increases opportunities for technological failures, increases communication requirements for the whole team, and can reduce the ability to maintain vision in the operative field. These data suggest specific opportunities to reduce the training costs and the learning curve.

Hand Rehabilitation Robotics on Poststroke Motor Recovery

PubMed Central

2017-01-01

The recovery of hand function is one of the most challenging topics in stroke rehabilitation. Although the robot-assisted therapy has got some good results in the latest decades, the development of hand rehabilitation robotics is left behind. Existing reviews of hand rehabilitation robotics focus either on the mechanical design on designers' view or on the training paradigms on the clinicians' view, while these two parts are interconnected and both important for designers and clinicians. In this review, we explore the current literature surrounding hand rehabilitation robots, to help designers make better choices among varied components and thus promoting the application of hand rehabilitation robots. An overview of hand rehabilitation robotics is provided in this paper firstly, to give a general view of the relationship between subjects, rehabilitation theories, hand rehabilitation robots, and its evaluation. Secondly, the state of the art hand rehabilitation robotics is introduced in detail according to the classification of the hardware system and the training paradigm. As a result, the discussion gives available arguments behind the classification and comprehensive overview of hand rehabilitation robotics. PMID:29230081

Motor Learning Characterizes Habilitation of Children With Hemiplegic Cerebral Palsy

PubMed Central

Krebs, Hermano I.; Fasoli, Susan E.; Dipietro, Laura; Fragala-Pinkham, Maria; Hughes, Richard; Stein, Joel; Hogan, Neville

2015-01-01

Background This study tested in children with cerebral palsy (CP) whether motor habilitation resembles motor learning. Methods Twelve children with hemiplegic CP ages 5 to 12 years with moderate to severe motor impairments underwent a 16-session robot-mediated planar therapy program to improve upper limb reach, with a focus on shoulder and elbow movements. Participants were trained to execute point-to-point movements (with robot assistance) with the affected arm and were evaluated (without robot assistance) in trained (point-to-point) and untrained (circle-drawing) conditions. Outcomes were measured at baseline, midpoint, immediately after the program, and 1 month postcompletion. Outcome measures were the Fugl-Meyer (FM), Quality of Upper Extremity Skills Test (QUEST), and Modified Ashworth Scale (MAS) scores; parent questionnaire; and robot-based kinematic metrics. To assess whether learning best characterizes motor habilitation in CP, the authors quantified (a) improvement on trained tasks at completion of training (acquisition) and 1 month following completion (retention) and (b) quantified generalization of improvement to untrained tasks. Results After robotic intervention, the authors found significant gains in the FM, QUEST, and parent questionnaire. Robot-based evaluations demonstrated significant improvement in trained movements and that improvement was sustained at follow-up. Furthermore, children improved their performance in untrained movements indicating generalization. Conclusions Motor habilitation in CP exhibits some traits of motor learning. Optimal treatment may not require an extensive repertoire of tasks but rather a select set to promote generalization. PMID:22331211

[Robotics in general surgery: personal experience, critical analysis and prospectives].

PubMed

Fracastoro, Gerolamo; Borzellino, Giuseppe; Castelli, Annalisa; Fiorini, Paolo

2005-01-01

Today mini invasive surgery has the chance to be enhanced with sophisticated informative systems (Computer Assisted Surgery, CAS) like robotics, tele-mentoring and tele-presence. ZEUS and da Vinci, present in more than 120 Centres in the world, have been used in many fields of surgery and have been tested in some general surgical procedures. Since the end of 2003, we have performed 70 experimental procedures and 24 operations of general surgery with ZEUS robotic system, after having properly trained 3 surgeons and the operating room staff. Apart from the robot set-up, the mean operative time of the robotic operations was similar to the laparoscopic ones; no complications due to robotic technique occurred. The Authors report benefits and disadvantages related to robots' utilization, problems still to be solved and the possibility to make use of them with tele-surgery, training and virtual surgery.

The effects of embodied rhythm and robotic interventions on the spontaneous and responsive social attention patterns of children with Autism Spectrum Disorder (ASD): A pilot randomized controlled trial

PubMed Central

Srinivasan, Sudha M.; Eigsti, Inge-Marie; Neelly, Linda; Bhat, Anjana N.

2016-01-01

We compared the effects of 8-weeks of rhythm and robotic interventions with those of a comparison, standard-of-care intervention, on the spontaneous and responsive social attention patterns of school-age children with Autism Spectrum Disorder. Attention patterns were examined within a standardized pretest/posttest measure of joint attention (JA) and a training-specific social attention measure during early, mid, and late training sessions. The rhythm and comparison groups demonstrated improvements in JA. Social attention was greater in the rhythm followed by the robot and lastly the comparison group. The robot and comparison groups spent maximum time fixating on the robot and objects, respectively. Across sessions, the robot group decreased attention to the robot and increased attention to elsewhere. Overall, rhythmic movement contexts afford sustained social monitoring in children with autism. PMID:27453721

Clinical application of a modular ankle robot for stroke rehabilitation.

PubMed

Forrester, Larry W; Roy, Anindo; Goodman, Ronald N; Rietschel, Jeremy; Barton, Joseph E; Krebs, Hermano Igo; Macko, Richard F

2013-01-01

Advances in our understanding of neuroplasticity and motor learning post-stroke are now being leveraged with the use of robotics technology to enhance physical rehabilitation strategies. Major advances have been made with upper extremity robotics, which have been tested for efficacy in multi-site trials across the subacute and chronic phases of stroke. In contrast, use of lower extremity robotics to promote locomotor re-learning has been more recent and presents unique challenges by virtue of the complex multi-segmental mechanics of gait. Here we review a programmatic effort to develop and apply the concept of joint-specific modular robotics to the paretic ankle as a means to improve underlying impairments in distal motor control that may have a significant impact on gait biomechanics and balance. An impedance controlled ankle robot module (anklebot) is described as a platform to test the idea that a modular approach can be used to modify training and measure the time profile of treatment response. Pilot studies using seated visuomotor anklebot training with chronic patients are reviewed, along with results from initial efforts to evaluate the anklebot's utility as a clinical tool for assessing intrinsic ankle stiffness. The review includes a brief discussion of future directions for using the seated anklebot training in the earliest phases of sub-acute therapy, and to incorporate neurophysiological measures of cerebro-cortical activity as a means to reveal underlying mechanistic processes of motor learning and brain plasticity associated with robotic training. Finally we conclude with an initial control systems strategy for utilizing the anklebot as a gait training tool that includes integrating an Internal Model-based adaptive controller to both accommodate individual deficit severities and adapt to changes in patient performance.

Clinical application of a modular ankle robot for stroke rehabilitation

PubMed Central

Forrester, Larry W.; Roy, Anindo; Goodman, Ronald N.; Rietschel, Jeremy; Barton, Joseph E.; Krebs, Hermano Igo; Macko, Richard F.

2015-01-01

Background Advances in our understanding of neuroplasticity and motor learning post-stroke are now being leveraged with the use of robotics technology to enhance physical rehabilitation strategies. Major advances have been made with upper extremity robotics, which have been tested for efficacy in multi-site trials across the subacute and chronic phases of stroke. In contrast, use of lower extremity robotics to promote locomotor re-learning has been more recent and presents unique challenges by virtue of the complex multi-segmental mechanics of gait. Objectives Here we review a programmatic effort to develop and apply the concept of joint-specific modular robotics to the paretic ankle as a means to improve underlying impairments in distal motor control that may have a significant impact on gait biomechanics and balance. Methods An impedance controlled ankle robot module (anklebot) is described as a platform to test the idea that a modular approach can be used to modify training and measure the time profile of treatment response. Results Pilot studies using seated visuomotor anklebot training with chronic patients are reviewed, along with results from initial efforts to evaluate the anklebot's utility as a clinical tool for assessing intrinsic ankle stiffness. The review includes a brief discussion of future directions for using the seated anklebot training in the earliest phases of sub-acute therapy, and to incorporate neurophysiological measures of cerebro-cortical activity as a means to reveal underlying mechanistic processes of motor learning and brain plasticity associated with robotic training. Conclusions Finally we conclude with an initial control systems strategy for utilizing the anklebot as a gait training tool that includes integrating an Internal Model-based adaptive controller to both accommodate individual deficit severities and adapt to changes in patient performance. PMID:23949045

Effectuality of Cleaning Workers' Training and Cleaning Enterprises' Chemical Health Hazard Risk Profiling.

PubMed

Suleiman, Abdulqadir M; Svendsen, Kristin V H

2015-12-01

Goal-oriented communication of risk of hazards is necessary in order to reduce risk of workers' exposure to chemicals. Adequate training of workers and enterprise priority setting are essential elements. Cleaning enterprises have many challenges and the existing paradigms influence the risk levels of these enterprises. Information on organization and enterprises' prioritization in training programs was gathered from cleaning enterprises. A measure of enterprises' conceptual level of importance of chemical health hazards and a model for working out the risk index (RI) indicating enterprises' conceptual risk level was established and used to categorize the enterprises. In 72.3% of cases, training takes place concurrently with task performances and in 67.4% experienced workers conduct the trainings. There is disparity between employers' opinion on competence level of the workers and reality. Lower conceptual level of importance was observed for cleaning enterprises of different sizes compared with regional safety delegates and occupational hygienists. Risk index values show no difference in risk level between small and large enterprises. Training of cleaning workers lacks the prerequisite for suitability and effectiveness to counter risks of chemical health hazards. There is dereliction of duty by management in the sector resulting in a lack of competence among the cleaning workers. Instituting acceptable easily attainable safety competence level for cleaners will conduce to risk reduction, and enforcement of attainment of the competence level would be a positive step.

Think Tanks

NASA Technical Reports Server (NTRS)

2001-01-01

A new inspection robot from Solex Robotics Systems was designed to eliminate hazardous inspections of petroleum and chemical storage tanks. The submersible robot, named Maverick, is used to inspect the bottoms of tanks, keeping the tanks operational during inspection. Maverick is able to provide services that will make manual tank inspections obsolete. While the inspection is conducted, Maverick's remote human operators remain safe outside of the tank. The risk to human health and life is now virtually eliminated. The risk to the environment is also minimal because there is a reduced chance of spillage from emptying and cleaning the tanks, where previously, tons of pollutants were released through the process of draining and refilling.

Dynamic path planning for mobile robot based on particle swarm optimization

NASA Astrophysics Data System (ADS)

Wang, Yong; Cai, Feng; Wang, Ying

2017-08-01

In the contemporary, robots are used in many fields, such as cleaning, medical treatment, space exploration, disaster relief and so on. The dynamic path planning of robot without collision is becoming more and more the focus of people's attention. A new method of path planning is proposed in this paper. Firstly, the motion space model of the robot is established by using the MAKLINK graph method. Then the A* algorithm is used to get the shortest path from the start point to the end point. Secondly, this paper proposes an effective method to detect and avoid obstacles. When an obstacle is detected on the shortest path, the robot will choose the nearest safety point to move. Moreover, calculate the next point which is nearest to the target. Finally, the particle swarm optimization algorithm is used to optimize the path. The experimental results can prove that the proposed method is more effective.

Large robotized turning centers described

NASA Astrophysics Data System (ADS)

Kirsanov, V. V.; Tsarenko, V. I.

1985-09-01

The introduction of numerical control (NC) machine tools has made it possible to automate machining in series and small series production. The organization of automated production sections merged NC machine tools with automated transport systems. However, both the one and the other require the presence of an operative at the machine for low skilled operations. Industrial robots perform a number of auxiliary operations, such as equipment loading-unloading and control, changing cutting and auxiliary tools, controlling workpieces and parts, and cleaning of location surfaces. When used with a group of equipment they perform transfer operations between the machine tools. Industrial robots eliminate the need for workers to form auxiliary operations. This underscores the importance of developing robotized manufacturing centers providing for minimal human participation in production and creating conditions for two and three shift operation of equipment. Work carried out at several robotized manufacturing centers for series and small series production is described.

Robot-assisted gait training versus treadmill training in patients with Parkinson’s disease: a kinematic evaluation with gait profile score

PubMed Central

Galli, Manuela; Cimolin, Veronica; De Pandis, Maria Francesca; Le Pera, Domenica; Sova, Ivan; Albertini, Giorgio; Stocchi, Fabrizio; Franceschini, Marco

2016-01-01

Summary The purpose of this study was to quantitatively compare the effects, on walking performance, of end-effector robotic rehabilitation locomotor training versus intensive training with a treadmill in Parkinson’s disease (PD). Fifty patients with PD were randomly divided into two groups: 25 were assigned to the robot-assisted therapy group (RG) and 25 to the intensive treadmill therapy group (IG). They were evaluated with clinical examination and 3D quantitative gait analysis [gait profile score (GPS) and its constituent gait variable scores (GVSs) were calculated from gait analysis data] at the beginning (T0) and at the end (T1) of the treatment. In the RG no differences were found in the GPS, but there were significant improvements in some GVSs (Pelvic Obl and Hip Ab-Add). The IG showed no statistically significant changes in either GPS or GVSs. The end-effector robotic rehabilitation locomotor training improved gait kinematics and seems to be effective for rehabilitation in patients with mild PD. PMID:27678210

Objective assessment in residency-based training for transoral robotic surgery.

PubMed

Curry, Martin; Malpani, Anand; Li, Ryan; Tantillo, Thomas; Jog, Amod; Blanco, Ray; Ha, Patrick K; Califano, Joseph; Kumar, Rajesh; Richmon, Jeremy

2012-10-01

To develop a robotic surgery training regimen integrating objective skill assessment for otolaryngology and head and neck surgery trainees consisting of training modules of increasing complexity leading up to procedure-specific training. In particular, we investigated applications of such a training approach for surgical extirpation of oropharyngeal tumors via a transoral approach using the da Vinci robotic system. Prospective blinded data collection and objective evaluation (Objective Structured Assessment of Technical Skills [OSATS]) of three distinct phases using the da Vinci robotic surgical system in an academic university medical engineering/computer science laboratory setting. Between September 2010 and July 2011, eight otolaryngology-head and neck surgery residents and four staff experts from an academic hospital participated in three distinct phases of robotic surgery training involving 1) robotic platform operational skills, 2) set up of the patient side system, and 3) a complete ex vivo surgical extirpation of an oropharyngeal tumor located in the base of tongue. Trainees performed multiple (four) approximately equally spaced training sessions in each stage of the training. In addition to trainees, baseline performance data were obtained for the experts. Each surgical stage was documented with motion and event data captured from the application programming interfaces of the da Vinci system, as well as separate video cameras as appropriate. All data were assessed using automated skill measures of task efficiency and correlated with structured assessment (OSATS and similar Likert scale) from three experts to assess expert and trainee differences and compute automated and expert assessed learning curves. Our data show that such training results in an improved didactic robotic knowledge base and improved clinical efficiency with respect to the set up and console manipulation. Experts (e.g., average OSATS, 25; standard deviation [SD], 3.1; module 1, suturing) and trainees (average OSATS, 15.9; SD, 3.9; week 1) are well separated at the beginning of the training, and the separation reduces significantly (expert average OSATS, 27.6; SD, 2.7; trainee average OSATS, 24.2; SD, 6.8; module 3) at the conclusion of the training. Learning curves in each of the three stages show diminishing differences between the experts and trainees, which is also consistent with expert assessment. Subjective assessment by experts verified the clinical utility of the module 3 surgical environment, and a survey of trainees consistently rated the curriculum as very useful in progression to human operating room assistance. Structured curricular robotic surgery training with objective assessment promises to reduce the overhead for mentors, allow detailed assessment of human-machine interface skills, and create customized training models for individualized training. This preliminary study verifies the utility of such training in improving human-machine operations skills (module 1), and operating room and surgical skills (modules 2 and 3). In contrast to current coarse measures of total operating time and subjective assessment of error for short mass training sessions, these methods may allow individual tasks to be removed from the trainee regimen when skill levels are within the standard deviation of the experts for these tasks, which can greatly enhance overall efficiency of the training regimen and allow time for additional and more complex training to be incorporated in the same time frame. Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.

Robotic inspection for vehicle-borne contraband

NASA Astrophysics Data System (ADS)

Witus, Gary; Gerhart, Grant; Smuda, W.; Andrusz, H.

2006-05-01

Vehicle-borne smuggling is widespread because of the availability, flexibility and capacity of the cars and trucks. Inspecting vehicles at border crossings and checkpoints are key security elements. At the present time, most vehicle security inspections at home and abroad are conducted manually. Remotely operated vehicle inspection robots could be integrated into the operating procedures to improve throughput while reducing the workload burden on security personnel. The robotic inspection must be effective at detecting contraband and efficient at clearing the "clean" vehicles that make up the bulk of the traffic stream, while limiting the workload burden on the operators. In this paper, we present a systems engineering approach to robotic vehicle inspection. We review the tactics, techniques and procedures to interdict contraband. We present an operational concept for robotic vehicle inspection within this framework, and identify needed capabilities. We review the technologies currently available to meet these needs. Finally, we summarize the immediate potential and R&D challenges for effective contraband detection robots.

Myoelectrically controlled wrist robot for stroke rehabilitation

PubMed Central

2013-01-01

Background Robot-assisted rehabilitation is an advanced new technology in stroke rehabilitation to provide intensive training. Post-stroke motor recovery depends on active rehabilitation by voluntary participation of patient’s paretic motor system as early as possible in order to promote reorganization of brain. However, voluntary residual motor efforts to the affected limb have not been involved enough in most robot-assisted rehabilitation for patients after stroke. The objective of this study is to evaluate the feasibility of robot-assisted rehabilitation using myoelectric control on upper limb motor recovery. Methods In the present study, an exoskeleton-type rehabilitation robotic system was designed to provide voluntarily controlled assisted torque to the affected wrist. Voluntary intention was involved by using the residual surface electromyography (EMG) from flexor carpi radialis(FCR) and extensor carpi radialis (ECR)on the affected limb to control the mechanical assistance provided by the robotic system during wrist flexion and extension in a 20-session training. The system also applied constant resistant torque to the affected wrist during the training. Sixteen subjects after stroke had been recruited for evaluating the tracking performance and therapeutical effects of myoelectrically controlled robotic system. Results With the myoelectrically-controlled assistive torque, stroke survivors could reach a larger range of motion with a significant decrease in the EMG signal from the agonist muscles. The stroke survivors could be trained in the unreached range with their voluntary residual EMG on the paretic side. After 20-session rehabilitation training, there was a non-significant increase in the range of motion and a significant decrease in the root mean square error (RMSE) between the actual wrist angle and target angle. Significant improvements also could be found in muscle strength and clinical scales. Conclusions These results indicate that robot-aided therapy with voluntary participation of patient’s paretic motor system using myoelectric control might have positive effect on upper limb motor recovery. PMID:23758925

The effects of post-stroke upper-limb training with an electromyography (EMG)-driven hand robot.

PubMed

Hu, X L; Tong, K Y; Wei, X J; Rong, W; Susanto, E A; Ho, S K

2013-10-01

Loss of hand function and finger dexterity are main disabilities in the upper limb after stroke. An electromyography (EMG)-driven hand robot had been developed for post-stroke rehabilitation training. The effectiveness of the hand robot assisted whole upper limb training was investigated on persons with chronic stroke (n=10) in this work. All subjects attended a 20-session training (3-5times/week) by using the hand robot to practice object grasp/release and arm transportation tasks. Significant motor improvements were observed in the Fugl-Meyer hand/wrist and shoulder/elbow scores (p<0.05), and also in the Action Research Arm Test and Wolf Motor Function Test (p<0.05). Significant reduction in spasticity of the fingers as was measured by the Modified Ashworth Score (p<0.05). The training improved the muscle co-ordination between the antagonist muscle pair (flexor digitorum (FD) and extensor digitorum (ED)), associated with a significant reduction in the ED EMG level (p<0.05) and a significant decrease of ED and FD co-contraction during the training (p<0.05); the excessive muscle activities in the biceps brachii were also reduced significantly after the training (p<0.05). Copyright © 2013 Elsevier Ltd. All rights reserved.

Crowdsourcing: a valid alternative to expert evaluation of robotic surgery skills.

PubMed

Polin, Michael R; Siddiqui, Nazema Y; Comstock, Bryan A; Hesham, Helai; Brown, Casey; Lendvay, Thomas S; Martino, Martin A

2016-11-01

Robotic-assisted gynecologic surgery is common, but requires unique training. A validated assessment tool for evaluating trainees' robotic surgery skills is Robotic-Objective Structured Assessments of Technical Skills. We sought to assess whether crowdsourcing can be used as an alternative to expert surgical evaluators in scoring Robotic-Objective Structured Assessments of Technical Skills. The Robotic Training Network produced the Robotic-Objective Structured Assessments of Technical Skills, which evaluate trainees across 5 dry lab robotic surgical drills. Robotic-Objective Structured Assessments of Technical Skills were previously validated in a study of 105 participants, where dry lab surgical drills were recorded, de-identified, and scored by 3 expert surgeons using the Robotic-Objective Structured Assessments of Technical Skills checklist. Our methods-comparison study uses these previously obtained recordings and expert surgeon scores. Mean scores per participant from each drill were separated into quartiles. Crowdworkers were trained and calibrated on Robotic-Objective Structured Assessments of Technical Skills scoring using a representative recording of a skilled and novice surgeon. Following this, 3 recordings from each scoring quartile for each drill were randomly selected. Crowdworkers evaluated the randomly selected recordings using Robotic-Objective Structured Assessments of Technical Skills. Linear mixed effects models were used to derive mean crowdsourced ratings for each drill. Pearson correlation coefficients were calculated to assess the correlation between crowdsourced and expert surgeons' ratings. In all, 448 crowdworkers reviewed videos from 60 dry lab drills, and completed a total of 2517 Robotic-Objective Structured Assessments of Technical Skills assessments within 16 hours. Crowdsourced Robotic-Objective Structured Assessments of Technical Skills ratings were highly correlated with expert surgeon ratings across each of the 5 dry lab drills (r ranging from 0.75-0.91). Crowdsourced assessments of recorded dry lab surgical drills using a validated assessment tool are a rapid and suitable alternative to expert surgeon evaluation. Copyright © 2016 Elsevier Inc. All rights reserved.

Android Robot-Mediated Mock Job Interview Sessions for Young Adults with Autism Spectrum Disorder: A Pilot Study

PubMed Central

Kumazaki, Hirokazu; Warren, Zachary; Corbett, Blythe A.; Yoshikawa, Yuichiro; Matsumoto, Yoshio; Higashida, Haruhiro; Yuhi, Teruko; Ikeda, Takashi; Ishiguro, Hiroshi; Kikuchi, Mitsuru

2017-01-01

The feasibility and preliminary efficacy of an android robot-mediated mock job interview training in terms of both bolstering self-confidence and reducing biological levels of stress in comparison to a psycho-educational approach human interview was assessed in a randomized study. Young adults (ages 18–25 years) with autism spectrum disorder (ASD) were randomized to participate either in a mock job interview training with our android robot system (n = 7) or a self-paced review of materials about job-interviewing skills (n = 8). Baseline and outcome measurements of self-reported performance/efficacy and salivary cortisol were obtained after a mock job interview with a human interviewer. After training sessions, individuals with ASD participating in the android robot-mediated sessions reported marginally improved self-confidence and demonstrated significantly lower levels of salivary cortisol as compared to the control condition. These results provide preliminary support for the feasibility and efficacy of android robot-mediated learning. PMID:28955254

Android Robot-Mediated Mock Job Interview Sessions for Young Adults with Autism Spectrum Disorder: A Pilot Study.

PubMed

Kumazaki, Hirokazu; Warren, Zachary; Corbett, Blythe A; Yoshikawa, Yuichiro; Matsumoto, Yoshio; Higashida, Haruhiro; Yuhi, Teruko; Ikeda, Takashi; Ishiguro, Hiroshi; Kikuchi, Mitsuru

2017-01-01

The feasibility and preliminary efficacy of an android robot-mediated mock job interview training in terms of both bolstering self-confidence and reducing biological levels of stress in comparison to a psycho-educational approach human interview was assessed in a randomized study. Young adults (ages 18-25 years) with autism spectrum disorder (ASD) were randomized to participate either in a mock job interview training with our android robot system ( n  = 7) or a self-paced review of materials about job-interviewing skills ( n  = 8). Baseline and outcome measurements of self-reported performance/efficacy and salivary cortisol were obtained after a mock job interview with a human interviewer. After training sessions, individuals with ASD participating in the android robot-mediated sessions reported marginally improved self-confidence and demonstrated significantly lower levels of salivary cortisol as compared to the control condition. These results provide preliminary support for the feasibility and efficacy of android robot-mediated learning.

Tele-surgery simulation with a patient organ model for robotic surgery training.

PubMed

Suzuki, S; Suzuki, N; Hattori, A; Hayashibe, M; Konishi, K; Kakeji, Y; Hashizume, M

2005-12-01

Robotic systems are increasingly being incorporated into general laparoscopic and thoracoscopic surgery to perform procedures such as cholecystectomy and prostatectomy. Robotic assisted surgery allows the surgeon to conduct minimally invasive surgery with increased accuracy and with potential benefits for patients. However, current robotic systems have their limitations. These include the narrow operative field of view, which can make instrument manipulation difficult. Current robotic applications are also tailored to specific surgical procedures. For these reasons, there is an increasing demand on surgeons to master the skills of instrument manipulation and their surgical application within a controlled environment. This study describes the development of a surgical simulator for training and mastering procedures performed with the da Vinci surgical system. The development of a tele-surgery simulator and the construction of a training center are also described, which will enable surgeons to simulate surgery from or in remote places, to collaborate over long distances, and for off-site expert assistance. Copyright 2005 John Wiley & Sons, Ltd.

Evolutionary programming-based univector field navigation method for past mobile robots.

PubMed

Kim, Y J; Kim, J H; Kwon, D S

2001-01-01

Most of navigation techniques with obstacle avoidance do not consider the robot orientation at the target position. These techniques deal with the robot position only and are independent of its orientation and velocity. To solve these problems this paper proposes a novel univector field method for fast mobile robot navigation which introduces a normalized two dimensional vector field. The method provides fast moving robots with the desired posture at the target position and obstacle avoidance. To obtain the sub-optimal vector field, a function approximator is used and trained by evolutionary programming. Two kinds of vector fields are trained, one for the final posture acquisition and the other for obstacle avoidance. Computer simulations and real experiments are carried out for a fast moving mobile robot to demonstrate the effectiveness of the proposed scheme.

Serendipitous Offline Learning in a Neuromorphic Robot.

PubMed

Stewart, Terrence C; Kleinhans, Ashley; Mundy, Andrew; Conradt, Jörg

2016-01-01

We demonstrate a hybrid neuromorphic learning paradigm that learns complex sensorimotor mappings based on a small set of hard-coded reflex behaviors. A mobile robot is first controlled by a basic set of reflexive hand-designed behaviors. All sensor data is provided via a spike-based silicon retina camera (eDVS), and all control is implemented via spiking neurons simulated on neuromorphic hardware (SpiNNaker). Given this control system, the robot is capable of simple obstacle avoidance and random exploration. To train the robot to perform more complex tasks, we observe the robot and find instances where the robot accidentally performs the desired action. Data recorded from the robot during these times is then used to update the neural control system, increasing the likelihood of the robot performing that task in the future, given a similar sensor state. As an example application of this general-purpose method of training, we demonstrate the robot learning to respond to novel sensory stimuli (a mirror) by turning right if it is present at an intersection, and otherwise turning left. In general, this system can learn arbitrary relations between sensory input and motor behavior.

Does robot-assisted gait training ameliorate gait abnormalities in multiple sclerosis? A pilot randomized-control trial.

PubMed

Straudi, S; Benedetti, M G; Venturini, E; Manca, M; Foti, C; Basaglia, N

2013-01-01

Gait disorders are common in multiple sclerosis (MS) and lead to a progressive reduction of function and quality of life. Test the effects of robot-assisted gait rehabilitation in MS subjects through a pilot randomized-controlled study. We enrolled MS subjects with Expanded Disability Status Scale scores within 4.5-6.5. The experimental group received 12 robot-assisted gait training sessions over 6 weeks. The control group received the same amount of conventional physiotherapy. Outcomes measures were both biomechanical assessment of gait, including kinematics and spatio-temporal parameters, and clinical test of walking endurance (six-minute walk test) and mobility (Up and Go Test). 16 subjects (n = 8 experimental group, n = 8 control group) were included in the final analysis. At baseline the two groups were similar in all variables, except for step length. Data showed walking endurance, as well as spatio-temporal gait parameters improvements after robot-assisted gait training. Pelvic antiversion and reduced hip extension during terminal stance ameliorated after aforementioned intervention. Robot-assisted gait training seems to be effective in increasing walking competency in MS subjects. Moreover, it could be helpful in restoring the kinematic of the hip and pelvis.

Towards more effective robotic gait training for stroke rehabilitation: a review

PubMed Central

2012-01-01

Background Stroke is the most common cause of disability in the developed world and can severely degrade walking function. Robot-driven gait therapy can provide assistance to patients during training and offers a number of advantages over other forms of therapy. These potential benefits do not, however, seem to have been fully realised as of yet in clinical practice. Objectives This review determines ways in which robot-driven gait technology could be improved in order to achieve better outcomes in gait rehabilitation. Methods The literature on gait impairments caused by stroke is reviewed, followed by research detailing the different pathways to recovery. The outcomes of clinical trials investigating robot-driven gait therapy are then examined. Finally, an analysis of the literature focused on the technical features of the robot-based devices is presented. This review thus combines both clinical and technical aspects in order to determine the routes by which robot-driven gait therapy could be further developed. Conclusions Active subject participation in robot-driven gait therapy is vital to many of the potential recovery pathways and is therefore an important feature of gait training. Higher levels of subject participation and challenge could be promoted through designs with a high emphasis on robotic transparency and sufficient degrees of freedom to allow other aspects of gait such as balance to be incorporated. PMID:22953989

Supporting the joint warfighter by development, training, and fielding of man-portable UGVs

NASA Astrophysics Data System (ADS)

Ebert, Kenneth A.; Stratton, Benjamin V.

2005-05-01

The Robotic Systems Pool (RSP), sponsored by the Joint Robotics Program (JRP), is an inventory of small robotic systems, payloads, and components intended to expedite the development and integration of technology into effective, supportable, fielded robotic assets. The RSP loans systems to multiple users including the military, first-responders, research organizations, and academia. These users provide feedback in their specific domain, accelerating research and development improvements of robotic systems, which in turn allow the joint warfighter to benefit from such changes more quickly than from traditional acquisition cycles. Over the past year, RSP assets have been used extensively for pre-deployment operator and field training of joint Explosive Ordnance Disposal (EOD) teams, and for the training of Navy Reservist repair technicians. These Reservists are part of the Robotic Systems Combat Support Platoon (RSCSP), attached to Space and Naval Warfare Systems Center, San Diego. The RSCSP maintains and repairs RSP assets and provides deployable technical support for users of robotic systems. Currently, a small team from the RSCSP is deployed at Camp Victory repairing and maintaining man-portable unmanned ground vehicles (UGVs) used by joint EOD teams in Operation Iraqi Freedom. The focus of this paper is to elaborate on the RSP and RSCSP and their role as invaluable resources for spiral development in the robotics community by gaining first-hand technical feedback from the warfighter and other users.

Slow Versus Fast Robot-Assisted Locomotor Training After Severe Stroke: A Randomized Controlled Trial.

PubMed

Rodrigues, Thais Amanda; Goroso, Daniel Gustavo; Westgate, Philip M; Carrico, Cheryl; Batistella, Linamara R; Sawaki, Lumy

2017-10-01

Robot-assisted locomotor training on a bodyweight-supported treadmill is a rehabilitation intervention that compels repetitive practice of gait movements. Standard treadmill speed may elicit rhythmic movements generated primarily by spinal circuits. Slower-than-standard treadmill speed may elicit discrete movements, which are more complex than rhythmic movements and involve cortical areas. Compare effects of fast (i.e., rhythmic) versus slow (i.e., discrete) robot-assisted locomotor training on a bodyweight-supported treadmill in subjects with chronic, severe gait deficit after stroke. Subjects (N = 18) were randomized to receive 30 sessions (5 d/wk) of either fast or slow robot-assisted locomotor training on a bodyweight-supported treadmill in an inpatient setting. Functional ambulation category, time up and go, 6-min walk test, 10-m walk test, Berg Balance Scale, and Fugl-Meyer Assessment were administered at baseline and postintervention. The slow group had statistically significant improvement on functional ambulation category (first quartile-third quartile, P = 0.004), 6-min walk test (95% confidence interval [CI] = 1.8 to 49.0, P = 0.040), Berg Balance Scale (95% CI = 7.4 to 14.8, P < 0.0001), time up and go (95% CI = -79.1 to 5.0, P < 0.0030), and Fugl-Meyer Assessment (95% CI = 24.1 to 45.1, P < 0.0001). The fast group had statistically significant improvement on Berg Balance Scale (95% CI = 1.5 to 10.5, P = 0.02). In initial stages of robot-assisted locomotor training on a bodyweight-supported treadmill after severe stroke, slow training targeting discrete movement may yield greater benefit than fast training.

Can a virtual reality surgical simulation training provide a self-driven and mentor-free skills learning? Investigation of the practical influence of the performance metrics from the virtual reality robotic surgery simulator on the skill learning and associated cognitive workloads.

PubMed

Lee, Gyusung I; Lee, Mija R

2018-01-01

While it is often claimed that virtual reality (VR) training system can offer self-directed and mentor-free skill learning using the system's performance metrics (PM), no studies have yet provided evidence-based confirmation. This experimental study investigated what extent to which trainees achieved their self-learning with a current VR simulator and whether additional mentoring improved skill learning, skill transfer and cognitive workloads in robotic surgery simulation training. Thirty-two surgical trainees were randomly assigned to either the Control-Group (CG) or Experiment-Group (EG). While the CG participants reviewed the PM at their discretion, the EG participants had explanations about PM and instructions on how to improve scores. Each subject completed a 5-week training using four simulation tasks. Pre- and post-training data were collected using both a simulator and robot. Peri-training data were collected after each session. Skill learning, time spent on PM (TPM), and cognitive workloads were compared between groups. After the simulation training, CG showed substantially lower simulation task scores (82.9 ± 6.0) compared with EG (93.2 ± 4.8). Both groups demonstrated improved physical model tasks performance with the actual robot, but the EG had a greater improvement in two tasks. The EG exhibited lower global mental workload/distress, higher engagement, and a better understanding regarding using PM to improve performance. The EG's TPM was initially long but substantially shortened as the group became familiar with PM. Our study demonstrated that the current VR simulator offered limited self-skill learning and additional mentoring still played an important role in improving the robotic surgery simulation training.

Training Surgical Residents With a Haptic Robotic Central Venous Catheterization Simulator.

PubMed

Pepley, David F; Gordon, Adam B; Yovanoff, Mary A; Mirkin, Katelin A; Miller, Scarlett R; Han, David C; Moore, Jason Z

Ultrasound guided central venous catheterization (CVC) is a common surgical procedure with complication rates ranging from 5 to 21 percent. Training is typically performed using manikins that do not simulate anatomical variations such as obesity and abnormal vessel positioning. The goal of this study was to develop and validate the effectiveness of a new virtual reality and force haptic based simulation platform for CVC of the right internal jugular vein. A CVC simulation platform was developed using a haptic robotic arm, 3D position tracker, and computer visualization. The haptic robotic arm simulated needle insertion force that was based on cadaver experiments. The 3D position tracker was used as a mock ultrasound device with realistic visualization on a computer screen. Upon completion of a practice simulation, performance feedback is given to the user through a graphical user interface including scoring factors based on good CVC practice. The effectiveness of the system was evaluated by training 13 first year surgical residents using the virtual reality haptic based training system over a 3 month period. The participants' performance increased from 52% to 96% on the baseline training scenario, approaching the average score of an expert surgeon: 98%. This also resulted in improvement in positive CVC practices including a 61% decrease between final needle tip position and vein center, a decrease in mean insertion attempts from 1.92 to 1.23, and a 12% increase in time spent aspirating the syringe throughout the procedure. A virtual reality haptic robotic simulator for CVC was successfully developed. Surgical residents training on the simulation improved to near expert levels after three robotic training sessions. This suggests that this system could act as an effective training device for CVC. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Training Strategies to Improve Muscle Power: Is Olympic-style Weightlifting Relevant?

PubMed

Helland, Christian; Hole, Eirik; Iversen, Erik; Olsson, Monica Charlotte; Seynnes, Olivier; Solberg, Paul Andre; Paulsen, Gøran

2017-04-01

This efficacy study investigated the effects of 1) Olympic-style weightlifting (OWL), 2) motorized strength and power training (MSPT), and 3) free weight strength and power training (FSPT) on muscle power. Thirty-nine young athletes (20 ± 3 yr; ice hockey, volleyball, and badminton) were randomized into the three training groups. All groups participated in two to three sessions per week for 8 wk. The MSPT and FSPT groups trained using squats (two legs and single leg) with high force and high power, whereas the OWL group trained using clean and snatch exercises. MSPT was conducted as slow-speed isokinetic strength training and isotonic power training with augmented eccentric load, controlled by a computerized robotic engine system. FSPT used free weights. The training volume (sum of repetitions × kg) was similar between all three groups. Vertical jumping capabilities were assessed by countermovement jump (CMJ), squat jump (SJ), drop jump (DJ), and loaded CMJ (10-80 kg). Sprinting capacity was assessed in a 30-m sprint. Secondary variables were squat one-repetition maximum (1RM), body composition, quadriceps thickness, and architecture. OWL resulted in trivial improvements and inferior gains compared with FSPT and MSPT for CMJ, SJ, DJ, and 1RM. MSPT demonstrated small but robust effects on SJ, DJ, loaded CMJ, and 1RM (3%-13%). MSPT was superior to FSPT in improving 30-m sprint performance. FSPT and MSPT, but not OWL, demonstrated increased thickness in the vastus lateralis and rectus femoris (4%-7%). MSPT was time-efficient and equally or more effective than FSPT training in improving vertical jumping and sprinting performance. OWL was generally ineffective and inferior to the two other interventions.

Comparative assessment of three standardized robotic surgery training methods.

PubMed

Hung, Andrew J; Jayaratna, Isuru S; Teruya, Kara; Desai, Mihir M; Gill, Inderbir S; Goh, Alvin C

2013-10-01

To evaluate three standardized robotic surgery training methods, inanimate, virtual reality and in vivo, for their construct validity. To explore the concept of cross-method validity, where the relative performance of each method is compared. Robotic surgical skills were prospectively assessed in 49 participating surgeons who were classified as follows: 'novice/trainee': urology residents, previous experience <30 cases (n = 38) and 'experts': faculty surgeons, previous experience ≥30 cases (n = 11). Three standardized, validated training methods were used: (i) structured inanimate tasks; (ii) virtual reality exercises on the da Vinci Skills Simulator (Intuitive Surgical, Sunnyvale, CA, USA); and (iii) a standardized robotic surgical task in a live porcine model with performance graded by the Global Evaluative Assessment of Robotic Skills (GEARS) tool. A Kruskal-Wallis test was used to evaluate performance differences between novices and experts (construct validity). Spearman's correlation coefficient (ρ) was used to measure the association of performance across inanimate, simulation and in vivo methods (cross-method validity). Novice and expert surgeons had previously performed a median (range) of 0 (0-20) and 300 (30-2000) robotic cases, respectively (P < 0.001). Construct validity: experts consistently outperformed residents with all three methods (P < 0.001). Cross-method validity: overall performance of inanimate tasks significantly correlated with virtual reality robotic performance (ρ = -0.7, P < 0.001) and in vivo robotic performance based on GEARS (ρ = -0.8, P < 0.0001). Virtual reality performance and in vivo tissue performance were also found to be strongly correlated (ρ = 0.6, P < 0.001). We propose the novel concept of cross-method validity, which may provide a method of evaluating the relative value of various forms of skills education and assessment. We externally confirmed the construct validity of each featured training tool. © 2013 BJU International.

A force-controllable macro-micro manipulator and its application to medical robots

NASA Technical Reports Server (NTRS)

Marzwell, Neville I.; Uecker, Darrin R.; Wang, Yulun

1994-01-01

This paper describes an 8-degrees-of-freedom macro-micro robot. This robot is capable of performing tasks that require accurate force control, such as polishing, finishing, grinding, deburring, and cleaning. The design of the macro-micro mechanism, the control algorithms, and the hardware/software implementation of the algorithms are described in this paper. Initial experimental results are reported. In addition, this paper includes a discussion of medical surgery and the role that force control may play. We introduce a new class of robotic systems collectively called Robotic Enhancement Technology (RET). RET systems introduce the combination of robotic manipulation with human control to perform manipulation tasks beyond the individual capability of either human or machine. The RET class of robotic systems offers new challenges in mechanism design, control-law development, and man/machine interface design. We believe force-controllable mechanisms such as the macro-micro structure we have developed are a necessary part of RET. Work in progress in the area of RET systems and their application to minimally invasive surgery is presented, along with future research directions.

Robot-guided ankle sensorimotor rehabilitation of patients with multiple sclerosis.

PubMed

Lee, Yunju; Chen, Kai; Ren, Yupeng; Son, Jongsang; Cohen, Bruce A; Sliwa, James A; Zhang, Li-Qun

2017-01-01

People with multiple sclerosis (MS) often develop symptoms including muscle weakness, spasticity, imbalance, and sensory loss in the lower limbs, especially at the ankle, which result in impaired balance and locomotion and increased risk of falls. Rehabilitation strategies that improve ankle function may improve mobility and safety of ambulation in patients with MS. This pilot study investigated effectiveness of a robot-guided ankle passive-active movement training in reducing motor and sensory impairments and improving balance and gait functions. Seven patients with MS participated in combined passive stretching and active movement training using an ankle rehabilitation robot. Six of the patients finished robotic training 3 sessions per week over 6 weeks for a total of 18 sessions. Biomechanical and clinical outcome evaluations were done before and after the 6-week treatment, and at a follow-up six weeks afterwards. After six-week ankle sensorimotor training, there were increases in active range of motion in dorsiflexion, dorsiflexor and plantar flexor muscle strength, and balance and locomotion (p<0.05). Proprioception acuity showed a trend of improvement. Improvements in four biomechanical outcome measures and two of the clinical outcome measures were maintained at the 6-week follow-up. The study showed the six-week training duration was appropriate to see improvement of range of motion and strength for MS patients with ankle impairment. Robot-guided ankle training is potentially a useful therapeutic intervention to improve mobility in patients with MS. Copyright © 2016 Elsevier B.V. All rights reserved.

Computerized visual feedback: an adjunct to robotic-assisted gait training.

PubMed

Banz, Raphael; Bolliger, Marc; Colombo, Gery; Dietz, Volker; Lünenburger, Lars

2008-10-01

Robotic devices for walking rehabilitation allow new possibilities for providing performance-related information to patients during gait training. Based on motor learning principles, augmented feedback during robotic-assisted gait training might improve the rehabilitation process used to regain walking function. This report presents a method to provide visual feedback implemented in a driven gait orthosis (DGO). The purpose of the study was to compare the immediate effect on motor output in subjects during robotic-assisted gait training when they used computerized visual feedback and when they followed verbal instructions of a physical therapist. Twelve people with neurological gait disorders due to incomplete spinal cord injury participated. Subjects were instructed to walk within the DGO in 2 different conditions. They were asked to increase their motor output by following the instructions of a therapist and by observing visual feedback. In addition, the subjects' opinions about using visual feedback were investigated by a questionnaire. Computerized visual feedback and verbal instructions by the therapist were observed to result in a similar change in motor output in subjects when walking within the DGO. Subjects reported that they were more motivated and concentrated on their movements when using computerized visual feedback compared with when no form of feedback was provided. Computerized visual feedback is a valuable adjunct to robotic-assisted gait training. It represents a relevant tool to increase patients' motor output, involvement, and motivation during gait training, similar to verbal instructions by a therapist.

Learning a locomotor task: with or without errors?

PubMed

Marchal-Crespo, Laura; Schneider, Jasmin; Jaeger, Lukas; Riener, Robert

2014-03-04

Robotic haptic guidance is the most commonly used robotic training strategy to reduce performance errors while training. However, research on motor learning has emphasized that errors are a fundamental neural signal that drive motor adaptation. Thus, researchers have proposed robotic therapy algorithms that amplify movement errors rather than decrease them. However, to date, no study has analyzed with precision which training strategy is the most appropriate to learn an especially simple task. In this study, the impact of robotic training strategies that amplify or reduce errors on muscle activation and motor learning of a simple locomotor task was investigated in twenty two healthy subjects. The experiment was conducted with the MAgnetic Resonance COmpatible Stepper (MARCOS) a special robotic device developed for investigations in the MR scanner. The robot moved the dominant leg passively and the subject was requested to actively synchronize the non-dominant leg to achieve an alternating stepping-like movement. Learning with four different training strategies that reduce or amplify errors was evaluated: (i) Haptic guidance: errors were eliminated by passively moving the limbs, (ii) No guidance: no robot disturbances were presented, (iii) Error amplification: existing errors were amplified with repulsive forces, (iv) Noise disturbance: errors were evoked intentionally with a randomly-varying force disturbance on top of the no guidance strategy. Additionally, the activation of four lower limb muscles was measured by the means of surface electromyography (EMG). Strategies that reduce or do not amplify errors limit muscle activation during training and result in poor learning gains. Adding random disturbing forces during training seems to increase attention, and therefore improve motor learning. Error amplification seems to be the most suitable strategy for initially less skilled subjects, perhaps because subjects could better detect their errors and correct them. Error strategies have a great potential to evoke higher muscle activation and provoke better motor learning of simple tasks. Neuroimaging evaluation of brain regions involved in learning can provide valuable information on observed behavioral outcomes related to learning processes. The impacts of these strategies on neurological patients need further investigations.

Best facilitated cortical activation during different stepping, treadmill, and robot-assisted walking training paradigms and speeds: A functional near-infrared spectroscopy neuroimaging study.

PubMed

Kim, Ha Yeon; Yang, Sung Phil; Park, Gyu Lee; Kim, Eun Joo; You, Joshua Sung Hyun

2016-01-01

Robot-assisted and treadmill-gait training are promising neurorehabilitation techniques, with advantages over conventional gait training, but the neural substrates underpinning locomotor control remain unknown particularly during different gait training modes and speeds. The present optical imaging study compared cortical activities during conventional stepping walking (SW), treadmill walking (TW), and robot-assisted walking (RW) at different speeds. Fourteen healthy subjects (6 women, mean age 30.06, years ± 4.53) completed three walking training modes (SW, TW, and RW) at various speeds (self-selected, 1.5, 2.0, 2.5, and 3.0  km/h). A functional near-infrared spectroscopy (fNIRS) system determined cerebral hemodynamic changes associated with cortical locomotor network areas in the primary sensorimotor cortex (SMC), premotor cortex (PMC), supplementary motor area (SMA), prefrontal cortex (PFC), and sensory association cortex (SAC). There was increased cortical activation in the SMC, PMC, and SMA during different walking training modes. More global locomotor network activation was observed during RW than TW or SW. As walking speed increased, multiple locomotor network activations were observed, and increased activation power spectrum. This is the first empirical evidence highlighting the neural substrates mediating dynamic locomotion for different gait training modes and speeds. Fast, robot-assisted gait training best facilitated cortical activation associated with locomotor control.

A Sit-to-Stand Training Robot and Its Performance Evaluation: Dynamic Analysis in Lower Limb Rehabilitation Activities

NASA Astrophysics Data System (ADS)

Cao, Enguo; Inoue, Yoshio; Liu, Tao; Shibata, Kyoko

In many countries in which the phenomenon of population aging is being experienced, motor function recovery activities have aroused much interest. In this paper, a sit-to-stand rehabilitation robot utilizing a double-rope system was developed, and the performance of the robot was evaluated by analyzing the dynamic parameters of human lower limbs. For the robot control program, an impedance control method with a training game was developed to increase the effectiveness and frequency of rehabilitation activities, and a calculation method was developed for evaluating the joint moments of hip, knee, and ankle. Test experiments were designed, and four subjects were requested to stand up from a chair with assistance from the rehabilitation robot. In the experiments, body segment rotational angles, trunk movement trajectories, rope tensile forces, ground reaction forces (GRF) and centers of pressure (COP) were measured by sensors, and the moments of ankle, knee and hip joint were real-time calculated using the sensor-measured data. The experiment results showed that the sit-to-stand rehabilitation robot with impedance control method could maintain the comfortable training postures of users, decrease the moments of limb joints, and enhance training effectiveness. Furthermore, the game control method could encourage collaboration between the brain and limbs, and allow for an increase in the frequency and intensity of rehabilitation activities.

Robotic nurse duties in the urology operative room: 11 years of experience.

PubMed

Abdel Raheem, Ali; Song, Hyun Jung; Chang, Ki Don; Choi, Young Deuk; Rha, Koon Ho

2017-04-01

The robotic nurse plays an essential role in a successful robotic surgery. As part of the robotic surgical team, the robotic nurse must demonstrate a high level of professional knowledge, and be an expert in robotic technology and dealing with robotic malfunctions. Each one of the robotic nursing team "nurse coordinator, scrub-nurse and circulating-nurse" has a certain job description to ensure maximum patient's safety and robotic surgical efficiency. Well-structured training programs should be offered to the robotic nurse to be well prepared, feel confident, and maintain high-quality of care.

Taking a lesson from patients' recovery strategies to optimize training during robot-aided rehabilitation.

PubMed

Colombo, Roberto; Sterpi, Irma; Mazzone, Alessandra; Delconte, Carmen; Pisano, Fabrizio

2012-05-01

In robot-assisted neurorehabilitation, matching the task difficulty level to the patient's needs and abilities, both initially and as the relearning process progresses, can enhance the effectiveness of training and improve patients' motivation and outcome. This study presents a Progressive Task Regulation algorithm implemented in a robot for upper limb rehabilitation. It evaluates the patient's performance during training through the computation of robot-measured parameters, and automatically changes the features of the reaching movements, adapting the difficulty level of the motor task to the patient's abilities. In particular, it can select different types of assistance (time-triggered, activity-triggered, and negative assistance) and implement varied therapy practice to promote generalization processes. The algorithm was tuned by assessing the performance data obtained in 22 chronic stroke patients who underwent robotic rehabilitation, in which the difficulty level of the task was manually adjusted by the therapist. Thus, we could verify the patient's recovery strategies and implement task transition rules to match both the patient's and therapist's behavior. In addition, the algorithm was tested in a sample of five chronic stroke patients. The findings show good agreement with the therapist decisions so indicating that it could be useful for the implementation of training protocols allowing individualized and gradual treatment of upper limb disabilities in patients after stroke. The application of this algorithm during robot-assisted therapy should allow an easier management of the different motor tasks administered during training, thereby facilitating the therapist's activity in the treatment of different pathologic conditions of the neuromuscular system.

Human-robot cooperative movement training: learning a novel sensory motor transformation during walking with robotic assistance-as-needed.

PubMed

Emken, Jeremy L; Benitez, Raul; Reinkensmeyer, David J

2007-03-28

A prevailing paradigm of physical rehabilitation following neurologic injury is to "assist-as-needed" in completing desired movements. Several research groups are attempting to automate this principle with robotic movement training devices and patient cooperative algorithms that encourage voluntary participation. These attempts are currently not based on computational models of motor learning. Here we assume that motor recovery from a neurologic injury can be modelled as a process of learning a novel sensory motor transformation, which allows us to study a simplified experimental protocol amenable to mathematical description. Specifically, we use a robotic force field paradigm to impose a virtual impairment on the left leg of unimpaired subjects walking on a treadmill. We then derive an "assist-as-needed" robotic training algorithm to help subjects overcome the virtual impairment and walk normally. The problem is posed as an optimization of performance error and robotic assistance. The optimal robotic movement trainer becomes an error-based controller with a forgetting factor that bounds kinematic errors while systematically reducing its assistance when those errors are small. As humans have a natural range of movement variability, we introduce an error weighting function that causes the robotic trainer to disregard this variability. We experimentally validated the controller with ten unimpaired subjects by demonstrating how it helped the subjects learn the novel sensory motor transformation necessary to counteract the virtual impairment, while also preventing them from experiencing large kinematic errors. The addition of the error weighting function allowed the robot assistance to fade to zero even though the subjects' movements were variable. We also show that in order to assist-as-needed, the robot must relax its assistance at a rate faster than that of the learning human. The assist-as-needed algorithm proposed here can limit error during the learning of a dynamic motor task. The algorithm encourages learning by decreasing its assistance as a function of the ongoing progression of movement error. This type of algorithm is well suited for helping people learn dynamic tasks for which large kinematic errors are dangerous or discouraging, and thus may prove useful for robot-assisted movement training of walking or reaching following neurologic injury.

Leg surface electromyography patterns in children with neuro-orthopedic disorders walking on a treadmill unassisted and assisted by a robot with and without encouragement

PubMed Central

2013-01-01

Background Robot-assisted gait training and treadmill training can complement conventional physical therapy in children with neuro-orthopedic movement disorders. The aim of this study was to investigate surface electromyography (sEMG) activity patterns during robot-assisted gait training (with and without motivating instructions from a therapist) and unassisted treadmill walking and to compare these with physiological sEMG patterns. Methods Nine children with motor impairments and eight healthy children walked in various conditions: (a) on a treadmill in the driven gait orthosis Lokomat®, (b) same condition, with additional motivational instructions from a therapist, and (c) on the treadmill without assistance. sEMG recordings were made of the tibialis anterior, gastrocnemius lateralis, vastus medialis, and biceps femoris muscles. Differences in sEMG amplitudes between the three conditions were analyzed for the duration of stance and swing phase (for each group and muscle separately) using non-parametric tests. Spearman’s correlation coefficients illustrated similarity of muscle activation patterns between conditions, between groups, and with published reference trajectories. Results The relative duration of stance and swing phase differed between patients and controls, and between driven gait orthosis conditions and treadmill walking. While sEMG amplitudes were higher when being encouraged by a therapist compared to robot-assisted gait training without instructions (0.008 ≤ p-value ≤ 0.015), muscle activation patterns were highly comparable (0.648 ≤ Spearman correlation coefficients ≤ 0.969). In general, comparisons of the sEMG patterns with published reference data of over-ground walking revealed that walking in the driven gait orthosis could induce more physiological muscle activation patterns compared to unsupported treadmill walking. Conclusions Our results suggest that robotic-assisted gait training with therapeutic encouragement could appropriately increase muscle activity. Robotic-assisted gait training in general could induce physiological muscle activation patterns, which might indicate that this training exploits restorative rather than compensatory mechanisms. PMID:23867005

Robot-Applied Resistance Augments the Effects of Body Weight-Supported Treadmill Training on Stepping and Synaptic Plasticity in a Rodent Model of Spinal Cord Injury.

PubMed

Hinahon, Erika; Estrada, Christina; Tong, Lin; Won, Deborah S; de Leon, Ray D

2017-08-01

The application of resistive forces has been used during body weight-supported treadmill training (BWSTT) to improve walking function after spinal cord injury (SCI). Whether this form of training actually augments the effects of BWSTT is not yet known. To determine if robotic-applied resistance augments the effects of BWSTT using a controlled experimental design in a rodent model of SCI. Spinally contused rats were treadmill trained using robotic resistance against horizontal (n = 9) or vertical (n = 8) hind limb movements. Hind limb stepping was tested before and after 6 weeks of training. Two control groups, one receiving standard training (ie, without resistance; n = 9) and one untrained (n = 8), were also tested. At the terminal experiment, the spinal cords were prepared for immunohistochemical analysis of synaptophysin. Six weeks of training with horizontal resistance increased step length, whereas training with vertical resistance enhanced step height and movement velocity. None of these changes occurred in the group that received standard (ie, no resistance) training or in the untrained group. Only standard training increased the number of step cycles and shortened cycle period toward normal values. Synaptophysin expression in the ventral horn was highest in rats trained with horizontal resistance and in untrained rats and was positively correlated with step length. Adding robotic-applied resistance to BWSTT produced gains in locomotor function over BWSTT alone. The impact of resistive forces on spinal connections may depend on the nature of the resistive forces and the synaptic milieu that is present after SCI.

Lessons Learned from Pit Viper System Deployment

DOE Office of Scientific and Technical Information (OSTI.GOV)

Catalan, Michael A.; Alzheimer, James M.; Valdez, Patrick LJ

2002-04-11

Tele-operated and robotic systems operated in unstructured field environments pose unique challenges for tool design. Since field tasks are not always well defined and the robot work area usually cannot be designed for ease of operation, the tools must be versatile. It's important to carefully consider the orientation of the grip the robot takes on the tool, as it's not easily changed in the field. The stiffness of the robot and the possibility of robot positioning errors encourages the use of non-contact or minimal-contact tooling. While normal hand tools can usually be modified for use by the robot, this ismore » not always the most effective approach. It's desirable to have tooling that is relatively independent of the robot; in this case, the robot places the tool near the desired work location and the tool performs its task relatively independently. Here we consider the adaptation of a number of tools for cleanup of a radioactively contaminated piping junction and valve pit. The tasks to be considered are debris removal (small nuts and bolts and pipe up to 100 mm in diameter), size reduction, surface cleaning, and support of past practice crane-based methods for working in the pits.« less

Validation of Robotic Surgery Simulator (RoSS).

PubMed

Kesavadas, Thenkurussi; Stegemann, Andrew; Sathyaseelan, Gughan; Chowriappa, Ashirwad; Srimathveeravalli, Govindarajan; Seixas-Mikelus, Stéfanie; Chandrasekhar, Rameella; Wilding, Gregory; Guru, Khurshid

2011-01-01

Recent growth of daVinci Robotic Surgical System as a minimally invasive surgery tool has led to a call for better training of future surgeons. In this paper, a new virtual reality simulator, called RoSS is presented. Initial results from two studies - face and content validity, are very encouraging. 90% of the cohort of expert robotic surgeons felt that the simulator was excellent or somewhat close to the touch and feel of the daVinci console. Content validity of the simulator received 90% approval in some cases. These studies demonstrate that RoSS has the potential of becoming an important training tool for the daVinci surgical robot.

Robotic/virtual reality intervention program individualized to meet the specific sensorimotor impairments of an individual patient: a case study.

PubMed

Fluet, Gerard G; Merians, Alma S; Qiu, Qinyin; Saleh, Soha; Ruano, Viviana; Delmonico, Andrea R; Adamovich, Sergei V

2014-09-01

A majority of studies examining repetitive task practice facilitated by robots for the treatment of upper extremity paresis utilize standardized protocols applied to large groups. This study will describe a virtually simulated, robot-based intervention customized to match the goals and clinical presentation of a gentleman with upper extremity hemiparesis secondary to stroke. MP, the subject of this case, is an 85-year-old man with left hemiparesis secondary to an intracerebral hemorrhage 5 years prior to examination. Outcomes were measured before and after a 1-month period of home therapy and after a 1-month virtually simulated, robotic intervention. The intervention was designed to address specific impairments identified during his PT examination. When necessary, activities were modified based on MP's response to his first week of treatment. MP's home training program produced a 3-s decline in Wolf Motor Function Test (WMFT) time and a 5-s improvement in Jebsen Test of Hand Function (JTHF) time. He demonstrated an additional 35-s improvement in JTHF and an additional 44-s improvement in WMFT subsequent to the robotic training intervention. A 24-h activity measurement and the Hand and Activities of Daily Living scales of the Stroke Impact Scale improved following the robotic intervention. Based on his responses to training we feel that we have established that a customized program of virtually simulated, robotically facilitated rehabilitation was feasible and resulted in larger improvements than an intensive home training program in several measurements of upper extremity function in our patient with chronic hemiparesis.

Sliding Mode Tracking Control of a Wire-Driven Upper-Limb Rehabilitation Robot with Nonlinear Disturbance Observer.

PubMed

Niu, Jie; Yang, Qianqian; Wang, Xiaoyun; Song, Rong

2017-01-01

Robot-aided rehabilitation has become an important technology to restore and reinforce motor functions of patients with extremity impairment, whereas it can be extremely challenging to achieve satisfactory tracking performance due to uncertainties and disturbances during rehabilitation training. In this paper, a wire-driven rehabilitation robot that can work over a three-dimensional space is designed for upper-limb rehabilitation, and sliding mode control with nonlinear disturbance observer is designed for the robot to deal with the problem of unpredictable disturbances during robot-assisted training. Then, simulation and experiments of trajectory tracking are carried out to evaluate the performance of the system, the position errors, and the output forces of the designed control scheme are compared with those of the traditional sliding mode control (SMC) scheme. The results show that the designed control scheme can effectively reduce the tracking errors and chattering of the output forces as compared with the traditional SMC scheme, which indicates that the nonlinear disturbance observer can reduce the effect of unpredictable disturbances. The designed control scheme for the wire-driven rehabilitation robot has potential to assist patients with stroke in performing repetitive rehabilitation training.

Robotics training program: evaluation of the satisfaction and the factors that influence success of skills training in a resident robotics curriculum.

PubMed

Lucas, Steven M; Gilley, David A; Joshi, Shreyas S; Gardner, Thomas A; Sundaram, Chandru P

2011-10-01

We present our experience of training residents in a weekend robotic training program to assess its effectiveness and perceived usefulness. Bimonthly training sessions were arranged such that residents could sign up for hour-long, weekend training sessions. They are required to complete four training sessions. Five tasks were scored for time and accuracy: Peg-Board, checkerboard, string running, pattern cutting, and suturing. Participants completed surveys (5-point Likert scale) regarding program utility, ease of attendance, and interest in future weekend training sessions. Mean number of trials completed by 19 residents was >4, and 16 completed the trials within an average of 13.7±8.1 mos. Significant improvements (P<0.05) were seen in final trials for Peg-Board accuracy (95.8% vs 79.0%), checkerboard deviation (4.8% vs 18.2%), and time (293 s vs 404 s), pattern-cutting time (257 s vs 399 s), and suture time (203 s vs 305 s). Time to previous session correlated with relative improvement in Peg-Board and pattern-cutting time (r=0.300 and 0.277, P=0.021 and 0.041), but no specific training interval was predictive of improvement. Residents found the course easy to attend (3.6), noted skills improvement (4.1), and found it useful (4.0). Training in the weekend sessions improved performance of basic tasks on the robot. Training interval had a modest effect on some exercises and may be more important for difficult tasks. This training program is a useful supplement to resident training and would be easy to implement in most programs.

Setting up a pediatric robotic urology program: A USA institution experience.

PubMed

Murthy, Prithvi B; Schadler, Eric D; Orvieto, Marcelo; Zagaja, Gregory; Shalhav, Arieh L; Gundeti, Mohan S

2018-02-01

Implementing a robotic urological surgery program requires institutional support, and necessitates a comprehensive, detail-oriented plan that accounts for training, oversight, cost and case volume. Given the prevalence of robotic surgery in adult urology, in many instances it might be feasible to implement a pediatric robotic urology program within the greater context of adult urology. This involves, from an institutional standpoint, proportional distribution of equipment cost and operating room time. However, the pediatric urology team primarily determines goals for volume expansion, operative case selection, resident training and surgical innovation within the specialty. In addition to the clinical model, a robust economic model that includes marketing must be present. This review specifically highlights these factors in relationship to establishing and maintaining a pediatric robotic urology program. In addition, we share our data involving robot use over the program's first nine years (December 2007-December 2016). © 2017 The Japanese Urological Association.

An advanced rehabilitation robotic system for augmenting healthcare.

PubMed

Hu, John; Lim, Yi-Je; Ding, Ye; Paluska, Daniel; Solochek, Aaron; Laffery, David; Bonato, Paolo; Marchessault, Ronald

2011-01-01

Emerging technologies such as rehabilitation robots (RehaBot) for retraining upper and lower limb functions have shown to carry tremendous potential to improve rehabilitation outcomes. Hstar Technologies is developing a revolutionary rehabilitation robot system enhancing healthcare quality for patients with neurological and muscular injuries or functional impairments. The design of RehaBot is a safe and robust system that can be run at a rehabilitation hospital under the direct monitoring and interactive supervision control and at a remote site via telepresence operation control. RehaBot has a wearable robotic structure design like exoskeleton, which employs a unique robotic actuation--Series Elastic Actuator. These electric actuators provide robotic structural compliance, safety, flexibility, and required strength for upper extremity dexterous manipulation rehabilitation training. RehaBot also features a novel non-treadmill paddle platform capable of haptics feedback locomotion rehabilitation training. In this paper, we concern mainly about the motor incomplete patient and rehabilitation applications.

Effect of body weight support variation on muscle activities during robot assisted gait: a dynamic simulation study.

PubMed

Hussain, Shahid; Jamwal, Prashant K; Ghayesh, Mergen H

2017-05-01

While body weight support (BWS) intonation is vital during conventional gait training of neurologically challenged subjects, it is important to evaluate its effect during robot assisted gait training. In the present research we have studied the effect of BWS intonation on muscle activities during robotic gait training using dynamic simulations. Two dimensional (2-D) musculoskeletal model of human gait was developed conjointly with another 2-D model of a robotic orthosis capable of actuating hip, knee and ankle joints simultaneously. The musculoskeletal model consists of eight major muscle groups namely; soleus (SOL), gastrocnemius (GAS), tibialis anterior (TA), hamstrings (HAM), vasti (VAS), gluteus maximus (GLU), uniarticular hip flexors (iliopsoas, IP), and Rectus Femoris (RF). BWS was provided at levels of 0, 20, 40 and 60% during the simulations. In order to obtain a feasible set of muscle activities during subsequent gait cycles, an inverse dynamics algorithm along with a quadratic minimization algorithm was implemented. The dynamic parameters of the robot assisted human gait such as joint angle trajectories, ground contact force (GCF), human limb joint torques and robot induced torques at different levels of BWS were derived. The patterns of muscle activities at variable BWS were derived and analysed. For most part of the gait cycle (GC) the muscle activation patterns are quite similar for all levels of BWS as is apparent from the mean of muscle activities for the complete GC. Effect of BWS variation during robot assisted gait on muscle activities was studied by developing dynamic simulation. It is expected that the proposed dynamic simulation approach will provide important inferences and information about the muscle function variations consequent upon a change in BWS during robot assisted gait. This information shall be quite important while investigating the influence of BWS intonation on neuromuscular parameters of interest during robotic gait training.

Case Study: Review of Operating Room Utilization at Mayo Clinic Arizona (MCA)

DTIC Science & Technology

2008-05-01

or CRNA in training. The training of staff and the use of advanced technology, such as the Davinci Surgical Robot, may lead to an increase in time...gynecology performed during block-time will involve the use of the Davinci robot. When using the robot for a case, the set-up and prep-time before...1999). It is because of the cost of surgical staff that block-time lost to delays is concerning. MCA implemented block-time because it provides a tool

An Assessment of the State of the Art of Curriculum Materials and a Status Assessment of Training Programs for Robotics/Automated Systems Technicians. Task Analysis and Descriptions of Required Job Competencies of Robotics/Automated Systems Technicians.

ERIC Educational Resources Information Center

Hull, Daniel M.; Lovett, James E.

This report presents the results of research conducted to determine the current state of the art of robotics/automated systems technician (RAST) training offered in the United States. Section I discusses the RAST curriculum project, of which this state-of-the-art review is a part, and offers a RAST job description. Section II describes the…

Video games and surgical ability: a literature review.

PubMed

Lynch, Jeremy; Aughwane, Paul; Hammond, Toby M

2010-01-01

Surgical training is rapidly evolving because of reduced training hours and the reduction of training opportunities due to patient safety concerns. There is a popular conception that video game usage might be linked to improved operating ability especially those techniques involving endoscopic modalities. If true this might suggest future directions for training. A search was made of the MEDLINE databases for the MeSH term, "Video Games," combined with the terms "Surgical Procedures, Operative," "Endoscopy," "Robotics," "Education," "Learning," "Simulators," "Computer Simulation," "Psychomotor Performance," and "Surgery, Computer-Assisted,"encompassing all journal articles before November 2009. References of articles were searched for further studies. Twelve relevant journal articles were discovered. Video game usage has been studied in relationship to laparoscopic, gastrointestinal endoscopic, endovascular, and robotic surgery. Video game users acquire endoscopic but not robotic techniques quicker, and training on video games appears to improve performance. Copyright (c) 2010 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

75 FR 43562 - FANUC Robotics America, Inc., Including On-Site Leased Workers From Right Angle Staffing, Inc...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-26

... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-70,749] FANUC Robotics America... negative determination which was based on the finding that, during the relevant period, Fanuc Robotics... Robotics America, Inc., Rochester Hills, Michigan. Signed in Washington, DC, this 13th day of July 2010...

The Robots Are Coming! Training Tomorrow's High-Tech Workers.

ERIC Educational Resources Information Center

Zemke, Ron

1983-01-01

The United States, running second to Japan in the robot race, is employing 19 percent of the world's robots. This article presents six classes of robots that were defined by the Japanese trade association. All are multifunctional, equipped with a memory device, capable of rotation, and able to replace human workers. (SSH)

Robotics. Guidance for Further Education. FEU/PICKUP Project Report.

ERIC Educational Resources Information Center

Further Education Unit, London (England).

This report contains materials to assist teachers and others in designing curricula in robotics. The first section includes the results of a survey of technicians and supervisors in nine companies involved with robots that was designed to gather information concerning the education and training needed to prepare for a career in robotics. The…

Robot-Assisted Thoracic Surgery (RATS): Perioperative Nursing Professional Development Program.

PubMed

Sarmanian, Julie D

2015-09-01

Robot-assisted surgery continues to grow in popularity worldwide. Competency and training of personnel for robot-assisted thoracic surgery (RATS) is less established compared with other robot-assisted specialties. Major differences between minimally invasive approaches to thoracic surgery (eg, video-assisted thoracoscopic surgery) and RATS are presented to address a paucity of literature on the subject. Although perioperative nursing considerations are universal to all robot-assisted procedures, there are nursing consideration specific to RATS. This article provides a RATS perioperative nursing development program for RN circulators and scrub personnel. Development of perioperative nursing knowledge and skills through implementation of targeted training programs enables nurses to provide a safe surgical experience for patients undergoing RATS. Copyright © 2015 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Ankle Training With a Robotic Device Improves Hemiparetic Gait After a Stroke

PubMed Central

Forrester, Larry W.; Roy, Anindo; Krebs, Hermano Igo; Macko, Richard F.

2013-01-01

Background Task-oriented therapies such as treadmill exercise can improve gait velocity after stroke, but slow velocities and abnormal gait patterns often persist, suggesting a need for additional strategies to improve walking. Objectives To determine the effects of a 6-week visually guided, impedance controlled, ankle robotics intervention on paretic ankle motor control and gait function in chronic stroke. Methods This was a single-arm pilot study with a convenience sample of 8 stroke survivors with chronic hemiparetic gait, trained and tested in a laboratory. Subjects trained in dorsiflexion–plantarflexion by playing video games with the robot during three 1-hour training sessions weekly, totaling 560 repetitions per session. Assessments included paretic ankle ranges of motion, strength, motor control, and overground gait function. Results Improved paretic ankle motor control was seen as increased target success, along with faster and smoother movements. Walking velocity also increased significantly, whereas durations of paretic single support increased and double support decreased. Conclusions Robotic feedback training improved paretic ankle motor control with improvements in floor walking. Increased walking speeds were comparable with reports from other task-oriented, locomotor training approaches used in stroke, suggesting that a focus on ankle motor control may provide a valuable adjunct to locomotor therapies. PMID:21115945

Can robotic surgery be done efficiently while training residents?

PubMed

Honaker, Michael Drew; Paton, Beverly L; Stefanidis, Dimitrios; Schiffern, Lynnette M

2015-01-01

Robotic surgery is a rapidly growing area in surgery. In an era of emphasis on cost reduction, the question becomes how do you train residents in robotic surgery? The aim of this study was to determine if there was a difference in operative time and complications when comparing general surgery residents learning robotic cholecystectomies to those learning standard laparoscopic cholecystectomies. A retrospective analysis of adult patients undergoing robotic and laparoscopic cholecystectomy by surgical residents between March 2013 and February 2014 was conducted. Demographic data, operative factors, length of stay (LOS), and complications were examined. Univariate and multivariate analyses were performed. The significance was set at p < 0.05. A total of 58 patients were included in the study (18 in the robotic cholecystectomy group and 40 in the laparoscopic group). Age, diagnosis, and American Society of Anesthesiologists score were not significantly different between groups. There was only 1 complication in the standard laparoscopic group in which a patient had to be taken back to surgery because of an incarcerated port site. LOS was significantly higher in the standard laparoscopic group (mean = 2.28) than in the robotic group (mean = 0.56; p < 0.0001). Operating room (OR) time was not statistically different between the standard laparoscopic group (mean = 90.98 minutes) and the robotic group (mean = 97.00 minutes; p = 0.4455). When intraoperative cholangiogram was evaluated, OR time was shorter in the robotic group. Robotic training in general surgery residency does not amount to extra OR time. LOS in our study was significantly longer in the standard laparoscopic group. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Feasibility and acceptance of a robotic surgery ergonomic training program.

PubMed

Franasiak, Jason; Craven, Renatta; Mosaly, Prithima; Gehrig, Paola A

2014-01-01

Assessment of ergonomic strain during robotic surgery indicates there is a need for intervention. However, limited data exist detailing the feasibility and acceptance of ergonomic training (ET) for robotic surgeons. This prospective, observational pilot study evaluates the implementation of an evidence-based ET module. A two-part survey was conducted. The first survey assessed robotic strain using the Nordic Musculoskeletal Questionnaire (NMQ). Participants were given the option to participate in either an online or an in-person ET session. The ET was derived from Occupational Safety and Health Administration guidelines and developed by a human factors engineer experienced with health care ergonomics. After ET, a follow-up survey including the NMQ and an assessment of the ET were completed. The survey was sent to 67 robotic surgeons. Forty-two (62.7%) responded, including 18 residents, 8 fellows, and 16 attending physicians. Forty-five percent experienced strain resulting from performing robotic surgery and 26.3% reported persistent strain. Only 16.6% of surgeons reported prior ET in robotic surgery. Thirty-five (78%) surgeons elected to have in-person ET, which was successfully arranged for 32 surgeons (91.4%). Thirty-seven surgeons (88.1%) completed the follow-up survey. All surgeons participating in the in-person ET found it helpful and felt formal ET should be standard, 88% changed their practice as a result of the training, and 74% of those reporting strain noticed a decrease after their ET. Thus, at a high-volume robotics center, evidence-based ET was easily implemented, well-received, changed some surgeons' practice, and decreased self-reported strain related to robotic surgery.

Robotic Resistance Treadmill Training Improves Locomotor Function in Children With Cerebral Palsy: A Randomized Controlled Pilot Study.

PubMed

Wu, Ming; Kim, Janis; Gaebler-Spira, Deborah J; Schmit, Brian D; Arora, Pooja

2017-11-01

To determine whether applying controlled resistance forces to the legs during the swing phase of gait may improve the efficacy of treadmill training as compared with applying controlled assistance forces in children with cerebral palsy (CP). Randomized controlled study. Research unit of a rehabilitation hospital. Children with spastic CP (N=23; mean age, 10.6y; range, 6-14y; Gross Motor Function Classification System levels, I-IV). Participants were randomly assigned to receive controlled assistance (n=11) or resistance (n=12) loads applied to the legs at the ankle. Participants underwent robotic treadmill training 3 times a week for 6 weeks (18 sessions). A controlled swing assistance/resistance load was applied to both legs starting from the toe-off to mid-swing phase of gait during training. Outcome measures consisted of overground walking speed, 6-minute walk distance, and Gross Motor Function Measure scores and were assessed pre and post 6 weeks of training and 8 weeks after the end of training. After 6 weeks of treadmill training in participants from the resistance training group, fast walking speed and 6-minute walk distance significantly improved (18% and 30% increases, respectively), and 6-minute walk distance was still significantly greater than that at baseline (35% increase) 8 weeks after the end of training. In contrast, overground gait speed and 6-minute walk distance had no significant changes after robotic assistance training. The results of the present study indicated that robotic resistance treadmill training is more effective than assistance training in improving locomotor function in children with CP. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Robotic Waterjet System

NASA Technical Reports Server (NTRS)

1996-01-01

NASA needed a way to safely strip old paint and thermal protection material from reusable components from the Space Shuttle; to meet this requirement, Marshall Space Flight Center teamed with United Technologies' USBI Company and developed a stripping system based on hydroblasting. United Technology spun off a new company, Waterjet Systems, to commercialize and market the technology. The resulting ARMS (Automated Robotic Maintenance Systems), employ waterblasts at 55,000 pounds per square inch controlled by target-sensitive robots. The systems are used on aircraft and engine parts, and the newest application is on ships, where it not only strips but catches the ensuing wastewater. This innovation results in faster, cheaper stripping with less clean-up and reduced environmental impact.

A macro-micro robot for precise force applications

NASA Technical Reports Server (NTRS)

Marzwell, Neville I.; Wang, Yulun

1993-01-01

This paper describes an 8 degree-of-freedom macro-micro robot capable of performing tasks which require accurate force control. Applications such as polishing, finishing, grinding, deburring, and cleaning are a few examples of tasks which need this capability. Currently these tasks are either performed manually or with dedicated machinery because of the lack of a flexible and cost effective tool, such as a programmable force-controlled robot. The basic design and control of the macro-micro robot is described in this paper. A modular high-performance multiprocessor control system was designed to provide sufficient compute power for executing advanced control methods. An 8 degree of freedom macro-micro mechanism was constructed to enable accurate tip forces. Control algorithms based on the impedance control method were derived, coded, and load balanced for maximum execution speed on the multiprocessor system.

Deploying the ODIS robot in Iraq and Afghanistan

NASA Astrophysics Data System (ADS)

Smuda, Bill; Schoenherr, Edward; Andrusz, Henry; Gerhart, Grant

2005-05-01

The wars in Iraq and Afghanistan have shown the importance of robotic technology as a force multiplier and a tool for moving soldiers out of harms way. Situations on the ground make soldiers performing checkpoint operations easy targets for snipers and suicide bombers. Robotics technology reduces risk to soldiers and other personnel at checkpoints. Early user involvement in innovative and aggressive development and acquisition strategies are the key to moving robotic and associated technology into the hands of the user. This paper updates activity associated with rapid development of the Omni-Directional Inspection System (ODIS) robot for under vehicle inspection and reports on our field experience with robotics in Iraq and Afghanistan. In February of 2004, two TARDEC Engineers departed for a mission to Iraq and Afghanistan with ten ODIS Robots. Six robots were deployed in the Green Zone in Baghdad. Two Robots were deployed at Kandahar Army Airfield and two were deployed at Bagram Army Airfield in Afghanistan. The TARDEC Engineers who performed this mission trained the soldiers and provided initial on site support. They also trained Exponent employees assigned to the Rapid Equipping Force in ODIS repair. We will discuss our initial deployment, lessons learned and future plans.

Conflicting results of robot-assisted versus usual gait training during postacute rehabilitation of stroke patients: a randomized clinical trial

PubMed Central

Taveggia, Giovanni; Borboni, Alberto; Mulé, Chiara; Negrini, Stefano

2016-01-01

Robot gait training has the potential to increase the effectiveness of walking therapy. Clinical outcomes after robotic training are often not superior to conventional therapy. We evaluated the effectiveness of a robot training compared with a usual gait training physiotherapy during a standardized rehabilitation protocol in inpatient participants with poststroke hemiparesis. This was a randomized double-blind clinical trial in a postacute physical and rehabilitation medicine hospital. Twenty-eight patients, 39.3% women (72±6 years), with hemiparesis (<6 months after stroke) receiving a conventional treatment according to the Bobath approach were assigned randomly to an experimental or a control intervention of robot gait training to improve walking (five sessions a week for 5 weeks). Outcome measures included the 6-min walk test, the 10 m walk test, Functional Independence Measure, SF-36 physical functioning and the Tinetti scale. Outcomes were collected at baseline, immediately following the intervention period and 3 months following the end of the intervention. The experimental group showed a significant increase in functional independence and gait speed (10 m walk test) at the end of the treatment and follow-up, higher than the minimal detectable change. The control group showed a significant increase in the gait endurance (6-min walk test) at the follow-up, higher than the minimal detectable change. Both treatments were effective in the improvement of gait performances, although the statistical analysis of functional independence showed a significant improvement in the experimental group, indicating possible advantages during generic activities of daily living compared with overground treatment. PMID:26512928

The effect of random or sequential presentation of targets during robot-assisted therapy on children.

PubMed

Ladenheim, Barbara; Altenburger, Peter; Cardinal, Ryan; Monterroso, Linda; Dierks, Tracy; Mast, Joelle; Krebs, Hermano Igo

2013-01-01

Robot assisted upper extremity therapy has been shown to be effective in adult stroke patients and in children with cerebral palsy (CP) and other acquired brain injuries (ABI). The patient's active involvement is a factor in its efficacy. However, this demands focused attention during training sessions, which can be a challenge for children. To compare results of training requiring two different levels of focused attention. Differences in short term performance and retention of gains as a function of training protocol as measured by the Fugl-Meyer (FM) were predicted. Thirty-one children with CP or ABI were randomly divided into two groups. All received 16 one hour sessions of robot-assisted therapy (twice a week for 8 weeks) where they moved a robot handle to direct a cursor on the screen toward designated targets. One group had targets presented sequentially in clockwise fashion, the other presented in random order. Thus, one group could anticipate the position of each target, the other could not. Both groups showed significant functional improvement after therapy, but no significant difference between groups was observed. Assist-as-needed robotic training is effective in children with CP or ABI with small non-significant differences attributed to attentional demand.

PERSONNEL PROTECTION THROUGH RECONNAISSANCE ROBOTICS AT SUPERFUND REMEDIAL SITES

EPA Science Inventory

Investigation, mitigation, and clean-up of hazardous materials at Superfund sites normally require on-site workers to perform hazardous and sometimes potentially dangerous functions. uch functions include site surveys and the reconnaissance for airborne and buried toxic environme...

DEMONSTRATION OF AUTONOMOUS AIR MONITORING THROUGH ROBOTICS

EPA Science Inventory

Hazardous and/or tedious functions are often performed by on-site workers during investigation, mitigation and clean-up of hazardous substances. These functions include site surveys, sampling and analysis, excavation, and treatment and preparation of wastes for shipment to chemic...

Advanced real-time multi-display educational system (ARMES): An innovative real-time audiovisual mentoring tool for complex robotic surgery.

PubMed

Lee, Joong Ho; Tanaka, Eiji; Woo, Yanghee; Ali, Güner; Son, Taeil; Kim, Hyoung-Il; Hyung, Woo Jin

2017-12-01

The recent scientific and technologic advances have profoundly affected the training of surgeons worldwide. We describe a novel intraoperative real-time training module, the Advanced Robotic Multi-display Educational System (ARMES). We created a real-time training module, which can provide a standardized step by step guidance to robotic distal subtotal gastrectomy with D2 lymphadenectomy procedures, ARMES. The short video clips of 20 key steps in the standardized procedure for robotic gastrectomy were created and integrated with TilePro™ software to delivery on da Vinci Surgical Systems (Intuitive Surgical, Sunnyvale, CA). We successfully performed the robotic distal subtotal gastrectomy with D2 lymphadenectomy for patient with gastric cancer employing this new teaching method without any transfer errors or system failures. Using this technique, the total operative time was 197 min and blood loss was 50 mL and there were no intra- or post-operative complications. Our innovative real-time mentoring module, ARMES, enables standardized, systematic guidance during surgical procedures. © 2017 Wiley Periodicals, Inc.

Rehabilitation robotics for the upper extremity: review with new directions for orthopaedic disorders.

PubMed

Hakim, Renée M; Tunis, Brandon G; Ross, Michael D

2017-11-01

The focus of research using technological innovations such as robotic devices has been on interventions to improve upper extremity function in neurologic populations, particularly patients with stroke. There is a growing body of evidence describing rehabilitation programs using various types of supportive/assistive and/or resistive robotic and virtual reality-enhanced devices to improve outcomes for patients with neurologic disorders. The most promising approaches are task-oriented, based on current concepts of motor control/learning and practice-induced neuroplasticity. Based on this evidence, we describe application and feasibility of virtual reality-enhanced robotics integrated with current concepts in orthopaedic rehabilitation shifting from an impairment-based focus to inclusion of more intense, task-specific training for patients with upper extremity disorders, specifically emphasizing the wrist and hand. The purpose of this paper is to describe virtual reality-enhanced rehabilitation robotic devices, review evidence of application in patients with upper extremity deficits related to neurologic disorders, and suggest how this technology and task-oriented rehabilitation approach can also benefit patients with orthopaedic disorders of the wrist and hand. We will also discuss areas for further research and development using a task-oriented approach and a commercially available haptic robotic device to focus on training of grasp and manipulation tasks. Implications for Rehabilitation There is a growing body of evidence describing rehabilitation programs using various types of supportive/assistive and/or resistive robotic and virtual reality-enhanced devices to improve outcomes for patients with neurologic disorders. The most promising approaches using rehabilitation robotics are task-oriented, based on current concepts of motor control/learning and practice-induced neuroplasticity. Based on the evidence in neurologic populations, virtual reality-enhanced robotics may be integrated with current concepts in orthopaedic rehabilitation shifting from an impairment-based focus to inclusion of more intense, task-specific training for patients with UE disorders, specifically emphasizing the wrist and hand. Clinical application of a task-oriented approach may be accomplished using commercially available haptic robotic device to focus on training of grasp and manipulation tasks.

Influence of psychologic features on rehabilitation outcomes in patients with subacute stroke trained with robotic-aided walking therapy.

PubMed

Bragoni, Maura; Broccoli, Marco; Iosa, Marco; Morone, Giovanni; De Angelis, Domenico; Venturiero, Vincenzo; Coiro, Paola; Pratesi, Luca; Mezzetti, Giulia; Fusco, Augusto; Paolucci, Stefano

2013-10-01

The aim of this study was to investigate whether the rehabilitation outcomes with robotic-aided gait therapy may be affected by patients' and caregivers' psychologic features after subacute stroke. This is a controlled, longitudinal, observational pilot study conducted on 42 patients divided in robotic-assisted gait training plus conventional physical therapy group, robotic-assisted gait training dropout group, and conventional physical therapy group. The outcome measures were walking ability (Functional Ambulation Category) and independency in activities of daily living (Barthel Index) measured before and after intervention. Psychologic features were measured before intervention using the Hospital Anxiety and Depression Scale, the Eysenck Personality Questionnaire, and recovery locus of control in the patients and the State-Trait Anxiety Inventory and the Beck Depression Inventory in the caregivers. Patient anxiety was significantly higher in those who refused/abandoned robotic therapy (P = 0.002). In the subjects allocated to the robotic group, the recovery of walking ability was significantly affected by the perceived recovery locus of control (P = 0.039, odds ratio = 14); and the recovery of independency in activities of daily living, by anxiety (P = 0.018, odds ratio = 0.042). Conversely, psychologic factors did not significantly affect the outcomes of conventional rehabilitation. Psychologic features, particularly recovery locus of control and anxiety, affected the rehabilitative outcomes of the patients involved in robotic treatment more than those in conventional rehabilitation.

Kinematics effectively delineate accomplished users of endovascular robotics with a physical training model.

PubMed

Duran, Cassidy; Estrada, Sean; O'Malley, Marcia; Lumsden, Alan B; Bismuth, Jean

2015-02-01

Endovascular robotics systems, now approved for clinical use in the United States and Europe, are seeing rapid growth in interest. Determining who has sufficient expertise for safe and effective clinical use remains elusive. Our aim was to analyze performance on a robotic platform to determine what defines an expert user. During three sessions, 21 subjects with a range of endovascular expertise and endovascular robotic experience (novices <2 hours to moderate-extensive experience with >20 hours) performed four tasks on a training model. All participants completed a 2-hour training session on the robot by a certified instructor. Completion times, global rating scores, and motion metrics were collected to assess performance. Electromagnetic tracking was used to capture and to analyze catheter tip motion. Motion analysis was based on derivations of speed and position including spectral arc length and total number of submovements (inversely proportional to proficiency of motion) and duration of submovements (directly proportional to proficiency). Ninety-eight percent of competent subjects successfully completed the tasks within the given time, whereas 91% of noncompetent subjects were successful. There was no significant difference in completion times between competent and noncompetent users except for the posterior branch (151 s:105 s; P = .01). The competent users had more efficient motion as evidenced by statistically significant differences in the metrics of motion analysis. Users with >20 hours of experience performed significantly better than those newer to the system, independent of prior endovascular experience. This study demonstrates that motion-based metrics can differentiate novice from trained users of flexible robotics systems for basic endovascular tasks. Efficiency of catheter movement, consistency of performance, and learning curves may help identify users who are sufficiently trained for safe clinical use of the system. This work will help identify the learning curve and specific movements that translate to expert robotic navigation. Copyright © 2015 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

Robotics: Using Technology to Teach New Technologies.

ERIC Educational Resources Information Center

Cohen, Karen C.; Meyer, Carol D.

1984-01-01

Discusses the development of industrial robotics training materials, considering the need for such materials, preliminary curriculum design, the Piagetian approach followed, and the uses of computer assisted instruction. A list of robotics curriculum courses (with content and audience indicated) is included. (JN)

Energy Efficient Legged Robotics at Sandia Labs

DOE Office of Scientific and Technical Information (OSTI.GOV)

Buerger, Steve

Sandia is developing energy efficient actuation and drive train technologies to dramatically improve the charge life of legged robots. The work is supported by DARPA, and Sandia will demonstrate an energy efficient bipedal robot at the technology exposition section of the DARPA Robotics Challenge Finals in June, 2015. This video, the first in a series, describes early development and initial integration of the Sandia Transmission Efficient Prototype Promoting Research (STEPPR) robot.

Energy Efficient Legged Robotics at Sandia Labs

ScienceCinema

Buerger, Steve

2018-05-07

Sandia is developing energy efficient actuation and drive train technologies to dramatically improve the charge life of legged robots. The work is supported by DARPA, and Sandia will demonstrate an energy efficient bipedal robot at the technology exposition section of the DARPA Robotics Challenge Finals in June, 2015. This video, the first in a series, describes early development and initial integration of the Sandia Transmission Efficient Prototype Promoting Research (STEPPR) robot.

Construction of multi-agent mobile robots control system in the problem of persecution with using a modified reinforcement learning method based on neural networks

NASA Astrophysics Data System (ADS)

Patkin, M. L.; Rogachev, G. N.

2018-02-01

A method for constructing a multi-agent control system for mobile robots based on training with reinforcement using deep neural networks is considered. Synthesis of the management system is proposed to be carried out with reinforcement training and the modified Actor-Critic method, in which the Actor module is divided into Action Actor and Communication Actor in order to simultaneously manage mobile robots and communicate with partners. Communication is carried out by sending partners at each step a vector of real numbers that are added to the observation vector and affect the behaviour. Functions of Actors and Critic are approximated by deep neural networks. The Critics value function is trained by using the TD-error method and the Actor’s function by using DDPG. The Communication Actor’s neural network is trained through gradients received from partner agents. An environment in which a cooperative multi-agent interaction is present was developed, computer simulation of the application of this method in the control problem of two robots pursuing two goals was carried out.

Medical Robotic and Tele surgical Simulation Education Research

DTIC Science & Technology

2017-05-01

training exercises, DVSS = 40, dVT = 65, and RoSS = 52 for skills development. All three offer 3D visual images but use different display technologies...capabilities with an emphasis on their educational skills. They offer unique advantages and capabilities in training robotic sur- geons. Each device has been...evaluate the transfer of training effect of each simulator. Collectively, this work will offer end users and potential buyers a comparison of the value

A comparative analysis and guide to virtual reality robotic surgical simulators.

PubMed

Julian, Danielle; Tanaka, Alyssa; Mattingly, Patricia; Truong, Mireille; Perez, Manuela; Smith, Roger

2018-02-01

Since the US Food and Drug Administration approved robotically assisted surgical devices for human surgery in 2000, the number of surgeries utilizing this innovative technology has risen. In 2015, approximately 650 000 robot-assisted procedures were performed worldwide. Surgeons must be properly trained to safely transition to using such innovative technology. Multiple virtual reality robotic simulators are now commercially available for educational and training purposes. There is a need for comparative evaluations of these simulators to aid users in selecting an appropriate device for their purposes. We conducted a comparison of the design and capabilities of all dedicated simulators of the da Vinci robot - the da Vinci Skills Simulator (dVSS), dV-Trainer (dVT), Robotic Skills Simulators (RoSS) and the RobotiX Mentor. This paper provides the base specifications of the hardware and software, with an emphasis on the training capabilities of each system. Each simulator contains a large number of training exercises for skills development: dVSS n = 40, dVT n = 65, RoSS n = 52, RobotiX Mentor n = 31. All four offer 3D visual images but use different display technologies. The dVSS leverages the real robotic surgical console to provide visualization, hand controls and foot pedals. The dVT, RoSS and RobotiX Mentor created simulated versions of all of these control systems. Each includes systems management services that allow instructors to collect, export and analyze the scores of students using the simulators. This study provides comparative information on the four simulators' functional capabilities. Each device offers unique advantages and capabilities for training robotic surgeons. Each has been the subject of validation experiments, which have been published in the literature. But those do not provide specific details on the capabilities of the simulators, which are necessary for an understanding sufficient to select the one best suited for an organization's needs. This article provides comparative information to assist with that type of selection. Copyright © 2017 John Wiley & Sons, Ltd.

Training modalities in robot-mediated upper limb rehabilitation in stroke: a framework for classification based on a systematic review.

PubMed

Basteris, Angelo; Nijenhuis, Sharon M; Stienen, Arno H A; Buurke, Jaap H; Prange, Gerdienke B; Amirabdollahian, Farshid

2014-07-10

Robot-mediated post-stroke therapy for the upper-extremity dates back to the 1990s. Since then, a number of robotic devices have become commercially available. There is clear evidence that robotic interventions improve upper limb motor scores and strength, but these improvements are often not transferred to performance of activities of daily living. We wish to better understand why. Our systematic review of 74 papers focuses on the targeted stage of recovery, the part of the limb trained, the different modalities used, and the effectiveness of each. The review shows that most of the studies so far focus on training of the proximal arm for chronic stroke patients. About the training modalities, studies typically refer to active, active-assisted and passive interaction. Robot-therapy in active assisted mode was associated with consistent improvements in arm function. More specifically, the use of HRI features stressing active contribution by the patient, such as EMG-modulated forces or a pushing force in combination with spring-damper guidance, may be beneficial.Our work also highlights that current literature frequently lacks information regarding the mechanism about the physical human-robot interaction (HRI). It is often unclear how the different modalities are implemented by different research groups (using different robots and platforms). In order to have a better and more reliable evidence of usefulness for these technologies, it is recommended that the HRI is better described and documented so that work of various teams can be considered in the same group and categories, allowing to infer for more suitable approaches. We propose a framework for categorisation of HRI modalities and features that will allow comparing their therapeutic benefits.

Training modalities in robot-mediated upper limb rehabilitation in stroke: a framework for classification based on a systematic review

PubMed Central

2014-01-01

Robot-mediated post-stroke therapy for the upper-extremity dates back to the 1990s. Since then, a number of robotic devices have become commercially available. There is clear evidence that robotic interventions improve upper limb motor scores and strength, but these improvements are often not transferred to performance of activities of daily living. We wish to better understand why. Our systematic review of 74 papers focuses on the targeted stage of recovery, the part of the limb trained, the different modalities used, and the effectiveness of each. The review shows that most of the studies so far focus on training of the proximal arm for chronic stroke patients. About the training modalities, studies typically refer to active, active-assisted and passive interaction. Robot-therapy in active assisted mode was associated with consistent improvements in arm function. More specifically, the use of HRI features stressing active contribution by the patient, such as EMG-modulated forces or a pushing force in combination with spring-damper guidance, may be beneficial. Our work also highlights that current literature frequently lacks information regarding the mechanism about the physical human-robot interaction (HRI). It is often unclear how the different modalities are implemented by different research groups (using different robots and platforms). In order to have a better and more reliable evidence of usefulness for these technologies, it is recommended that the HRI is better described and documented so that work of various teams can be considered in the same group and categories, allowing to infer for more suitable approaches. We propose a framework for categorisation of HRI modalities and features that will allow comparing their therapeutic benefits. PMID:25012864

Autonomous Exploration Using an Information Gain Metric

DTIC Science & Technology

2016-03-01

implemented on 2 different robotic platforms: the PackBot designed by iRobot and the Jackal designed by Clearpath Robotics. The PackBot, shown in Fig. 1, is a... Jackal is a wheeled, man-portable robot system. Both robots were equipped with a Hokuyo UTM-30LX-EW scanning laser range finder with a motor...Fig. 2, the robot was used to explore and map the second floor of a building located in a military and rescue training facility. The Jackal platform

Human voluntary activity integration in the control of a standing-up rehabilitation robot: a simulation study.

PubMed

Kamnik, Roman; Bajd, Tadej

2007-11-01

The paper presents a novel control approach for the robot-assisted motion augmentation of disabled subjects during the standing-up manoeuvre. The main goal of the proposal is to integrate the voluntary activity of a person in the control scheme of the rehabilitation robot. The algorithm determines the supportive force to be tracked by a robot force controller. The basic idea behind the calculation of supportive force is to quantify the deficit in the dynamic equilibrium of the trunk. The proposed algorithm was implemented as a Kalman filter procedure and evaluated in a simulation environment. The simulation results proved the adequate and robust performance of "patient-driven" robot-assisted standing-up training. In addition, the possibility of varying the training conditions with different degrees of the subject's initiative is demonstrated.

Use of Lower-Limb Robotics to Enhance Practice and Participation in Individuals With Neurological Conditions.

PubMed

Jayaraman, Arun; Burt, Sheila; Rymer, William Zev

2017-07-01

To review lower-limb technology currently available for people with neurological disorders, such as spinal cord injury, stroke, or other conditions. We focus on 3 emerging technologies: treadmill-based training devices, exoskeletons, and other wearable robots. Efficacy for these devices remains unclear, although preliminary data indicate that specific patient populations may benefit from robotic training used with more traditional physical therapy. Potential benefits include improved lower-limb function and a more typical gait trajectory. Use of these devices is limited by insufficient data, cost, and in some cases size of the machine. However, robotic technology is likely to become more prevalent as these machines are enhanced and able to produce targeted physical rehabilitation. Therapists should be aware of these technologies as they continue to advance but understand the limitations and challenges posed with therapeutic/mobility robots.

A self-paced motor imagery based brain-computer interface for robotic wheelchair control.

PubMed

Tsui, Chun Sing Louis; Gan, John Q; Hu, Huosheng

2011-10-01

This paper presents a simple self-paced motor imagery based brain-computer interface (BCI) to control a robotic wheelchair. An innovative control protocol is proposed to enable a 2-class self-paced BCI for wheelchair control, in which the user makes path planning and fully controls the wheelchair except for the automatic obstacle avoidance based on a laser range finder when necessary. In order for the users to train their motor imagery control online safely and easily, simulated robot navigation in a specially designed environment was developed. This allowed the users to practice motor imagery control with the core self-paced BCI system in a simulated scenario before controlling the wheelchair. The self-paced BCI can then be applied to control a real robotic wheelchair using a protocol similar to that controlling the simulated robot. Our emphasis is on allowing more potential users to use the BCI controlled wheelchair with minimal training; a simple 2-class self paced system is adequate with the novel control protocol, resulting in a better transition from offline training to online control. Experimental results have demonstrated the usefulness of the online practice under the simulated scenario, and the effectiveness of the proposed self-paced BCI for robotic wheelchair control.

[Rehabilitation and nursing-care robots].

PubMed

Hachisuka, Kenji

2016-04-01

In the extremely aged society, rehabilitation staff will be required to provide ample rehabilitation training for more stroke patients and more aged people with disabilities despite limitations in human resources. A nursing-care robot is one potential solution from the standpoint of rehabilitation. The nursing-care robot is defined as a robot which assists aged people and persons with disabilities in daily life and social life activities. The nursing-care robot consists of an independent support robot, caregiver support robot, and life support robot. Although many nursing-care robots have been developed, the most appropriate robot must be selected according to its features and the needs of patients and caregivers in the field of nursing-care.

Human-robot cooperative movement training: Learning a novel sensory motor transformation during walking with robotic assistance-as-needed

PubMed Central

Emken, Jeremy L; Benitez, Raul; Reinkensmeyer, David J

2007-01-01

Background A prevailing paradigm of physical rehabilitation following neurologic injury is to "assist-as-needed" in completing desired movements. Several research groups are attempting to automate this principle with robotic movement training devices and patient cooperative algorithms that encourage voluntary participation. These attempts are currently not based on computational models of motor learning. Methods Here we assume that motor recovery from a neurologic injury can be modelled as a process of learning a novel sensory motor transformation, which allows us to study a simplified experimental protocol amenable to mathematical description. Specifically, we use a robotic force field paradigm to impose a virtual impairment on the left leg of unimpaired subjects walking on a treadmill. We then derive an "assist-as-needed" robotic training algorithm to help subjects overcome the virtual impairment and walk normally. The problem is posed as an optimization of performance error and robotic assistance. The optimal robotic movement trainer becomes an error-based controller with a forgetting factor that bounds kinematic errors while systematically reducing its assistance when those errors are small. As humans have a natural range of movement variability, we introduce an error weighting function that causes the robotic trainer to disregard this variability. Results We experimentally validated the controller with ten unimpaired subjects by demonstrating how it helped the subjects learn the novel sensory motor transformation necessary to counteract the virtual impairment, while also preventing them from experiencing large kinematic errors. The addition of the error weighting function allowed the robot assistance to fade to zero even though the subjects' movements were variable. We also show that in order to assist-as-needed, the robot must relax its assistance at a rate faster than that of the learning human. Conclusion The assist-as-needed algorithm proposed here can limit error during the learning of a dynamic motor task. The algorithm encourages learning by decreasing its assistance as a function of the ongoing progression of movement error. This type of algorithm is well suited for helping people learn dynamic tasks for which large kinematic errors are dangerous or discouraging, and thus may prove useful for robot-assisted movement training of walking or reaching following neurologic injury. PMID:17391527

Feasibility and Acceptance of a Robotic Surgery Ergonomic Training Program

PubMed Central

Craven, Renatta; Mosaly, Prithima; Gehrig, Paola A.

2014-01-01

Background and Objectives: Assessment of ergonomic strain during robotic surgery indicates there is a need for intervention. However, limited data exist detailing the feasibility and acceptance of ergonomic training (ET) for robotic surgeons. This prospective, observational pilot study evaluates the implementation of an evidence-based ET module. Methods: A two-part survey was conducted. The first survey assessed robotic strain using the Nordic Musculoskeletal Questionnaire (NMQ). Participants were given the option to participate in either an online or an in-person ET session. The ET was derived from Occupational Safety and Health Administration guidelines and developed by a human factors engineer experienced with health care ergonomics. After ET, a follow-up survey including the NMQ and an assessment of the ET were completed. Results: The survey was sent to 67 robotic surgeons. Forty-two (62.7%) responded, including 18 residents, 8 fellows, and 16 attending physicians. Forty-five percent experienced strain resulting from performing robotic surgery and 26.3% reported persistent strain. Only 16.6% of surgeons reported prior ET in robotic surgery. Thirty-five (78%) surgeons elected to have in-person ET, which was successfully arranged for 32 surgeons (91.4%). Thirty-seven surgeons (88.1%) completed the follow-up survey. All surgeons participating in the in-person ET found it helpful and felt formal ET should be standard, 88% changed their practice as a result of the training, and 74% of those reporting strain noticed a decrease after their ET. Conclusion: Thus, at a high-volume robotics center, evidence-based ET was easily implemented, well-received, changed some surgeons' practice, and decreased self-reported strain related to robotic surgery. PMID:25489213

A robotic wheelchair trainer: design overview and a feasibility study

PubMed Central

2010-01-01

Background Experiencing independent mobility is important for children with a severe movement disability, but learning to drive a powered wheelchair can be labor intensive, requiring hand-over-hand assistance from a skilled therapist. Methods To improve accessibility to training, we developed a robotic wheelchair trainer that steers itself along a course marked by a line on the floor using computer vision, haptically guiding the driver's hand in appropriate steering motions using a force feedback joystick, as the driver tries to catch a mobile robot in a game of "robot tag". This paper provides a detailed design description of the computer vision and control system. In addition, we present data from a pilot study in which we used the chair to teach children without motor impairment aged 4-9 (n = 22) to drive the wheelchair in a single training session, in order to verify that the wheelchair could enable learning by the non-impaired motor system, and to establish normative values of learning rates. Results and Discussion Training with haptic guidance from the robotic wheelchair trainer improved the steering ability of children without motor impairment significantly more than training without guidance. We also report the results of a case study with one 8-year-old child with a severe motor impairment due to cerebral palsy, who replicated the single-session training protocol that the non-disabled children participated in. This child also improved steering ability after training with guidance from the joystick by an amount even greater than the children without motor impairment. Conclusions The system not only provided a safe, fun context for automating driver's training, but also enhanced motor learning by the non-impaired motor system, presumably by demonstrating through intuitive movement and force of the joystick itself exemplary control to follow the course. The case study indicates that a child with a motor system impaired by CP can also gain a short-term benefit from driver's training with haptic guidance. PMID:20707886

A robotic wheelchair trainer: design overview and a feasibility study.

PubMed

Marchal-Crespo, Laura; Furumasu, Jan; Reinkensmeyer, David J

2010-08-13

Experiencing independent mobility is important for children with a severe movement disability, but learning to drive a powered wheelchair can be labor intensive, requiring hand-over-hand assistance from a skilled therapist. To improve accessibility to training, we developed a robotic wheelchair trainer that steers itself along a course marked by a line on the floor using computer vision, haptically guiding the driver's hand in appropriate steering motions using a force feedback joystick, as the driver tries to catch a mobile robot in a game of "robot tag". This paper provides a detailed design description of the computer vision and control system. In addition, we present data from a pilot study in which we used the chair to teach children without motor impairment aged 4-9 (n = 22) to drive the wheelchair in a single training session, in order to verify that the wheelchair could enable learning by the non-impaired motor system, and to establish normative values of learning rates. Training with haptic guidance from the robotic wheelchair trainer improved the steering ability of children without motor impairment significantly more than training without guidance. We also report the results of a case study with one 8-year-old child with a severe motor impairment due to cerebral palsy, who replicated the single-session training protocol that the non-disabled children participated in. This child also improved steering ability after training with guidance from the joystick by an amount even greater than the children without motor impairment. The system not only provided a safe, fun context for automating driver's training, but also enhanced motor learning by the non-impaired motor system, presumably by demonstrating through intuitive movement and force of the joystick itself exemplary control to follow the course. The case study indicates that a child with a motor system impaired by CP can also gain a short-term benefit from driver's training with haptic guidance.

Energy Efficient Legged Robotics at Sandia Labs, Part 2

ScienceCinema

Buerger, Steve; Mazumdar, Ani; Spencer, Steve

2018-01-16

Sandia is developing energy efficient actuation and drive train technologies to dramatically improve the charge life of legged robots. The work is supported by DARPA, and Sandia will demonstrate an energy efficient bipedal robot at the technology exposition section of the DARPA Robotics Challenge Finals in June, 2015. This video, the second in a series, describes the continued development and integration of the Sandia Transmission Efficient Prototype Promoting Research (STEPPR) robot.

Energy Efficient Legged Robotics at Sandia Labs, Part 2

DOE Office of Scientific and Technical Information (OSTI.GOV)

Buerger, Steve; Mazumdar, Ani; Spencer, Steve

Sandia is developing energy efficient actuation and drive train technologies to dramatically improve the charge life of legged robots. The work is supported by DARPA, and Sandia will demonstrate an energy efficient bipedal robot at the technology exposition section of the DARPA Robotics Challenge Finals in June, 2015. This video, the second in a series, describes the continued development and integration of the Sandia Transmission Efficient Prototype Promoting Research (STEPPR) robot.

Comparative assessment of physical and cognitive ergonomics associated with robotic and traditional laparoscopic surgeries.

PubMed

Lee, Gyusung I; Lee, Mija R; Clanton, Tameka; Clanton, Tamera; Sutton, Erica; Park, Adrian E; Marohn, Michael R

2014-02-01

We conducted this study to investigate how physical and cognitive ergonomic workloads would differ between robotic and laparoscopic surgeries and whether any ergonomic differences would be related to surgeons' robotic surgery skill level. Our hypothesis is that the unique features in robotic surgery will demonstrate skill-related results both in substantially less physical and cognitive workload and uncompromised task performance. Thirteen MIS surgeons were recruited for this institutional review board-approved study and divided into three groups based on their robotic surgery experiences: laparoscopy experts with no robotic experience, novices with no or little robotic experience, and robotic experts. Each participant performed six surgical training tasks using traditional laparoscopy and robotic surgery. Physical workload was assessed by using surface electromyography from eight muscles (biceps, triceps, deltoid, trapezius, flexor carpi ulnaris, extensor digitorum, thenar compartment, and erector spinae). Mental workload assessment was conducted using the NASA-TLX. The cumulative muscular workload (CMW) from the biceps and the flexor carpi ulnaris with robotic surgery was significantly lower than with laparoscopy (p < 0.05). Interestingly, the CMW from the trapezius was significantly higher with robotic surgery than with laparoscopy (p < 0.05), but this difference was only observed in laparoscopic experts (LEs) and robotic surgery novices. NASA-TLX analysis showed that both robotic surgery novices and experts expressed lower global workloads with robotic surgery than with laparoscopy, whereas LEs showed higher global workload with robotic surgery (p > 0.05). Robotic surgery experts and novices had significantly higher performance scores with robotic surgery than with laparoscopy (p < 0.05). This study demonstrated that the physical and cognitive ergonomics with robotic surgery were significantly less challenging. Additionally, several ergonomic components were skill-related. Robotic experts could benefit the most from the ergonomic advantages in robotic surgery. These results emphasize the need for well-structured training and well-defined ergonomics guidelines to maximize the benefits utilizing the robotic surgery.

Virtual reality surgical simulators- a prerequisite for robotic surgery.

PubMed

Rajanbabu, Anupama; Drudi, Laura; Lau, Susie; Press, Joshua Z; Gotlieb, Walter H

2014-06-01

The field of computer assisted minimally invasive surgery is rapidly expanding worldwide, including in India. With more hospitals in India contemplating the acquisition of a robotic platform, training of robotic surgeons is becoming essential. Virtual reality simulators can be used for surgeons to become acquainted with the robotic console prior to live surgery. Our aim was to evaluate the amount of simulator training required before a surgeon first operates on the da Vinci® Surgical System. Simulations were conducted on the Intuitive Surgical's da Vinci® Robot Skill Simulator using the software obtained from Mimic Technologies. Participants included attending staff surgeons experienced in robotic surgery and novices. A set of seven activities were chosen for each participant. Based on the mean exercise score from the first attempt, staff surgeons outperformed the novices in all exercises. However, the difference in score between the staff and the novices decreased after the participants repeated the exercises and by the sixth attempt most of the novices obtained similar scores to the staff, suggesting that this might be at present the minimum set of repetitions indicated (or required) prior to performing life robotic surgery.

Fine finger motor skill training with exoskeleton robotic hand in chronic stroke: stroke rehabilitation.

PubMed

Ockenfeld, Corinna; Tong, Raymond K Y; Susanto, Evan A; Ho, Sze-Kit; Hu, Xiao-ling

2013-06-01

Background and Purpose. Stroke survivors often show a limited recovery in the hand function to perform delicate motions, such as full hand grasping, finger pinching and individual finger movement. The purpose of this study is to describe the implementation of an exoskeleton robotic hand together with fine finger motor skill training on 2 chronic stroke patients. Case Descriptions. Two post-stroke patients participated in a 20-session training program by integrating 10 minutes physical therapy, 20 minutes robotic hand training and 15 minutes functional training tasks with delicate objects(card, pen and coin). These two patients (A and B) had cerebrovascular accident at 6 months and 11 months respectively when enrolled in this study. Outcomes. The results showed that both patients had improvements in Fugl-Meyer assessment (FM), Action Research Arm Test (ARAT). Patients had better isolation of the individual finger flexion and extension based on the reduced muscle co-contraction from the electromyographic(EMG) signals and finger extension force after 20 sessions of training. Discussion. This preliminary study showed that by focusing on the fine finger motor skills together with the exoskeleton robotic hand, it could improve the motor recovery of the upper extremity in the fingers and hand function, which were showed in the ARAT. Future randomized controlled trials are needed to evaluate the clinical effectiveness.

Robotic Arm-Assisted Sonography: Review of Technical Developments and Potential Clinical Applications.

PubMed

Swerdlow, Daniel R; Cleary, Kevin; Wilson, Emmanuel; Azizi-Koutenaei, Bamshad; Monfaredi, Reza

2017-04-01

Ultrasound imaging requires trained personnel. Advances in robotics and data transmission create the possibility of telesonography. This review introduces clinicians to current technical work in and potential applications of this developing capability. Telesonography offers advantages in hazardous or remote environments. Robotically assisted ultrasound can reduce stress injuries in sonographers and has potential utility during robotic surgery and interventional procedures.

Realtime motion planning for a mobile robot in an unknown environment using a neurofuzzy based approach

NASA Astrophysics Data System (ADS)

Zheng, Taixiong

2005-12-01

A neuro-fuzzy network based approach for robot motion in an unknown environment was proposed. In order to control the robot motion in an unknown environment, the behavior of the robot was classified into moving to the goal and avoiding obstacles. Then, according to the dynamics of the robot and the behavior character of the robot in an unknown environment, fuzzy control rules were introduced to control the robot motion. At last, a 6-layer neuro-fuzzy network was designed to merge from what the robot sensed to robot motion control. After being trained, the network may be used for robot motion control. Simulation results show that the proposed approach is effective for robot motion control in unknown environment.

Consistency of performance of robot-assisted surgical tasks in virtual reality.

PubMed

Suh, I H; Siu, K-C; Mukherjee, M; Monk, E; Oleynikov, D; Stergiou, N

2009-01-01

The purpose of this study was to investigate consistency of performance of robot-assisted surgical tasks in a virtual reality environment. Eight subjects performed two surgical tasks, bimanual carrying and needle passing, with both the da Vinci surgical robot and a virtual reality equivalent environment. Nonlinear analysis was utilized to evaluate consistency of performance by calculating the regularity and the amount of divergence in the movement trajectories of the surgical instrument tips. Our results revealed that movement patterns for both training tasks were statistically similar between the two environments. Consistency of performance as measured by nonlinear analysis could be an appropriate methodology to evaluate the complexity of the training tasks between actual and virtual environments and assist in developing better surgical training programs.

Electromechanical and robot-assisted arm training for improving generic activities of daily living, arm function, and arm muscle strength after stroke.

PubMed

Mehrholz, Jan; Hädrich, Anja; Platz, Thomas; Kugler, Joachim; Pohl, Marcus

2012-06-13

Electromechanical and robot-assisted arm training devices are used in rehabilitation, and might help to improve arm function after stroke. To assess the effectiveness of electromechanical and robot-assisted arm training for improving generic activities of daily living, arm function, and arm muscle strength in patients after stroke. We will also assess the acceptability and safety of the therapy. We searched the Cochrane Stroke Group's Trials Register (last searched July 2011), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 7), MEDLINE (1950 to July 2011), EMBASE (1980 to July 2011), CINAHL (1982 to July 2011), AMED (1985 to July 2011), SPORTDiscus (1949 to July 2011), PEDro (searched August 2011), COMPENDEX (1972 to July 2011), and INSPEC (1969 to July 2011). We also handsearched relevant conference proceedings, searched trials and research registers, checked reference lists, and contacted trialists, experts and researchers in our field, as well as manufacturers of commercial devices. Randomised controlled trials (RCTs) comparing electromechanical and robot-assisted arm training for recovery of arm function with other rehabilitation or placebo interventions, or no treatment, for patients after stroke. Two review authors independently selected trials for inclusion, assessed trial quality, and extracted data. We contacted trialists for additional information. We analysed the results as standardised mean differences (SMDs) for continuous variables and risk differences (RDs) for dichotomous variables. We included 19 trials (involving 666 participants) in this update of our review. Electromechanical and robot-assisted arm training did improve activities of daily living (SMD 0.43, 95% confidence interval (CI) 0.11 to 0.75, P = 0.009, I(2) = 67%) as well as arm function (SMD 0.45, 95% CI 0.20 to 0.69, P = 0.0004, I(2) = 45%), but arm muscle strength did not improve (SMD 0.48, 95% CI -0.06 to 1.03, P = 0.08, I(2) = 79%). Electromechanical and robot-assisted arm training did not increase the risk of patients to drop out (RD 0.00, 95% CI -0.04 to 0.04, P = 0.82, I(2) = 0.0%), and adverse events were rare. Patients who receive electromechanical and robot-assisted arm training after stroke are more likely to improve their generic activities of daily living. Paretic arm function may also improve, but not arm muscle strength. However, the results must be interpreted with caution because there were variations between the trials in the duration and amount of training, type of treatment, and in the patient characteristics.

Final Report, University Research Program in Robotics (URPR), Nuclear Facilities Clean-up

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tesar, Delbert; Kapoor, Chetan; Pryor, Mitch

This final report describes the research activity at the University of Texas at Austin with application to EM needs at DOE. This research activity is divided in to two major thrusts and contributes to the overall University Research Program in Robotics (URPR) thrust by providing mechanically oriented robotic solutions based on modularity and generalized software. These thrusts are also the core strengths of the UTA program that has a 40-year history in machine development, 30 years specifically devoted to robotics. Since 1975, much of this effort has been to establish the general analytical and design infrastructure for an open (modular)more » architecture of systems with many degrees of freedom that are able to satisfy a broad range of applications for future production machines. This work has coalesced from two principal areas: standardized actuators and generalized software.« less

Validated robotic laparoscopic surgical training in a virtual-reality environment.

PubMed

Katsavelis, Dimitrios; Siu, Ka-Chun; Brown-Clerk, Bernadette; Lee, Irene H; Lee, Yong Kwon; Oleynikov, Dmitry; Stergiou, Nick

2009-01-01

A robotic virtual-reality (VR) simulator has been developed to improve robot-assisted training for laparoscopic surgery and to enhance surgical performance in laparoscopic skills. The simulated VR training environment provides an effective approach to evaluate and improve surgical performance. This study presents our findings of the VR training environment for robotic laparoscopy. Eight volunteers performed two inanimate tasks in both the VR and the actual training environment. The tasks were bimanual carrying (BC) and needle passing (NP). For the BC task, the volunteers simultaneously transferred two plastic pieces in opposite directions five times consecutively. The same volunteers passed a surgical needle through six pairs of holes in the NP task. Both tasks require significant bimanual coordination that mimics actual laparoscopic skills. Data analysis included time to task completion, speed and distance traveled of the instrument tip, as well as range of motion of the subject's wrist and elbow of the right arm. Electromyography of the right wrist flexor and extensor were also analyzed. Paired t-tests and Pearson's r were used to explore the differences and correlations between the two environments. There were no significant differences between the actual and the simulated VR environment with respect to the BC task, while there were significant differences in almost all dependent parameters for the NP task. Moderate to high correlations for most dependent parameters were revealed for both tasks. Our data shows that the VR environment adequately simulated the BC task. The significant differences found for the NP task may be attributed to an oversimplification in the VR environment. However, they do point to the need for improvements in the complexity of our VR simulation. Further research work is needed to develop effective and reliable VR environments for robotic laparoscopic training.

Automated carbon dioxide cleaning system

NASA Technical Reports Server (NTRS)

Hoppe, David T.

1991-01-01

Solidified CO2 pellets are an effective blast media for the cleaning of a variety of materials. CO2 is obtained from the waste gas streams generated from other manufacturing processes and therefore does not contribute to the greenhouse effect, depletion of the ozone layer, or the environmental burden of hazardous waste disposal. The system is capable of removing as much as 90 percent of the contamination from a surface in one pass or to a high cleanliness level after multiple passes. Although the system is packaged and designed for manual hand held cleaning processes, the nozzle can easily be attached to the end effector of a robot for automated cleaning of predefined and known geometries. Specific tailoring of cleaning parameters are required to optimize the process for each individual geometry. Using optimum cleaning parameters the CO2 systems were shown to be capable of cleaning to molecular levels below 0.7 mg/sq ft. The systems were effective for removing a variety of contaminants such as lubricating oils, cutting oils, grease, alcohol residue, biological films, and silicone. The system was effective on steel, aluminum, and carbon phenolic substrates.

Developing a Wearable Ankle Rehabilitation Robotic Device for in-Bed Acute Stroke Rehabilitation.

PubMed

Ren, Yupeng; Wu, Yi-Ning; Yang, Chung-Yong; Xu, Tao; Harvey, Richard L; Zhang, Li-Qun

2017-06-01

Ankle movement training is important in motor recovery post stroke and early intervention is critical to stroke rehabilitation. However, acute stroke survivors receive motor rehabilitation in only a small fraction of time, partly due to the lack of effective devices and protocols suitable for early in-bed rehabilitation. Considering the first few months post stroke is critical in stroke recovery, there is a strong need to start motor rehabilitation early, mobilize the ankle, and conduct movement therapy. This study seeks to address the need and deliver intensive passive and active movement training in acute stroke using a wearable ankle robotic device. Isometric torque generation mode under real-time feedback is used to guide patients in motor relearning. In the passive stretching mode, the wearable robotic device stretches the ankle throughout its range of motion to the extreme dorsiflexion forcefully and safely. In the active movement training mode, a patient is guided and motivated to actively participate in movement training through game playing. Clinical testing of the wearable robotic device on 10 acute stroke survivors over 12 sessions of feedback-facilitated isometric torque generation, and passive and active movement training indicated that the early in-bed rehabilitation could have facilitated neuroplasticity and helped improve motor control ability.

Teaching Adult Rats Spinalized as Neonates to Walk Using Trunk Robotic Rehabilitation: Elements of Success, Failure, and Dependence

PubMed Central

Udoekwere, Ubong I.; Oza, Chintan S.

2016-01-01

Robot therapy promotes functional recovery after spinal cord injury (SCI) in animal and clinical studies. Trunk actions are important in adult rats spinalized as neonates (NTX rats) that walk autonomously. Quadrupedal robot rehabilitation was tested using an implanted orthosis at the pelvis. Trunk cortical reorganization follows such rehabilitation. Here, we test the functional outcomes of such training. Robot impedance control at the pelvis allowed hindlimb, trunk, and forelimb mechanical interactions. Rats gradually increased weight support. Rats showed significant improvement in hindlimb stepping ability, quadrupedal weight support, and all measures examined. Function in NTX rats both before and after training showed bimodal distributions, with “poor” and “high weight support” groupings. A total of 35% of rats initially classified as “poor” were able to increase their weight-supported step measures to a level considered “high weight support” after robot training, thus moving between weight support groups. Recovered function in these rats persisted on treadmill with the robot both actuated and nonactuated, but returned to pretraining levels if they were completely disconnected from the robot. Locomotor recovery in robot rehabilitation of NTX rats thus likely included context dependence and/or incorporation of models of robot mechanics that became essential parts of their learned strategy. Such learned dependence is likely a hurdle to autonomy to be overcome for many robot locomotor therapies. Notwithstanding these limitations, trunk-based quadrupedal robot rehabilitation helped the rats to visit mechanical states they would never have achieved alone, to learn novel coordinations, and to achieve major improvements in locomotor function. SIGNIFICANCE STATEMENT Neonatal spinal transected rats without any weight support can be taught weight support as adults by using robot rehabilitation at trunk. No adult control rats with neonatal spinal transections spontaneously achieve similar changes. The robot rehabilitation system can be inactivated and the skills that were learned persist. Responding rats cannot be detached from the robot altogether, a dependence develops in the skill learned. From data and analysis here, the likelihood of such rats to respond to the robot therapy can also now be predicted. These results are all novel. Understanding trunk roles in voluntary and spinal reflex integration after spinal cord injury and in recovery of function are broadly significant for basic and clinical understanding of motor function. PMID:27511008

Teaching Adult Rats Spinalized as Neonates to Walk Using Trunk Robotic Rehabilitation: Elements of Success, Failure, and Dependence.

PubMed

Udoekwere, Ubong I; Oza, Chintan S; Giszter, Simon F

2016-08-10

Robot therapy promotes functional recovery after spinal cord injury (SCI) in animal and clinical studies. Trunk actions are important in adult rats spinalized as neonates (NTX rats) that walk autonomously. Quadrupedal robot rehabilitation was tested using an implanted orthosis at the pelvis. Trunk cortical reorganization follows such rehabilitation. Here, we test the functional outcomes of such training. Robot impedance control at the pelvis allowed hindlimb, trunk, and forelimb mechanical interactions. Rats gradually increased weight support. Rats showed significant improvement in hindlimb stepping ability, quadrupedal weight support, and all measures examined. Function in NTX rats both before and after training showed bimodal distributions, with "poor" and "high weight support" groupings. A total of 35% of rats initially classified as "poor" were able to increase their weight-supported step measures to a level considered "high weight support" after robot training, thus moving between weight support groups. Recovered function in these rats persisted on treadmill with the robot both actuated and nonactuated, but returned to pretraining levels if they were completely disconnected from the robot. Locomotor recovery in robot rehabilitation of NTX rats thus likely included context dependence and/or incorporation of models of robot mechanics that became essential parts of their learned strategy. Such learned dependence is likely a hurdle to autonomy to be overcome for many robot locomotor therapies. Notwithstanding these limitations, trunk-based quadrupedal robot rehabilitation helped the rats to visit mechanical states they would never have achieved alone, to learn novel coordinations, and to achieve major improvements in locomotor function. Neonatal spinal transected rats without any weight support can be taught weight support as adults by using robot rehabilitation at trunk. No adult control rats with neonatal spinal transections spontaneously achieve similar changes. The robot rehabilitation system can be inactivated and the skills that were learned persist. Responding rats cannot be detached from the robot altogether, a dependence develops in the skill learned. From data and analysis here, the likelihood of such rats to respond to the robot therapy can also now be predicted. These results are all novel. Understanding trunk roles in voluntary and spinal reflex integration after spinal cord injury and in recovery of function are broadly significant for basic and clinical understanding of motor function. Copyright © 2016 the authors 0270-6474/16/368341-15$15.00/0.

Enhancing State Clean Energy Workforce Training to Meet Demand. Issue Brief

ERIC Educational Resources Information Center

Saha, Devashree

2010-01-01

Recent state policy and federal funding initiatives are driving the demand for clean energy in both the short and long term. This increased demand has created the need for many more workers trained or retrained in a variety of clean energy jobs. In response, states are utilizing funding under the American Recovery and Reinvestment Act of 2009…

Views of physiatrists and physical therapists on the use of gait-training robots for stroke patients

PubMed Central

Kang, Chang Gu; Chun, Min Ho; Chang, Min Cheol; Kim, Won; Hee Do, Kyung

2016-01-01

[Purpose] Gait-training robots have been developed for stroke patients with gait disturbance. It is important to survey the views of physiatrists and physical therapists on the characteristics of these devices during their development. [Subjects and Methods] A total of 100 physiatrists and 100 physical therapists from 38 hospitals participated in our questionnaire survey. [Results] The most common answers about the merits of gait-training robots concern improving the treatment effects (28.5%), followed by standardizing treatment (19%), motivating patients about treatment (17%), and improving patients’ self-esteem (14%). The subacute period (1–3 months post-stroke onset) was most often chosen as the ideal period (47.3%) for the use of these devices, and a functional ambulation classification of 0–2 was the most selected response for the optimal patient status (27%). The preferred model was the treadmill type (47.5%) over the overground walking type (40%). The most favored commercial price was $50,000–$100,000 (38.3%). The most selected optimal duration for robot-assisted gait therapy was 30–45 min (47%), followed by 15–30 min (29%), 45–60 min (18%), ≥ 60 min (5%), and < 15 min (1%). [Conclusion] Our study findings could guide the future designs of more effective gait-training robots for stroke patients. PMID:26957758

Adaptive locomotor training on an end-effector gait robot: evaluation of the ground reaction forces in different training conditions.

PubMed

Tomelleri, Christopher; Waldner, Andreas; Werner, Cordula; Hesse, Stefan

2011-01-01

The main goal of robotic gait rehabilitation is the restoration of independent gait. To achieve this goal different and specific patterns have to be practiced intensively in order to stimulate the learning process of the central nervous system. The gait robot G-EO Systems was designed to allow the repetitive practice of floor walking, stair climbing and stair descending. A novel control strategy allows training in adaptive mode. The force interactions between the foot and the ground were analyzed on 8 healthy volunteers in three different conditions: real floor walking on a treadmill, floor walking on the gait robot in passive mode, floor walking on the gait robot in adaptive mode. The ground reaction forces were measured by a Computer Dyno Graphy (CDG) analysis system. The results show different intensities of the ground reaction force across all of the three conditions. The intensities of force interactions during the adaptive training mode are comparable to the real walking on the treadmill. Slight deviations still occur in regard to the timing pattern of the forces. The adaptive control strategy comes closer to the physiological swing phase than the passive mode and seems to be a promising option for the treatment of gait disorders. Clinical trials will validate the efficacy of this new option in locomotor therapy on the patients. © 2011 IEEE

A Dynamic Compliance Cervix Phantom Robot for Latent Labor Simulation.

PubMed

Luk, Michelle Jennifer; Lobb, Derek; Smith, James Andrew

2018-06-01

Physical simulation systems are commonly used in training of midwifery and obstetrics students, but none of these systems offers a dynamic compliance aspect that would make them more truly representative of cervix ripening. In this study, we introduce a unique soft robot phantom that simulates the cervix softening during the latent labor phase of birth. This proof-of-concept robotic phantom can be dilated by 1 cm and effaced by 35% through the application of a Foley catheter-like loading mechanism. Furthermore, psychophysics trials demonstrate how untrained subjects can identify hard and soft states of the phantom with specificities of 91% and 87%, respectively. Both results indicated the appropriateness for application of this soft robot technology to birth training simulators.

Evolution of robotics in surgery and implementing a perioperative robotics nurse specialist role.

PubMed

Francis, Paula

2006-03-01

Use of robotics is expanding rapidly in the medical arena. Not only are a growing number of facilities purchasing robotic systems, but the number of surgeons using them also is increasing, which creates many challenges (eg, cost, training, safety). The evolution of robotics in surgery is presented within the context of virtual reality, telepresence, telemanipulation, and passive (ie, master-slave) robotic surgical systems. A new perioperative nursing role, the robotics nurse specialist, was developed and implemented at one facility. The need for a robotics nurse specialist and how this role can help the entire surgical team promote positive patient and facility outcomes also is discussed.

Using advanced computer vision algorithms on small mobile robots

NASA Astrophysics Data System (ADS)

Kogut, G.; Birchmore, F.; Biagtan Pacis, E.; Everett, H. R.

2006-05-01

The Technology Transfer project employs a spiral development process to enhance the functionality and autonomy of mobile robot systems in the Joint Robotics Program (JRP) Robotic Systems Pool by converging existing component technologies onto a transition platform for optimization. An example of this approach is the implementation of advanced computer vision algorithms on small mobile robots. We demonstrate the implementation and testing of the following two algorithms useful on mobile robots: 1) object classification using a boosted Cascade of classifiers trained with the Adaboost training algorithm, and 2) human presence detection from a moving platform. Object classification is performed with an Adaboost training system developed at the University of California, San Diego (UCSD) Computer Vision Lab. This classification algorithm has been used to successfully detect the license plates of automobiles in motion in real-time. While working towards a solution to increase the robustness of this system to perform generic object recognition, this paper demonstrates an extension to this application by detecting soda cans in a cluttered indoor environment. The human presence detection from a moving platform system uses a data fusion algorithm which combines results from a scanning laser and a thermal imager. The system is able to detect the presence of humans while both the humans and the robot are moving simultaneously. In both systems, the two aforementioned algorithms were implemented on embedded hardware and optimized for use in real-time. Test results are shown for a variety of environments.

The immediate intervention effects of robotic training in patients after anterior cruciate ligament reconstruction.

PubMed

Hu, Chunying; Huang, Qiuchen; Yu, Lili; Ye, Miao

2016-07-01

[Purpose] The purpose of this study was to examine the immediate effects of robot-assisted therapy on functional activity level after anterior cruciate ligament reconstruction. [Subjects and Methods] Participants included 10 patients (8 males and 2 females) following anterior cruciate ligament reconstruction. The subjects participated in robot-assisted therapy and treadmill exercise on different days. The Timed Up-and-Go test, Functional Reach Test, surface electromyography of the vastus lateralis and vastus medialis, and maximal extensor strength of isokinetic movement of the knee joint were evaluated in both groups before and after the experiment. [Results] The results for the Timed Up-and-Go Test and the 10-Meter Walk Test improved in the robot-assisted rehabilitation group. Surface electromyography of the vastus medialis muscle showed significant increases in maximum and average discharge after the intervention. [Conclusion] The results suggest that walking ability and muscle strength can be improved by robotic training.

Neurophysiology of Robot-Mediated Training and Therapy: A Perspective for Future Use in Clinical Populations

PubMed Central

Turner, Duncan L.; Ramos-Murguialday, Ander; Birbaumer, Niels; Hoffmann, Ulrich; Luft, Andreas

2013-01-01

The recovery of functional movements following injury to the central nervous system (CNS) is multifaceted and is accompanied by processes occurring in the injured and non-injured hemispheres of the brain or above/below a spinal cord lesion. The changes in the CNS are the consequence of functional and structural processes collectively termed neuroplasticity and these may occur spontaneously and/or be induced by movement practice. The neurophysiological mechanisms underlying such brain plasticity may take different forms in different types of injury, for example stroke vs. spinal cord injury (SCI). Recovery of movement can be enhanced by intensive, repetitive, variable, and rewarding motor practice. To this end, robots that enable or facilitate repetitive movements have been developed to assist recovery and rehabilitation. Here, we suggest that some elements of robot-mediated training such as assistance and perturbation may have the potential to enhance neuroplasticity. Together the elemental components for developing integrated robot-mediated training protocols may form part of a neurorehabilitation framework alongside those methods already employed by therapists. Robots could thus open up a wider choice of options for delivering movement rehabilitation grounded on the principles underpinning neuroplasticity in the human CNS. PMID:24312073

Co-op Essay - Tour 1

NASA Technical Reports Server (NTRS)

Porter, Derrick

2014-01-01

The Mission Operations Directorate (MOD) is responsible for the training, planning and performance of all U.S. manned operations in space. Within this directorate all responsibilities are divided up into divisions. The EVA, Robotics & Crew Systems Operations Division performs ground operations and trains astronauts to carry out some of the more "high action" procedures in space. For example they orchestrate procedures like EVAs, or ExtraVehicular Activities (spacewalks), and robotics operations external to the International Space Station (ISS). The robotics branch of this division is responsible for the use of the Mobile Servicing System (MSS). This system is a combination of two robotic mechanisms and a series of equipment used to transport them on the ISS. The MSS is used to capture and position visiting vehicles, transport astronauts during EVAs, and perform external maintenance tasks on the ISS. This branch consists of two groups which are responsible for crew training and flight controlling, respectively. My first co-op tour took place Fall 2013. During this time I was given the opportunity to work in the robotics operations branch of the Mission Operations Directorate at NASA's Johnson Space Center. I was given a variety of tasks that encompassed, at a base level, all the aspects of the branch.

Proctorship and mentoring: Its backbone and application in robotic surgery.

PubMed

Santok, Glen Denmer; Raheem, Ali Abdel; Kim, Lawrence Hc; Chang, Kidon; Chung, Byung Ha; Choi, Young Deuk; Rha, Koon Ho

2016-12-01

In pursuit of continuing medical education in robotic surgery, several forms of training have been implemented. This variable application of curriculum has brought acquisition of skills in a heterogeneous and unstandardized fashion from different parts of the world. Recently, efforts have been made to provide cost effective and well-structured curricula with the aim of bridging the gap between formal fellowship training and short courses. Proctorship training has been implicated on some curriculum to provide excellent progression during the learning curve while ensuring patient safety.

Technical Tension Between Achieving Particulate and Molecular Organic Environmental Cleanliness: Data from Astromaterial Curation Laboratories

NASA Technical Reports Server (NTRS)

Allton, J. H.; Burkett, P. J.

2011-01-01

NASA Johnson Space Center operates clean curation facilities for Apollo lunar, Antarctic meteorite, stratospheric cosmic dust, Stardust comet and Genesis solar wind samples. Each of these collections is curated separately due unique requirements. The purpose of this abstract is to highlight the technical tensions between providing particulate cleanliness and molecular cleanliness, illustrated using data from curation laboratories. Strict control of three components are required for curating samples cleanly: a clean environment; clean containers and tools that touch samples; and use of non-shedding materials of cleanable chemistry and smooth surface finish. This abstract focuses on environmental cleanliness and the technical tension between achieving particulate and molecular cleanliness. An environment in which a sample is manipulated or stored can be a room, an enclosed glovebox (or robotic isolation chamber) or an individual sample container.

2010 FIRST Robotics Bayou Regional Tournament

NASA Technical Reports Server (NTRS)

2010-01-01

Student-built robots maneuver the course during the 2010 Bayou Regional FIRST (For Inspiration and Recognition of Science and Technology) Robotics competition in Westwego on March 5-6. The annual competition drew 36 high school teams from eight states. NASA's John C. Stennis Space Center supports FIRST Robotics by providing financing, mentors and training, as well as competition judges and referees, audiovisual staff and other volunteer personnel.

2010 FIRST Robotics Bayou Regional Tournament

NASA Image and Video Library

2010-03-05

Student-built robots maneuver the course during the 2010 Bayou Regional FIRST (For Inspiration and Recognition of Science and Technology) Robotics competition in Westwego on March 5-6. The annual competition drew 36 high school teams from eight states. NASA's John C. Stennis Space Center supports FIRST Robotics by providing financing, mentors and training, as well as competition judges and referees, audiovisual staff and other volunteer personnel.

Kotov and Williams with SSRMS arm training session in Node 1 / Unity module

NASA Image and Video Library

2007-04-18

ISS014-E-19587 (17 April 2007) --- Cosmonaut Oleg V. Kotov (foreground), Expedition 15 flight engineer representing Russia's Federal Space Agency, and astronaut Sunita L. Williams, flight engineer, participate in a Space Station Remote Manipulator System (SSRMS) training session using the Robotic Onboard Trainer (ROBOT) simulator in the Unity node of the International Space Station.

Surgeon Training in Telerobotic Surgery via a Hardware-in-the-Loop Simulator

PubMed Central

Alemzadeh, Homa; Chen, Daniel; Kalbarczyk, Zbigniew; Iyer, Ravishankar K.; Kesavadas, Thenkurussi

2017-01-01

This work presents a software and hardware framework for a telerobotic surgery safety and motor skill training simulator. The aims are at providing trainees a comprehensive simulator for acquiring essential skills to perform telerobotic surgery. Existing commercial robotic surgery simulators lack features for safety training and optimal motion planning, which are critical factors in ensuring patient safety and efficiency in operation. In this work, we propose a hardware-in-the-loop simulator directly introducing these two features. The proposed simulator is built upon the Raven-II™ open source surgical robot, integrated with a physics engine and a safety hazard injection engine. Also, a Fast Marching Tree-based motion planning algorithm is used to help trainee learn the optimal instrument motion patterns. The main contributions of this work are (1) reproducing safety hazards events, related to da Vinci™ system, reported to the FDA MAUDE database, with a novel haptic feedback strategy to provide feedback to the operator when the underlying dynamics differ from the real robot's states so that the operator will be aware and can mitigate the negative impact of the safety-critical events, and (2) using motion planner to generate semioptimal path in an interactive robotic surgery training environment. PMID:29065635

Trainer variability during step training after spinal cord injury: Implications for robotic gait-training device design.

PubMed

Galvez, Jose A; Budovitch, Amy; Harkema, Susan J; Reinkensmeyer, David J

2011-01-01

Robotic devices are being developed to automate repetitive aspects of walking retraining after neurological injuries, in part because they might improve the consistency and quality of training. However, it is unclear how inconsistent manual training actually is or whether stepping quality depends strongly on the trainers' manual skill. The objective of this study was to quantify trainer variability of manual skill during step training using body-weight support on a treadmill and assess factors of trainer skill. We attached a sensorized orthosis to one leg of each patient with spinal cord injury and measured the shank kinematics and forces exerted by different trainers during six training sessions. An expert trainer rated the trainers' skill level based on videotape recordings. Between-trainer force variability was substantial, about two times greater than within-trainer variability. Trainer skill rating correlated strongly with two gait features: better knee extension during stance and fewer episodes of toe dragging. Better knee extension correlated directly with larger knee horizontal assistance force, but better toe clearance did not correlate with larger ankle push-up force; rather, it correlated with better knee and hip extension. These results are useful to inform robotic gait-training design.

Getting started with robotics in general surgery with cholecystectomy: the Canadian experience.

PubMed

Jayaraman, Shiva; Davies, Ward; Schlachta, Christopher M

2009-10-01

The value of robotics in general surgery may be for advanced minimally invasive procedures. Unlike other specialties, formal fellowship training opportunities for robotic general surgery are few. As a result, most surgeons currently develop robotic skills in practice. Our goal was to determine whether robotic cholecystectomy is a safe and effective bridge to advanced robotics in general surgery. Before performing advanced robotic procedures, 2 surgeons completed the Intuitive Surgical da Vinci training course and agreed to work together on all procedures. Clinical surgery began with da Vinci cholecystectomy with a plan to begin advanced procedures after at least 10 cholecystectomies. We performed a retrospective review of our pilot series of robotic cholecystectomies and compared them with contemporaneous laparoscopic controls. The primary outcome was safety, and the secondary outcome was learning curve. There were 16 procedures in the robotics arm and 20 in the laparoscopic arm. Two complications (da Vinci port-site hernia, transient elevation of liver enzymes) occurred in the robotic arm, whereas only 1 laparoscopic patient (slow to awaken from anesthetic) experienced a complication. None was significant. The mean time required to perform robotic cholecystectomy was significantly longer than laparoscopic surgery (91 v. 41 min, p < 0.001). The mean time to clear the operating room was significantly longer for robotic procedures (14 v. 11 min, p = 0.015). We observed a trend showing longer mean anesthesia time for robotic procedures (23 v. 15 min). Regarding learning curve, the mean operative time needed for the first 3 robotic procedures was longer than for the last 3 (101 v. 80 min); however, this difference was not significant. Since this experience, the team has confidently gone on to perform robotic biliary, pancreatic, gastresophageal, intestinal and colorectal operations. Robotic cholecystectomy can be performed reliably; however, owing to the significant increase in operating room resources, it cannot be justified for routine use. Our experience, however, demonstrates that robotic cholecystectomy is one means by which general surgeons may gain confidence in performing advanced robotic procedures.

Perioperative nurse training in cardiothoracic surgical robotics.

PubMed

Connor, M A; Reinbolt, J A; Handley, P J

2001-12-01

The exponential growth of OR technology during the past 10 years has placed increased demands on perioperative nurses. Proficiency is required not only in patient care but also in the understanding, operating, and troubleshooting of video systems, computers, and cutting edge medical devices. The formation of a surgical team dedicated to robotically assisted cardiac surgery requires careful selection, education, and hands-on practice. This article details the six-week training process undertaken at Sarasota Memorial Hospital, Sarasota, Fla, which enabled staff members to deliver excellent patient care with a high degree of confidence in themselves and the robotic technology.

Application of the statistical process control method for prospective patient safety monitoring during the learning phase: robotic kidney transplantation with regional hypothermia (IDEAL phase 2a-b).

PubMed

Sood, Akshay; Ghani, Khurshid R; Ahlawat, Rajesh; Modi, Pranjal; Abaza, Ronney; Jeong, Wooju; Sammon, Jesse D; Diaz, Mireya; Kher, Vijay; Menon, Mani; Bhandari, Mahendra

2014-08-01

Traditional evaluation of the learning curve (LC) of an operation has been retrospective. Furthermore, LC analysis does not permit patient safety monitoring. To prospectively monitor patient safety during the learning phase of robotic kidney transplantation (RKT) and determine when it could be considered learned using the techniques of statistical process control (SPC). From January through May 2013, 41 patients with end-stage renal disease underwent RKT with regional hypothermia at one of two tertiary referral centers adopting RKT. Transplant recipients were classified into three groups based on the robotic training and kidney transplant experience of the surgeons: group 1, robot trained with limited kidney transplant experience (n=7); group 2, robot trained and kidney transplant experienced (n=20); and group 3, kidney transplant experienced with limited robot training (n=14). We employed prospective monitoring using SPC techniques, including cumulative summation (CUSUM) and Shewhart control charts, to perform LC analysis and patient safety monitoring, respectively. Outcomes assessed included post-transplant graft function and measures of surgical process (anastomotic and ischemic times). CUSUM and Shewhart control charts are time trend analytic techniques that allow comparative assessment of outcomes following a new intervention (RKT) relative to those achieved with established techniques (open kidney transplant; target value) in a prospective fashion. CUSUM analysis revealed an initial learning phase for group 3, whereas groups 1 and 2 had no to minimal learning time. The learning phase for group 3 varied depending on the parameter assessed. Shewhart control charts demonstrated no compromise in functional outcomes for groups 1 and 2. Graft function was compromised in one patient in group 3 (p<0.05) secondary to reasons unrelated to RKT. In multivariable analysis, robot training was significantly associated with improved task-completion times (p<0.01). Graft function was not adversely affected by either the lack of robotic training (p=0.22) or kidney transplant experience (p=0.72). The LC and patient safety of a new surgical technique can be assessed prospectively using CUSUM and Shewhart control chart analytic techniques. These methods allow determination of the duration of mentorship and identification of adverse events in a timely manner. A new operation can be considered learned when outcomes achieved with the new intervention are at par with outcomes following established techniques. Statistical process control techniques allowed for robust, objective, and prospective monitoring of robotic kidney transplantation and can similarly be applied to other new interventions during the introduction and adoption phase. Copyright © 2014 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Development of a standardised training curriculum for robotic surgery: a consensus statement from an international multidisciplinary group of experts.

PubMed

Ahmed, Kamran; Khan, Reenam; Mottrie, Alexandre; Lovegrove, Catherine; Abaza, Ronny; Ahlawat, Rajesh; Ahlering, Thomas; Ahlgren, Goran; Artibani, Walter; Barret, Eric; Cathelineau, Xavier; Challacombe, Ben; Coloby, Patrick; Khan, Muhammad S; Hubert, Jacques; Michel, Maurice Stephan; Montorsi, Francesco; Murphy, Declan; Palou, Joan; Patel, Vipul; Piechaud, Pierre-Thierry; Van Poppel, Hendrik; Rischmann, Pascal; Sanchez-Salas, Rafael; Siemer, Stefan; Stoeckle, Michael; Stolzenburg, Jens-Uwe; Terrier, Jean-Etienne; Thüroff, Joachim W; Vaessen, Christophe; Van Der Poel, Henk G; Van Cleynenbreugel, Ben; Volpe, Alessandro; Wagner, Christian; Wiklund, Peter; Wilson, Timothy; Wirth, Manfred; Witt, Jörn; Dasgupta, Prokar

2015-07-01

To explore the views of experts about the development and validation of a robotic surgery training curriculum, and how this should be implemented. An international expert panel was invited to a structured session for discussion. The study was of a mixed design, including qualitative and quantitative components based on focus group interviews during the European Association of Urology (EAU) Robotic Urology Section (ERUS) (2012), EAU (2013) and ERUS (2013) meetings. After introduction to the aims, principles and current status of the curriculum development, group responses were elicited. After content analysis of recorded interviews generated themes were discussed at the second meeting, where consensus was achieved on each theme. This discussion also underwent content analysis, and was used to draft a curriculum proposal. At the third meeting, a quantitative questionnaire about this curriculum was disseminated to attendees to assess the level of agreement with the key points. In all, 150 min (19 pages) of the focus group discussion was transcribed (21 316 words). Themes were agreed by two raters (median agreement κ 0.89) and they included: need for a training curriculum (inter-rater agreement κ 0.85); identification of learning needs (κ 0.83); development of the curriculum contents (κ 0.81); an overview of available curricula (κ 0.79); settings for robotic surgery training ((κ 0.89); assessment and training of trainers (κ 0.92); requirements for certification and patient safety (κ 0.83); and need for a universally standardised curriculum (κ 0.78). A training curriculum was proposed based on the above discussions. This group proposes a multi-step curriculum for robotic training. Studies are in process to validate the effectiveness of the curriculum and to assess transfer of skills to the operating room. © 2015 The Authors BJU International © 2015 BJU International Published by John Wiley & Sons Ltd.

Development and training of a learning expert system in an autonomous mobile robot via simulation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Spelt, P.F.; Lyness, E.; DeSaussure, G.

1989-11-01

The Center for Engineering Systems Advanced Research (CESAR) conducts basic research in the area of intelligent machines. Recently at CESAR a learning expert system was created to operate on board an autonomous robot working at a process control panel. The authors discuss two-computer simulation system used to create, evaluate and train this learning system. The simulation system has a graphics display of the current status of the process being simulated, and the same program which does the simulating also drives the actual control panel. Simulation results were validated on the actual robot. The speed and safety values of using amore » computerized simulator to train a learning computer, and future uses of the simulation system, are discussed.« less

[Walking assist robot and its clinical application].

PubMed

Kakou, Hiroaki; Shitama, Hideo; Kimura, Yoshiko; Nakamoto, Yoko; Furuta, Nami; Honda, Kanae; Wada, Futoshi; Hachisuka, Kenji

2009-06-01

The walking assist robot was developed to improve gait disturbance in patients with severe disabilities. The robot had a trunk supporter, power generator and operating arms which held patient's lower extremities and simulated walking, a control unit, biofeedback system, and a treadmill. We applied the robot-aided gait training to three patients with severe gait disturbance induced by stroke, axonal Guillan-Barré syndrome or spinal cord injury, and the walking assist robot turned out to be effective in improving the gait disturbance.

A Novel Robot System Integrating Biological and Mechanical Intelligence Based on Dissociated Neural Network-Controlled Closed-Loop Environment.

PubMed

Li, Yongcheng; Sun, Rong; Wang, Yuechao; Li, Hongyi; Zheng, Xiongfei

2016-01-01

We propose the architecture of a novel robot system merging biological and artificial intelligence based on a neural controller connected to an external agent. We initially built a framework that connected the dissociated neural network to a mobile robot system to implement a realistic vehicle. The mobile robot system characterized by a camera and two-wheeled robot was designed to execute the target-searching task. We modified a software architecture and developed a home-made stimulation generator to build a bi-directional connection between the biological and the artificial components via simple binomial coding/decoding schemes. In this paper, we utilized a specific hierarchical dissociated neural network for the first time as the neural controller. Based on our work, neural cultures were successfully employed to control an artificial agent resulting in high performance. Surprisingly, under the tetanus stimulus training, the robot performed better and better with the increasement of training cycle because of the short-term plasticity of neural network (a kind of reinforced learning). Comparing to the work previously reported, we adopted an effective experimental proposal (i.e. increasing the training cycle) to make sure of the occurrence of the short-term plasticity, and preliminarily demonstrated that the improvement of the robot's performance could be caused independently by the plasticity development of dissociated neural network. This new framework may provide some possible solutions for the learning abilities of intelligent robots by the engineering application of the plasticity processing of neural networks, also for the development of theoretical inspiration for the next generation neuro-prostheses on the basis of the bi-directional exchange of information within the hierarchical neural networks.

Locomotor training using an overground robotic exoskeleton in long-term manual wheelchair users with a chronic spinal cord injury living in the community: Lessons learned from a feasibility study in terms of recruitment, attendance, learnability, performance and safety.

PubMed

Gagnon, Dany H; Escalona, Manuel J; Vermette, Martin; Carvalho, Lívia P; Karelis, Antony D; Duclos, Cyril; Aubertin-Leheudre, Mylène

2018-03-01

For individuals who sustain a complete motor spinal cord injury (SCI) and rely on a wheelchair as their primary mode of locomotion, overground robotic exoskeletons represent a promising solution to stand and walk again. Although overground robotic exoskeletons have gained tremendous attention over the past decade and are now being transferred from laboratories to clinical settings, their effects remain unclear given the paucity of scientific evidence and the absence of large-scale clinical trials. This study aims to examine the feasibility of a locomotor training program with an overground robotic exoskeleton in terms of recruitment, attendance, and drop-out rates as well as walking performance, learnability, and safety. Individuals with a SCI were invited to participate in a 6 to 8-week locomotor training program with a robotic exoskeleton encompassing 18 sessions. Selected participants underwent a comprehensive screening process and completed two familiarization sessions with the robotic exoskeleton. The outcome measures were the rate of recruitment of potential participants, the rate of attendance at training sessions, the rate of drop-outs, the ability to walk with the exoskeleton, and its progression over the program as well as the adverse events. Out of 49 individuals who expressed their interest in participating in the study, only 14 initiated the program (recruitment rate = 28.6%). Of these, 13 individuals completed the program (drop-out rate = 7.1%) and attended 17.6 ± 1.1 sessions (attendance rate = 97.9%). Their greatest standing time, walking time, and number of steps taken during a session were 64.5 ± 10.2 min, 47.2 ± 11.3 min, and 1843 ± 577 steps, respectively. During the training program, these last three parameters increased by 45.3%, 102.1%, and 248.7%, respectively. At the end of the program, when walking with the exoskeleton, most participants required one therapist (85.7%), needed stand-by or contact-guard assistance (57.1%), used forearm crutches (71.4%), and reached a walking speed of 0.25 ± 0.05 m/s. Five participants reported training-related pain or stiffness in the upper extremities during the program. One participant sustained bilateral calcaneal fractures and stopped the program. This study confirms that larger clinical trials investigating the effects of a locomotor training program with an overground robotic exoskeleton are feasible and relatively safe in individuals with complete motor SCI. Moreover, to optimize the recruitment rate and safety in future trials, this study now highlights the need of developing pre-training rehabilitation programs to increase passive lower extremity range of motion and standing tolerance. This study also calls for the development of clinical practice guidelines targeting fragility fracture risk assessment linked to the use of overground robotic exoskeletons.

Comparative analysis of the functionality of simulators of the da Vinci surgical robot.

PubMed

Smith, Roger; Truong, Mireille; Perez, Manuela

2015-04-01

The implementation of robotic technology in minimally invasive surgery has led to the need to develop more efficient and effective training methods, as well as assessment and skill maintenance tools for surgical education. Multiple simulators and procedures are available for educational and training purposes. A need for comparative evaluations of these simulators exists to aid users in selecting an appropriate device for their purposes. We conducted an objective review and comparison of the design and capabilities of all dedicated simulators of the da Vinci robot, the da Vinci Skill Simulator (DVSS) (Intuitive Surgical Inc., Sunnyvale, CA, USA), dV-Trainer (dVT) (Mimic Technologies Inc., Seattle, WA, USA), and Robotic Surgery Simulator (RoSS) (Simulated Surgical Skills, LLC, Williamsville, NY, USA). This provides base specifications of the hardware and software, with an emphasis on the training capabilities of each system. Each simulator contains a large number of training exercises, DVSS = 40, dVT = 65, and RoSS = 52 for skills development. All three offer 3D visual images but use different display technologies. The DVSS leverages the real robotic surgeon's console to provide visualization, hand controls, and foot pedals. The dVT and RoSS created simulated versions of all of these control systems. They include systems management services which allow instructors to collect, export, and analyze the scores of students using the simulators. This study is the first to provide comparative information of the three simulators functional capabilities with an emphasis on their educational skills. They offer unique advantages and capabilities in training robotic surgeons. Each device has been the subject of multiple validation experiments which have been published in the literature. But those do not provide specific details on the capabilities of the simulators which are necessary for an understanding sufficient to select the one best suited for an organization's needs.

Home-based tele-assisted robotic rehabilitation of joint impairments in children with cerebral palsy.

PubMed

Chen, Kai; Ren, Yupeng; Gaebler-Spira, Deborah; Zhang, Li-Qun

2014-01-01

A portable rehabilitation robot incorporating intelligent stretching, robot-guided voluntary movement training with motivating games and tele-rehabilitation was developed to provide convenient and cost-effective rehabilitation to children with cerebral palsy (CP) and extend rehabilitation care beyond hospital. Clinicians interact with the patients remotely for periodic evaluations and updated guidance. The tele-assisted stretching and active movement training was done over 6-week 18 sessions on the impaired ankle of 23 children with CP in their home setting. Treatment effectiveness was evaluated using biomechanical measures and clinical outcome measures. After the tele-assisted home robotic rehabilitation intervention, there were significant increases in the ankle passive and active range of motion, muscle strength, a decrease in spasticity, and increases in balance and selective control assessment of lower-extremity.

Direct manipulation of tool-like masters for controlling a master-slave surgical robotic system.

PubMed

Zhang, Linan; Zhou, Ningxin; Wang, Shuxin

2014-12-01

Robotic-assisted minimally invasive surgery (MIS) can benefit both patients and surgeons. However, the learning curve for robotically assisted procedures can be long and the total system costs are high. Therefore, there is considerable interest in new methods and lower cost controllers for a surgical robotic system. In this study, a knife-master and a forceps-master, shaped similarly to a surgical knife and forceps, were developed as input devices for control of a master-slave surgical robotic system. In addition, a safety strategy was developed to eliminate the master-slave orientation difference and stabilize the surgical system. Master-slave tracking experiments and a ring-and-bar experiment showed that the safety tracking strategy could ensure that the robot system moved stably without any tremor in the tracking motion. Subjects could manipulate the surgical tool to achieve the master-slave operation with less training compared to a mechanical master. Direct manipulation of the small, light and low-cost surgical tools to control a robotic system is a possible operating mode. Surgeons can operate the robotic system in their own familiar way, without long training. The main potential safety issues can be solved by the proposed safety control strategy. Copyright © 2013 John Wiley & Sons, Ltd.

Teaching Human Poses Interactively to a Social Robot

PubMed Central

Gonzalez-Pacheco, Victor; Malfaz, Maria; Fernandez, Fernando; Salichs, Miguel A.

2013-01-01

The main activity of social robots is to interact with people. In order to do that, the robot must be able to understand what the user is saying or doing. Typically, this capability consists of pre-programmed behaviors or is acquired through controlled learning processes, which are executed before the social interaction begins. This paper presents a software architecture that enables a robot to learn poses in a similar way as people do. That is, hearing its teacher's explanations and acquiring new knowledge in real time. The architecture leans on two main components: an RGB-D (Red-, Green-, Blue- Depth) -based visual system, which gathers the user examples, and an Automatic Speech Recognition (ASR) system, which processes the speech describing those examples. The robot is able to naturally learn the poses the teacher is showing to it by maintaining a natural interaction with the teacher. We evaluate our system with 24 users who teach the robot a predetermined set of poses. The experimental results show that, with a few training examples, the system reaches high accuracy and robustness. This method shows how to combine data from the visual and auditory systems for the acquisition of new knowledge in a natural manner. Such a natural way of training enables robots to learn from users, even if they are not experts in robotics. PMID:24048336

Allothetic and idiothetic sensor fusion in rat-inspired robot localization

NASA Astrophysics Data System (ADS)

Weitzenfeld, Alfredo; Fellous, Jean-Marc; Barrera, Alejandra; Tejera, Gonzalo

2012-06-01

We describe a spatial cognition model based on the rat's brain neurophysiology as a basis for new robotic navigation architectures. The model integrates allothetic (external visual landmarks) and idiothetic (internal kinesthetic information) cues to train either rat or robot to learn a path enabling it to reach a goal from multiple starting positions. It stands in contrast to most robotic architectures based on SLAM, where a map of the environment is built to provide probabilistic localization information computed from robot odometry and landmark perception. Allothetic cues suffer in general from perceptual ambiguity when trying to distinguish between places with equivalent visual patterns, while idiothetic cues suffer from imprecise motions and limited memory recalls. We experiment with both types of cues in different maze configurations by training rats and robots to find the goal starting from a fixed location, and then testing them to reach the same target from new starting locations. We show that the robot, after having pre-explored a maze, can find a goal with improved efficiency, and is able to (1) learn the correct route to reach the goal, (2) recognize places already visited, and (3) exploit allothetic and idiothetic cues to improve on its performance. We finally contrast our biologically-inspired approach to more traditional robotic approaches and discuss current work in progress.

Teaching human poses interactively to a social robot.

PubMed

Gonzalez-Pacheco, Victor; Malfaz, Maria; Fernandez, Fernando; Salichs, Miguel A

2013-09-17

The main activity of social robots is to interact with people. In order to do that, the robot must be able to understand what the user is saying or doing. Typically, this capability consists of pre-programmed behaviors or is acquired through controlled learning processes, which are executed before the social interaction begins. This paper presents a software architecture that enables a robot to learn poses in a similar way as people do. That is, hearing its teacher's explanations and acquiring new knowledge in real time. The architecture leans on two main components: an RGB-D (Red-, Green-, Blue- Depth) -based visual system, which gathers the user examples, and an Automatic Speech Recognition (ASR) system, which processes the speech describing those examples. The robot is able to naturally learn the poses the teacher is showing to it by maintaining a natural interaction with the teacher. We evaluate our system with 24 users who teach the robot a predetermined set of poses. The experimental results show that, with a few training examples, the system reaches high accuracy and robustness. This method shows how to combine data from the visual and auditory systems for the acquisition of new knowledge in a natural manner. Such a natural way of training enables robots to learn from users, even if they are not experts in robotics.

Reviewing Clinical Effectiveness of Active Training Strategies of Platform-Based Ankle Rehabilitation Robots

PubMed Central

2018-01-01

Objective This review aims to provide a systematical investigation of clinical effectiveness of active training strategies applied in platform-based ankle robots. Method English-language studies published from Jan 1980 to Aug 2017 were searched from four databases using key words of “Ankle∗” AND “Robot∗” AND “Effect∗ OR Improv∗ OR Increas∗.” Following an initial screening, three rounds of discrimination were successively conducted based on the title, the abstract, and the full paper. Result A total of 21 studies were selected with 311 patients involved; of them, 13 studies applied a single group while another eight studies used different groups for comparison to verify the therapeutic effect. Virtual-reality (VR) game training was applied in 19 studies, while two studies used proprioceptive neuromuscular facilitation (PNF) training. Conclusion Active training techniques delivered by platform ankle rehabilitation robots have been demonstrated with great potential for clinical applications. Training strategies are mostly combined with one another by considering rehabilitation schemes and motion ability of ankle joints. VR game environment has been commonly used with active ankle training. Bioelectrical signals integrated with VR game training can implement intelligent identification of movement intention and assessment. These further provide the foundation for advanced interactive training strategies that can lead to enhanced training safety and confidence for patients and better treatment efficacy. PMID:29675142

The effect of different training exercises on the performance outcome on the da Vinci Skills Simulator.

PubMed

Walliczek-Dworschak, U; Schmitt, M; Dworschak, P; Diogo, I; Ecke, A; Mandapathil, M; Teymoortash, A; Güldner, C

2017-06-01

Increasing usage of robotic surgery presents surgeons with the question of how to acquire the special skills required. This study aimed to analyze the effect of different exercises on their performance outcomes. This prospective study was conducted on the da Vinci Skills Simulator from December 2014 till August 2015. Sixty robotic novices were included and randomized to three groups of 20 participants each. Each group performed three different exercises with comparable difficulty levels. The exercises were performed three times in a row within two training sessions, with an interval of 1 week in between. On the final training day, two new exercises were added and a questionnaire was completed. Technical metrics of performance (overall score, time to complete, economy of motion, instrument collisions, excessive instrument force, instruments out of view, master work space range, drops, missed targets, misapplied energy time, blood loss and broken vessels) were recorded by the simulator software for further analysis. Training with different exercises led to comparable results in performance metrics for the final exercises among the three groups. A significant skills gain was recorded between the first and last exercises, with improved performance in overall score, time to complete and economy of motion for all exercises in all three groups. As training with different exercises led to comparable results in robotic training, the type of exercise seems to play a minor role in the outcome. For a robotic training curriculum, it might be important to choose exercises with comparable difficulty levels. In addition, it seems to be advantageous to limit the duration of the training to maintain the concentration throughout the entire session.

Overground vs. treadmill-based robotic gait training to improve seated balance in people with motor-complete spinal cord injury: a case report.

PubMed

Chisholm, Amanda E; Alamro, Raed A; Williams, Alison M M; Lam, Tania

2017-04-11

Robotic overground gait training devices, such as the Ekso, require users to actively participate in triggering steps through weight-shifting movements. It remains unknown how much the trunk muscles are activated during these movements, and if it is possible to transfer training effects to seated balance control. This study was conducted to compare the activity of postural control muscles of the trunk during overground (Ekso) vs. treadmill-based (Lokomat) robotic gait training, and evaluate changes in seated balance control in people with high-thoracic motor-complete spinal cord injury (SCI). Three individuals with motor-complete SCI from C7-T4, assumed to have no voluntary motor function below the chest, underwent robotic gait training. The participants were randomly assigned to Ekso-Lokomat-Ekso or Lokomat-Ekso-Lokomat for 10 sessions within each intervention phase for a total of 30 sessions. We evaluated static and dynamic balance control through analysis of center of pressure (COP) movements after each intervention phase. Surface electromyography was used to compare activity of the abdominal and erector spinae muscles during Ekso and Lokomat walking. We observed improved postural stability after training with Ekso compared to Lokomat during static balance tasks, indicated by reduced COP root mean square distance and ellipse area. In addition, Ekso training increased total distance of COP movements during a dynamic balance task. The trunk muscles showed increased activation during Ekso overground walking compared to Lokomat walking. Our findings suggest that the Ekso actively recruits trunk muscles through postural control mechanisms, which may lead to improved balance during sitting. Developing effective training strategies to reactivate the trunk muscles is important to facilitate independence during seated balance activity in people with SCI.

Acceptance and perceived usefulness of robots to assist with activities of daily living and healthcare tasks.

PubMed

Hall, Amanda K; Backonja, Uba; Painter, Ian; Cakmak, Maya; Sung, Minjung; Lau, Timothy; Thompson, Hilaire J; Demiris, George

2017-11-29

As the number of older adults living with chronic conditions continues to rise, they will require assistance with activities of daily living (ADL) and healthcare tasks to continue living independently in their homes. One proposed solution to assist with the care needs of an aging population and a shrinking healthcare workforce is robotic technology. Using a cross-sectional survey design, we purposively sampled adults (≥18 years old) to assess generational acceptance and perceived usefulness of robots to assist with ADLs, healthcare tasks, and evaluate acceptance of robotic healthcare assistance across different settings. A total of 499 adults (age range [years] 18-98, Mean = 38.7, SD = 22.7) responded to the survey. Significant differences were found among young, middle-aged, and older adults on perceived usefulness of robots for cleaning, escorting them around town, acting as companionship, delivering meals, assessing sadness and calling for help, providing medical advice, taking vital sign assessments, and assisting with personal care (p < 0.05). The majority of younger adults reported that they would like a robot to provide healthcare assistance in the hospital, compared to middle-aged and older adults (p < 0.001). Results of this study can guide the design of robots to assist adults of all ages with useful tasks.

Robot-supported assessment of balance in standing and walking.

PubMed

Shirota, Camila; van Asseldonk, Edwin; Matjačić, Zlatko; Vallery, Heike; Barralon, Pierre; Maggioni, Serena; Buurke, Jaap H; Veneman, Jan F

2017-08-14

Clinically useful and efficient assessment of balance during standing and walking is especially challenging in patients with neurological disorders. However, rehabilitation robots could facilitate assessment procedures and improve their clinical value. We present a short overview of balance assessment in clinical practice and in posturography. Based on this overview, we evaluate the potential use of robotic tools for such assessment. The novelty and assumed main benefits of using robots for assessment are their ability to assess 'severely affected' patients by providing assistance-as-needed, as well as to provide consistent perturbations during standing and walking while measuring the patient's reactions. We provide a classification of robotic devices on three aspects relevant to their potential application for balance assessment: 1) how the device interacts with the body, 2) in what sense the device is mobile, and 3) on what surface the person stands or walks when using the device. As examples, nine types of robotic devices are described, classified and evaluated for their suitability for balance assessment. Two example cases of robotic assessments based on perturbations during walking are presented. We conclude that robotic devices are promising and can become useful and relevant tools for assessment of balance in patients with neurological disorders, both in research and in clinical use. Robotic assessment holds the promise to provide increasingly detailed assessment that allows to individually tailor rehabilitation training, which may eventually improve training effectiveness.

A magnetic compatible supernumerary robotic finger for functional magnetic resonance imaging (fMRI) acquisitions: Device description and preliminary results.

PubMed

Hussain, Irfan; Santarnecchi, Emiliano; Leo, Andrea; Ricciardi, Emiliano; Rossi, Simone; Prattichizzo, Domenico

2017-07-01

The Supernumerary robotic limbs are a recently introduced class of wearable robots that, differently from traditional prostheses and exoskeletons, aim at adding extra effectors (i.e., arms, legs, or fingers) to the human user, rather than substituting or enhancing the natural ones. However, it is still undefined whether the use of supernumerary robotic limbs could specifically lead to neural modifications in brain dynamics. The illusion of owning the part of body has been already proven in many experimental observations, such as those relying on multisensory integration (e.g., rubber hand illusion), prosthesis and even on virtual reality. In this paper we present a description of a novel magnetic compatible supernumerary robotic finger together with preliminary observations from two functional magnetic resonance imaging (fMRI) experiments, in which brain activity was measured before and after a period of training with the robotic device, and during the use of the novel MRI-compatible version of the supernumerary robotic finger. Results showed that the usage of the MR-compatible robotic finger is safe and does not produce artifacts on MRI images. Moreover, the training with the supernumerary robotic finger recruits a network of motor-related cortical regions (i.e. primary and supplementary motor areas), hence the same motor network of a fully physiological voluntary motor gestures.

Home-Based Versus Laboratory-Based Robotic Ankle Training for Children With Cerebral Palsy: A Pilot Randomized Comparative Trial.

PubMed

Chen, Kai; Wu, Yi-Ning; Ren, Yupeng; Liu, Lin; Gaebler-Spira, Deborah; Tankard, Kelly; Lee, Julia; Song, Weiqun; Wang, Maobin; Zhang, Li-Qun

2016-08-01

To examine the outcomes of home-based robot-guided therapy and compare it to laboratory-based robot-guided therapy for the treatment of impaired ankles in children with cerebral palsy. A randomized comparative trial design comparing a home-based training group and a laboratory-based training group. Home versus laboratory within a research hospital. Children (N=41) with cerebral palsy who were at Gross Motor Function Classification System level I, II, or III were randomly assigned to 2 groups. Children in home-based and laboratory-based groups were 8.7±2.8 (n=23) and 10.7±6.0 (n=18) years old, respectively. Six-week combined passive stretching and active movement intervention of impaired ankle in a laboratory or home environment using a portable rehabilitation robot. Active dorsiflexion range of motion (as the primary outcome), mobility (6-minute walk test and timed Up and Go test), balance (Pediatric Balance Scale), Selective Motor Control Assessment of the Lower Extremity, Modified Ashworth Scale (MAS) for spasticity, passive range of motion (PROM), strength, and joint stiffness. Significant improvements were found for the home-based group in all biomechanical outcome measures except for PROM and all clinical outcome measures except the MAS. The laboratory-based group also showed significant improvements in all the biomechanical outcome measures and all clinical outcome measures except the MAS. There were no significant differences in the outcome measures between the 2 groups. These findings suggest that the translation of repetitive, goal-directed, biofeedback training through motivating games from the laboratory to the home environment is feasible. The benefits of home-based robot-guided therapy were similar to those of laboratory-based robot-guided therapy. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Robotically assisted treadmill exercise training for improving peak fitness in chronic motor incomplete spinal cord injury: A randomized controlled trial

PubMed Central

Scott, William; York, Henry; Theyagaraj, Melita; Price-Miller, Naomi; McQuaid, Jean; Eyvazzadeh, Megan; Ivey, Frederick M.; Macko, Richard F.

2016-01-01

Objective To assess the effectiveness of robotically assisted body weight supported treadmill training (RABWSTT) for improving cardiovascular fitness in chronic motor incomplete spinal cord injury (CMISCI). Design Pilot prospective randomized, controlled clinical trial. Setting Outpatient rehabilitation specialty hospital. Participants Eighteen individuals with CMISCI with American Spinal Injury Association (ASIA) level between C4 and L2 and at least one-year post injury. Interventions CMISCI participants were randomized to RABWSTT or a home stretching program (HSP) three times per week for three months. Those in the home stretching group were crossed over to three months of RABWSTT following completion of the initial three month phase. Outcome measures Peak oxygen consumption (peak VO2) was measured during both robotic treadmill walking and arm cycle ergometry: twice at baseline, once at six weeks (mid-training) and twice at three months (post-training). Peak VO2 values were normalized for body mass. Results The RABWSTT group improved peak VO2 by 12.3% during robotic treadmill walking (20.2 ± 7.4 to 22.7 ± 7.5 ml/kg/min, P = 0.018), compared to a non-significant 3.9% within group change observed in HSP controls (P = 0.37). Neither group displayed a significant change in peak VO2 during arm cycle ergometry (RABWSTT, 8.5% (P = 0.25); HSP, 1.76% (P = 0.72)). A repeated measures analysis showed statistically significant differences between treatments for peak VO2 during both robotic treadmill walking (P = 0.002) and arm cycle ergometry (P = 0.001). Conclusion RABWSTT is an effective intervention model for improving peak fitness levels assessed during robotic treadmill walking in persons with CMISCI. PMID:25520035

Effects of intensive arm training with the rehabilitation robot ARMin II in chronic stroke patients: four single-cases

PubMed Central

2009-01-01

Background Robot-assisted therapy offers a promising approach to neurorehabilitation, particularly for severely to moderately impaired stroke patients. The objective of this study was to investigate the effects of intensive arm training on motor performance in four chronic stroke patients using the robot ARMin II. Methods ARMin II is an exoskeleton robot with six degrees of freedom (DOF) moving shoulder, elbow and wrist joints. Four volunteers with chronic (≥ 12 months post-stroke) left side hemi-paresis and different levels of motor severity were enrolled in the study. They received robot-assisted therapy over a period of eight weeks, three to four therapy sessions per week, each session of one hour. Patients 1 and 4 had four one-hour training sessions per week and patients 2 and 3 had three one-hour training sessions per week. Primary outcome variable was the Fugl-Meyer Score of the upper extremity Assessment (FMA), secondary outcomes were the Wolf Motor Function Test (WMFT), the Catherine Bergego Scale (CBS), the Maximal Voluntary Torques (MVTs) and a questionnaire about ADL-tasks, progress, changes, motivation etc. Results Three out of four patients showed significant improvements (p < 0.05) in the main outcome. The improvements in the FMA scores were aligned with the objective results of MVTs. Most improvements were maintained or even increased from discharge to the six-month follow-up. Conclusion Data clearly indicate that intensive arm therapy with the robot ARMin II can significantly improve motor function of the paretic arm in some stroke patients, even those in a chronic state. The findings of the study provide a basis for a subsequent controlled randomized clinical trial. PMID:20017939

Combined effects of cerebellar transcranial direct current stimulation and transcutaneous spinal direct current stimulation on robot-assisted gait training in patients with chronic brain stroke: A pilot, single blind, randomized controlled trial.

PubMed

Picelli, Alessandro; Chemello, Elena; Castellazzi, Paola; Filippetti, Mirko; Brugnera, Annalisa; Gandolfi, Marialuisa; Waldner, Andreas; Saltuari, Leopold; Smania, Nicola

2018-01-01

Preliminary evidence showed additional effects of anodal transcranial direct current stimulation over the damaged cerebral hemisphere combined with cathodal transcutaneous spinal direct current stimulation during robot-assisted gait training in chronic stroke patients. This is consistent with the neural organization of locomotion involving cortical and spinal control. The cerebellum is crucial for locomotor control, in particular for avoidance of obstacles, and adaptation to novel conditions during walking. Despite its key role in gait control, to date the effects of transcranial direct current stimulation of the cerebellum have not been investigated on brain stroke patients treated with robot-assisted gait training. To evaluate the effects of cerebellar transcranial direct current stimulation combined with transcutaneous spinal direct current stimulation on robot-assisted gait training in patients with chronic brain stroke. After balanced randomization, 20 chronic stroke patients received ten, 20-minute robot-assisted gait training sessions (five days a week, for two consecutive weeks) combined with central nervous system stimulation. Group 1 underwent on-line cathodal transcranial direct current stimulation over the contralesional cerebellar hemisphere + cathodal transcutaneous spinal direct current stimulation. Group 2 received on-line anodal transcranial direct current stimulation over the damaged cerebral hemisphere + cathodal transcutaneous spinal direct current stimulation. The primary outcome was the 6-minute walk test performed before, after, and at follow-up at 2 and 4 weeks post-treatment. The significant differences in the 6-minute walk test noted between groups at the first post-treatment evaluation (p = 0.041) were not maintained at either the 2-week (P = 0.650) or the 4-week (P = 0.545) follow-up evaluations. Our preliminary findings support the hypothesis that cathodal transcranial direct current stimulation over the contralesional cerebellar hemisphere in combination with cathodal transcutaneous spinal direct current stimulation might be useful to boost the effects of robot-assisted gait training in chronic brain stroke patients with walking impairment.

Hand Robotic Therapy in Children with Hemiparesis: A Pilot Study.

PubMed

Bishop, Lauri; Gordon, Andrew M; Kim, Heakyung

2017-01-01

The aim of this study was to understand the impact of training with a hand robotic device on hand paresis and function in a population of children with hemiparesis. Twelve children with hemiparesis (mean age, 9 [SD, 3.64] years) completed participation in this prospective, experimental, pilot study. Participants underwent clinical assessments at baseline and again 6 weeks later with instructions to not initiate new therapies. After these assessments, participants received 6 weeks of training with a hand robotic device, consisting of 1-hour sessions, 3 times weekly. Assessments were repeated on completion of training. Results showed significant improvements after training on the Assisting Hand Assessment (mean difference, 2.0 Assisting Hand Assessment units; P = 0.011) and on the upper-extremity component of the Fugl-Meyer scale (raw score mean difference, 4.334; P = 0.001). No significant improvements between pretest and posttest were noted on the Jebsen-Taylor Test of Hand Function, the Quality of Upper Extremity Skills Test, or the Pediatric Evaluation of Disability Inventory after intervention. Total active mobility of digits and grip strength also failed to demonstrate significant changes after training. Participants tolerated training with the hand robotic device, and significant improvements in bimanual hand use, as well as impairment-based scales, were noted. Improvements were carried over into bimanual skills during play. Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME CME OBJECTIVES: Upon completion of this article, the reader should be able to: (1) Understand key components of neuroplasticity; (2) Discuss the benefits of robotic therapy in the recovery of hand function in pediatric patients with hemiplegia; and (3) Appropriately incorporate robotic therapy into the treatment plan of pediatric patients with hemiplegia. Advanced ACCREDITATION: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this activity for a maximum of 1.5 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Powered robotic exoskeletons in post-stroke rehabilitation of gait: a scoping review.

PubMed

Louie, Dennis R; Eng, Janice J

2016-06-08

Powered robotic exoskeletons are a potential intervention for gait rehabilitation in stroke to enable repetitive walking practice to maximize neural recovery. As this is a relatively new technology for stroke, a scoping review can help guide current research and propose recommendations for advancing the research development. The aim of this scoping review was to map the current literature surrounding the use of robotic exoskeletons for gait rehabilitation in adults post-stroke. Five databases (Pubmed, OVID MEDLINE, CINAHL, Embase, Cochrane Central Register of Clinical Trials) were searched for articles from inception to October 2015. Reference lists of included articles were reviewed to identify additional studies. Articles were included if they utilized a robotic exoskeleton as a gait training intervention for adult stroke survivors and reported walking outcome measures. Of 441 records identified, 11 studies, all published within the last five years, involving 216 participants met the inclusion criteria. The study designs ranged from pre-post clinical studies (n = 7) to controlled trials (n = 4); five of the studies utilized a robotic exoskeleton device unilaterally, while six used a bilateral design. Participants ranged from sub-acute (<7 weeks) to chronic (>6 months) stroke. Training periods ranged from single-session to 8-week interventions. Main walking outcome measures were gait speed, Timed Up and Go, 6-min Walk Test, and the Functional Ambulation Category. Meaningful improvement with exoskeleton-based gait training was more apparent in sub-acute stroke compared to chronic stroke. Two of the four controlled trials showed no greater improvement in any walking outcomes compared to a control group in chronic stroke. In conclusion, clinical trials demonstrate that powered robotic exoskeletons can be used safely as a gait training intervention for stroke. Preliminary findings suggest that exoskeletal gait training is equivalent to traditional therapy for chronic stroke patients, while sub-acute patients may experience added benefit from exoskeletal gait training. Efforts should be invested in designing rigorous, appropriately powered controlled trials before powered exoskeletons can be translated into a clinical tool for gait rehabilitation post-stroke.

STS-61 crew utilizing Virtual Reality in training for HST repair mission

NASA Image and Video Library

1993-06-11

Astronaut Jeffrey A. Hoffman, one of four crewmembers for STS-61 that will conduct scheduled spacewalks during the flight, wears a special helmet and gloves designed to assist in proper positioning near the telescope while on the end of the robot arm. Crewmembers are utilizing a new virtual reality training aid which assists in refining positioning patterns for Space Shuttle Endeavour's Remote Manipulator System (RMS) (36890); Astronaut Claude Nicollier looks at a computer display of the Shuttle's robot arm movements as Thomas D. Akers and Kathryn C. Thornton, mission specialists look on. Nicollier will be responsible for maneuvering the astronauts while they stand in a foot restraint on the end of the RMS arm (36891,36894); Hoffman wears a special helmet and gloves designed to assist in proper positioning near the telescope while on the end of the robot arm (35892); Nicollier looks at a computer display of the Shuttle's robot arm movements as Akers looks on (36893); While (l-r) Astronauts Kenneth Bowersox, Kathryn Thornton, Richard O. Covey and Thomas D. Akers watch, Nicollier moves the Robot arm to desired locations in the Shuttle's payload bay using the Virtual Reality program (36895); Bowersox takes his turn maneuvering the RMS while mission specialist Hoffman, wearing the Virtual Reality helmet, follows his own progress on the end of the robot arm. Crewmembers participating during the training session are (l-r) Astronauts Akers, Hoffman, Bowersox, Nicollier, Covey, and Thornton. In the background, David Homan, an engineer in the JSC Engineering Directorate's Automation and Robotics Division, looks on (36896).

Modular ankle robotics training in early subacute stroke: a randomized controlled pilot study.

PubMed

Forrester, Larry W; Roy, Anindo; Krywonis, Amanda; Kehs, Glenn; Krebs, Hermano Igo; Macko, Richard F

2014-09-01

BACKGROUND. Modular lower extremity robotics may offer a valuable avenue for restoring neuromotor control after hemiparetic stroke. Prior studies show that visually guided and visually evoked practice with an ankle robot (anklebot) improves paretic ankle motor control that translates into improved overground walking. To assess the feasibility and efficacy of daily anklebot training during early subacute hospitalization poststroke. Thirty-four inpatients from a stroke unit were randomly assigned to anklebot (n = 18) or passive manual stretching (n = 16) treatments. All suffered a first stroke with residual hemiparesis (ankle manual muscle test grade 1/5 to 4/5), and at least trace muscle activation in plantar- or dorsiflexion. Anklebot training employed an "assist-as-needed" approach during >200 volitional targeted paretic ankle movements, with difficulty adjusted to active range of motion and success rate. Stretching included >200 daily mobilizations in these same ranges. All sessions lasted 1 hour and assessments were not blinded. Both groups walked faster at discharge; however, the robot group improved more in percentage change of temporal symmetry (P = .032) and also of step length symmetry (P = .038), with longer nonparetic step lengths in the robot (133%) versus stretching (31%) groups. Paretic ankle control improved in the robot group, with increased peak (P ≤ .001) and mean (P ≤ .01) angular speeds, and increased movement smoothness (P ≤ .01). There were no adverse events. Though limited by small sample size and restricted entry criteria, our findings suggest that modular lower extremity robotics during early subacute hospitalization is well tolerated and improves ankle motor control and gait patterning. © The Author(s) 2014.

Rapid Prototyping Platform for Robotics Applications

ERIC Educational Resources Information Center

Hwang, Kao-Shing; Hsiao, Wen-Hsu; Shing, Gaung-Ting; Chen, Kim-Joan

2011-01-01

For the past several years, a team in the Department of Electrical Engineering (EE), National Chung Cheng University, Taiwan, has been establishing a pedagogical approach to embody embedded systems in the context of robotics. To alleviate the burden on students in the robotics curriculum in their junior and senior years, a training platform on…

Robots, Jobs, and Education. State-of-the-Art Paper.

ERIC Educational Resources Information Center

Benton, Oliver; Branch, Charles W.

The purpose of this paper is to assist those in education, government, and industry who are responsible for managing vocational and technical training in their decisions about what programs should be initiated to accommodate the growing use of robots. Section 1 describes robot characteristics (type of drive, method of teaching, lifting capacity,…

Robot-Assisted Task-Specific Training in Cerebral Palsy

ERIC Educational Resources Information Center

Krebs, Hermano I.; Ladenheim, Barbara; Hippolyte, Christopher; Monterroso, Linda; Mast, Joelle

2009-01-01

Our goal was to examine the feasibility of applying therapeutic robotics to children and adults with severe to moderate impairment due to cerebral palsy (CP). Pilot results demonstrated significant gains for both groups. These results suggest that robot-mediated therapy may be an effective tool to ameliorate the debilitating effects of CP and…

Learning Probabilistic Features for Robotic Navigation Using Laser Sensors

PubMed Central

Aznar, Fidel; Pujol, Francisco A.; Pujol, Mar; Rizo, Ramón; Pujol, María-José

2014-01-01

SLAM is a popular task used by robots and autonomous vehicles to build a map of an unknown environment and, at the same time, to determine their location within the map. This paper describes a SLAM-based, probabilistic robotic system able to learn the essential features of different parts of its environment. Some previous SLAM implementations had computational complexities ranging from O(Nlog(N)) to O(N 2), where N is the number of map features. Unlike these methods, our approach reduces the computational complexity to O(N) by using a model to fuse the information from the sensors after applying the Bayesian paradigm. Once the training process is completed, the robot identifies and locates those areas that potentially match the sections that have been previously learned. After the training, the robot navigates and extracts a three-dimensional map of the environment using a single laser sensor. Thus, it perceives different sections of its world. In addition, in order to make our system able to be used in a low-cost robot, low-complexity algorithms that can be easily implemented on embedded processors or microcontrollers are used. PMID:25415377

Learning probabilistic features for robotic navigation using laser sensors.

PubMed

Aznar, Fidel; Pujol, Francisco A; Pujol, Mar; Rizo, Ramón; Pujol, María-José

2014-01-01

SLAM is a popular task used by robots and autonomous vehicles to build a map of an unknown environment and, at the same time, to determine their location within the map. This paper describes a SLAM-based, probabilistic robotic system able to learn the essential features of different parts of its environment. Some previous SLAM implementations had computational complexities ranging from O(Nlog(N)) to O(N(2)), where N is the number of map features. Unlike these methods, our approach reduces the computational complexity to O(N) by using a model to fuse the information from the sensors after applying the Bayesian paradigm. Once the training process is completed, the robot identifies and locates those areas that potentially match the sections that have been previously learned. After the training, the robot navigates and extracts a three-dimensional map of the environment using a single laser sensor. Thus, it perceives different sections of its world. In addition, in order to make our system able to be used in a low-cost robot, low-complexity algorithms that can be easily implemented on embedded processors or microcontrollers are used.

Systematic Review of Appropriate Robotic Intervention for Gait Function in Subacute Stroke Patients

PubMed Central

Yoo, Jun Sang; Kim, Kyoung Eun; Cho, Sung Tae; Jang, Woo Seok

2018-01-01

The purpose of this study was to critically evaluate the effects of robot-assisted gait training (RAGT) on gait-related function in patients with acute/subacute stroke. We conducted a systematic review of randomized controlled trials published between May 2012 and April 2016. This search included 334 articles (Cochrane, 51 articles; Embase, 175 articles; PubMed, 108 articles). Based on the inclusion and exclusion criteria, 7 studies were selected for this review. We performed a quality evaluation using the PEDro scale. In this review, 3 studies used an exoskeletal robot, and 4 studies used an end-effector robot as interventions. As a result, RAGT was found to be effective in improving walking ability in subacute stroke patients. Significant improvements in gait speed, functional ambulatory category, and Rivermead mobility index were found with RAGT compared with conventional physical therapy (p < 0.05). Therefore, aggressive weight support and gait training at an early stage using a robotic device are helpful, and robotic intervention should be applied according to the patient's functional level and onset time of stroke. PMID:29546057

Surgical flow disruptions during robotic-assisted radical prostatectomy.

PubMed

Dru, Christopher J; Anger, Jennifer T; Souders, Colby P; Bresee, Catherine; Weigl, Matthias; Hallett, Elyse; Catchpole, Ken

2017-06-01

We sought to apply the principles of human factors research to robotic-assisted radical prostatectomy to understand where training and integration challenges lead to suboptimal and inefficient care. Thirty-four robotic-assisted radical prostatectomy and bilateral pelvic lymph node dissections over a 20 week period were observed for flow disruptions (FD) - deviations from optimal care that can compromise safety or efficiency. Other variables - physician experience, trainee involvement, robot model (S versus Si), age, body mass index (BMI), and American Society of Anesthesiologists (ASA) physical status - were used to stratify the data and understand the effect of context. Effects were studied across four operative phases - entry to insufflations, robot docking, surgical intervention, and undocking. FDs were classified into one of nine categories. An average of 9.2 (SD = 3.7) FD/hr were recorded, with the highest rates during robot docking (14.7 [SD = 4.3] FDs/hr). The three most common flow disruptions were disruptions of communication, coordination, and equipment. Physicians with more robotic experience were faster during docking (p < 0.003). Training cases had a greater FD rate (8.5 versus 10.6, p < 0.001), as did the Si model robot (8.2 versus 9.8, p = 0.002). Patient BMI and ASA classification yielded no difference in operative duration, but had phase-specific differences in FD. Our data reflects the demands placed on the OR team by the patient, equipment, environment and context of a robotic surgical intervention, and suggests opportunities to enhance safety, quality, efficiency, and learning in robotic surgery.

Energy Expenditure of Trotting Gait Under Different Gait Parameters

NASA Astrophysics Data System (ADS)

Chen, Xian-Bao; Gao, Feng

2017-07-01

Robots driven by batteries are clean, quiet, and can work indoors or in space. However, the battery endurance is a great problem. A new gait parameter design energy saving strategy to extend the working hours of the quadruped robot is proposed. A dynamic model of the robot is established to estimate and analyze the energy expenditures during trotting. Given a trotting speed, optimal stride frequency and stride length can minimize the energy expenditure. However, the relationship between the speed and the optimal gait parameters is nonlinear, which is difficult for practical application. Therefore, a simplified gait parameter design method for energy saving is proposed. A critical trotting speed of the quadruped robot is found and can be used to decide the gait parameters. When the robot is travelling lower than this speed, it is better to keep a constant stride length and change the cycle period. When the robot is travelling higher than this speed, it is better to keep a constant cycle period and change the stride length. Simulations and experiments on the quadruped robot show that by using the proposed gait parameter design approach, the energy expenditure can be reduced by about 54% compared with the 100 mm stride length under 500 mm/s speed. In general, an energy expenditure model based on the gait parameter of the quadruped robot is built and the trotting gait parameters design approach for energy saving is proposed.

Robot arm apparatus

DOEpatents

Nachbar, Henry D.

1992-12-01

A robot arm apparatus is provided for inspecting and/or maintaining an interior of a steam generator which has an outside wall and a port for accessing the interior of the steam generator. The robot arm apparatus includes a flexible movable conduit for conveying inspection and/or maintenance apparatus from outside the steam generator to the interior of the steam generator. The flexible conduit has a terminal working end which is translated into and around the interior of the steam generator. Three motors located outside the steam generator are employed for moving the terminal working end inside the steam generator in "x", "y", and "z" directions, respectively. Commonly conducted inspection and maintenance operations include visual inspection for damaged areas, water jet lancing for cleaning sludge deposits, core boring for obtaining sludge deposits, and scrubbing of internal parts.

Robot arm apparatus

DOEpatents

Nachbar, Henry D.

1992-01-01

A robot arm apparatus is provided for inspecting and/or maintaining an interior of a steam generator which has an outside wall and a port for accessing the interior of the steam generator. The robot arm apparatus includes a flexible movable conduit for conveying inspection and/or maintenance apparatus from outside the steam generator to the interior of the steam generator. The flexible conduit has a terminal working end which is translated into and around the interior of the steam generator. Three motors located outside the steam generator are employed for moving the terminal working end inside the steam generator in "x", "y", and "z" directions, respectively. Commonly conducted inspection and maintenance operations include visual inspection for damaged areas, water jet lancing for cleaning sludge deposits, core boring for obtaining sludge deposits, and scrubbing of internal parts.

Design and control of a macro-micro robot for precise force applications

NASA Technical Reports Server (NTRS)

Wang, Yulun; Mangaser, Amante; Laby, Keith; Jordan, Steve; Wilson, Jeff

1993-01-01

Creating a robot which can delicately interact with its environment has been the goal of much research. Primarily two difficulties have made this goal hard to attain. The execution of control strategies which enable precise force manipulations are difficult to implement in real time because such algorithms have been too computationally complex for available controllers. Also, a robot mechanism which can quickly and precisely execute a force command is difficult to design. Actuation joints must be sufficiently stiff, frictionless, and lightweight so that desired torques can be accurately applied. This paper describes a robotic system which is capable of delicate manipulations. A modular high-performance multiprocessor control system was designed to provide sufficient compute power for executing advanced control methods. An 8 degree of freedom macro-micro mechanism was constructed to enable accurate tip forces. Control algorithms based on the impedance control method were derived, coded, and load balanced for maximum execution speed on the multiprocessor system. Delicate force tasks such as polishing, finishing, cleaning, and deburring, are the target applications of the robot.

Solar panel cleaning robot

NASA Astrophysics Data System (ADS)

Nalladhimmu, Pavan Kumar Reddy; Priyadarshini, S.

2018-04-01

As the demand of electricity is increasing, there is need to using the renewable sources to produce the energy at present of power shortage, the use of solar energy could be beneficial to great extent and easy to get the maximum efficiency. There is an urgent in improving the efficiency of solar power generation. Current solar panels setups take a major power loss when unwanted obstructions cover the surface of the panels. To make solar energy more efficiency of solar array systems must be maximized efficiency evaluation of PV panels, that has been discussed with particular attention to the presence of dust on the efficiency of the PV panels have been highlighted. This paper gives the how the solar panel cleaning system works and designing of the cleaning system.

Electromechanical and robot-assisted arm training for improving activities of daily living, arm function, and arm muscle strength after stroke.

PubMed

Mehrholz, Jan; Pohl, Marcus; Platz, Thomas; Kugler, Joachim; Elsner, Bernhard

2015-11-07

Electromechanical and robot-assisted arm training devices are used in rehabilitation, and may help to improve arm function after stroke. To assess the effectiveness of electromechanical and robot-assisted arm training for improving activities of daily living, arm function, and arm muscle strength in people after stroke. We also assessed the acceptability and safety of the therapy. We searched the Cochrane Stroke Group's Trials Register (last searched February 2015), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library 2015, Issue 3), MEDLINE (1950 to March 2015), EMBASE (1980 to March 2015), CINAHL (1982 to March 2015), AMED (1985 to March 2015), SPORTDiscus (1949 to March 2015), PEDro (searched April 2015), Compendex (1972 to March 2015), and Inspec (1969 to March 2015). We also handsearched relevant conference proceedings, searched trials and research registers, checked reference lists, and contacted trialists, experts, and researchers in our field, as well as manufacturers of commercial devices. Randomised controlled trials comparing electromechanical and robot-assisted arm training for recovery of arm function with other rehabilitation or placebo interventions, or no treatment, for people after stroke. Two review authors independently selected trials for inclusion, assessed trial quality and risk of bias, and extracted data. We contacted trialists for additional information. We analysed the results as standardised mean differences (SMDs) for continuous variables and risk differences (RDs) for dichotomous variables. We included 34 trials (involving 1160 participants) in this update of our review. Electromechanical and robot-assisted arm training improved activities of daily living scores (SMD 0.37, 95% confidence interval (CI) 0.11 to 0.64, P = 0.005, I² = 62%), arm function (SMD 0.35, 95% CI 0.18 to 0.51, P < 0.0001, I² = 36%), and arm muscle strength (SMD 0.36, 95% CI 0.01 to 0.70, P = 0.04, I² = 72%), but the quality of the evidence was low to very low. Electromechanical and robot-assisted arm training did not increase the risk of participant drop-out (RD 0.00, 95% CI -0.02 to 0.03, P = 0.84, I² = 0%) with moderate-quality evidence, and adverse events were rare. People who receive electromechanical and robot-assisted arm and hand training after stroke might improve their activities of daily living, arm and hand function, and arm and hand muscle strength. However, the results must be interpreted with caution because the quality of the evidence was low to very low, and there were variations between the trials in the intensity, duration, and amount of training; type of treatment; and participant characteristics.

The responsiveness and correlation between Fugl-Meyer Assessment, Motor Status Scale, and the Action Research Arm Test in chronic stroke with upper-extremity rehabilitation robotic training.

PubMed

Wei, Xi-Jun; Tong, Kai-Yu; Hu, Xiao-Ling

2011-12-01

Responsiveness of clinical assessments is an important element in the report of clinical effectiveness after rehabilitation. The correlation could reflect the validity of assessments as an indication of clinical performance before and after interventions. This study investigated the correlation and responsiveness of Fugl-Meyer Assessment (FMA), Motor Status Scale (MSS), Action Research Arm Test (ARAT) and the Modified Ashworth Scale (MAS), which are used frequently in effectiveness studies of robotic upper-extremity training in stroke rehabilitation. Twenty-seven chronic stroke patients were recruited for a 20-session upper-extremity rehabilitation robotic training program. This was a rater-blinded randomized controlled trial. All participants were evaluated with FMA, MSS, ARAT, MAS, and Functional Independent Measure before and after robotic training. Spearman's rank correlation coefficient was applied for the analysis of correlation. The standardized response mean (SRM) and Guyatt's responsiveness index (GRI) were used to analyze responsiveness. Spearman's correlation coefficient showed a significantly high correlation (ρ=0.91-0.96) among FMA, MSS, and ARAT and a fair-to-moderate correlation (ρ=0.40-0.62) between MAS and the other assessments. FMA, MSS, and MAS on the wrist showed higher responsiveness (SRM=0.85-0.98, GRI=1.59-3.62), whereas ARAT showed relatively less responsiveness (SRM=0.22, GRI=0.81). The results showed that FMA or MSS would be the best choice for evaluating the functional improvement in stroke studies on robotic upper-extremity training with high responsiveness and good correlation with ARAT. MAS could be used separately to evaluate the spasticity changes after intervention in terms of high responsiveness.

Real-time closed-loop control of cognitive load in neurological patients during robot-assisted gait training.

PubMed

Koenig, Alexander; Novak, Domen; Omlin, Ximena; Pulfer, Michael; Perreault, Eric; Zimmerli, Lukas; Mihelj, Matjaz; Riener, Robert

2011-08-01

Cognitively challenging training sessions during robot-assisted gait training after stroke were shown to be key requirements for the success of rehabilitation. Despite a broad variability of cognitive impairments amongst the stroke population, current rehabilitation environments do not adapt to the cognitive capabilities of the patient, as cognitive load cannot be objectively assessed in real-time. We provided healthy subjects and stroke patients with a virtual task during robot-assisted gait training, which allowed modulating cognitive load by adapting the difficulty level of the task. We quantified the cognitive load of stroke patients by using psychophysiological measurements and performance data. In open-loop experiments with healthy subjects and stroke patients, we obtained training data for a linear, adaptive classifier that estimated the current cognitive load of patients in real-time. We verified our classification results via questionnaires and obtained 88% correct classification in healthy subjects and 75% in patients. Using the pre-trained, adaptive classifier, we closed the cognitive control loop around healthy subjects and stroke patients by automatically adapting the difficulty level of the virtual task in real-time such that patients were neither cognitively overloaded nor under-challenged. © 2011 IEEE

The Combined Effects of Adaptive Control and Virtual Reality on Robot-Assisted Fine Hand Motion Rehabilitation in Chronic Stroke Patients: A Case Study.

PubMed

Huang, Xianwei; Naghdy, Fazel; Naghdy, Golshah; Du, Haiping; Todd, Catherine

2018-01-01

Robot-assisted therapy is regarded as an effective and reliable method for the delivery of highly repetitive training that is needed to trigger neuroplasticity following a stroke. However, the lack of fully adaptive assist-as-needed control of the robotic devices and an inadequate immersive virtual environment that can promote active participation during training are obstacles hindering the achievement of better training results with fewer training sessions required. This study thus focuses on these research gaps by combining these 2 key components into a rehabilitation system, with special attention on the rehabilitation of fine hand motion skills. The effectiveness of the proposed system is tested by conducting clinical trials on a chronic stroke patient and verified through clinical evaluation methods by measuring the key kinematic features such as active range of motion (ROM), finger strength, and velocity. By comparing the pretraining and post-training results, the study demonstrates that the proposed method can further enhance the effectiveness of fine hand motion rehabilitation training by improving finger ROM, strength, and coordination. Copyright © 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Education and training in pediatric robotic surgery: lessons learned from an inaugural multinational workshop.

PubMed

Cundy, Thomas P; Mayer, Erik K; Camps, Juan I; Olsen, Lars H; Pelizzo, Gloria; Yang, Guang-Zhong; Darzi, Ara; Najmaldin, Azad S

2015-03-01

The introduction of robotic surgery into clinical practice brings new and specific needs for education and training. Application to the pediatric setting comes with unique considerations, warranting dedicated training resources that are accessible. A pediatric robotic surgery workshop was convened to address initial education and training requirements. The event was designed to offer an exposure rich environment for delegates to familiarize and learn basic principles in a maximally efficient manner. Pre- and post-workshop survey responses were evaluated to reflect on the quality of the educational experience and scope for improvement. Feasibility and sustainability of such events was further evaluated by reviewing various challenges encountered. A total of 29 surgeons participated in the workshop, with 7 countries represented. The majority of delegates (94 %) indicated they were "very satisfied" with the overall program. Delegates almost unanimously expressed preference and satisfaction for hands-on content. Qualitative feedback favored a stepwise and modular workshop structure, transitioning from didactic teaching to progressively more advanced training. At the basic and intermediate level, this style of event is able to satisfy initial training and educational needs. Feasibility and sustainability of such events is highly dependent on infrastructure resources that have numerous barriers to accessibility.

STS-119 Extravehicular Activity (EVA) 3 Clean-Up OPS

NASA Image and Video Library

2009-03-23

S119-E-007137 (23 March 2009) --- Astronaut Joseph Acaba, STS-119 mission specialist, participates in the mission's third scheduled session of extravehicular activity (EVA) as construction and maintenance continue on the International Space Station. During the six-hour, 27-minute spacewalk, Acaba and Richard Arnold (out of frame), mission specialist, helped robotic arm operators relocate the Crew Equipment Translation Aid (CETA) cart from the Port 1 to Starboard 1 truss segment, installed a new coupler on the CETA cart, lubricated snares on the "B" end of the space station's robotic arm and performed a few "get ahead" tasks.

STS-119 Extravehicular Activity (EVA) 3 Clean-Up OPS

NASA Image and Video Library

2009-03-23

S119-E-007154 (23 March 2009) --- Astronaut Joseph Acaba, STS-119 mission specialist, participates in the mission's third scheduled session of extravehicular activity (EVA) as construction and maintenance continue on the International Space Station. During the six-hour, 27-minute spacewalk, Acaba and Richard Arnold (out of frame), mission specialist, helped robotic arm operators relocate the Crew Equipment Translation Aid (CETA) cart from the Port 1 to Starboard 1 truss segment, installed a new coupler on the CETA cart, lubricated snares on the "B" end of the space station's robotic arm and performed a few "get ahead" tasks.

STS-119 Extravehicular Activity (EVA) 3 Clean-Up OPS

NASA Image and Video Library

2009-03-23

S119-E-007165 (23 March 2009) --- Astronaut Joseph Acaba, STS-119 mission specialist, participates in the mission's third scheduled session of extravehicular activity (EVA) as construction and maintenance continue on the International Space Station. During the six-hour, 27-minute spacewalk, Acaba and Richard Arnold (out of frame), mission specialist, helped robotic arm operators relocate the Crew Equipment Translation Aid (CETA) cart from the Port 1 to Starboard 1 truss segment, installed a new coupler on the CETA cart, lubricated snares on the "B" end of the space station's robotic arm and performed a few "get ahead" tasks.

STS-119 Extravehicular Activity (EVA) 3 Clean-Up OPS

NASA Image and Video Library

2009-03-23

S119-E-007123 (23 March 2009) --- Astronaut Joseph Acaba, STS-119 mission specialist, participates in the mission's third scheduled session of extravehicular activity (EVA) as construction and maintenance continue on the International Space Station. During the six-hour, 27-minute spacewalk, Acaba and Richard Arnold (out of frame), mission specialist, helped robotic arm operators relocate the Crew Equipment Translation Aid (CETA) cart from the Port 1 to Starboard 1 truss segment, installed a new coupler on the CETA cart, lubricated snares on the "B" end of the space station's robotic arm and performed a few "get ahead" tasks.

STS-119 Extravehicular Activity (EVA) 3 Clean-Up OPS

NASA Image and Video Library

2009-03-23

S119-E-007128 (23 March 2009) --- Astronaut Joseph Acaba, STS-119 mission specialist, participates in the mission's third scheduled session of extravehicular activity (EVA) as construction and maintenance continue on the International Space Station. During the six-hour, 27-minute spacewalk, Acaba and Richard Arnold (out of frame), mission specialist, helped robotic arm operators relocate the Crew Equipment Translation Aid (CETA) cart from the Port 1 to Starboard 1 truss segment, installed a new coupler on the CETA cart, lubricated snares on the "B" end of the space station's robotic arm and performed a few "get ahead" tasks.

STS-119 Extravehicular Activity (EVA) 3 Clean-Up OPS

NASA Image and Video Library

2009-03-23

S119-E-007129 (23 March 2009) --- Astronaut Joseph Acaba, STS-119 mission specialist, participates in the mission's third scheduled session of extravehicular activity (EVA) as construction and maintenance continue on the International Space Station. During the six-hour, 27-minute spacewalk, Acaba and Richard Arnold (out of frame), mission specialist, helped robotic arm operators relocate the Crew Equipment Translation Aid (CETA) cart from the Port 1 to Starboard 1 truss segment, installed a new coupler on the CETA cart, lubricated snares on the "B" end of the space station's robotic arm and performed a few "get ahead" tasks.

STS-119 Extravehicular Activity (EVA) 3 Clean-Up OPS

NASA Image and Video Library

2009-03-23

S119-E-007134 (23 March 2009) --- Astronaut Joseph Acaba, STS-119 mission specialist, participates in the mission's third scheduled session of extravehicular activity (EVA) as construction and maintenance continue on the International Space Station. During the six-hour, 27-minute spacewalk, Acaba and Richard Arnold (out of frame), mission specialist, helped robotic arm operators relocate the Crew Equipment Translation Aid (CETA) cart from the Port 1 to Starboard 1 truss segment, installed a new coupler on the CETA cart, lubricated snares on the "B" end of the space station's robotic arm and performed a few "get ahead" tasks.

[Robotic surgery: toy or tool?].

PubMed

Vallancien, Guy; Cathelineau, Xavier; Rozet, François; Barret, Eric

2005-05-01

Telemanipulation has been developed for industrial purposes since the 1970s. More recently, telemanipulated arms entered the operating room. This paper briefly describes the history of surgical robotics and discusses the advantages and disadvantages for both patients and surgeons. The authors advocate the development of robotic surgery, as it facilitates the training of young surgeons and can be useful during certain phases of an operation. Thus, robotic surgery is more a promising tool than a simple toy.

Robotics in otolaryngology and head and neck surgery: Recommendations for training and credentialing: A report of the 2015 AHNS education committee, AAO-HNS robotic task force and AAO-HNS sleep disorders committee.

PubMed

Gross, Neil D; Holsinger, F Christopher; Magnuson, J Scott; Duvvuri, Umamaheswar; Genden, Eric M; Ghanem, Tamer Ah; Yaremchuk, Kathleen L; Goldenberg, David; Miller, Matthew C; Moore, Eric J; Morris, Luc Gt; Netterville, James; Weinstein, Gregory S; Richmon, Jeremy

2016-04-01

Training and credentialing for robotic surgery in otolaryngology - head and neck surgery is currently not standardized, but rather relies heavily on industry guidance. This manuscript represents a comprehensive review of this increasingly important topic and outlines clear recommendations to better standardize the practice. The recommendations provided can be used as a reference by individuals and institutions alike, and are expected to evolve over time. © 2016 Wiley Periodicals, Inc. Head Neck 38: E151-E158. © 2016 Wiley Periodicals, Inc.

The impact of goal-oriented task design on neurofeedback learning for brain-computer interface control.

PubMed

McWhinney, S R; Tremblay, A; Boe, S G; Bardouille, T

2018-02-01

Neurofeedback training teaches individuals to modulate brain activity by providing real-time feedback and can be used for brain-computer interface control. The present study aimed to optimize training by maximizing engagement through goal-oriented task design. Participants were shown either a visual display or a robot, where each was manipulated using motor imagery (MI)-related electroencephalography signals. Those with the robot were instructed to quickly navigate grid spaces, as the potential for goal-oriented design to strengthen learning was central to our investigation. Both groups were hypothesized to show increased magnitude of these signals across 10 sessions, with the greatest gains being seen in those navigating the robot due to increased engagement. Participants demonstrated the predicted increase in magnitude, with no differentiation between hemispheres. Participants navigating the robot showed stronger left-hand MI increases than those with the computer display. This is likely due to success being reliant on maintaining strong MI-related signals. While older participants showed stronger signals in early sessions, this trend later reversed, suggesting greater natural proficiency but reduced flexibility. These results demonstrate capacity for modulating neurofeedback using MI over a series of training sessions, using tasks of varied design. Importantly, the more goal-oriented robot control task resulted in greater improvements.

Webinar: Green Cleaning for Improved Health: The Return on Investment of Green Cleaning in Schools

EPA Pesticide Factsheets

A page to register to view the June 22, 2017, webinar in the IAQ Knowledge-to-Action Professional Training Webinar Series: Green Cleaning for Improved Health: The Return on Investment of Green Cleaning in Schools

An architectural approach to create self organizing control systems for practical autonomous robots

NASA Technical Reports Server (NTRS)

Greiner, Helen

1991-01-01

For practical industrial applications, the development of trainable robots is an important and immediate objective. Therefore, the developing of flexible intelligence directly applicable to training is emphasized. It is generally agreed upon by the AI community that the fusion of expert systems, neural networks, and conventionally programmed modules (e.g., a trajectory generator) is promising in the quest for autonomous robotic intelligence. Autonomous robot development is hindered by integration and architectural problems. Some obstacles towards the construction of more general robot control systems are as follows: (1) Growth problem; (2) Software generation; (3) Interaction with environment; (4) Reliability; and (5) Resource limitation. Neural networks can be successfully applied to some of these problems. However, current implementations of neural networks are hampered by the resource limitation problem and must be trained extensively to produce computationally accurate output. A generalization of conventional neural nets is proposed, and an architecture is offered in an attempt to address the above problems.

Training Medical Novices in Spinal Microsurgery: Does the Modality Matter? A Pilot Study Comparing Traditional Microscopic Surgery and a Novel Robotic Optoelectronic Visualization Tool

PubMed Central

Tubbs, R. Shane; Page, Jeni; Chapman, Alexandra; Burgess, Brittni; Laws, Tyler; Warren, Haylie; Oskouian, Rod J

2016-01-01

The operative microscope has been a staple instrument in the neurosurgical operating room over the last 50 years. With advances in optoelectronics, options such as robotically controlled high magnification have become available. Such robotically controlled optoelectronic systems may offer new opportunities in surgical technique and teaching. However, traditionally trained surgeons may find it hard to accept newer technologies due to an inherent bias emerging from their previous background. We, therefore, studied how a medically naïve population in a pilot study would meet set microsurgical goals in a cadaver experiment using either a conventional operative microscope or BrightMatter™ Servo system, ​a robotically controlled optoelectronic system (Synaptive Medical, Toronto, Ontario, Canada). We found that the relative ease in teaching medical novices with a robotically controlled optoelectronic system was more valuable when compared to using a modern-day surgical microscope. PMID:26973804

Torque Control of a Rehabilitation Teaching Robot Using Magneto-Rheological Fluid Clutches

NASA Astrophysics Data System (ADS)

Hakogi, Hokuto; Ohaba, Motoyoshi; Kuramochi, Naimu; Yano, Hidenori

A new robot that makes use of MR-fluid clutches for simulating torque is proposed to provide an appropriate device for training physical therapy students in knee-joint rehabilitation. The feeling of torque provided by the robot is expected to correspond to the torque performance obtained by physical therapy experts in a clinical setting. The torque required for knee-joint rehabilitation, which is a function of the rotational angle and the rotational angular velocity of a knee movement, is modeled using a mechanical system composed of typical spring-mass-damper elements. The robot consists of two MR-fluid clutches, two induction motors, and a feedback control system. In the torque experiments, output torque is controlled using the spring and damper coefficients separately. The values of these coefficients are determined experimentally. The experimental results show that the robot would be suitable for training physical therapy students to experience similar torque feelings as needed in a clinical situation.

Path optimisation of a mobile robot using an artificial neural network controller

NASA Astrophysics Data System (ADS)

Singh, M. K.; Parhi, D. R.

2011-01-01

This article proposed a novel approach for design of an intelligent controller for an autonomous mobile robot using a multilayer feed forward neural network, which enables the robot to navigate in a real world dynamic environment. The inputs to the proposed neural controller consist of left, right and front obstacle distance with respect to its position and target angle. The output of the neural network is steering angle. A four layer neural network has been designed to solve the path and time optimisation problem of mobile robots, which deals with the cognitive tasks such as learning, adaptation, generalisation and optimisation. A back propagation algorithm is used to train the network. This article also analyses the kinematic design of mobile robots for dynamic movements. The simulation results are compared with experimental results, which are satisfactory and show very good agreement. The training of the neural nets and the control performance analysis has been done in a real experimental setup.

Design and evaluation of a trilateral shared-control architecture for teleoperated training robots.

PubMed

Shamaei, Kamran; Kim, Lawrence H; Okamura, Allison M

2015-08-01

Multilateral teleoperated robots can be used to train humans to perform complex tasks that require collaborative interaction and expert supervision, such as laparoscopic surgical procedures. In this paper, we explain the design and performance evaluation of a shared-control architecture that can be used in trilateral teleoperated training robots. The architecture includes dominance and observation factors inspired by the determinants of motor learning in humans, including observational practice, focus of attention, feedback and augmented feedback, and self-controlled practice. Toward the validation of such an architecture, we (1) verify the stability of a trilateral system by applying Llewellyn's criterion on a two-port equivalent architecture, and (2) demonstrate that system transparency remains generally invariant across relevant observation factors and movement frequencies. In a preliminary experimental study, a dyad of two human users (one novice, one expert) collaborated on the control of a robot to follow a trajectory. The experiment showed that the framework can be used to modulate the efforts of the users and adjust the source and level of haptic feedback to the novice user.

A novel 3D-printed hybrid simulation model for robotic-assisted kidney transplantation (RAKT).

PubMed

Uwechue, Raphael; Gogalniceanu, Petrut; Kessaris, Nicos; Byrne, Nick; Chandak, Pankaj; Olsburgh, Jonathon; Ahmed, Kamran; Mamode, Nizam; Loukopoulos, Ioannis

2018-01-27

Robotic-assisted kidney transplantation (RAKT) offers key benefits for patients that have been demonstrated in several studies. A barrier to the wider uptake of RAKT is surgical skill acquisition. This is exacerbated by the challenges of modern surgery with reduced surgical training time, patient safety concerns and financial pressures. Simulation is a well-established method of developing surgical skill in a safe and controlled environment away from the patient. We have developed a 3D printed simulation model for the key step of the kidney transplant operation which is the vascular anastomosis. The model is anatomically accurate, based on the CT scans of patients and it incorporates deceased donor vascular tissue. Crucially, it was developed to be used in the robotic operating theatre with the operating robot to enhance its fidelity. It is portable and relatively inexpensive when compared with other forms of simulation such as virtual reality or animal lab training. It thus has the potential of being more accessible as a training tool for the safe acquisition of RAKT specific skills. We demonstrate this model here.

How training and experience affect the benefits of autonomy in a dirty-bomb experiment

DOE Office of Scientific and Technical Information (OSTI.GOV)

David J. Bruemmer; Curtis W. Nielsen; David I. Gertman

2008-03-01

A dirty-bomb experiment conducted at the INL is used to evaluate the effectiveness and suitability of three different modes of robot control. The experiment uses three distinct user groups to understand how participants’ background and training affect the way in which they use and benefit from autonomy. The results show that the target mode, which involves automated mapping and plume tracing together with a point and click tasking tool, provides the best performance for each group. This is true for objective performance such as source detection and localization accuracy as well as subjective measures such as perceived workload, frustration andmore » preference. The best overall performance is achieved by the Explosive Ordinance Disposal group which has experience in both robot teleoperation and dirty bomb response. The user group that benefits least from autonomy is the Nuclear Engineers that have no experience with either robot operation or dirty bomb response. The group that benefits most from autonomy is the Weapons of Mass Destruction Civil Response Team that has extensive experience related to the task, but no robot training.« less

Computer visualizations in engineering applications

NASA Astrophysics Data System (ADS)

Bills, K. C.

The use of computerized simulations of various robotic tasks via IGRIP software is reported. The projects include underwater activities demonstrating clean up of a quarry; time study of methods to store waste drums inside a facility; design walk-through of a new facility; plant layout flyover; and conceptual development and layout of new mechanisms.

Mechanical vs. manual cleaning of hospital beds: a prospective intervention study.

PubMed

Hopman, J; Nillesen, M; de Both, E; Witte, J; Teerenstra, S; Hulscher, M; Voss, A

2015-06-01

Cleaning regimens for hospital beds were evaluated in the context of a rising prevalence of highly resistant micro-organisms and increasing financial pressure on healthcare systems. Dutch hospitals have to choose between standardized, mechanical bed-washers advised in national guidance and manual cleaning. To evaluate the quality of mechanical and manual bed-cleaning regimens. The multi-faceted analysis of bed-cleaning regimens consisted of three steps. In Step 1, the training of the domestic service team was evaluated. In Step 2, the cleaning quality of manual and mechanical regimens was assessed. Soiled beds, obtained at random, from different departments were evaluated using microbiological analysis (N = 40) and ATP (N = 20). ATP and microbiological contamination were measured in five predetermined locations on all beds. In Step 3, manual cleaning was introduced over a two-month pilot study at the surgical short-stay unit, and beds from other departments were processed according to the 'gold standard' mechanical cleaning. ATP levels were evaluated in three locations on 300 beds after cleaning. Training was found to improve the quality of cleaning significantly. Mechanical cleaning resulted in significantly lower ATP levels than manual cleaning. Mechanical cleaning shows less variation and results in consistently lower ATP levels than manual cleaning. Copyright © 2015 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Robotics in otolaryngology and head and neck surgery: Recommendations for training and credentialing

PubMed Central

Gross, Neil D.; Holsinger, F. Christopher; Magnuson, J. Scott; Duvvuri, Umamaheswar; Genden, Eric M.; Ghanem, Tamer AH.; Yaremchuk, Kathleen L.; Goldenberg, David; Miller, Matthew C.; Moore, Eric J.; Morris, Luc GT.; Netterville, James; Weinstein, Gregory S.; Richmon, Jeremy

2016-01-01

Training and credentialing for robotic surgery in otolaryngology - head and neck surgery is currently not standardized, but rather relies heavily on industry guidance. This manuscript represents a comprehensive review of this increasingly important topic and outlines clear recommendations to better standardize the practice. The recommendations provided can be used as a reference by individuals and institutions alike, and are expected to evolve over time. PMID:26950771

Robot-assisted gait training in multiple sclerosis patients: a randomized trial.

PubMed

Schwartz, Isabella; Sajin, Anna; Moreh, Elior; Fisher, Iris; Neeb, Martin; Forest, Adina; Vaknin-Dembinsky, Adi; Karusis, Dimitrios; Meiner, Zeev

2012-06-01

Preservation of locomotor activity in multiple sclerosis (MS) patients is of utmost importance. Robotic-assisted body weight-supported treadmill training is a promising method to improve gait functions in neurologically impaired patients, although its effectiveness in MS patients is still unknown. To compare the effectiveness of robot-assisted gait training (RAGT) with that of conventional walking treatment (CWT) on gait and generalized functions in a group of stable MS patients. A prospective randomized controlled trial of 12 sessions of RAGT or CWT in MS patients of EDSS score 5-7. Primary outcome measures were gait parameters and the secondary outcomes were functional and quality of life parameters. All tests were performed at baseline, 3 and 6 months post-treatment by a blinded rater. Fifteen and 17 patients were randomly allocated to RAGT and CWT, respectively. Both groups were comparable at baseline in all parameters. As compared with baseline, although some gait parameters improved significantly following the treatment at each time point there was no difference between the groups. Both FIM and EDSS scores improved significantly post-treatment with no difference between the groups. At 6 months, most gait and functional parameters had returned to baseline. Robot-assisted gait training is feasible and safe and may be an effective additional therapeutic option in MS patients with severe walking disabilities.

Increased reward in ankle robotics training enhances motor control and cortical efficiency in stroke.

PubMed

Goodman, Ronald N; Rietschel, Jeremy C; Roy, Anindo; Jung, Brian C; Diaz, Jason; Macko, Richard F; Forrester, Larry W

2014-01-01

Robotics is rapidly emerging as a viable approach to enhance motor recovery after disabling stroke. Current principles of cognitive motor learning recognize a positive relationship between reward and motor learning. Yet no prior studies have established explicitly whether reward improves the rate or efficacy of robotics-assisted rehabilitation or produces neurophysiologic adaptations associated with motor learning. We conducted a 3 wk, 9-session clinical pilot with 10 people with chronic hemiparetic stroke, randomly assigned to train with an impedance-controlled ankle robot (anklebot) under either high reward (HR) or low reward conditions. The 1 h training sessions entailed playing a seated video game by moving the paretic ankle to hit moving onscreen targets with the anklebot only providing assistance as needed. Assessments included paretic ankle motor control, learning curves, electroencephalograpy (EEG) coherence and spectral power during unassisted trials, and gait function. While both groups exhibited changes in EEG, the HR group had faster learning curves (p = 0.05), smoother movements (p

Hybrid gait training with an overground robot for people with incomplete spinal cord injury: a pilot study.

PubMed

Del-Ama, Antonio J; Gil-Agudo, Angel; Pons, José L; Moreno, Juan C

2014-01-01

Locomotor training has proved to provide beneficial effect in terms of mobility in incomplete paraplegic patients. Neuroprosthetic technology can contribute to increase the efficacy of a training paradigm in the promotion of a locomotor pattern. Robotic exoskeletons can be used to manage the unavoidable loss of performance of artificially driven muscles. Hybrid exoskeletons blend complementary robotic and neuro-prosthetic technologies. The aim of this pilot study was to determine the effects of hybrid gait training in three case studies with persons with incomplete spinal cord injury (iSCI) in terms of locomotion performance during assisted gait, patient-robot adaptations, impact on ambulation and assessment of lower limb muscle strength and spasticity. Participants with iSCI received interventions with a hybrid bilateral exoskeleton for 4 days. Assessment of gait function revealed that patients improved the 6 min and 10 m walking tests after the intervention, and further improvements were observed 1 week after the intervention. Muscle examination revealed improvements in knee and hip sagittal muscle balance scores and decreased score in ankle extensor balance. It is concluded that improvements in biomechanical function of the knee joint after the tested overground hybrid gait trainer are coherent with improvements in gait performance.

Hybrid gait training with an overground robot for people with incomplete spinal cord injury: a pilot study

PubMed Central

del-Ama, Antonio J.; Gil-Agudo, Ángel; Pons, José L.; Moreno, Juan C.

2014-01-01

Locomotor training has proved to provide beneficial effect in terms of mobility in incomplete paraplegic patients. Neuroprosthetic technology can contribute to increase the efficacy of a training paradigm in the promotion of a locomotor pattern. Robotic exoskeletons can be used to manage the unavoidable loss of performance of artificially driven muscles. Hybrid exoskeletons blend complementary robotic and neuro-prosthetic technologies. The aim of this pilot study was to determine the effects of hybrid gait training in three case studies with persons with incomplete spinal cord injury (iSCI) in terms of locomotion performance during assisted gait, patient-robot adaptations, impact on ambulation and assessment of lower limb muscle strength and spasticity. Participants with iSCI received interventions with a hybrid bilateral exoskeleton for 4 days. Assessment of gait function revealed that patients improved the 6 min and 10 m walking tests after the intervention, and further improvements were observed 1 week after the intervention. Muscle examination revealed improvements in knee and hip sagittal muscle balance scores and decreased score in ankle extensor balance. It is concluded that improvements in biomechanical function of the knee joint after the tested overground hybrid gait trainer are coherent with improvements in gait performance. PMID:24860478

Technological advances in robotic-assisted laparoscopic surgery.

PubMed

Tan, Gerald Y; Goel, Raj K; Kaouk, Jihad H; Tewari, Ashutosh K

2009-05-01

In this article, the authors describe the evolution of urologic robotic systems and the current state-of-the-art features and existing limitations of the da Vinci S HD System (Intuitive Surgical, Inc.). They then review promising innovations in scaling down the footprint of robotic platforms, the early experience with mobile miniaturized in vivo robots, advances in endoscopic navigation systems using augmented reality technologies and tracking devices, the emergence of technologies for robotic natural orifice transluminal endoscopic surgery and single-port surgery, advances in flexible robotics and haptics, the development of new virtual reality simulator training platforms compatible with the existing da Vinci system, and recent experiences with remote robotic surgery and telestration.

Speeding up the learning of robot kinematics through function decomposition.

PubMed

Ruiz de Angulo, Vicente; Torras, Carme

2005-11-01

The main drawback of using neural networks or other example-based learning procedures to approximate the inverse kinematics (IK) of robot arms is the high number of training samples (i.e., robot movements) required to attain an acceptable precision. We propose here a trick, valid for most industrial robots, that greatly reduces the number of movements needed to learn or relearn the IK to a given accuracy. This trick consists in expressing the IK as a composition of learnable functions, each having half the dimensionality of the original mapping. Off-line and on-line training schemes to learn these component functions are also proposed. Experimental results obtained by using nearest neighbors and parameterized self-organizing map, with and without the decomposition, show that the time savings granted by the proposed scheme grow polynomially with the precision required.

The effect of a robot-assisted surgical system on the kinematics of user movements.

PubMed

Nisky, Ilana; Hsieh, Michael H; Okamura, Allison M

2013-01-01

Teleoperated robot-assisted surgery (RAS) offers many advantages over traditional minimally invasive surgery. However, RAS has not yet realized its full potential, and it is not clear how to optimally train surgeons to use these systems. We hypothesize that the dynamics of the master manipulator impact the ability of users to make desired movements with the robot. We compared freehand and teleoperated movements of novices and experienced surgeons. To isolate the effects of dynamics from procedural knowledge, we chose simple movements rather than surgical tasks. We found statistically significant effects of teleoperation and user expertise in several aspects of motion, including target acquisition error, movement speed, and movement smoothness. Such quantitative assessment of human motor performance in RAS can impact the design of surgical robots, their control, and surgeon training methods, and eventually, improve patient outcomes.

Indirect iterative learning control for a discrete visual servo without a camera-robot model.

PubMed

Jiang, Ping; Bamforth, Leon C A; Feng, Zuren; Baruch, John E F; Chen, YangQuan

2007-08-01

This paper presents a discrete learning controller for vision-guided robot trajectory imitation with no prior knowledge of the camera-robot model. A teacher demonstrates a desired movement in front of a camera, and then, the robot is tasked to replay it by repetitive tracking. The imitation procedure is considered as a discrete tracking control problem in the image plane, with an unknown and time-varying image Jacobian matrix. Instead of updating the control signal directly, as is usually done in iterative learning control (ILC), a series of neural networks are used to approximate the unknown Jacobian matrix around every sample point in the demonstrated trajectory, and the time-varying weights of local neural networks are identified through repetitive tracking, i.e., indirect ILC. This makes repetitive segmented training possible, and a segmented training strategy is presented to retain the training trajectories solely within the effective region for neural network approximation. However, a singularity problem may occur if an unmodified neural-network-based Jacobian estimation is used to calculate the robot end-effector velocity. A new weight modification algorithm is proposed which ensures invertibility of the estimation, thus circumventing the problem. Stability is further discussed, and the relationship between the approximation capability of the neural network and the tracking accuracy is obtained. Simulations and experiments are carried out to illustrate the validity of the proposed controller for trajectory imitation of robot manipulators with unknown time-varying Jacobian matrices.

From Illusion to Reality: A Brief History of Robotic Surgery.

PubMed

Marino, Marco Vito; Shabat, Galyna; Gulotta, Gaspare; Komorowski, Andrzej Lech

2018-06-01

Robotic surgery is currently employed for many surgical procedures, yielding interesting results. We performed an historical review of robots and robotic surgery evaluating some critical phases of its evolution, analyzing its impact on our life and the steps completed that gave the robotics its current popularity. The origins of robotics can be traced back to Greek mythology. Different aspects of robotics have been explored by some of the greatest inventors like Leonardo da Vinci, Pierre Jaquet-Droz, and Wolfgang Von-Kempelen. Advances in many fields of science made possible the development of advanced surgical robots. Over 3000 da Vinci robotic platforms are installed worldwide, and more than 200 000 robotic procedures are performed every year. Despite some potential adverse events, robotic technology seems safe and feasible. It is strictly linked to our life, leading surgeons to a new concept of surgery and training.

Robots remove explosive waste from flooded site

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1993-10-01

Explosive industrial waste can remain hazardous for years, making remediation extremely dangerous, particularly when using traditional methods involving people and manually operated equipment. The work is even more complex if the waste is submerged. Authorities in 1988 faced an unusual challenge when they decided to clean up a flooded area that had been used for more than 30 years as a dump for explosive materials. They devised an innovative but highly effective solution. Instead of using divers, two robots perform the cleanup while site personnel remain 600 feet away from the restricted area. The robots were developed by Sonsub Environmentalmore » Services Inc. (Houston), which is responsible for their operation. The robots initially located and cleared a small area underwater to set up a metal-processing system, which also was designed by Sonsub. The system is similar to a metal-recycling shredder. The robots then assembled the 25-foot-tall, 20-ton system 60 feet below the surface on the pit floor. A large, surface robot carried sections of the shredder to the cleared area and lowered them, while a smaller, submersible robot guided them into position. This required extreme precision by the smaller robot, which had to ensure that sections mated properly. Both robots now retrieve waste from the pit bottom and feed it into the shredder. The larger robot has a 40-foot jointed arm for lifting up to 1,000 pounds of debris, a manipulator hand for sorting through rock piles and removing small containers, and a grapple for picking up items from the pit floor.« less

SyRoTek--Distance Teaching of Mobile Robotics

ERIC Educational Resources Information Center

Kulich, M.; Chudoba, J.; Kosnar, K.; Krajnik, T.; Faigl, J.; Preucil, L.

2013-01-01

E-learning is a modern and effective approach for training in various areas and at different levels of education. This paper gives an overview of SyRoTek, an e-learning platform for mobile robotics, artificial intelligence, control engineering, and related domains. SyRoTek provides remote access to a set of fully autonomous mobile robots placed in…

Robotic laparoscopic surgery: cost and training.

PubMed

Amodeo, A; Linares Quevedo, A; Joseph, J V; Belgrano, E; Patel, H R H

2009-06-01

The advantages of minimally invasive surgery are well accepted. Shorter hospital stays, decreased postoperative pain, rapid return to preoperative activity, decreased postoperative ileus, and preserved immune function are among the benefits of the laparoscopic approach. However, the instruments of laparoscopy afford surgeons limited precision and poor ergonomics, and their use is associated with a significant learning curve and the amount of time and energy necessary to develop and maintain such advanced laparoscopic skills is not insignificant. The robotic surgery allows all laparoscopists to perform advanced laparoscopic procedures with greater ease. The potential advantages of surgical robotic systems include making advanced laparoscopic surgical procedures accessible to surgeons who do not have advanced video endoscopic training and broadening the scope of surgical procedures that can be performed using the laparoscopic method. The wristed instruments, x10 magnifications, tremor filtering, scaling of movements and three-dimensional view allow the urologist to perform the intricate dissection and anastomosis with high precision. The robot is not, however, without significant disadvantages as compared with traditional laparoscopy. These include greater expense and consumption of operating room resources such as space and the availability of skilled technical staff, complete elimination of tactile feedback, and more limited options for trocar placement. The current cost of the da Vinci system is $ 1.2 million and annual maintenance is $ 138000. Many studies suggest that depreciation and maintenance costs can be minimised if the number of robotic cases is increased. The high cost of purchasing and maintaining the instruments of the robotic system is one of its many disadvantages. The availability of the robotic systems to only a limited number of centres reduces surgical training opportunities. Hospital administrators and surgeons must define the reasons for developing a robotic surgical program: it is very important to show that robotics will add a dimension that will benefit the hospital, the patient care and institutional recognition. Another essential task to overcome is the important education of the operating room nursing staff, a significant difference between this modality and traditional surgery. Without operating room environment support, most surgeons will revert to traditional methods even after a few successful robotics cases. As the field of robotic surgery continues to grow, graduate medical education and continuing medical education programs that address the surgical robotic learning needs of residents and practicing surgeons need to be developed.

Computer-controlled wall servicing robot

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lefkowitz, S.

1995-03-01

After four years of cooperative research, Pentek has unveiled a new robot with the capability to automatically deliver a variety of cleaning, painting, inspection, and surveillance devices to large vertical surfaces. The completely computer-controlled robot can position a working tool on a 50-foot tall by 50-foot wide vertical surface with a repeatability of 1/16 inch. The working end can literally {open_quotes}fly{close_quotes} across the face of a wall at speed of 60 per minute, and can handle working loads of 350 pounds. The robot was originally developed to decontaminate the walls of reactor fueling cavities at commercial nuclear power plants duringmore » fuel outages. If these cavities are left to dry after reactor refueling, contamination present in the residue could later become airborne and move throughout the containment building. Decontaminating the cavity during the refueling outage reduces the need for restrictive personal protective equipment during plant operations to limit the dose rates.« less

Improved walking ability with wearable robot-assisted training in patients suffering chronic stroke.

PubMed

Li, Lifang; Ding, Li; Chen, Na; Mao, Yurong; Huang, Dongfeng; Li, Le

2015-01-01

Wearable robotic devices provide safe and intensive rehabilitation, enabling repeated motions for motor function recovery in stroke patients. The aim of this small case series was to demonstrate the training effects of a three-week robotic leg orthosis, and to investigate possible mechanisms of the sensory-motor alterations and improvements by using gait analysis and EMG. Three survivors of chronic strokes participated in robot-assisted gait therapy for three weeks. EMG signals from the rectus femoris (RF), tibialis anterior (TA), biceps femoris (BF), and medial gastrocnemius (MG), as well as kinetics and kinematics data of the lower limb, were recorded before and after the training. The normalized root mean squared (RMS) values of the muscles, the joint moments, joint angles, and the results of two clinical scales (Berg Balance scale, BBS, and the lower extremity subscale of Fugl-Meyer assessment, LE-FMA) were used for analysis. All participants experienced improved balance and functional performances and increased BBS and LE-FMA scores. The EMG results showed there was an increase of the normalized RMS values of the MG and BF on the affected side. Additionally, EMG activities of the agonist and antagonist pair (i.e. RF and BF) appeared to return to similar levels after training. The peak moment of hip flexor, knee extensor, and plantar flexor, which all contributed to push-off power, were found to have increased after training. In summary, the three-week training period using the wearable RLO improved the three participants' gait performance by regaining push-off power and improved muscle activation and walking speed.

Getting started with robotics in general surgery with cholecystectomy: the Canadian experience

PubMed Central

Jayaraman, Shiva; Davies, Ward; Schlachta, Christopher M.

2009-01-01

Background The value of robotics in general surgery may be for advanced minimally invasive procedures. Unlike other specialties, formal fellowship training opportunities for robotic general surgery are few. As a result, most surgeons currently develop robotic skills in practice. Our goal was to determine whether robotic cholecystectomy is a safe and effective bridge to advanced robotics in general surgery. Methods Before performing advanced robotic procedures, 2 surgeons completed the Intuitive Surgical da Vinci training course and agreed to work together on all procedures. Clinical surgery began with da Vinci cholecystectomy with a plan to begin advanced procedures after at least 10 cholecystectomies. We performed a retrospective review of our pilot series of robotic cholecystectomies and compared them with contemporaneous laparoscopic controls. The primary outcome was safety, and the secondary outcome was learning curve. Results There were 16 procedures in the robotics arm and 20 in the laparoscopic arm. Two complications (da Vinci port-site hernia, transient elevation of liver enzymes) occurred in the robotic arm, whereas only 1 laparoscopic patient (slow to awaken from anesthetic) experienced a complication. None was significant. The mean time required to perform robotic cholecystectomy was significantly longer than laparoscopic surgery (91 v. 41 min, p < 0.001). The mean time to clear the operating room was significantly longer for robotic procedures (14 v. 11 min, p = 0.015). We observed a trend showing longer mean anesthesia time for robotic procedures (23 v. 15 min). Regarding learning curve, the mean operative time needed for the first 3 robotic procedures was longer than for the last 3 (101 v. 80 min); however, this difference was not significant. Since this experience, the team has confidently gone on to perform robotic biliary, pancreatic, gastresophageal, intestinal and colorectal operations. Conclusion Robotic cholecystectomy can be performed reliably; however, owing to the significant increase in operating room resources, it cannot be justified for routine use. Our experience, however, demonstrates that robotic cholecystectomy is one means by which general surgeons may gain confidence in performing advanced robotic procedures. PMID:19865571

Analyzing Robotic Kinematics Via Computed Simulations

NASA Technical Reports Server (NTRS)

Carnahan, Timothy M.

1992-01-01

Computing system assists in evaluation of kinematics of conceptual robot. Displays positions and motions of robotic manipulator within work cell. Also displays interactions between robotic manipulator and other objects. Results of simulation displayed on graphical computer workstation. System includes both off-the-shelf software originally developed for automotive industry and specially developed software. Simulation system also used to design human-equivalent hand, to model optical train in infrared system, and to develop graphical interface for teleoperator simulation system.

Motor-response learning at a process control panel by an autonomous robot

DOE Office of Scientific and Technical Information (OSTI.GOV)

Spelt, P.F.; de Saussure, G.; Lyness, E.

1988-01-01

The Center for Engineering Systems Advanced Research (CESAR) was founded at Oak Ridge National Laboratory (ORNL) by the Department of Energy's Office of Energy Research/Division of Engineering and Geoscience (DOE-OER/DEG) to conduct basic research in the area of intelligent machines. Therefore, researchers at the CESAR Laboratory are engaged in a variety of research activities in the field of machine learning. In this paper, we describe our approach to a class of machine learning which involves motor response acquisition using feedback from trial-and-error learning. Our formulation is being experimentally validated using an autonomous robot, learning tasks of control panel monitoring andmore » manipulation for effect process control. The CLIPS Expert System and the associated knowledge base used by the robot in the learning process, which reside in a hypercube computer aboard the robot, are described in detail. Benchmark testing of the learning process on a robot/control panel simulation system consisting of two intercommunicating computers is presented, along with results of sample problems used to train and test the expert system. These data illustrate machine learning and the resulting performance improvement in the robot for problems similar to, but not identical with, those on which the robot was trained. Conclusions are drawn concerning the learning problems, and implications for future work on machine learning for autonomous robots are discussed. 16 refs., 4 figs., 1 tab.« less

Robotic Lung Resection for Non-Small Cell Lung Cancer.

PubMed

Wei, Benjamin; Eldaif, Shady M; Cerfolio, Robert J

2016-07-01

Robotic-assisted pulmonary lobectomy can be considered for patients able to tolerate conventional lobectomy. Contraindications to resection via thoracotomy apply to patients undergoing robotic lobectomy. Team training, familiarity with equipment, troubleshooting, and preparation are critical for successful robotic lobectomy. Robotic lobectomy is associated with decreased rates of blood loss, blood transfusion, air leak, chest tube duration, length of stay, and mortality compared with thoracotomy. Robotic lobectomy offers many of the same benefits in perioperative morbidity and mortality, and additional advantages in optics, dexterity, and surgeon ergonomics as video-assisted thoracic lobectomy. Long-term oncologic efficacy and cost implications remain areas of study. Copyright © 2016 Elsevier Inc. All rights reserved.

Robotic therapy provides a stimulus for upper limb motor recovery after stroke that is complementary to and distinct from conventional therapy.

PubMed

Brokaw, Elizabeth B; Nichols, Diane; Holley, Rahsaan J; Lum, Peter S

2014-05-01

Individuals with chronic stroke often have long-lasting upper extremity impairments that impede function during activities of daily living. Rehabilitation robotics have shown promise in improving arm function, but current systems do not allow realistic training of activities of daily living. We have incorporated the ARMin III and HandSOME device into a novel robotic therapy modality that provides functional training of reach and grasp tasks. To compare the effects of equal doses of robotic and conventional therapy in individuals with chronic stroke. Subjects were randomized to 12 hours of robotic or conventional therapy and then crossed over to the other therapy type after a 1-month washout period. Twelve moderate to severely impaired individuals with chronic stroke were enrolled, and 10 completed the study. Across the 3-month study period, subjects showed significant improvements in the Fugl-Meyer (P = .013) and Box and Blocks tests (P = .028). The robotic intervention produced significantly greater improvements in the Action Research Arm Test than conventional therapy (P = .033). Gains in the Box and Blocks test from conventional therapy were larger than from robotic therapy in subjects who received conventional therapy after robotic therapy (P = .044). Data suggest that robotic therapy can elicit improvements in arm function that are distinct from conventional therapy and supplements conventional methods to improve outcomes. Results from this pilot study should be confirmed in a larger study.

Clean Energy Solutions Center Services (Arabic Translation) (Fact Sheet)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

2014-06-01

This is the Arabic translation of the Clean Energy Solutions Center Services fact sheet. The Clean Energy Solutions Center (Solutions Center) helps governments, advisors and analysts create policies and programs that advance the deployment of clean energy technologies. The Solutions Center partners with international organizations to provide online training, expert assistance, and technical resources on clean energy policy.

Modular Ankle Robotics Training in Early Sub-Acute Stroke: A Randomized Controlled Pilot Study

PubMed Central

Forrester, Larry W.; Roy, Anindo; Krywonis, Amanda; Kehs, Glenn; Krebs, Hermano Igo; Macko, Richard F.

2014-01-01

Background Modular lower extremity (LE) robotics may offer a valuable avenue for restoring neuromotor control after hemiparetic stroke. Prior studies show that visually-guided and visually-evoked practice with an ankle robot (anklebot) improves paretic ankle motor control that translates into improved overground walking. Objective Assess the feasibility and efficacy of daily anklebot training during early sub-acute hospitalization post-stroke. Methods Thirty-four inpatients from a stroke unit were randomly assigned to anklebot (N=18) or passive manual stretching (N=16) treatments. All suffered a first stroke with residual hemiparesis (ankle manual muscle test grade 1/5 to 4/5), and at least trace muscle activation in plantar- or dorsiflexion. Anklebot training employed an “assist-as-needed” approach during > 200 volitional targeted paretic ankle movements, with difficulty adjusted to active range of motion and success rate. Stretching included >200 daily mobilizations in these same ranges. All sessions lasted 1 hour and assessments were not blinded. Results Both groups walked faster at discharge, however the robot group improved more in percent change of temporal symmetry (p=0.032) and also of step length symmetry (p=0.038), with longer nonparetic step lengths in the robot (133%) vs. stretching (31%) groups. Paretic ankle control improved in the robot group, with increased peak (p≤ 0.001) and mean (p≤ 0.01) angular speeds, and increased movement smoothness (p≤ 0.01). There were no adverse events. Conclusion Though limited by small sample size and restricted entry criteria, our findings suggest that modular lower extremity robotics during early sub-acute hospitalization is well tolerated and improves ankle motor control and gait patterning. PMID:24515923

A Novel Robot System Integrating Biological and Mechanical Intelligence Based on Dissociated Neural Network-Controlled Closed-Loop Environment

PubMed Central

Wang, Yuechao; Li, Hongyi; Zheng, Xiongfei

2016-01-01

We propose the architecture of a novel robot system merging biological and artificial intelligence based on a neural controller connected to an external agent. We initially built a framework that connected the dissociated neural network to a mobile robot system to implement a realistic vehicle. The mobile robot system characterized by a camera and two-wheeled robot was designed to execute the target-searching task. We modified a software architecture and developed a home-made stimulation generator to build a bi-directional connection between the biological and the artificial components via simple binomial coding/decoding schemes. In this paper, we utilized a specific hierarchical dissociated neural network for the first time as the neural controller. Based on our work, neural cultures were successfully employed to control an artificial agent resulting in high performance. Surprisingly, under the tetanus stimulus training, the robot performed better and better with the increasement of training cycle because of the short-term plasticity of neural network (a kind of reinforced learning). Comparing to the work previously reported, we adopted an effective experimental proposal (i.e. increasing the training cycle) to make sure of the occurrence of the short-term plasticity, and preliminarily demonstrated that the improvement of the robot’s performance could be caused independently by the plasticity development of dissociated neural network. This new framework may provide some possible solutions for the learning abilities of intelligent robots by the engineering application of the plasticity processing of neural networks, also for the development of theoretical inspiration for the next generation neuro-prostheses on the basis of the bi-directional exchange of information within the hierarchical neural networks. PMID:27806074

Ankle passive and active movement training in children with acute brain injury using a wearable robot.

PubMed

Chen, Kai; Xiong, Bo; Ren, Yupeng; Dvorkin, Assaf Y; Gaebler-Spira, Deboah; Sisung, Charles E; Zhang, Li-Qun

2018-01-10

To evaluate the feasibility and effectiveness of a wearable robotic device in guiding isometric torque generation and passive-active movement training for ankle motor recovery in children with acute brain injury. Ten inpatient children with acute brain injury being treated in a rehabilitation hospital. Daily robot-guided ankle passive-active movement therapy for 15 sessions, including isometric torque generation under real-time feedback, stretch-ing, and active movement training with motivating games using a wearable ankle rehabilitation robot. Ankle biomechanical improvements induced by each training session including ankle range of motion (ROM), muscle strength, and clinical (Fugl-Meyer Lower-Extremity (FMLE), Pediatric Balance Scale (PBS)) and biomechanical (ankle ROM and muscle strength) outcomes over 15 training sessions. As training progressed, improvements in biomechanical performance measures followed logarithmic curves. Each training session increased median dorsiflexion active range of motion (AROM) 2.73° (standard deviation (SD) 1.14), dorsiflexion strength 0.87 Nm (SD 0.90), and plantarflexion strength 0.60 Nm (SD 1.19). After 15 training sessions the median FMLE score had increased from 14.0 (SD 10.11) to 23.0 (SD 11.4), PBS had increased from 33.0 (SD 19.99) to 50.0 (SD 23.13) (p < 0.05), median dorsiflexion and plantarflexion strength had improved from 0.21 Nm (SD 4.45) to 4.0 Nm (SD 7.63) and 8.33 Nm (SD 10.18) to 18.45 Nm (SD 14.41), respectively, median dorsiflexion AROM had improved from -10.45° (SD 12.01) to 11.87° (SD 20.69), and median dorsiflexion PROM increased from 20.0° (SD 9.04) to 25.0° (SD 8.03). Isometric torque generation with real-time feedback, stretching and active movement training helped promote neuroplasticity and improve motor performance in children with acute brain injury.

Implementation of an i.v.-compounding robot in a hospital-based cancer center pharmacy.

PubMed

Yaniv, Angela W; Knoer, Scott J

2013-11-15

The implementation of a robotic device for compounding patient-specific chemotherapy doses is described, including a review of data on the robot's performance over a 13-month period. The automated system prepares individualized i.v. chemotherapy doses in a variety of infusion bags and syringes; more than 50 drugs are validated for use in the machine. The robot is programmed to recognize the physical parameters of syringes and vials and uses photographic identification, barcode identification, and gravimetric measurements to ensure that the correct ingredients are compounded and the final dose is accurate. The implementation timeline, including site preparation, logistics planning, installation, calibration, staff training, development of a pharmacy information system (PIS) interface, and validation by the state board of pharmacy, was about 10 months. In its first 13 months of operation, the robot was used to prepare 7384 medication doses; 85 doses (1.2%) found to be outside the desired accuracy range (±4%) were manually modified by pharmacy staff. Ongoing system monitoring has identified mechanical and materials-related problems including vial-recognition failures (in many instances, these issues were resolved by the system operator and robotic compounding proceeded successfully), interface issues affecting robot-PIS communication, and human errors such as the loading of an incorrect vial or bag into the machine. Through staff training, information technology improvements, and workflow adjustments, the robot's throughput has been steadily improved. An i.v.-compounding robot was successfully implemented in a cancer center pharmacy. The robot performs compounding tasks safely and accurately and has been integrated into the pharmacy's workflow.

Reward-Modulated Hebbian Plasticity as Leverage for Partially Embodied Control in Compliant Robotics

PubMed Central

Burms, Jeroen; Caluwaerts, Ken; Dambre, Joni

2015-01-01

In embodied computation (or morphological computation), part of the complexity of motor control is offloaded to the body dynamics. We demonstrate that a simple Hebbian-like learning rule can be used to train systems with (partial) embodiment, and can be extended outside of the scope of traditional neural networks. To this end, we apply the learning rule to optimize the connection weights of recurrent neural networks with different topologies and for various tasks. We then apply this learning rule to a simulated compliant tensegrity robot by optimizing static feedback controllers that directly exploit the dynamics of the robot body. This leads to partially embodied controllers, i.e., hybrid controllers that naturally integrate the computations that are performed by the robot body into a neural network architecture. Our results demonstrate the universal applicability of reward-modulated Hebbian learning. Furthermore, they demonstrate the robustness of systems trained with the learning rule. This study strengthens our belief that compliant robots should or can be seen as computational units, instead of dumb hardware that needs a complex controller. This link between compliant robotics and neural networks is also the main reason for our search for simple universal learning rules for both neural networks and robotics. PMID:26347645

Clean Energy Solutions Center Services (Chinese Translation)

DOE Office of Scientific and Technical Information (OSTI.GOV)

2016-03-01

This is a Mandarin translation of the Clean Energy Solutions Center fact sheet. The Solutions Center offers no-cost expert policy assistance, webinars and training forums, clean energy policy reports, data, and tools provided in partnership with more than 35 leading international and regional clean energy organizations.

Clean Energy Solutions Center Services (Vietnamese Translation)

DOE Office of Scientific and Technical Information (OSTI.GOV)

2016-03-01

This is a Vietnamese translation of the Clean Energy Solutions Center fact sheet. The Solutions Center offers no-cost expert policy assistance, webinars and training forums, clean energy policy reports, data, and tools provided in partnership with more than 35 leading international and regional clean energy organizations.

Clean Energy Solutions Center Services (French Translation)

DOE Office of Scientific and Technical Information (OSTI.GOV)

This is a French translation of the Clean Energy Solutions Center fact sheet. The Solutions Center offers no-cost expert policy assistance, webinars and training forums, clean energy policy reports, data, and tools provided in partnership with more than 35 leading international and regional clean energy organizations.

Clean Energy Solutions Center Services (Arabic Translation)

DOE Office of Scientific and Technical Information (OSTI.GOV)

2016-03-01

This is an Arabic translation of the Clean Energy Solutions Center fact sheet. The Solutions Center offers no-cost expert policy assistance, webinars and training forums, clean energy policy reports, data, and tools provided in partnership with more than 35 leading international and regional clean energy organizations.

Clean Energy Solutions Center Services (Portuguese Translation)

DOE Office of Scientific and Technical Information (OSTI.GOV)

This is a Portuguese translation of the Clean Energy Solutions Center Services fact sheet. The Solutions Center offers no-cost expert policy assistance, webinars and training forums, clean energy policy reports, data, and tools provided in partnership with more than 35 leading international and regional clean energy organizations.

Self-Paced Reaching after Stroke: A Quantitative Assessment of Longitudinal and Directional Sensitivity Using the H-Man Planar Robot for Upper Limb Neurorehabilitation.

PubMed

Hussain, Asif; Budhota, Aamani; Hughes, Charmayne Mary Lee; Dailey, Wayne D; Vishwanath, Deshmukh A; Kuah, Christopher W K; Yam, Lester H L; Loh, Yong J; Xiang, Liming; Chua, Karen S G; Burdet, Etienne; Campolo, Domenico

2016-01-01

Technology aided measures offer a sensitive, accurate and time-efficient approach for the assessment of sensorimotor function after neurological insult compared to standard clinical assessments. This study investigated the sensitivity of robotic measures to capture differences in planar reaching movements as a function of neurological status (stroke, healthy), direction (front, ipsilateral, contralateral), movement segment (outbound, inbound), and time (baseline, post-training, 2-week follow-up) using a planar, two-degrees of freedom, robotic-manipulator (H-Man). Twelve chronic stroke (age: 55 ± 10.0 years, 5 female, 7 male, time since stroke: 11.2 ± 6.0 months) and nine aged-matched healthy participants (age: 53 ± 4.3 years, 5 female, 4 male) participated in this study. Both healthy and stroke participants performed planar reaching movements in contralateral, ipsilateral and front directions with the H-Man, and the robotic measures, spectral arc length (SAL), normalized time to peak velocities ( T peakN ), and root-mean square error (RMSE) were evaluated. Healthy participants went through a one-off session of assessment to investigate the baseline. Stroke participants completed a 2-week intensive robotic training plus standard arm therapy (8 × 90 min sessions). Motor function for stroke participants was evaluated prior to training (baseline, week-0), immediately following training (post-training, week-2), and 2-weeks after training (follow-up, week-4) using robotic assessment and the clinical measures Fugl-Meyer Assessment (FMA), Activity-Research-Arm Test (ARAT), and grip-strength. Robotic assessments were able to capture differences due to neurological status, movement direction, and movement segment. Movements performed by stroke participants were less-smooth, featured longer T peakN , and larger RMSE values, compared to healthy controls. Significant movement direction differences were observed, with improved reaching performance for the front, compared to ipsilateral and contralateral movement directions. There were group differences depending on movement segment. Outbound reaching movements were smoother and featured longer T peakN values than inbound movements for control participants, whereas SAL, T peakN , and RMSE values were similar regardless of movement segment for stroke patients. Significant change in performance was observed between initial and post-assessments using H-Man in stroke participants, compared to conventional scales which showed no significant difference. Results of the study indicate the potential of H-Man as a sensitive tool for tracking changes in performance compared to ordinal scales (i.e., FM, ARAT).

Robot-assisted gait training in patients with Parkinson disease: a randomized controlled trial.

PubMed

Picelli, Alessandro; Melotti, Camilla; Origano, Francesca; Waldner, Andreas; Fiaschi, Antonio; Santilli, Valter; Smania, Nicola

2012-05-01

. Gait impairment is a common cause of disability in Parkinson disease (PD). Electromechanical devices to assist stepping have been suggested as a potential intervention. . To evaluate whether a rehabilitation program of robot-assisted gait training (RAGT) is more effective than conventional physiotherapy to improve walking. . A total of 41 patients with PD were randomly assigned to 45-minute treatment sessions (12 in all), 3 days a week, for 4 consecutive weeks of either robotic stepper training (RST; n = 21) using the Gait Trainer or physiotherapy (PT; n = 20) with active joint mobilization and a modest amount of conventional gait training. Participants were evaluated before, immediately after, and 1 month after treatment. Primary outcomes were 10-m walking speed and distance walked in 6 minutes. . Baseline measures revealed no statistical differences between groups, but the PT group walked 0.12 m/s slower; 5 patients withdrew. A statistically significant improvement was found in favor of the RST group (walking speed 1.22 ± 0.19 m/s [P = .035]; distance 366.06 ± 78.54 m [P < .001]) compared with the PT group (0.98 ± 0.32 m/s; 280.11 ± 106.61 m). The RAGT mean speed increased by 0.13 m/s, which is probably not clinically important. Improvements were maintained 1 month later. . RAGT may improve aspects of walking ability in patients with PD. Future trials should compare robotic assistive training with treadmill or equal amounts of overground walking practice.

Using Functional Electrical Stimulation Mediated by Iterative Learning Control and Robotics to Improve Arm Movement for People With Multiple Sclerosis.

PubMed

Sampson, Patrica; Freeman, Chris; Coote, Susan; Demain, Sara; Feys, Peter; Meadmore, Katie; Hughes, Ann-Marie

2016-02-01

Few interventions address multiple sclerosis (MS) arm dysfunction but robotics and functional electrical stimulation (FES) appear promising. This paper investigates the feasibility of combining FES with passive robotic support during virtual reality (VR) training tasks to improve upper limb function in people with multiple sclerosis (pwMS). The system assists patients in following a specified trajectory path, employing an advanced model-based paradigm termed iterative learning control (ILC) to adjust the FES to improve accuracy and maximise voluntary effort. Reaching tasks were repeated six times with ILC learning the optimum control action from previous attempts. A convenience sample of five pwMS was recruited from local MS societies, and the intervention comprised 18 one-hour training sessions over 10 weeks. The accuracy of tracking performance without FES and the amount of FES delivered during training were analyzed using regression analysis. Clinical functioning of the arm was documented before and after treatment with standard tests. Statistically significant results following training included: improved accuracy of tracking performance both when assisted and unassisted by FES; reduction in maximum amount of FES needed to assist tracking; and less impairment in the proximal arm that was trained. The system was well tolerated by all participants with no increase in muscle fatigue reported. This study confirms the feasibility of FES combined with passive robot assistance as a potentially effective intervention to improve arm movement and control in pwMS and provides the basis for a follow-up study.

Urology residents experience comparable workload profiles when performing live porcine nephrectomies and robotic surgery virtual reality training modules.

PubMed

Mouraviev, Vladimir; Klein, Martina; Schommer, Eric; Thiel, David D; Samavedi, Srinivas; Kumar, Anup; Leveillee, Raymond J; Thomas, Raju; Pow-Sang, Julio M; Su, Li-Ming; Mui, Engy; Smith, Roger; Patel, Vipul

2016-03-01

In pursuit of improving the quality of residents' education, the Southeastern Section of the American Urological Association (SES AUA) hosts an annual robotic training course for its residents. The workshop involves performing a robotic live porcine nephrectomy as well as virtual reality robotic training modules. The aim of this study was to evaluate workload levels of urology residents when performing a live porcine nephrectomy and the virtual reality robotic surgery training modules employed during this workshop. Twenty-one residents from 14 SES AUA programs participated in 2015. On the first-day residents were taught with didactic lectures by faculty. On the second day, trainees were divided into two groups. Half were asked to perform training modules of the Mimic da Vinci-Trainer (MdVT, Mimic Technologies, Inc., Seattle, WA, USA) for 4 h, while the other half performed nephrectomy procedures on a live porcine model using the da Vinci Si robot (Intuitive Surgical Inc., Sunnyvale, CA, USA). After the first 4 h the groups changed places for another 4-h session. All trainees were asked to complete the NASA-TLX 1-page questionnaire following both the MdVT simulation and live animal model sessions. A significant interface and TLX interaction was observed. The interface by TLX interaction was further analyzed to determine whether the scores of each of the six TLX scales varied across the two interfaces. The means of the TLX scores observed at the two interfaces were similar. The only significant difference was observed for frustration, which was significantly higher at the simulation than the animal model, t (20) = 4.12, p = 0.001. This could be due to trainees' familiarity with live anatomical structures over skill set simulations which remain a real challenge to novice surgeons. Another reason might be that the simulator provides performance metrics for specific performance traits as well as composite scores for entire exercises. Novice trainees experienced substantial mental workload while performing tasks on both the simulator and the live animal model during the robotics course. The NASA-TLX profiles demonstrated that the live animal model and the MdVT were similar in difficulty, as indicated by their comparable workload profiles.

Research on Kinematic Trajectory Simulation System of KUKA Arc Welding Robot System

NASA Astrophysics Data System (ADS)

Hu, Min

2017-10-01

In this paper, the simulation trajectory simulation of KUKA arc welding robot system is realized by means of VC platform. It is used to realize the teaching of professional training of welding robot in middle school. It provides teaching resources for the combination of work and study and integration teaching, which enriches the content of course teaching.

Movement analysis of upper limb during resistance training using general purpose robot arm "PA10"

NASA Astrophysics Data System (ADS)

Morita, Yoshifumi; Yamamoto, Takashi; Suzuki, Takahiro; Hirose, Akinori; Ukai, Hiroyuki; Matsui, Nobuyuki

2005-12-01

In this paper we perform movement analysis of an upper limb during resistance training. We selected sanding training, which is one type of resistance training for upper limbs widely performed in occupational therapy. Our final aims in the future are to quantitatively evaluate the therapeutic effect of upper limb motor function during training and to develop a new rehabilitation training support system. For these purposes, first of all we perform movement analysis using a conventional training tool. By measuring upper limb motion during the sanding training we perform feature abstraction. Next we perform movement analysis using the simulated sanding training system. This system is constructed using the general purpose robot arm "PA10". This system enables us to measure the force/torque exerted by subjects and to easily change the load of resistance. The control algorithm is based on impedance control. We found these features of the upper limb motion during the sanding training.

EEG Analysis During Active and Assisted Repetitive Movements: Evidence for Differences in Neural Engagement.

PubMed

Tacchino, Giulia; Gandolla, Marta; Coelli, Stefania; Barbieri, Riccardo; Pedrocchi, Alessandra; Bianchi, Anna M

2017-06-01

Two key ingredients of a successful neuro-rehabilitative intervention have been identified as intensive and repetitive training and subject's active participation, which can be coupled in an active robot-assisted training. To exploit these two elements, we recorded electroencephalography, electromyography and kinematics signals from nine healthy subjects performing a 2×2 factorial design protocol, with subject's volitional intention and robotic glove assistance as factors. We quantitatively evaluated primary sensorimotor, premotor and supplementary motor areas activation during movement execution by computing event-related desynchronization (ERD) patterns associated to mu and beta rhythms. ERD patterns showed a similar behavior for all investigated regions: statistically significant ERDs began earlier in conditions requiring subject's volitional contribution; ERDs were prolonged towards the end of movement in conditions in which the robotic assistance was present. Our study suggests that the combination between subject volitional contribution and movement assistance provided by the robotic device (i.e., active robot-assisted modality) is able to provide early brain activation (i.e., earlier ERD) associated with stronger proprioceptive feedback (i.e., longer ERD). This finding might be particularly important for neurological patients, where movement cannot be completed autonomously and passive/active robot-assisted modalities are the only possibilities of execution.

Robotic surgery training: construct validity of Global Evaluative Assessment of Robotic Skills (GEARS).

PubMed

Sánchez, Renata; Rodríguez, Omaira; Rosciano, José; Vegas, Liumariel; Bond, Verónica; Rojas, Aram; Sanchez-Ismayel, Alexis

2016-09-01

The objective of this study is to determine the ability of the GEARS scale (Global Evaluative Assessment of Robotic Skills) to differentiate individuals with different levels of experience in robotic surgery, as a fundamental validation. This is a cross-sectional study that included three groups of individuals with different levels of experience in robotic surgery (expert, intermediate, novice) their performance were assessed by GEARS applied by two reviewers. The difference between groups was determined by Mann-Whitney test and the consistency between the reviewers was studied by Kendall W coefficient. The agreement between the reviewers of the scale GEARS was 0.96. The score was 29.8 ± 0.4 to experts, 24 ± 2.8 to intermediates and 16 ± 3 to novices, with a statistically significant difference between all of them (p < 0.05). All parameters from the scale allow discriminating between different levels of experience, with exception of the depth perception item. We conclude that the scale GEARS was able to differentiate between individuals with different levels of experience in robotic surgery and, therefore, is a validated and useful tool to evaluate surgeons in training.

Powered lower limb orthoses for gait rehabilitation

PubMed Central

Ferris, Daniel P.; Sawicki, Gregory S.; Domingo, Antoinette

2006-01-01

Bodyweight supported treadmill training has become a prominent gait rehabilitation method in leading rehabilitation centers. This type of locomotor training has many functional benefits but the labor costs are considerable. To reduce therapist effort, several groups have developed large robotic devices for assisting treadmill stepping. A complementary approach that has not been adequately explored is to use powered lower limb orthoses for locomotor training. Recent advances in robotic technology have made lightweight powered orthoses feasible and practical. An advantage to using powered orthoses as rehabilitation aids is they allow practice starting, turning, stopping, and avoiding obstacles during overground walking. PMID:16568153

Stereoscopic, Force-Feedback Trainer For Telerobot Operators

NASA Technical Reports Server (NTRS)

Kim, Won S.; Schenker, Paul S.; Bejczy, Antal K.

1994-01-01

Computer-controlled simulator for training technicians to operate remote robots provides both visual and kinesthetic virtual reality. Used during initial stage of training; saves time and expense, increases operational safety, and prevents damage to robots by inexperienced operators. Computes virtual contact forces and torques of compliant robot in real time, providing operator with feel of forces experienced by manipulator as well as view in any of three modes: single view, two split views, or stereoscopic view. From keyboard, user specifies force-reflection gain and stiffness of manipulator hand for three translational and three rotational axes. System offers two simulated telerobotic tasks: insertion of peg in hole in three dimensions, and removal and insertion of drawer.

Effect of hang cleans or squats paired with countermovement vertical jumps on vertical displacement.

PubMed

Andrews, Tedi R; Mackey, Theresa; Inkrott, Thomas A; Murray, Steven R; Clark, Ida E; Pettitt, Robert W

2011-09-01

Complex training is characterized by pairing resistance exercise with plyometric exercise to exploit the postactivation potentiation (PAP) phenomenon, thereby promising a better training effect. Studies on PAP as measured by human power performances are equivocal. One issue may be the lack of analyses across multiple sets of paired exercises, a common practice used by athletes. We evaluated countermovement vertical jump (CMJ) performance in 19 women, collegiate athletes in 3 of the following trials: (a) CMJs-only, where 1 set of CMJs served as a conditioning exercise, (b) heavy-load, back squats paired with CMJs, and (c) hang cleans paired with CMJs. The CMJ vertical displacement (3-attempt average), as measured with digital video, served as the dependent variable of CMJ performance. Across 3 sets of paired-exercise regimens, CMJ-only depreciated 1.6 cm and CMJ paired with back squats depreciated 2.0 cm (main effect, p < 0.05). Conversely, CMJ paired with hang cleans depreciated 0.30 cm (interaction, p < 0.05). Thus, the best complex training scheme was achieved by pairing CMJs with hang cleans in comparison to back squats or CMJs in and of themselves. Future research on exercise modes of complex training that best help athletes preserve and train with the highest power possible, in a given training session, is warranted.

Experiments in advanced control concepts for space robotics - An overview of the Stanford Aerospace Robotics Laboratory

NASA Technical Reports Server (NTRS)

Hollars, M. G.; Cannon, R. H., Jr.; Alexander, H. L.; Morse, D. F.

1987-01-01

The Stanford University Aerospace Robotics Laboratory is actively developing and experimentally testing advanced robot control strategies for space robotic applications. Early experiments focused on control of very lightweight one-link manipulators and other flexible structures. The results are being extended to position and force control of mini-manipulators attached to flexible manipulators and multilink manipulators with flexible drive trains. Experimental results show that end-point sensing and careful dynamic modeling or adaptive control are key to the success of these control strategies. Free-flying space robot simulators that operate on an air cushion table have been built to test control strategies in which the dynamics of the base of the robot and the payload are important.

Adaptive artificial neural network for autonomous robot control

NASA Technical Reports Server (NTRS)

Arras, Michael K.; Protzel, Peter W.; Palumbo, Daniel L.

1992-01-01

The topics are presented in viewgraph form and include: neural network controller for robot arm positioning with visual feedback; initial training of the arm; automatic recovery from cumulative fault scenarios; and error reduction by iterative fine movements.

Brain computer interface for operating a robot

NASA Astrophysics Data System (ADS)

Nisar, Humaira; Balasubramaniam, Hari Chand; Malik, Aamir Saeed

2013-10-01

A Brain-Computer Interface (BCI) is a hardware/software based system that translates the Electroencephalogram (EEG) signals produced by the brain activity to control computers and other external devices. In this paper, we will present a non-invasive BCI system that reads the EEG signals from a trained brain activity using a neuro-signal acquisition headset and translates it into computer readable form; to control the motion of a robot. The robot performs the actions that are instructed to it in real time. We have used the cognitive states like Push, Pull to control the motion of the robot. The sensitivity and specificity of the system is above 90 percent. Subjective results show a mixed trend of the difficulty level of the training activities. The quantitative EEG data analysis complements the subjective results. This technology may become very useful for the rehabilitation of disabled and elderly people.

A simple highly efficient non invasive EMG-based HMI.

PubMed

Vitiello, N; Olcese, U; Oddo, C M; Carpaneto, J; Micera, S; Carrozza, M C; Dario, P

2006-01-01

Muscle activity recorded non-invasively is sufficient to control a mobile robot if it is used in combination with an algorithm for its asynchronous analysis. In this paper, we show that several subjects successfully can control the movements of a robot in a structured environment made up of six rooms by contracting two different muscles using a simple algorithm. After a small training period, subjects were able to control the robot with performances comparable to those achieved manually controlling the robot.

Design of rehabilitation robot hand for fingers CPM training

NASA Astrophysics Data System (ADS)

Zhou, Hongfu; Chan, T. W.; Tong, K. Y.; Kwong, K. K.; Yao, Xifan

2008-10-01

This paper presents a low-cost prototype for rehabilitation robot aide patient do hands CPM (continuous passive motion) training. The design of the prototype is based on the principle of Rutgers Master II glove, but it is better in performance for more improvement made. In the design, it uses linear motors to replace pneumatic actuators to make the product more portable and mobile. It increases finger training range to 180 degree for the full range training of hand finger holding and extension. Also the prototype can not only be wearing on palm and fore arm do training for face to face with finger move together, but also be put in the opposite hand glove wear direction for hand rehabilitation training. During the research, Solidworks is used as the tool for mechanical design and movement simulation. It proved through experiment that the prototype made in the research is appropriate for hand do CPM training.

The New Jersey Institute of Technology Robot-Assisted Virtual Rehabilitation (NJIT-RAVR) system for children with cerebral palsy: a feasibility study.

PubMed

Qiu, Qinyin; Ramirez, Diego A; Saleh, Soha; Fluet, Gerard G; Parikh, Heta D; Kelly, Donna; Adamovich, Sergei V

2009-11-16

We hypothesize that the integration of virtual reality (VR) with robot assisted rehabilitation could be successful if applied to children with hemiparetic CP. The combined benefits of increased attention provided by VR and the larger training stimulus afforded by adaptive robotics may increase the beneficial effects of these two approaches synergistically. This paper will describe the NJIT-RAVR system, which combines adaptive robotics with complex VR simulations for the rehabilitation of upper extremity impairments and function in children with CP and examine the feasibility of this system in the context of a two subject training study. The NJIT-RAVR system consists of the Haptic Master, a 6 degrees of freedom, admittance controlled robot and a suite of rehabilitation simulations that provide adaptive algorithms for the Haptic Master, allowing the user to interact with rich virtual environments. Two children, a ten year old boy and a seven year old girl, both with spastic hemiplegia secondary to Cerebral Palsy were recruited from the outpatient center of a comprehensive pediatric rehabilitation facility. Subjects performed a battery of clinical testing and kinematic measurements of reaching collected by the NJIT-RAVR system. Subjects trained with the NJIT-RAVR System for one hour, 3 days a week for three weeks. The subjects played a combination of four or five simulations depending on their therapeutic goals, tolerances and preferences. Games were modified to increase difficulty in order to challenge the subjects as their performance improved. The testing battery was repeated following the training period. Both participants completed 9 hours of training in 3 weeks. No untoward events occurred and no adverse responses to treatment or complaints of cyber sickness were reported. One participant showed improvements in overall performance on the functional aspects of the testing battery. The second subject made improvements in upper extremity active range of motion and in kinematic measures of reaching movements. We feel that this study establishes the feasibility of integrating robotics and rich virtual environments to address functional limitations and decreased motor performance in children with mild to moderate cerebral palsy.

A Single-Session Preliminary Evaluation of an Affordable BCI-Controlled Arm Exoskeleton and Motor-Proprioception Platform.

PubMed

Elnady, Ahmed Mohamed; Zhang, Xin; Xiao, Zhen Gang; Yong, Xinyi; Randhawa, Bubblepreet Kaur; Boyd, Lara; Menon, Carlo

2015-01-01

Traditional, hospital-based stroke rehabilitation can be labor-intensive and expensive. Furthermore, outcomes from rehabilitation are inconsistent across individuals and recovery is hard to predict. Given these uncertainties, numerous technological approaches have been tested in an effort to improve rehabilitation outcomes and reduce the cost of stroke rehabilitation. These techniques include brain-computer interface (BCI), robotic exoskeletons, functional electrical stimulation (FES), and proprioceptive feedback. However, to the best of our knowledge, no studies have combined all these approaches into a rehabilitation platform that facilitates goal-directed motor movements. Therefore, in this paper, we combined all these technologies to test the feasibility of using a BCI-driven exoskeleton with FES (robotic training device) to facilitate motor task completion among individuals with stroke. The robotic training device operated to assist a pre-defined goal-directed motor task. Because it is hard to predict who can utilize this type of technology, we considered whether the ability to adapt skilled movements with proprioceptive feedback would predict who could learn to control a BCI-driven robotic device. To accomplish this aim, we developed a motor task that requires proprioception for completion to assess motor-proprioception ability. Next, we tested the feasibility of robotic training system in individuals with chronic stroke (n = 9) and found that the training device was well tolerated by all the participants. Ability on the motor-proprioception task did not predict the time to completion of the BCI-driven task. Both participants who could accurately target (n = 6) and those who could not (n = 3), were able to learn to control the BCI device, with each BCI trial lasting on average 2.47 min. Our results showed that the participants' ability to use proprioception to control motor output did not affect their ability to use the BCI-driven exoskeleton with FES. Based on our preliminary results, we show that our robotic training device has potential for use as therapy for a broad range of individuals with stroke.

A Single-Session Preliminary Evaluation of an Affordable BCI-Controlled Arm Exoskeleton and Motor-Proprioception Platform

PubMed Central

Elnady, Ahmed Mohamed; Zhang, Xin; Xiao, Zhen Gang; Yong, Xinyi; Randhawa, Bubblepreet Kaur; Boyd, Lara; Menon, Carlo

2015-01-01

Traditional, hospital-based stroke rehabilitation can be labor-intensive and expensive. Furthermore, outcomes from rehabilitation are inconsistent across individuals and recovery is hard to predict. Given these uncertainties, numerous technological approaches have been tested in an effort to improve rehabilitation outcomes and reduce the cost of stroke rehabilitation. These techniques include brain–computer interface (BCI), robotic exoskeletons, functional electrical stimulation (FES), and proprioceptive feedback. However, to the best of our knowledge, no studies have combined all these approaches into a rehabilitation platform that facilitates goal-directed motor movements. Therefore, in this paper, we combined all these technologies to test the feasibility of using a BCI-driven exoskeleton with FES (robotic training device) to facilitate motor task completion among individuals with stroke. The robotic training device operated to assist a pre-defined goal-directed motor task. Because it is hard to predict who can utilize this type of technology, we considered whether the ability to adapt skilled movements with proprioceptive feedback would predict who could learn to control a BCI-driven robotic device. To accomplish this aim, we developed a motor task that requires proprioception for completion to assess motor-proprioception ability. Next, we tested the feasibility of robotic training system in individuals with chronic stroke (n = 9) and found that the training device was well tolerated by all the participants. Ability on the motor-proprioception task did not predict the time to completion of the BCI-driven task. Both participants who could accurately target (n = 6) and those who could not (n = 3), were able to learn to control the BCI device, with each BCI trial lasting on average 2.47 min. Our results showed that the participants’ ability to use proprioception to control motor output did not affect their ability to use the BCI-driven exoskeleton with FES. Based on our preliminary results, we show that our robotic training device has potential for use as therapy for a broad range of individuals with stroke. PMID:25870554

Deep Learning Methods for Quantifying Invasive Benthic Species in the Great Lakes

NASA Astrophysics Data System (ADS)

Billings, G.; Skinner, K.; Johnson-Roberson, M.

2017-12-01

In recent decades, invasive species such as the round goby and dreissenid mussels have greatly impacted the Great Lakes ecosystem. It is critical to monitor these species, model their distribution, and quantify the impacts on the native fisheries and surrounding ecosystem in order to develop an effective management response. However, data collection in underwater environments is challenging and expensive. Furthermore, the round goby is typically found in rocky habitats, which are inaccessible to standard survey techniques such as bottom trawling. In this work we propose a robotic system for visual data collection to automatically detect and quantify invasive round gobies and mussels in the Great Lakes. Robotic platforms equipped with cameras can perform efficient, cost-effective, low-bias benthic surveys. This data collection can be further optimized through automatic detection and annotation of the target species. Deep learning methods have shown success in image recognition tasks. However, these methods often rely on a labelled training dataset, with up to millions of labelled images. Hand labeling large numbers of images is expensive and often impracticable. Furthermore, data collected in the field may be sparse when only considering images that contain the objects of interest. It is easier to collect dense, clean data in controlled lab settings, but this data is not a realistic representation of real field environments. In this work, we propose a deep learning approach to generate a large set of labelled training data realistic of underwater environments in the field. To generate these images, first we draw random sample images of individual fish and mussels from a library of images captured in a controlled lab environment. Next, these randomly drawn samples will be automatically merged into natural background images. Finally, we will use a generative adversarial network (GAN) that incorporates constraints of the physical model of underwater light propagation to simulate the process of underwater image formation in various water conditions. The output of the GAN will be realistic looking annotated underwater images. This generated dataset of images will be used to train a classifier to identify round gobies and mussels in order to measure the biomass and abundance of these invasive species in the Great Lakes.

A new training model for robot-assisted urethrovesical anastomosis and posterior muscle-fascial reconstruction: the Verona training technique.

PubMed

Cacciamani, G; De Marco, V; Siracusano, S; De Marchi, D; Bizzotto, L; Cerruto, M A; Motton, G; Porcaro, A B; Artibani, W

2017-06-01

A training model is usually needed to teach robotic surgical technique successfully. In this way, an ideal training model should mimic as much as possible the "in vivo" procedure and allow several consecutive surgical simulations. The goal of this study was to create a "wet lab" model suitable for RARP training programs, providing the simulation of the posterior fascial reconstruction. The second aim was to compare the original "Venezuelan" chicken model described by Sotelo to our training model. Our training model consists of performing an anastomosis, reproducing the surgical procedure in "vivo" as in RARP, between proventriculus and the proximal portion of the esophagus. A posterior fascial reconstruction simulating Rocco's stitch is performed between the tissues located under the posterior surface of the esophagus and the tissue represented by the serosa of the proventriculus. From 2014 to 2015, during 6 different full-immersion training courses, thirty-four surgeons performed the urethrovesical anastomosis using our model and the Sotelo's one. After the training period, each surgeon was asked to fill out a non-validated questionnaire to perform an evaluation of the differences between the two training models. Our model was judged the best model, in terms of similarity with urethral tissue and similarity with the anatomic unit urethra-pelvic wall. Our training model as reported by all trainees is easily reproducible and anatomically comparable with the urethrovesical anastomosis as performed during radical prostatectomy in humans. It is suitable for performing posterior fascial reconstruction reported by Rocco. In this context, our surgical training model could be routinely proposed in all robotic training courses to develop specific expertise in urethrovesical anastomosis with the reproducibility of the Rocco stitch.

Robots integrated with virtual reality simulations for customized motor training in a person with upper extremity hemiparesis: a case report

PubMed Central

Fluet, Gerard G.; Merians, Alma S.; Qiu, Qinyin; Lafond, Ian; Saleh, Soha; Ruano, Viviana; Delmonico, Andrea R.; Adamovich, Sergei V.

2014-01-01

Background and Purpose A majority of studies examining repetitive task practice facilitated by robots for the treatment of upper extremity paresis utilize standardized protocols applied to large groups. Others utilize interventions tailored to patients but don't describe the clinical decision making process utilized to develop and modify interventions. This case report will describe a robot-based intervention customized to match the goals and clinical presentation of a gentleman with upper extremity hemiparesis secondary to stroke. Methods PM is an 85 year-old man with left hemiparesis secondary to an intracerebral hemorrhage five years prior to examination. Outcomes were measured before and after a one month period of home therapy and after a one month robotic intervention. The intervention was designed to address specific impairments identified during his PT examination. When necessary, activities were modified based on the patient's response to his first week of treatment. Outcomes PM trained twelve sessions using six virtually simulated activities. Modifications to original configurations of these activities resulted in performance improvements in five of these activities. PM demonstrated a 35 second improvement in Jebsen Test of Hand Function time and a 44 second improvement in Wolf Motor Function Test time subsequent to the robotic training intervention. Reaching kinematics, 24 hour activity measurement and the Hand and Activities of Daily Living scales of the Stroke Impact Scale all improved as well. Discussion A customized program of robotically facilitated rehabilitation resulted in large short-term improvements in several measurements of upper extremity function in a patient with chronic hemiparesis. PMID:22592063

Effect of visual distraction and auditory feedback on patient effort during robot-assisted movement training after stroke

PubMed Central

2011-01-01

Background Practicing arm and gait movements with robotic assistance after neurologic injury can help patients improve their movement ability, but patients sometimes reduce their effort during training in response to the assistance. Reduced effort has been hypothesized to diminish clinical outcomes of robotic training. To better understand patient slacking, we studied the role of visual distraction and auditory feedback in modulating patient effort during a common robot-assisted tracking task. Methods Fourteen participants with chronic left hemiparesis from stroke, five control participants with chronic right hemiparesis and fourteen non-impaired healthy control participants, tracked a visual target with their arms while receiving adaptive assistance from a robotic arm exoskeleton. We compared four practice conditions: the baseline tracking task alone; tracking while also performing a visual distracter task; tracking with the visual distracter and sound feedback; and tracking with sound feedback. For the distracter task, symbols were randomly displayed in the corners of the computer screen, and the participants were instructed to click a mouse button when a target symbol appeared. The sound feedback consisted of a repeating beep, with the frequency of repetition made to increase with increasing tracking error. Results Participants with stroke halved their effort and doubled their tracking error when performing the visual distracter task with their left hemiparetic arm. With sound feedback, however, these participants increased their effort and decreased their tracking error close to their baseline levels, while also performing the distracter task successfully. These effects were significantly smaller for the participants who used their non-paretic arm and for the participants without stroke. Conclusions Visual distraction decreased participants effort during a standard robot-assisted movement training task. This effect was greater for the hemiparetic arm, suggesting that the increased demands associated with controlling an affected arm make the motor system more prone to slack when distracted. Providing an alternate sensory channel for feedback, i.e., auditory feedback of tracking error, enabled the participants to simultaneously perform the tracking task and distracter task effectively. Thus, incorporating real-time auditory feedback of performance errors might improve clinical outcomes of robotic therapy systems. PMID:21513561

Plasticity and alterations of trunk motor cortex following spinal cord injury and non-stepping robot and treadmill training.

PubMed

Oza, Chintan S; Giszter, Simon F

2014-06-01

Spinal cord injury (SCI) induces significant reorganization in the sensorimotor cortex. Trunk motor control is crucial for postural stability and propulsion after low thoracic SCI and several rehabilitative strategies are aimed at trunk stability and control. However little is known about the effect of SCI and rehabilitation training on trunk motor representations and their plasticity in the cortex. Here, we used intracortical microstimulation to examine the motor cortex representations of the trunk in relation to other representations in three groups of chronic adult complete low thoracic SCI rats: chronic untrained, treadmill trained (but 'non-stepping') and robot assisted treadmill trained (but 'non-stepping') and compared with a group of normal rats. Our results demonstrate extensive and significant reorganization of the trunk motor cortex after chronic adult SCI which includes (1) expansion and rostral displacement of trunk motor representations in the cortex, with the greatest significant increase observed for rostral (to injury) trunk, and slight but significant increase of motor representation for caudal (to injury) trunk at low thoracic levels in all spinalized rats; (2) significant changes in coactivation and the synergy representation (or map overlap) between different trunk muscles and between trunk and forelimb. No significant differences were observed between the groups of transected rats for the majority of the comparisons. However, (3) the treadmill and robot-treadmill trained groups of rats showed a further small but significant rostral migration of the trunk representations, beyond the shift caused by transection alone. We conclude that SCI induces a significant reorganization of the trunk motor cortex, which is not qualitatively altered by non-stepping treadmill training or non-stepping robot assisted treadmill training, but is shifted further from normal topography by the training. This shift may potentially make subsequent rehabilitation with stepping longer or less successful. Copyright © 2014 Elsevier Inc. All rights reserved.

Augmenting Naval Capabilities in Remote Locations

DTIC Science & Technology

2009-12-01

suggested that the Navy adopt a different style of war fighting and that the Navy consider tailoring its forces by region and mission. Based on these...Vessel Return To Ship End 1 2 3 4 5 6 7 8 33 Figure 14. Future State Maps. From a Lean Six Sigma perspective, the project team was trained ...systems development and the training and support services robotics companies offer. In many cases, robotics firms and the customer sign up for modular

Functional inactivation of the rat hippocampus disrupts avoidance of a moving object.

PubMed

Telensky, Petr; Svoboda, Jan; Blahna, Karel; Bureš, Jan; Kubik, Stepan; Stuchlik, Ales

2011-03-29

The hippocampus is well known for its critical involvement in spatial memory and information processing. In this study, we examined the effect of bilateral hippocampal inactivation with tetrodotoxin (TTX) in an "enemy avoidance" task. In this paradigm, a rat foraging on a circular platform (82 cm diameter) is trained to avoid a moving robot in 20-min sessions. Whenever the rat is located within 25 cm of the robot's center, it receives a mild electrical foot shock, which may be repeated until the subject makes an escape response to a safe distance. Seventeen young male Long-Evans rats were implanted with cannulae aimed at the dorsal hippocampus 14 d before the start of the training. After 6 d of training, each rat received a bilateral intrahippocampal infusion of TTX (5 ng in 1 μL) 40 min before the training session on day 7. The inactivation severely impaired avoidance of a moving robot (n = 8). No deficit was observed in a different group of rats (n = 9) that avoided a stable robot that was only displaced once in the middle of the session, showing that the impairment was not due to a deficit in distance estimation, object-reinforcement association, or shock sensitivity. This finding suggests a specific role of the hippocampus in dynamic cognitive processes required for flexible navigation strategies such as continuous updating of information about the position of a moving stimulus.

Update on laparoscopic, robotic, and minimally invasive vaginal surgery for pelvic floor repair.

PubMed

Ross, J W; Preston, M R

2009-06-01

Advanced laparoscopic surgery marked the beginning of minimally invasive pelvic surgery. This technique lead to the development of laparoscopic hysterectomy, colposuspension, paravaginal repair, uterosacral suspension, and sacrocolpopexy without an abdominal incision. With laparoscopy there is a significant decrease in postoperative pain, shorter length of hospital stay, and a faster return to normal activities. These advantages made laparoscopy very appealing to patients. Advanced laparoscopy requires a special set of surgical skills and in the early phase of development training was not readily available. Advanced laparoscopy was developed by practicing physicians, instead of coming down through the more usual academic channels. The need for special training did hinder widespread acceptance. Nonetheless by physician to physician training and society training courses it has continued to grow and now has been incorporated in most medical school curriculums. In the last few years there has been new interest in laparoscopy because of the development of robotic assistance. The 3D vision and 720 degree articulating arms with robotics have made suture intensive procedures much easier. Laparosco-pic robotic-assisted sacrocolpopexy is in the reach of most surgeons. This field is so new that there is very little data to evaluate at this time. There are short comings with laparoscopy and even with robotic-assisted procedures it is not the cure all for pelvic floor surgery. Laparoscopic procedures are long and many patients requiring pelvic floor surgery have medical conditions preventing long anesthesia. Minimally invasive vaginal surgery has developed from the concept of tissue replacement by synthetic mesh. Initially sheets of synthetic mesh were tailored by physicians to repair the anterior and posterior vaginal compartment. The use of mesh by general surgeons for hernia repair has served as a model for urogynecology. There have been rapid improvements in biomaterials and specialized kits have been developed by industry. The purpose of this article is to present an update in urogynecologic laparoscopy, robotic surgery, and minimally invasive vaginal surgery.

Locomotion training of legged robots using hybrid machine learning techniques

NASA Technical Reports Server (NTRS)

Simon, William E.; Doerschuk, Peggy I.; Zhang, Wen-Ran; Li, Andrew L.

1995-01-01

In this study artificial neural networks and fuzzy logic are used to control the jumping behavior of a three-link uniped robot. The biped locomotion control problem is an increment of the uniped locomotion control. Study of legged locomotion dynamics indicates that a hierarchical controller is required to control the behavior of a legged robot. A structured control strategy is suggested which includes navigator, motion planner, biped coordinator and uniped controllers. A three-link uniped robot simulation is developed to be used as the plant. Neurocontrollers were trained both online and offline. In the case of on-line training, a reinforcement learning technique was used to train the neurocontroller to make the robot jump to a specified height. After several hundred iterations of training, the plant output achieved an accuracy of 7.4%. However, when jump distance and body angular momentum were also included in the control objectives, training time became impractically long. In the case of off-line training, a three-layered backpropagation (BP) network was first used with three inputs, three outputs and 15 to 40 hidden nodes. Pre-generated data were presented to the network with a learning rate as low as 0.003 in order to reach convergence. The low learning rate required for convergence resulted in a very slow training process which took weeks to learn 460 examples. After training, performance of the neurocontroller was rather poor. Consequently, the BP network was replaced by a Cerebeller Model Articulation Controller (CMAC) network. Subsequent experiments described in this document show that the CMAC network is more suitable to the solution of uniped locomotion control problems in terms of both learning efficiency and performance. A new approach is introduced in this report, viz., a self-organizing multiagent cerebeller model for fuzzy-neural control of uniped locomotion is suggested to improve training efficiency. This is currently being evaluated for a possible patent by NASA, Johnson Space Center. An alternative modular approach is also developed which uses separate controllers for each stage of the running stride. A self-organizing fuzzy-neural controller controls the height, distance and angular momentum of the stride. A CMAC-based controller controls the movement of the leg from the time the foot leaves the ground to the time of landing. Because the leg joints are controlled at each time step during flight, movement is smooth and obstacles can be avoided. Initial results indicate that this approach can yield fast, accurate results.

Virtual reality robotic surgical simulation: an analysis of gynecology trainees.

PubMed

Sheth, Sangini S; Fader, Amanda N; Tergas, Ana I; Kushnir, Christina L; Green, Isabel C

2014-01-01

To analyze the learning curves of gynecology trainees on several virtual reality da Vinci Skills Simulator exercises. Prospective cohort pilot study. Academic hospital-based gynecology training program. Novice robotic surgeons from a gynecology training program. Novice robotic surgeons from an academic gynecology training program completed 10 repetitions of 4 exercises on the da Vinci Skills Simulator: matchboard, ring and rail, suture sponge, and energy switching. Performance metrics measured included time to completion, economy of instrument movement, excessive force, collisions, master workspace range, missed targets, misapplied energy, critical errors, and overall score. Statistical analyses were conducted to define the learning curve for trainees and the optimal number of repetitions for each exercise. A total of 34 participants were enrolled, of which 9 were medical students, 22 were residents, and 3 were fellows. There was a significant improvement in performance between the 1st and 10th repetitions across multiple metrics for all exercises. Senior trainees performed the suture exercise significantly faster than the junior trainees during the first and last repetitions (p = 0.004 and p = 0.003, respectively). However, the performance gap between seniors and juniors narrowed significantly by the 10th repetition. The mean number of repetitions required to achieve performance plateau ranged from 6.4 to 9.3. Virtual reality robotic simulation improves ability through repetition at all levels of training. Further, a performance plateau may exist during a single training session. Larger studies are needed to further define the most high-yield simulator exercises, the ideal number of repetitions, and recommended intervals between training sessions to improve operative performance. Copyright © 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Robot-assisted training of the kinesthetic sense: enhancing proprioception after stroke.

PubMed

De Santis, Dalia; Zenzeri, Jacopo; Casadio, Maura; Masia, Lorenzo; Riva, Assunta; Morasso, Pietro; Squeri, Valentina

2014-01-01

Proprioception has a crucial role in promoting or hindering motor learning. In particular, an intact position sense strongly correlates with the chances of recovery after stroke. A great majority of neurological patients present both motor dysfunctions and impairments in kinesthesia, but traditional robot and virtual reality training techniques focus either in recovering motor functions or in assessing proprioceptive deficits. An open challenge is to implement effective and reliable tests and training protocols for proprioception that go beyond the mere position sense evaluation and exploit the intrinsic bidirectionality of the kinesthetic sense, which refers to both sense of position and sense of movement. Modulated haptic interaction has a leading role in promoting sensorimotor integration, and it is a natural way to enhance volitional effort. Therefore, we designed a preliminary clinical study to test a new proprioception-based motor training technique for augmenting kinesthetic awareness via haptic feedback. The feedback was provided by a robotic manipulandum and the test involved seven chronic hemiparetic subjects over 3 weeks. The protocol included evaluation sessions that consisted of a psychometric estimate of the subject's kinesthetic sensation, and training sessions, in which the subject executed planar reaching movements in the absence of vision and under a minimally assistive haptic guidance made by sequences of graded force pulses. The bidirectional haptic interaction between the subject and the robot was optimally adapted to each participant in order to achieve a uniform task difficulty over the workspace. All the subjects consistently improved in the perceptual scores as a consequence of training. Moreover, they could minimize the level of haptic guidance in time. Results suggest that the proposed method is effective in enhancing kinesthetic acuity, but the level of impairment may affect the ability of subjects to retain their improvement in time.

Robot-Assisted Training of the Kinesthetic Sense: Enhancing Proprioception after Stroke

PubMed Central

De Santis, Dalia; Zenzeri, Jacopo; Casadio, Maura; Masia, Lorenzo; Riva, Assunta; Morasso, Pietro; Squeri, Valentina

2015-01-01

Proprioception has a crucial role in promoting or hindering motor learning. In particular, an intact position sense strongly correlates with the chances of recovery after stroke. A great majority of neurological patients present both motor dysfunctions and impairments in kinesthesia, but traditional robot and virtual reality training techniques focus either in recovering motor functions or in assessing proprioceptive deficits. An open challenge is to implement effective and reliable tests and training protocols for proprioception that go beyond the mere position sense evaluation and exploit the intrinsic bidirectionality of the kinesthetic sense, which refers to both sense of position and sense of movement. Modulated haptic interaction has a leading role in promoting sensorimotor integration, and it is a natural way to enhance volitional effort. Therefore, we designed a preliminary clinical study to test a new proprioception-based motor training technique for augmenting kinesthetic awareness via haptic feedback. The feedback was provided by a robotic manipulandum and the test involved seven chronic hemiparetic subjects over 3 weeks. The protocol included evaluation sessions that consisted of a psychometric estimate of the subject’s kinesthetic sensation, and training sessions, in which the subject executed planar reaching movements in the absence of vision and under a minimally assistive haptic guidance made by sequences of graded force pulses. The bidirectional haptic interaction between the subject and the robot was optimally adapted to each participant in order to achieve a uniform task difficulty over the workspace. All the subjects consistently improved in the perceptual scores as a consequence of training. Moreover, they could minimize the level of haptic guidance in time. Results suggest that the proposed method is effective in enhancing kinesthetic acuity, but the level of impairment may affect the ability of subjects to retain their improvement in time. PMID:25601833

A Murine Model of Robotic Training to Evaluate Skeletal Muscle Recovery after Injury.

PubMed

Lai, Stefano; Panarese, Alessandro; Lawrence, Ross; Boninger, Michael L; Micera, Silvestro; Ambrosio, Fabrisia

2017-04-01

In vivo studies have suggested that motor exercise can improve muscle regeneration after injury. Nevertheless, preclinical investigations still lack reliable tools to monitor motor performance over time and to deliver optimal training protocols to maximize force recovery. Here, we evaluated the utility of a murine robotic platform (i) to detect early impairment and longitudinal recovery after acute skeletal muscle injury and (ii) to administer varying intensity training protocols to enhance forelimb motor performance. A custom-designed robotic platform was used to train mice to perform a forelimb retraction task. After an acute injury to bilateral biceps brachii muscles, animals performed a daily training protocol in the platform at high (HL) or low (LL) loading levels over the course of 3 wk. Control animals were not trained (NT). Motor performance was assessed by quantifying force, time, submovement count, and number of movement attempts to accomplish the task. Myofiber number and cross-sectional area at the injury site were quantified histologically. Two days after injury, significant differences in the time, submovement count, number of movement attempts, and exerted force were observed in all mice, as compared with baseline values. Interestingly, the recovery time of muscle force production differed significantly between intervention groups, with HL group showing a significantly accelerated recovery. Three weeks after injury, all groups showed motor performance comparable with baseline values. Accordingly, there were no differences in the number of myofibers or average cross-sectional area among groups after 3 wk. Our findings demonstrate the utility of our custom-designed robotic device for the quantitative assessment of skeletal muscle function in preclinical murine studies. Moreover, we demonstrate that this device may be used to apply varying levels of resistance longitudinally as a means manipulate physiological muscle responses.

A brain-controlled lower-limb exoskeleton for human gait training.

PubMed

Liu, Dong; Chen, Weihai; Pei, Zhongcai; Wang, Jianhua

2017-10-01

Brain-computer interfaces have been a novel approach to translate human intentions into movement commands in robotic systems. This paper describes an electroencephalogram-based brain-controlled lower-limb exoskeleton for gait training, as a proof of concept towards rehabilitation with human-in-the-loop. Instead of using conventional single electroencephalography correlates, e.g., evoked P300 or spontaneous motor imagery, we propose a novel framework integrated two asynchronous signal modalities, i.e., sensorimotor rhythms (SMRs) and movement-related cortical potentials (MRCPs). We executed experiments in a biologically inspired and customized lower-limb exoskeleton where subjects (N = 6) actively controlled the robot using their brain signals. Each subject performed three consecutive sessions composed of offline training, online visual feedback testing, and online robot-control recordings. Post hoc evaluations were conducted including mental workload assessment, feature analysis, and statistics test. An average robot-control accuracy of 80.16% ± 5.44% was obtained with the SMR-based method, while estimation using the MRCP-based method yielded an average performance of 68.62% ± 8.55%. The experimental results showed the feasibility of the proposed framework with all subjects successfully controlled the exoskeleton. The current paradigm could be further extended to paraplegic patients in clinical trials.

A brain-controlled lower-limb exoskeleton for human gait training

NASA Astrophysics Data System (ADS)

Liu, Dong; Chen, Weihai; Pei, Zhongcai; Wang, Jianhua

2017-10-01

Brain-computer interfaces have been a novel approach to translate human intentions into movement commands in robotic systems. This paper describes an electroencephalogram-based brain-controlled lower-limb exoskeleton for gait training, as a proof of concept towards rehabilitation with human-in-the-loop. Instead of using conventional single electroencephalography correlates, e.g., evoked P300 or spontaneous motor imagery, we propose a novel framework integrated two asynchronous signal modalities, i.e., sensorimotor rhythms (SMRs) and movement-related cortical potentials (MRCPs). We executed experiments in a biologically inspired and customized lower-limb exoskeleton where subjects (N = 6) actively controlled the robot using their brain signals. Each subject performed three consecutive sessions composed of offline training, online visual feedback testing, and online robot-control recordings. Post hoc evaluations were conducted including mental workload assessment, feature analysis, and statistics test. An average robot-control accuracy of 80.16% ± 5.44% was obtained with the SMR-based method, while estimation using the MRCP-based method yielded an average performance of 68.62% ± 8.55%. The experimental results showed the feasibility of the proposed framework with all subjects successfully controlled the exoskeleton. The current paradigm could be further extended to paraplegic patients in clinical trials.

Brain network involved in visual processing of movement stimuli used in upper limb robotic training: an fMRI study.

PubMed

Nocchi, Federico; Gazzellini, Simone; Grisolia, Carmela; Petrarca, Maurizio; Cannatà, Vittorio; Cappa, Paolo; D'Alessio, Tommaso; Castelli, Enrico

2012-07-24

The potential of robot-mediated therapy and virtual reality in neurorehabilitation is becoming of increasing importance. However, there is limited information, using neuroimaging, on the neural networks involved in training with these technologies. This study was intended to detect the brain network involved in the visual processing of movement during robotic training. The main aim was to investigate the existence of a common cerebral network able to assimilate biological (human upper limb) and non-biological (abstract object) movements, hence testing the suitability of the visual non-biological feedback provided by the InMotion2 Robot. A visual functional Magnetic Resonance Imaging (fMRI) task was administered to 22 healthy subjects. The task required observation and retrieval of motor gestures and of the visual feedback used in robotic training. Functional activations of both biological and non-biological movements were examined to identify areas activated in both conditions, along with differential activity in upper limb vs. abstract object trials. Control of response was also tested by administering trials with congruent and incongruent reaching movements. The observation of upper limb and abstract object movements elicited similar patterns of activations according to a caudo-rostral pathway for the visual processing of movements (including specific areas of the occipital, temporal, parietal, and frontal lobes). Similarly, overlapping activations were found for the subsequent retrieval of the observed movement. Furthermore, activations of frontal cortical areas were associated with congruent trials more than with the incongruent ones. This study identified the neural pathway associated with visual processing of movement stimuli used in upper limb robot-mediated training and investigated the brain's ability to assimilate abstract object movements with human motor gestures. In both conditions, activations were elicited in cerebral areas involved in visual perception, sensory integration, recognition of movement, re-mapping on the somatosensory and motor cortex, storage in memory, and response control. Results from the congruent vs. incongruent trials revealed greater activity for the former condition than the latter in a network including cingulate cortex, right inferior and middle frontal gyrus that are involved in the go-signal and in decision control. Results on healthy subjects would suggest the appropriateness of an abstract visual feedback provided during motor training. The task contributes to highlight the potential of fMRI in improving the understanding of visual motor processes and may also be useful in detecting brain reorganisation during training.

Robot-mediated Imitation Skill Training for Children with Autism

PubMed Central

Zheng, Zhi; Young, Eric M.; Swanson, Amy R.; Weitlauf, Amy S.; Warren, Zachary E.; Sarkar, Nilanjan

2016-01-01

Autism spectrum disorder (ASD) impacts 1 in 68 children in the US, with tremendous individual and societal costs. Technology-aided intervention, more specifically robotic intervention, has gained momentum in recent years due to the inherent affinity of many children with ASD towards technology. In this paper we present a novel robot-mediated intervention system for imitation skill learning, which is considered a core deficit area for children with ASD. The Robot-mediated Imitation Skill Training Architecture (RISTA) is designed in such a manner that it can operate either completely autonomously or in coordination with a human therapist depending on the intervention need. Experimental results are presented from small user studies validating system functionality, assessing user tolerance, and documenting subject performance. Preliminary results show that this novel robotic system draws more attention from the children with ASD and teaches gestures more effectively as compared to a human therapist. While no broad generalized conclusions can be made about the effectiveness of RISTA based on our small user studies, initial results are encouraging and justify further exploration in the future. PMID:26353376

Mentoring console improves collaboration and teaching in surgical robotics.

PubMed

Hanly, Eric J; Miller, Brian E; Kumar, Rajesh; Hasser, Christopher J; Coste-Maniere, Eve; Talamini, Mark A; Aurora, Alexander A; Schenkman, Noah S; Marohn, Michael R

2006-10-01

One of the most significant limitations of surgical robots has been their inability to allow multiple surgeons and surgeons-in-training to engage in collaborative control of robotic surgical instruments. We report the initial experience with a novel two-headed da Vinci surgical robot that has two collaborative modes: the "swap" mode allows two surgeons to simultaneously operate and actively swap control of the robot's four arms, and the "nudge" mode allows them to share control of two of the robot's arms. The utility of the mentoring console operating in its two collaborative modes was evaluated through a combination of dry laboratory exercises and animal laboratory surgery. The results from surgeon-resident collaborative performance of complex three-handed surgical tasks were compared to results from single-surgeon and single-resident performance. Statistical significance was determined using Student's t-test. Collaborative surgeon-resident swap control reduced the time to completion of complex three-handed surgical tasks by 25% compared to single-surgeon operation of a four-armed da Vinci (P < 0.01) and by 34% compared to single-resident operation (P < 0.001). While swap mode was found to be most helpful during parts of surgical procedures that require multiple hands (such as isolation and division of vessels), nudge mode was particularly useful for guiding a resident's hands during crucially precise steps of an operation (such as proper placement of stitches). The da Vinci mentoring console greatly facilitates surgeon collaboration during robotic surgery and improves the performance of complex surgical tasks. The mentoring console has the potential to improve resident participation in surgical robotics cases, enhance resident education in surgical training programs engaged in surgical robotics, and improve patient safety during robotic surgery.

Robotic surgery of the liver: Italian experience and review of the literature

PubMed Central

Reggiani, P; Antonelli, B; Rossi, G

2013-01-01

Robotic liver resection is a new promising minimally invasive surgical technique not yet validated by level I evidence. During recent years, the application of the laparoscopic approach to liver resection has grown less than other abdominal specialties due to the intrinsic limitations of laparoscopic instruments. Robotics can overcome these limitations above all for complex operations. A review of the literature on major hepatic surgery was conducted on PubMed using selected keywords. Two hundred and thirty-five patients in 17 series were analysed and outcomes such as operative time, estimated blood loss, length of hospital stay, complications, conversion rate, and costs were described. The most commonly performed procedures were wedge resection and segmentectomy, but the predominance of major hepatectomies performed with robotic surgery is likely due to the superior control achieved by the robotic system. The conversion and complication rates were 4.2% and 13.4%, respectively. Intracavitary fluid collections and bile leaks were the most frequently occurring morbidities. The mean operation time was 285 min. The mean intraoperative blood loss was 50–280 mL. The mean postoperative hospital stay was four to seven days. Overall survival and long-term outcomes were not reported. Robotic liver surgery in Italy has become a clinical reality that is gaining increasing acceptance; a survey was carried out on robotic surgery, which showed that it is perceived as a significant advantage for operators and a consistent gain for the patient. More than 100 robotic hepatic resections have been performed in Italy where important robotic training schools are active. Robotic liver surgery is feasible and safe in trained and experienced hands. Further evaluation is required to assess the improvement in outcomes and long-term oncologic follow-up. PMID:24174991

Medical Engineering and Microneurosurgery: Application and Future.

PubMed

Morita, Akio; Sora, Shigeo; Nakatomi, Hirofumi; Harada, Kanako; Sugita, Naohiko; Saito, Nobuhito; Mitsuishi, Mamoru

2016-10-15

Robotics and medical engineering can convert traditional surgery into digital and scientific procedures. Here, we describe our work to develop microsurgical robotic systems and apply engineering technology to assess microsurgical skills. With the collaboration of neurosurgeons and an engineering team, we have developed two types of microsurgical robotic systems. The first, the deep surgical systems, enable delicate surgical procedures such as vessel suturing in a deep and narrow space. The second type allows for super-fine surgical procedures such as anastomosing artificial vessels of 0.3 mm in diameter. Both systems are constructed with master and slave manipulator robots connected to local area networks. Robotic systems allowed for secure and accurate procedures in a deep surgical field. In cadaveric models, these systems showed a good potential of being useful in actual human surgeries, but mechanical refinements in thickness and durability are necessary for them to be established as clinical systems. The super-fine robotic system made the very intricate surgery possible and will be applied in clinical trials. Another trial included the digitization of surgical technique and scientific analysis of surgical skills. Robotic and human hand motions were analyzed in numerical fashion as we tried to define surgical skillfulness in a digital format. Engineered skill assessment is also feasible and should be useful for microsurgical training. Robotics and medical engineering should bring science into the surgical field and training of surgeons. Active collaboration between medical and engineering teams and academic and industry groups is mandatory to establish such medical systems to improve patient care.

Medical Engineering and Microneurosurgery: Application and Future

PubMed Central

MORITA, Akio; SORA, Shigeo; NAKATOMI, Hirofumi; HARADA, Kanako; SUGITA, Naohiko; SAITO, Nobuhito; MITSUISHI, Mamoru

2016-01-01

Robotics and medical engineering can convert traditional surgery into digital and scientific procedures. Here, we describe our work to develop microsurgical robotic systems and apply engineering technology to assess microsurgical skills. With the collaboration of neurosurgeons and an engineering team, we have developed two types of microsurgical robotic systems. The first, the deep surgical systems, enable delicate surgical procedures such as vessel suturing in a deep and narrow space. The second type allows for super-fine surgical procedures such as anastomosing artificial vessels of 0.3 mm in diameter. Both systems are constructed with master and slave manipulator robots connected to local area networks. Robotic systems allowed for secure and accurate procedures in a deep surgical field. In cadaveric models, these systems showed a good potential of being useful in actual human surgeries, but mechanical refinements in thickness and durability are necessary for them to be established as clinical systems. The super-fine robotic system made the very intricate surgery possible and will be applied in clinical trials. Another trial included the digitization of surgical technique and scientific analysis of surgical skills. Robotic and human hand motions were analyzed in numerical fashion as we tried to define surgical skillfulness in a digital format. Engineered skill assessment is also feasible and should be useful for microsurgical training. Robotics and medical engineering should bring science into the surgical field and training of surgeons. Active collaboration between medical and engineering teams and academic and industry groups is mandatory to establish such medical systems to improve patient care. PMID:27464471

Hang cleans and hang snatches produce similar improvements in female collegiate athletes

PubMed Central

Ayers, JL; DeBeliso, M; Sevene, TG

2016-01-01

Olympic weightlifting movements and their variations are believed to be among the most effective ways to improve power, strength, and speed in athletes. This study investigated the effects of two Olympic weightlifting variations (hang cleans and hang snatches), on power (vertical jump height), strength (1RM back squat), and speed (40-yard sprint) in female collegiate athletes. 23 NCAA Division I female athletes were randomly assigned to either a hang clean group or hang snatch group. Athletes participated in two workout sessions a week for six weeks, performing either hang cleans or hang snatches for five sets of three repetitions with a load of 80-85% 1RM, concurrent with their existing, season-specific, resistance training program. Vertical jump height, 1RM back squat, and 40-yard sprint all had a significant, positive improvement from pre-training to post-training in both groups (p≤0.01). However, when comparing the gain scores between groups, there was no significant difference between the hang clean and hang snatch groups for any of the three dependent variables (i.e., vertical jump height, p=0.46; 1RM back squat, p=0.20; and 40-yard sprint, p=0.46). Short-term training emphasizing hang cleans or hang snatches produced similar improvements in power, strength, and speed in female collegiate athletes. This provides strength and conditioning professionals with two viable programmatic options in athletic-based exercises to improve power, strength, and speed. PMID:27601779

Hang cleans and hang snatches produce similar improvements in female collegiate athletes.

PubMed

Ayers, J L; DeBeliso, M; Sevene, T G; Adams, K J

2016-09-01

Olympic weightlifting movements and their variations are believed to be among the most effective ways to improve power, strength, and speed in athletes. This study investigated the effects of two Olympic weightlifting variations (hang cleans and hang snatches), on power (vertical jump height), strength (1RM back squat), and speed (40-yard sprint) in female collegiate athletes. 23 NCAA Division I female athletes were randomly assigned to either a hang clean group or hang snatch group. Athletes participated in two workout sessions a week for six weeks, performing either hang cleans or hang snatches for five sets of three repetitions with a load of 80-85% 1RM, concurrent with their existing, season-specific, resistance training program. Vertical jump height, 1RM back squat, and 40-yard sprint all had a significant, positive improvement from pre-training to post-training in both groups (p≤0.01). However, when comparing the gain scores between groups, there was no significant difference between the hang clean and hang snatch groups for any of the three dependent variables (i.e., vertical jump height, p=0.46; 1RM back squat, p=0.20; and 40-yard sprint, p=0.46). Short-term training emphasizing hang cleans or hang snatches produced similar improvements in power, strength, and speed in female collegiate athletes. This provides strength and conditioning professionals with two viable programmatic options in athletic-based exercises to improve power, strength, and speed.

Robot-Assisted Rehabilitation of Ankle Plantar Flexors Spasticity: A 3-Month Study with Proprioceptive Neuromuscular Facilitation

PubMed Central

Zhou, Zhihao; Sun, Yao; Wang, Ninghua; Gao, Fan; Wei, Kunlin; Wang, Qining

2016-01-01

In this paper, we aim to investigate the effect of proprioceptive neuromuscular facilitation (PNF)-based rehabilitation for ankle plantar flexors spasticity by using a Robotic Ankle–foot Rehabilitation System (RARS). A modified robot-assisted system was proposed, and seven poststroke patients with hemiplegic spastic ankles participated in a 3-month robotic PNF training. Their impaired sides were used as the experimental group, while their unimpaired sides as the control group. A robotic intervention for the experimental group started from a 2-min passive stretching to warming-up or relaxing the soleus and gastrocnemius muscles and also ended with the same one. Then a PNF training session including 30 trials was activated between them. The rehabilitation trainings were carried out three times a week as an addition to their regular rehabilitation exercise. Passive range of motion, resistance torque, and stiffness were measured in both ankles before and after the interventions. The changes in Achilles tendon length, walking speed, and lower limb function were also evaluated by the same physician or physiotherapist for each participant. Biomechanical measurements before interventions showed significant difference between the experimental group and the control group due to ankle spasticity. For the control group, there was no significant difference in the 3 months with no robotic intervention. But for the experimental group, passive dorsiflexion range of motion increased (p < 0.01), resistance torque under different dorsiflexion angle levels (0°, 10°, and 20°) decreased (p < 0.05, p < 0.001, and p < 0.001, respectively), and quasi-static stiffness under different dorsiflexion angle levels (0°, 10°, and 20°) also decreased (p < 0.01, p < 0.001, and p < 0.001, respectively). Achilles’s tendon length shortened (p < 0.01), while its thickness showed no significant change (p > 0.05). The robotic rehabilitation also improved the muscle strength (p < 0.01) and muscle control performance (p < 0.001). In addition, improvements were observed in clinical and functional measurements, such as Timed Up-and-Go (p < 0.05), normal walking speed (p > 0.05), and fast walking speed (p < 0.05). These results indicated that the PNF-based robotic intervention could significantly alleviate lower limb spasticity and improve the motor function in chronic stroke participant. The robotic system could potentially be used as an effective tool in poststroke rehabilitation training. PMID:27895574

System-Level Reuse of Space Systems Simulations

NASA Technical Reports Server (NTRS)

Hazen, Michael R.; Williams, Joseph C.

2004-01-01

One of the best ways to enhance space systems simulation fidelity is to leverage off of (reuse) existing high-fidelity simulations. But what happens when the model you would like to reuse is in a different coding language or other barriers arise that make one want to just start over with a clean sheet of paper? Three diverse system-level simulation reuse case studies are described based on experience to date in the development of NASA's Space Station Training Facility (SSTF) at the Johnson Space Center in Houston, Texas. Case studies include (a) the Boeing/Rocketdyne-provided Electrical Power Simulation (EPSIM), (b) the NASA Automation and Robotics Division-provided TRICK robotics systems model, and (c) the Russian Space Agency- provided Russian Segment Trainer. In each case, there was an initial tendency to dismiss simulation reuse candidates based on an apparent lack of suitability. A more careful examination based on a more structured assessment of architectural and requirements-oriented representations of the reuse candidates revealed significant reuse potential. Specific steps used to conduct the detailed assessments are discussed. The steps include the following: 1) Identifying reuse candidates; 2) Requirements compatibility assessment; 3) Maturity assessment; 4) Life-cycle cost determination; and 5) Risk assessment. Observations and conclusions are presented related to the real cost of system-level simulation component reuse. Finally, lessons learned that relate to maximizing the benefits of space systems simulation reuse are shared. These concepts should be directly applicable for use in the development of space systems simulations in the future.

Control of autonomous robot using neural networks

NASA Astrophysics Data System (ADS)

Barton, Adam; Volna, Eva

2017-07-01

The aim of the article is to design a method of control of an autonomous robot using artificial neural networks. The introductory part describes control issues from the perspective of autonomous robot navigation and the current mobile robots controlled by neural networks. The core of the article is the design of the controlling neural network, and generation and filtration of the training set using ART1 (Adaptive Resonance Theory). The outcome of the practical part is an assembled Lego Mindstorms EV3 robot solving the problem of avoiding obstacles in space. To verify models of an autonomous robot behavior, a set of experiments was created as well as evaluation criteria. The speed of each motor was adjusted by the controlling neural network with respect to the situation in which the robot was found.

Exerciser for rehabilitation of the Arm (ERA): Development and unique features of a 3D end-effector robot.

PubMed

Milot, Marie-Helene; Hamel, Mathieu; Provost, Philippe-Olivier; Bernier-Ouellet, Julien; Dupuis, Maxime; Letourneau, Dominic; Briere, Simon; Michaud, Francois

2016-08-01

Stroke is one of the leading causes of disability worldwide. Consequently, many stroke survivors exhibit difficulties undergoing voluntary movement in their affected upper limb, compromising their functional performance and level of independence. To minimize the negative impact of stroke disabilities, exercises are recognized as a key element in post-stroke rehabilitation. In order to provide the practice of exercises in a uniform and controlled manner as well as increasing the efficiency of therapists' interventions, robotic training has been found, and continues to prove itself, as an innovative intervention for post-stroke rehabilitation. However, the complexity as well as the limited degrees of freedom and workspace of currently commercially available robots can limit their use in clinical settings. Up to now, user-friendly robots covering a sufficiently large workspace for training of the upper limb in its full range of motion are lacking. This paper presents the design and implementation of ERA, an upper-limb 3-DOF force-controlled exerciser robot, which presents a workspace covering the entire range of motion of the upper limb. The ERA robot provides 3D reaching movements in a haptic virtual environment. A description of the hardware and software components of the ERA robot is also presented along with a demonstration of its capabilities in one of the three operational modes that were developed.

Training industrial robots with gesture recognition techniques

NASA Astrophysics Data System (ADS)

Piane, Jennifer; Raicu, Daniela; Furst, Jacob

2013-01-01

In this paper we propose to use gesture recognition approaches to track a human hand in 3D space and, without the use of special clothing or markers, be able to accurately generate code for training an industrial robot to perform the same motion. The proposed hand tracking component includes three methods: a color-thresholding model, naïve Bayes analysis and Support Vector Machine (SVM) to detect the human hand. Next, it performs stereo matching on the region where the hand was detected to find relative 3D coordinates. The list of coordinates returned is expectedly noisy due to the way the human hand can alter its apparent shape while moving, the inconsistencies in human motion and detection failures in the cluttered environment. Therefore, the system analyzes the list of coordinates to determine a path for the robot to move, by smoothing the data to reduce noise and looking for significant points used to determine the path the robot will ultimately take. The proposed system was applied to pairs of videos recording the motion of a human hand in a „real‟ environment to move the end-affector of a SCARA robot along the same path as the hand of the person in the video. The correctness of the robot motion was determined by observers indicating that motion of the robot appeared to match the motion of the video.

Performance-based robotic assistance during rhythmic arm exercises.

PubMed

Leconte, Patricia; Ronsse, Renaud

2016-09-13

Rhythmic and discrete upper-limb movements are two fundamental motor primitives controlled by different neural pathways, at least partially. After stroke, both primitives can be impaired. Both conventional and robot-assisted therapies mainly train discrete functional movements like reaching and grasping. However, if the movements form two distinct neural and functional primitives, both should be trained to recover the complete motor repertoire. Recent studies show that rhythmic movements tend to be less impaired than discrete ones, so combining both movement types in therapy could support the execution of movements with a higher degree of impairment by movements that are performed more stably. A new performance-based assistance method was developed to train rhythmic movements with a rehabilitation robot. The algorithm uses the assist-as-needed paradigm by independently assessing and assisting movement features of smoothness, velocity, and amplitude. The method relies on different building blocks: (i) an adaptive oscillator captures the main movement harmonic in state variables, (ii) custom metrics measure the movement performance regarding the three features, and (iii) adaptive forces assist the patient. The patient is encouraged to improve performance regarding these three features with assistance forces computed in parallel to each other. The method was tested with simulated jerky signals and a pilot experiment with two stroke patients, who were instructed to make circular movements with an end-effector robot with assistance during half of the trials. Simulation data reveal sensitivity of the metrics for assessing the features while limiting interference between them. The assistance's effectiveness with stroke patients is established since it (i) adapts to the patient's real-time performance, (ii) improves patient motor performance, and (iii) does not lead the patient to slack. The smoothness assistance was by far the most used by both patients, while it provided no active mechanical work to the patient on average. Our performance-based assistance method for training rhythmic movements is a viable candidate to complement robot-assisted upper-limb therapies for training a larger motor repertoire.

Visuospatial Aptitude Testing Differentially Predicts Simulated Surgical Skill.

PubMed

Hinchcliff, Emily; Green, Isabel; Destephano, Christopher; Cox, Mary; Smink, Douglas; Kumar, Amanika; Hokenstad, Erik; Bengtson, Joan; Cohen, Sarah

2018-02-05

To determine if visuospatial perception (VSP) testing is correlated to simulated or intraoperative surgical performance as rated by the American College of Graduate Medical Education (ACGME) milestones. Classification II-2 SETTING: Two academic training institutions PARTICIPANTS: 41 residents, including 19 Brigham and Women's Hospital and 22 Mayo Clinic residents from three different specialties (OBGYN, general surgery, urology). Participants underwent three different tests: visuospatial perception testing (VSP), Fundamentals of Laparoscopic Surgery (FLS®) peg transfer, and DaVinci robotic simulation peg transfer. Surgical grading from the ACGME milestones tool was obtained for each participant. Demographic and subject background information was also collected including specialty, year of training, prior experience with simulated skills, and surgical interest. Standard statistical analysis using Student's t test were performed, and correlations were determined using adjusted linear regression models. In univariate analysis, BWH and Mayo training programs differed in both times and overall scores for both FLS® peg transfer and DaVinci robotic simulation peg transfer (p<0.05 for all). Additionally, type of residency training impacted time and overall score on robotic peg transfer. Familiarity with tasks correlated with higher score and faster task completion (p= 0.05 for all except VSP score). There was no difference in VSP scores by program, specialty, or year of training. In adjusted linear regression modeling, VSP testing was correlated only to robotic peg transfer skills (average time p=0.006, overall score p=0.001). Milestones did not correlate to either VSP or surgical simulation testing. VSP score was correlated with robotic simulation skills but not with FLS skills or ACGME milestones. This suggests that the ability of VSP score to predict competence differs between tasks. Therefore, further investigation is required into aptitude testing, especially prior to its integration as an entry examination into a surgical subspecialty. Copyright © 2018. Published by Elsevier Inc.

Work-rate-guided exercise testing in patients with incomplete spinal cord injury using a robotics-assisted tilt-table.

PubMed

Laubacher, Marco; Perret, Claudio; Hunt, Kenneth J

2015-01-01

Robotics-assisted tilt-table (RTT) technology allows neurological rehabilitation therapy to be started early thus alleviating some secondary complications of prolonged bed rest. This study assessed the feasibility of a novel work-rate-guided RTT approach for cardiopulmonary training and assessment in patients with incomplete spinal cord injury (iSCI). Three representative subjects with iSCI at three distinct stages of primary rehabilitation completed an incremental exercise test (IET) and a constant load test (CLT) on a RTT augmented with integrated leg-force and position measurement and visual work rate feedback. Feasibility assessment focused on: (i) implementation, (ii) limited efficacy testing, (iii) acceptability. (i) All subjects were able follow the work rate target profile by adapting their volitional leg effort. (ii) During the IETs, peak oxygen uptake above rest was 304, 467 and 1378 ml/min and peak heart rate (HR) was 46, 32 and 65 beats/min above rest (subjects A, B and C, respectively). During the CLTs, steady-state oxygen uptake increased by 42%, 38% and 162% and HR by 12%, 20% and 29%. (iii) All exercise tests were tolerated well. The novel work-rate guided RTT intervention is deemed feasible for cardiopulmonary training and assessment in patients with iSCI: substantial cardiopulmonary responses were observed and the approach was found to be tolerable and implementable. Implications for Rehabilitation Work-rate guided robotics-assisted tilt-table technology is deemed feasible for cardiopulmonary assessment and training in patients with incomplete spinal cord injury. Robotics-assisted tilt-tables might be a good way to start with an active rehabilitation as early as possible after a spinal cord injury. During training with robotics-assisted devices the active participation of the patients is crucial to strain the cardiopulmonary system and hence gain from the training.

Assessment of virtual reality robotic simulation performance by urology resident trainees.

PubMed

Ruparel, Raaj K; Taylor, Abby S; Patel, Janil; Patel, Vipul R; Heckman, Michael G; Rawal, Bhupendra; Leveillee, Raymond J; Thiel, David D

2014-01-01

To examine resident performance on the Mimic dV-Trainer (MdVT; Mimic Technologies, Inc., Seattle, WA) for correlation with resident trainee level (postgraduate year [PGY]), console experience (CE), and simulator exposure in their training program to assess for internal bias with the simulator. Residents from programs of the Southeastern Section of the American Urologic Association participated. Each resident was scored on 4 simulator tasks (peg board, camera targeting, energy dissection [ED], and needle targeting) with 3 different outcomes (final score, economy of motion score, and time to complete exercise) measured for each task. These scores were evaluated for association with PGY, CE, and simulator exposure. Robotic skills training laboratory. A total of 27 residents from 14 programs of the Southeastern Section of the American Urologic Association participated. Time to complete the ED exercise was significantly shorter for residents who had logged live robotic console compared with those who had not (p = 0.003). There were no other associations with live robotic console time that approached significance (all p ≥ 0.21). The only measure that was significantly associated with PGY was time to complete ED exercise (p = 0.009). No associations with previous utilization of a robotic simulator in the resident's home training program were statistically significant. The ED exercise on the MdVT is most associated with CE and PGY compared with other exercises. Exposure of trainees to the MdVT in training programs does not appear to alter performance scores compared with trainees who do not have the simulator. © 2013 Published by Association of Program Directors in Surgery on behalf of Association of Program Directors in Surgery.

[Geometry of laparoscopy, telesurgery, training and telementoring].

PubMed

Rassweiler, J; Frede, T

2002-03-01

Laparoscopic surgery in general is handicapped by the reduction of the range of motion from 6 to 4 degrees of freedom. This has a major impact on technically difficult procedures such as laparoscopic radical prostatectomy. Solutions for this problem include understanding the geometry of laparoscopy with sophisticated training programs, but also newly developed surgical robots, computer simulators, and telementoring. This article evaluates the value of these alternatives based on own experience and an analysis of the current literature. Our experience with robot-assisted surgery includes 244 laparoscopic radical prostatectomies using a voice-controlled camera arm (AESOP) and 6 telesurgical interventions with the da Vinci system. Additionally, experimental studies were performed focussing on the geometry of laparoscopy and new training concepts such as perfused pelvitrainers and computer simulation. Three-dimensional systems have not yet proved to be effective due to handling problems such as shutter glasses, video helmets, or reduced brightness. At present, there are only two robotic surgical systems (ZEUS, da Vinci) in clinical use for telesurgery, of which only the da Vinci provides stereovision and all 6 degrees of freedom (DOF). In the meantime, more than 100 laparoscopic radical prostatectomies have been performed with this system. However, there was no evidence of any advantages over the conventional laparoscopic approach. The ZEUS in combination with the telecommunication system SOKRATES is the only device that enables telemanipulation and telementoring over long distances (i.e., transatlantic). Robotic surgery represents a turning point in surgical research. However, broad use of robotic systems is limited mainly because of high investment and running costs. Whereas audiovisual telementoring will play a clear role in future training concepts, the need for telemanipulation or telesurgery has not yet been clarified.

Automated surgical skill assessment in RMIS training.

PubMed

Zia, Aneeq; Essa, Irfan

2018-05-01

Manual feedback in basic robot-assisted minimally invasive surgery (RMIS) training can consume a significant amount of time from expert surgeons' schedule and is prone to subjectivity. In this paper, we explore the usage of different holistic features for automated skill assessment using only robot kinematic data and propose a weighted feature fusion technique for improving score prediction performance. Moreover, we also propose a method for generating 'task highlights' which can give surgeons a more directed feedback regarding which segments had the most effect on the final skill score. We perform our experiments on the publicly available JHU-ISI Gesture and Skill Assessment Working Set (JIGSAWS) and evaluate four different types of holistic features from robot kinematic data-sequential motion texture (SMT), discrete Fourier transform (DFT), discrete cosine transform (DCT) and approximate entropy (ApEn). The features are then used for skill classification and exact skill score prediction. Along with using these features individually, we also evaluate the performance using our proposed weighted combination technique. The task highlights are produced using DCT features. Our results demonstrate that these holistic features outperform all previous Hidden Markov Model (HMM)-based state-of-the-art methods for skill classification on the JIGSAWS dataset. Also, our proposed feature fusion strategy significantly improves performance for skill score predictions achieving up to 0.61 average spearman correlation coefficient. Moreover, we provide an analysis on how the proposed task highlights can relate to different surgical gestures within a task. Holistic features capturing global information from robot kinematic data can successfully be used for evaluating surgeon skill in basic surgical tasks on the da Vinci robot. Using the framework presented can potentially allow for real-time score feedback in RMIS training and help surgical trainees have more focused training.

A Systematic Review of Virtual Reality Simulators for Robot-assisted Surgery.

PubMed

Moglia, Andrea; Ferrari, Vincenzo; Morelli, Luca; Ferrari, Mauro; Mosca, Franco; Cuschieri, Alfred

2016-06-01

No single large published randomized controlled trial (RCT) has confirmed the efficacy of virtual simulators in the acquisition of skills to the standard required for safe clinical robotic surgery. This remains the main obstacle for the adoption of these virtual simulators in surgical residency curricula. To evaluate the level of evidence in published studies on the efficacy of training on virtual simulators for robotic surgery. In April 2015 a literature search was conducted on PubMed, Web of Science, Scopus, Cochrane Library, the Clinical Trials Database (US) and the Meta Register of Controlled Trials. All publications were scrutinized for relevance to the review and for assessment of the levels of evidence provided using the classification developed by the Oxford Centre for Evidence-Based Medicine. The publications included in the review consisted of one RCT and 28 cohort studies on validity, and seven RCTs and two cohort studies on skills transfer from virtual simulators to robot-assisted surgery. Simulators were rated good for realism (face validity) and for usefulness as a training tool (content validity). However, the studies included used various simulation training methodologies, limiting the assessment of construct validity. The review confirms the absence of any consensus on which tasks and metrics are the most effective for the da Vinci Skills Simulator and dV-Trainer, the most widely investigated systems. Although there is consensus for the RoSS simulator, this is based on only two studies on construct validity involving four exercises. One study on initial evaluation of an augmented reality module for partial nephrectomy using the dV-Trainer reported high correlation (r=0.8) between in vivo porcine nephrectomy and a virtual renorrhaphy task according to the overall Global Evaluation Assessment of Robotic Surgery (GEARS) score. In one RCT on skills transfer, the experimental group outperformed the control group, with a significant difference in overall GEARS score (p=0.012) during performance of urethrovesical anastomosis on an inanimate model. Only one study included assessment of a surgical procedure on real patients: subjects trained on a virtual simulator outperformed the control group following traditional training. However, besides the small numbers, this study was not randomized. There is an urgent need for a large, well-designed, preferably multicenter RCT to study the efficacy of virtual simulation for acquisition competence in and safe execution of clinical robotic-assisted surgery. We reviewed the literature on virtual simulators for robot-assisted surgery. Validity studies used various simulation training methodologies. It is not clear which exercises and metrics are the most effective in distinguishing different levels of experience on the da Vinci robot. There is no reported evidence of skills transfer from simulation to clinical surgery on real patients. Copyright © 2015 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Innovative approaches to the rehabilitation of upper extremity hemiparesis using virtual environments

PubMed Central

MERIANS, A. S.; TUNIK, E.; FLUET, G. G.; QIU, Q.; ADAMOVICH, S. V.

2017-01-01

Aim Upper-extremity interventions for hemiparesis are a challenging aspect of stroke rehabilitation. Purpose of this paper is to report the feasibility of using virtual environments (VEs) in combination with robotics to assist recovery of hand-arm function and to present preliminary data demonstrating the potential of using sensory manipulations in VE to drive activation in targeted neural regions. Methods We trained 8 subjects for 8 three hour sessions using a library of complex VE’s integrated with robots, comparing training arm and hand separately to training arm and hand together. Instrumented gloves and hand exoskeleton were used for hand tracking and haptic effects. Haptic Master robotic arm was used for arm tracking and generating three-dimensional haptic VEs. To investigate the use of manipulations in VE to drive neural activations, we created a “virtual mirror” that subjects used while performing a unimanual task. Cortical activation was measured with functional MRI (fMRI) and transcranial magnetic stimulation. Results Both groups showed improvement in kinematics and measures of real-world function. The group trained using their arm and hand together showed greater improvement. In a stroke subject, fMRI data suggested virtual mirror feedback could activate the sensorimotor cortex contralateral to the reflected hand (ipsilateral to the moving hand) thus recruiting the lesioned hemisphere. Conclusion Gaming simulations interfaced with robotic devices provide a training medium that can modify movement patterns. In addition to showing that our VE therapies can optimize behavioral performance, we show preliminary evidence to support the potential of using specific sensory manipulations to selectively recruit targeted neural circuits. PMID:19158659

A Comparison of Robotic Simulation Performance on Basic Virtual Reality Skills: Simulator Subjective Versus Objective Assessment Tools.

PubMed

Dubin, Ariel K; Smith, Roger; Julian, Danielle; Tanaka, Alyssa; Mattingly, Patricia

To answer the question of whether there is a difference between robotic virtual reality simulator performance assessment and validated human reviewers. Current surgical education relies heavily on simulation. Several assessment tools are available to the trainee, including the actual robotic simulator assessment metrics and the Global Evaluative Assessment of Robotic Skills (GEARS) metrics, both of which have been independently validated. GEARS is a rating scale through which human evaluators can score trainees' performances on 6 domains: depth perception, bimanual dexterity, efficiency, force sensitivity, autonomy, and robotic control. Each domain is scored on a 5-point Likert scale with anchors. We used 2 common robotic simulators, the dV-Trainer (dVT; Mimic Technologies Inc., Seattle, WA) and the da Vinci Skills Simulator (dVSS; Intuitive Surgical, Sunnyvale, CA), to compare the performance metrics of robotic surgical simulators with the GEARS for a basic robotic task on each simulator. A prospective single-blinded randomized study. A surgical education and training center. Surgeons and surgeons in training. Demographic information was collected including sex, age, level of training, specialty, and previous surgical and simulator experience. Subjects performed 2 trials of ring and rail 1 (RR1) on each of the 2 simulators (dVSS and dVT) after undergoing randomization and warm-up exercises. The second RR1 trial simulator performance was recorded, and the deidentified videos were sent to human reviewers using GEARS. Eight different simulator assessment metrics were identified and paired with a similar performance metric in the GEARS tool. The GEARS evaluation scores and simulator assessment scores were paired and a Spearman rho calculated for their level of correlation. Seventy-four subjects were enrolled in this randomized study with 9 subjects excluded for missing or incomplete data. There was a strong correlation between the GEARS score and the simulator metric score for time to complete versus efficiency, time to complete versus total score, economy of motion versus depth perception, and overall score versus total score with rho coefficients greater than or equal to 0.70; these were significant (p < .0001). Those with weak correlation (rho ≥0.30) were bimanual dexterity versus economy of motion, efficiency versus master workspace range, bimanual dexterity versus master workspace range, and robotic control versus instrument collisions. On basic VR tasks, several simulator metrics are well matched with GEARS scores assigned by human reviewers, but others are not. Identifying these matches/mismatches can improve the training and assessment process when using robotic surgical simulators. Copyright © 2017 American Association of Gynecologic Laparoscopists. Published by Elsevier Inc. All rights reserved.

Reactor water cleanup system

DOEpatents

Gluntz, Douglas M.; Taft, William E.

1994-01-01

A reactor water cleanup system includes a reactor pressure vessel containing a reactor core submerged in reactor water. First and second parallel cleanup trains are provided for extracting portions of the reactor water from the pressure vessel, cleaning the extracted water, and returning the cleaned water to the pressure vessel. Each of the cleanup trains includes a heat exchanger for cooling the reactor water, and a cleaner for cleaning the cooled reactor water. A return line is disposed between the cleaner and the pressure vessel for channeling the cleaned water thereto in a first mode of operation. A portion of the cooled water is bypassed around the cleaner during a second mode of operation and returned through the pressure vessel for shutdown cooling.

[Robot-assisted and computer-based neurorehabilitation for children: the story behind].

PubMed

Meyer-Heim, Andreas; van Hedel, Hub J A

2014-07-23

Impairments of the central motor system can either be congenital (e. g. cerebral palsy) or acquired (e. g. traumatic brain injury, stroke). These lesions are the most frequent morbidities necessitating neuro-rehabilitative measures in childhood. Robot-assisted rehabilitation in combination with virtual reality can complement conventional therapies and provide a task-specific training, with a high number of repetitions over a prolonged time period. The advantage of virtual reality is that it can provide a real time feedback about the patient's performance. Furthermore, challenging virtual scenarios especially motivate young patients to continue with otherwise monotonous exercises. Preliminary findings indicate that robot-assisted training in children with central motor impairment could be beneficial, but conclusive evidence about its efficacy is still missing.

Advanced Curation Protocols for Mars Returned Sample Handling

NASA Astrophysics Data System (ADS)

Bell, M.; Mickelson, E.; Lindstrom, D.; Allton, J.

Introduction: Johnson Space Center has over 30 years experience handling precious samples which include Lunar rocks and Antarctic meteorites. However, we recognize that future curation of samples from such missions as Genesis, Stardust, and Mars S mple Return, will require a high degree of biosafety combined witha extremely low levels of inorganic, organic, and biological contamination. To satisfy these requirements, research in the JSC Advanced Curation Lab is currently focused toward two major areas: preliminary examination techniques and cleaning and verification techniques . Preliminary Examination Techniques : In order to minimize the number of paths for contamination we are exploring the synergy between human &robotic sample handling in a controlled environment to help determine the limits of clean curation. Within the Advanced Curation Laboratory is a prototype, next-generation glovebox, which contains a robotic micromanipulator. The remotely operated manipulator has six degrees-of- freedom and can be programmed to perform repetitive sample handling tasks. Protocols are being tested and developed to perform curation tasks such as rock splitting, weighing, imaging, and storing. Techniques for sample transfer enabling more detailed remote examination without compromising the integrity of sample science are also being developed . The glovebox is equipped with a rapid transfer port through which samples can be passed without exposure. The transfer is accomplished by using a unique seal and engagement system which allows passage between containers while maintaining a first seal to the outside environment and a second seal to prevent the outside of the container cover and port door from becoming contaminated by the material being transferred. Cleaning and Verification Techniques: As part of the contamination control effort, innovative cleaning techniques are being identified and evaluated in conjunction with sensitive cleanliness verification methods. Towards this end, cleaning techniques such as ultrasonication in ultra -pure water (UPW), oxygen (O2) plasma, and carbon dioxide (CO2) "snow" are being used to clean a variety of different contaminants on a variety of different surfaces. Additionally, once cleaned, techniques to directly verify the s rface cleanliness are being developed. Theseu include X ray photoelectron spectroscopy (XPS) quantification, and screening with- contact angle measure ments , which can be correlated with XPS standards. Methods developed in the Advanced Curation Laboratory will determine the extent to which inorganic and biological contamination can be controlled and minimized.

Cleaning Physical Education Areas.

ERIC Educational Resources Information Center

Griffin, William R.

1999-01-01

Discusses techniques to help create clean and inviting school locker rooms. Daily, weekly or monthly, biannual, and annual cleaning strategies for locker room showers are highlighted as are the specialized maintenance needs for aerobic and dance areas, running tracks, and weight training areas. (GR)