Fraunhofer-Institut für Produktionsanlagen und Konstruktionstechnik IPK

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Design and concept of a haptic robotic telerehabilitation system for upper limb movement training after stroke

2015 , Ivanova, E. , Krüger, J. , Steingräber, R. , Schmid, S. , Schmidt, H. , Hesse, S.

Robotic therapy devices have been an important part of clinical neurological rehabilitation for several years. Until now such devices are only available for patients receiving therapy inside rehabilitation hospitals. Since patients should continue rehabilitation training after hospital discharge at home, intelligent robotic rehab devices could help to achieve this goal. This paper proposes a novel multimodal home therapy concept and robot based system for motor telerehabilitation which is currently being further developed. The system is based on two haptic rehabilitation devices i) the Bi-Manu-Track (BMT) 2times1 DOF robotic haptic rehabilitation device with assist-as-needed control algorithms and ii) an enhanced version of the 3 DOF passive Reha-Slide system. The paper describes the technical system setup as well as user centered design aspects.

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Visuelles Biofeedback für die gerätegestützte neurologische Gangrehabilitation nach Schlaganfall

2010 , Brüning, M. , Hussein, S. , Bardeleben, A. , Schmidt, H. , Krüger, J. , Hesse, S.

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Ground reaction forces during different floor walking in robot assisted gait training

2009 , Hussein, S. , Schmidt, H. , Hesse, S. , Krüger, J.

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Muscle activation of stroke patients during stair climbing in robot assisted gait training

2008 , Hussein, S. , Schmidt, H. , Volkmar, M. , Krüger, J. , Hesse, S.

For central nervous system (CNS) impaired patients, e.g. after stroke, the achievement of an independent, stable gait function and endurance in walking is essential for independent mobility in daily life. Modern concepts of rehabilitation favor a task specific repetitive training, that facilitates natural motion and muscle activation patterns, i.e. in addition to commonly practiced floor walking other gait motions of daily living (ADL), such as stair climbing, should be trained. In gait rehabilitation of severely affected non-ambulatory patients, a guided training must be applied as no or only little voluntary motor control is left in the affected side. The rehabilitation robot HapticWalker is the first device that allows for robot assisted guided training of arbitrary foot trajectories, e.g. also stair climbing. The goal of this study was to assess the effect of guided training in stair climbing condition on the HapticWalker on the movement and muscle activation patterns of stroke patients. Generally rhythmic and phasic muscle activation patterns were observed, which is an important factor in gait rehabilitation. The training of stair climbing condition on the HapticWalker also facilitated body weight shift in all patients and proper activation of weight bearing muscles. The HapticWalker currently lacks a lateral hip guidance facility, hence individual differences in the ability of controlling hip movement and body weight shift depending on the level of gait ability were observed.

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Anforderungsanalyse für die nutzergerechte Gestaltung eines Bedienkonzepts für robotergestützte Telerehabilitationssysteme in der motorischen Schlaganfallrehabilitation

2015 , Ivanova, E. , Freydank, E. , Achner, J. , Klemke, J. , Schrader, M. , Wernicke, S. , Bryl, B. , Schauer, M. , Schmidt, H. , Jöbges, M. , Hesse, S. , Krüger, J.

Die motorische Rehabilitationsbehandlung nach Schlaganfall ist sehr langwierig, eine Fortsetzung der Übungstherapiebehandlung nach Entlassung aus der Rehaklinik ist daher für jeden Patienten von großer Bedeutung für einen dauerhaften und nachhaltigen Therapieerfolg. Mangels geeigneter Möglichkeiten der häuslichen Therapiedurchführung und -unterstützung von Patienten, bestehen hierbei in der Praxis große Defizite. Eine Möglichkeit der Verbesserung dieser Situation bietet ein Telerehabilitationssystem. Dabei spielt ein intuitives Bedienkonzept, welches für den Patienten leicht verständlich und zugänglich ist, eine wichtige Rolle. In diesem Beitrag werden die Ergebnisse der therapeutischen Anforderungsanalyse an das multimodale robotergestützte System für motorische Rehabilitation nach Schlaganfall in häuslicher Umgebung dargestellt.

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Multimodal biofeedback architecture for an electromechanical gait rehabilitation device

2009 , Hussein, S. , Schmidt, H. , Hesse, S. , Krüger, J.

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Effect of different training modes on ground reaction forces during robot assisted floor walking and stair climbing

2009 , Hussein, S. , Schmidt, H. , Hesse, S. , Krüger, J.

The HapticWalker is a robotic walking simulator for neurological gait rehabilitation. The device is based on the end-effector principle, i.e. the patients' feet are fixed on two footplates, his trunk is secured via a suspension harness. The footplates (end-effectors) of the robot guide the feet of the patient on freely programmable trajectories. Currently two different training modes are provided for each foot trajectory on the HapticWalker. Firstly training trajectories based on real motion capture data can be used. Secondly the vertical center of mass (CoM) motion can be incorporated into the foot trajectory. The latter method leaves the absolute position of the CoM constant, while the relative movement between CoM and feet remains the same as in free walking. Thereby the v ertical CoM motion can be actively supported by using a fixed passive suspension, any type of controlled body weight support will then be accomplished via force controlled footplates. To characterize the training on the machine in position controlled mode, muscle activities as well as ground reaction force data of healthy subjects were collected. This article presents preliminary results from the investigation of ground reaction force data of healthy subjects. Therefore data of 10 healthy subjects was used to compare HapticWalker training modes vs. free walking on level ground and upstairs without any assistive devices and the aforementioned two HapticWalker training modes against each other. Amplitude and timing of force peaks during heel strike, foot flat and push off in vertical ground reaction forces were used for the assessment. In spite of a footplate, which does not provide a separate metatarsal joint for relative motion between fore and hind foot, during heel strike and push off the known characteristic peaks at the beginning and the end of the stance phase can be clearly distinguished. Though compared to free walking a slower and premature rise and slower decline of ground reaction for- ces can be seen due to the stiff guidance of the feet in position controlled mode. No significant differences appeared between the two described HapticWalker training modes.

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Richtlinien für die Gestaltung von visuellem Biofeedback in der neurologischen Gangrehabilitation nach Schlaganfall

2010 , Brüning, M. , Hussein, S. , Bardeleben, A. , Schmidt, H. , Krüger, J. , Hesse, S.

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Geschwindigkeitsbasierte, adaptive Kraftregelung für ein elektromechanisches Trainingsgerät zur Gangrehabilitation

2009 , Hussein, S. , Schmidt, H. , Hesse, S. , Krüger, J.

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HapticWalker - haptic foot device for gait rehabilitation

2008 , Schmidt, H. , Krüger, J. , Hesse, S.

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