Intelligent control of a smart walker and its performance evaluation

Lightweight and compact smart walking cane

Devices such as canes and wheelchairs, used to assist locomotion, have remained mostly unchanged for centuries. Recent advances in robotics have the potential to develop smart versions of these devices that can offer better support and living conditions to their users. This is the underlying objective of this project. The existing devices, used during recovery and rehabilitation phases where gait stability is key, are often bulky and cannot be easily migrated from hospital to domestic environments, where maneuvering space tends to be restricted. This article discusses a compact, lightweight and minimally invasive, robotic cane to assist locomotion. The device can assist users with mild locomotion disabilities, e.g., in the final stages of rehabilitation, to maintain and recover their balance in standing and walking situations. This extends previous experiments with alternative control strategies, merged with indicators (based on the Gini index) able to recognize differences between users. Several experiments, with a range of users possessing different mobility impairments, confirm the viability of the robotic cane, with users comfortably using the cane after three minutes, on average, proving its ease of use and low intrusiveness, and with constant support offered during the whole movement. Furthermore, the real-time tuning of the controller gains, via the Gini inequality index, enables adjustment to the user's movement.

Adaptability of Assistive Mobility Devices and the Role of the Internet of Medical Things: Comprehensive Review

Background

With the projected upsurge in the percentage of people with some form of disability, there has been a significant increase in the need for assistive mobility devices. However, for mobility aids to be effective, such devices should be adapted to the user’s needs. This can be achieved by improving the confidence of the acquired information (interaction between the user, the environment, and the device) following design specifications. Therefore, there is a need for literature review on the adaptability of assistive mobility devices.

Objective

In this study, we aim to review the adaptability of assistive mobility devices and the role of the internet of medical things in terms of the acquired information for assistive mobility devices. We review internet-enabled assistive mobility technologies and non–internet of things (IoT) assistive mobility devices. These technologies will provide awareness of the status of adaptive mobility technology and serve as a source and reference regarding information to health care professionals and researchers.

Methods

We performed a literature review search on the following databases of academic references and journals: Google Scholar, ScienceDirect, Institute of Electrical and Electronics Engineers, Springer, and websites of assistive mobility and foundations presenting studies on assistive mobility found through a generic Google search (including the World Health Organization website). The following keywords were used: assistive mobility OR assistive robots, assistive mobility devices, internet-enabled assistive mobility technologies, IoT Framework OR IoT Architecture AND for Healthcare, assisted navigation OR autonomous navigation, mobility AND aids OR devices, adaptability of assistive technology, adaptive mobility devices, pattern recognition, autonomous navigational systems, human-robot interfaces, motor rehabilitation devices, perception, and ambient assisted living.

Results

We identified 13,286 results (excluding titles that were not relevant to this study). Then, through a narrative review, we selected 189 potential studies (189/13,286, 1.42%) from the existing literature on the adaptability of assistive mobility devices and IoT frameworks for assistive mobility and conducted a critical analysis. Of the 189 potential studies, 82 (43.4%) were selected for analysis after meeting the inclusion criteria. On the basis of the type of technologies presented in the reviewed articles, we proposed a categorization of the adaptability of smart assistive mobility devices in terms of their interaction with the user (user system interface), perception techniques, and communication and sensing frameworks.

Conclusions

We discussed notable limitations of the reviewed literature studies. The findings revealed that an improvement in the adaptation of assistive mobility systems would require a reduction in training time and avoidance of cognitive overload. Furthermore, sensor fusion and classification accuracy are critical for achieving real-world testing requirements. Finally, the trade-off between cost and performance should be considered in the commercialization of these devices.

Automatic Assessment of a Rollator-User's Condition During Rehabilitation Using the i-Walker Platform

Patient condition during rehabilitation has been traditionally assessed using clinical scales. These scales typically require the patient and/or the clinician to rate a number of condition-related items to obtain a final score. This is a time-consuming task, specially if a large number of patients are involved. Furthermore, during rehabilitation, user condition is expected to change steadily in time, so assessment may require to run these scales several times to each user. To save time, much effort has been focused on developing clinical scales that require little time to be completed. This is usually achieved by measuring a reduced set of features, i.e., focusing the scales on specific features of a defined target population (Parkinson's disease, Stroke, and so on). However, these scales still require the therapist's intervention and may be tiresome for patients who have to fill them repeatedly. This paper proposes a novel approach to automatically obtain balance scales from the onboard sensors of a robotic rollator. These sensors are used to extract spatiotemporal gait parameters from patients using the rollator for support. These parameters are derived from the user forces on the rollator handles and its odometry. Resulting parameters are used to predict the Tinetti mobility clinical scale on the fly, without therapist intervention. Our approach has been validated with 19 rollator volunteers with a variety of physical and neurological disabilities at Hospital Civil (Malaga) and Fondazione Santa Lucia (Rome). Clinicians provided traditionally obtained Tinetti scores and the proposed system was used to estimate them on the fly. Results show a small root mean squared prediction error. This method can be used for any rollator user anywhere in everyday walking conditions to obtain the Tinetti scores as often as desired and, hence evaluate their progress.

A systematic review of study results reported for the evaluation of robotic rollators from the perspective of users

PURPOSE

To evaluate the effectiveness and perception of robotic rollators (RRs) from the perspective of users.

METHODS

Studies identified in a previous systematic review published on 2016 on the methodology of studies evaluating RRs by the user perspective were re-screened for eligibility based on the following inclusion criteria: evaluation of the human-robot interaction from the user perspective, use of standardized outcome measurements, and quantitative presentation of study results.

RESULTS

Seventeen studies were eligible for inclusion. Due to the clinical and methodological heterogeneity across studies, a narrative synthesis of study results was conducted. We found conflicting results concerning the effectiveness of the robotic functionalities of the RRs. Only a few studies reported superior user performance or reduced physical demands with the RRs compared to unassisted conditions or conventional assistive mobility devices; however, without providing statistical evidence. The user perception of the RRs was found to be generally positive.

CONCLUSIONS

There is still no sufficient evidence on the effectiveness of RRs from the user perspective. More well-designed, high-quality studies with adequate study populations, larger sample sizes, appropriate assessment strategies with outcomes specifically tailored to the robotic functionalities, and statistical analyses of results are required to evaluate RRs at a higher level of evidence. Implications for Rehabilitation RRs cover intelligent functionalities that focus on gait assistance, obstacle avoidance, navigation assistance, sit-to-stand transfer, body weight support or fall prevention. The evaluation from the user perspective is essential to ensure that RRs effectively address users' needs, requirements and preferences. The evidence on the effectiveness of RRs is severely hampered by the low methodological quality of most of the available studies. RRs seem generally to be perceived as positive by the users. There is very limited evidence on the effectiveness and benefits of RRs compared to conventional assistive mobility devices. Further research with high methodological quality needs to be conducted to reach more robust conclusions about the effectiveness of RRs.

Evaluation Studies of Robotic Rollators by the User Perspective: A Systematic Review

BACKGROUND

Robotic rollators enhance the basic functions of established devices by technically advanced physical, cognitive, or sensory support to increase autonomy in persons with severe impairment. In the evaluation of such ambient assisted living solutions, both the technical and user perspectives are important to prove usability, effectiveness and safety, and to ensure adequate device application.

OBJECTIVE

The aim of this systematic review is to summarize the methodology of studies evaluating robotic rollators with focus on the user perspective and to give recommendations for future evaluation studies.

METHODS

A systematic literature search up to December 31, 2014, was conducted based on the Cochrane Review methodology using the electronic databases PubMed and IEEE Xplore. Articles were selected according to the following inclusion criteria: evaluation studies of robotic rollators documenting human-robot interaction, no case reports, published in English language.

RESULTS

Twenty-eight studies were identified that met the predefined inclusion criteria. Large heterogeneity in the definitions of the target user group, study populations, study designs and assessment methods was found across the included studies. No generic methodology to evaluate robotic rollators could be identified. We found major methodological shortcomings related to insufficient sample descriptions and sample sizes, and lack of appropriate, standardized and validated assessment methods. Long-term use in habitual environment was also not evaluated.

CONCLUSIONS

Apart from the heterogeneity, methodological deficits in most of the identified studies became apparent. Recommendations for future evaluation studies include: clear definition of target user group, adequate selection of subjects, inclusion of other assistive mobility devices for comparison, evaluation of the habitual use of advanced prototypes, adequate assessment strategy with established, standardized and validated methods, and statistical analysis of study results. Assessment strategies may additionally focus on specific functionalities of the robotic rollators allowing an individually tailored assessment of innovative features to document their added value.

Smart walkers: an application-oriented review

In this paper, a development method for smart walker prototypes is proposed. Development of such prototypes is based on technological choices and device evaluations. The method is aimed at guiding technological choices in a modular fashion. First, the method for choosing modules to be integrated in a smart walker is presented. Application-specific modules are then studied. Finally, the issues of evaluation are investigated. In order to work out this method, more than 50 smart walkers and their pros and cons with respect to the different studied applications are reviewed.