Feasibility Study: Towards a Robot-Assisted Gait Training in Ophthalmological Rehabilitation

The idea of using mobile assistance robots for gait training in rehabilitation has been increasingly explored in recent years due to the associated benefits. This paper describes how the previous results of research and praxis on gait training with a mobile assistance robot in orthopedic rehabilitation can be transferred to ophthalmic-related orientation and mobility training for blind and visually impaired people. To this end, the specific requirements for such orientation and mobility training are presented from a therapeutic perspective. Using sensory data, it is investigated how the analysis of training errors can be automated and transferred back to the training person. These pre-examinations are the prerequisite for any form of robot-assisted mobile gait training in ophthamological rehabilitation, which does not exist so far and which is expected to be of great benefit to these patients.

Robot-Assisted Gait Self-Training: Assessing the Level Achieved

This paper presents the technological status of robot-assisted gait self-training under real clinical environment conditions. A successful rehabilitation after surgery in hip endoprosthetics comprises self-training of the lessons taught by physiotherapists. While doing this, immediate feedback to the patient about deviations from the expected physiological gait pattern during training is important. Hence, the Socially Assistive Robot (SAR) developed for this type of training employs task-specific, user-centered navigation and autonomous, real-time gait feature classification techniques to enrich the self-training through companionship and timely corrective feedback. The evaluation of the system took place during user tests in a hospital from the point of view of technical benchmarking, considering the therapists' and patients' point of view with regard to training motivation and from the point of view of initial findings on medical efficacy as a prerequisite from an economic perspective. In this paper, the following research questions were primarily considered: Does the level of technology achieved enable autonomous use in everyday clinical practice? Has the gait pattern of patients who used additional robot-assisted gait self-training for several days been changed or improved compared to patients without this training? How does the use of a SAR-based self-training robot affect the motivation of the patients?

Mobile Robot-Based Gait Training after Total Hip Arthroplasty (THA) Improves Walking in Biomechanical Gait Analysis

There are multiple attempts to decrease costs in the healthcare system while maintaining a high treatment quality. Digital therapies receive increasing attention in clinical practice, mainly relating to home-based exercises supported by mobile devices, eventually in combination with wearable sensors. The aim of this study was to determine if patients following total hip arthroplasty (THA) could benefit from gait training on crutches conducted by a mobile robot in a clinical setting.

METHOD

This clinical trial was conducted with 30 patients following total hip arthroplasty. Fifteen patients received the conventional physiotherapy program in the clinic (including 5 min of gait training supported by a physiotherapist). The intervention group of 15 patients passed the same standard physiotherapy program, but the 5-min gait training supported by a physiotherapist was replaced by 2 × 5 min of gait training conducted by the robot. Length of stay of the patients was set to five days. Biomechanical gait parameters of the patients were assessed pre-surgery and upon patient discharge.

RESULTS

While before surgery no significant difference in gait parameters was existent, patients from the intervention group showed a significant higher absolute walking speed (0.83 vs. 0.65 m/s, p = 0.029), higher relative walking speed (0.2 vs. 0.16 m/s, p = 0.043) or shorter relative cycle time (3.35 vs. 3.68 s, p = 0.041) than the patients from the control group.

CONCLUSION

The significant higher walking speed of patients indicates that such robot-based gait training on crutches may shorten length of stay (LOS) in acute clinics. However, the number of patients involved was rather small, thus calling for further studies.

May I Keep an Eye on Your Training? Gait Assessment Assisted by a Mobile Robot

A successful rehabilitation after surgery in hip endoprosthetics comprises self-training of the lessons taught by physiotherapists. While doing this, immediate feedback to the patient about deviations from physiological gait patterns during training is important. Such immediate feedback also concerns the correct usage of forearm crutches in three-point gait. In the project ROGER, a mobile Socially Assistive Robot (SAR) to support patients after surgery in hip endoprosthetics is going to be developed. The current implementation status of the robotic application developed for the use in a real-world scenario is presented below.

Robotic Companions for Older People: A Case Study in the Wild

Older people tend to have difficulties using unknown technical devices and are less willing to accept technical shortcomings. Therefore, a robot that is supposed to support older people in managing daily life has to adapt to the users' needs and capabilities that are very heterogeneous within the target group. The aim of the presented case study was to provide in-depth insights on individual usage patterns and acceptance of a mobile service robot in real live environments (i.e. in the users' homes). Results from three cases (users aged 67, 78 and 85 living in their own apartments) are reported. Findings on usability and user experience illustrate that the robot has considerable potential to be accepted to support daily living at home.

A Monocular Pointing Pose Estimator for Gestural Instruction of a Mobile Robot

We present an important aspect of our human-robot communication interface which is being developed in the context of our long-term research framework PERSES dealing with highly interactive mobile companion robots. Based on a multi-modal people detection and tracking system, we present a hierarchical neural architecture that estimates a target point at the floor indicated by a pointing pose, thus enabling a user to navigate a mobile robot to a specific target position in his local surroundings by means of pointing. In this context, we were especially interested in determining whether it is possible to accomplish such a target point estimator using only monocular images of low-cost cameras. The estimator has been implemented and experimentally investigated on our mobile robotic assistant HOROS. Although only monocular image data of relatively poor quality were utilized, the estimator accomplishes a good estimation performance, achieving an accuracy better than that of a human viewer on the same data. The achieved recognition results demonstrate that it is in fact possible to realize a user-independent pointing direction estimation using monocular images only, but further efforts are necessary to improve the robustness of this approach for everyday application.

Studies on the structure and mechanism of H-ras p21

Current knowledge of the structure of H-ras p21 is reviewed with particular emphasis on the interaction between guanine nucleotides and the active site of the protein. The nature of the conformational change induced by GTP hydrolysis is discussed. The major change is seen in the region known as the effector loop (loop 2), with significant but less well-defined changes occurring in loop 4, which is implicated in the GTPase reaction. Other evidence concerning the mechanism of GTP hydrolysis and its activation by GAP (GTPase-activating protein) is also discussed. Evidence regarding the rate limiting step in the p21 GTPase reaction, and the manner in which this and possibly other steps are accelerated by GAP, is inconclusive.