Centro tecnológico Cartif

Rehabilitation and support

Each year thousands of people have accidents that cause upper-limb paralysis due to damage to the nervous system (head injury, backbone damage, etc.). Fortunately, more than two thirds of the people that have these accidents survive, but most of them end up with damaged sensory and motor centers, which provoke a notable loss of mobility and ability in the upper and lower limbs. This decline of movement ability can be of different degrees of severity.

The upper-limbs therapy is used on neurorehabilitation for patients with their extremities paralyzed due to injuries to the central or peripheral nervous system, for example, a stroke or cerebrovascular accident (CVA), a brain hemorrhage, or a backbone injury. The objective of these therapies is to recover motor skills, improve movement coordination, learn new movement strategies, and prevent secondary complications, like muscular atrophy, osteoporosis, or spasticity (muscular hypertonicity.)

Beyond the classic therapies, innovative methods have been recently developed, which have yielded very interesting results. These new methods include:

• Limited induced movements for patients with partial functional deficiencies.
• Repetitive training techniques.
• Electromyographic biofeedback.
• Functional electrical stimulation (FES) for patients with severe arm paralysis.

On neurorehabilitation, the first objective of the therapies is to maintain and restore the movements of the afflicted limb (arm or leg). The biological basis of the motor restoration is the neuroplasticity, which is the ability of the brain to adapt to new conditions, by reorganizing itself and forming new synapses, replacing the lost ones.

In the Biomedical Engineering area we are developing a novel methodology for the rehabilitation of patients with upper limbs (wrist, arm, shoulder) disability by using a robotic device, which can change the intensity of assistive therapies, dynamically regulating the amount of assistance/resistance given to the patient by the robotic system, according to the values of the physiological signals of the patient (“biofeedback”) that are being measured and processed “on-line” while the patient is undergoing the robot-assisted rehabilitation therapy.

In our research we want to use as biofeedback the physiological signals of the autonomous nervous system of the patient. It controls all the involuntary functions of the body: cardiac rhythm, perspiration, etc. The processing and analysis oh these signals will allow adapting the assistive therapy to the real state of the patient that is undergoing rehabilitation using the robot.

Therefore, the use of intelligent robotic devices, along with the feedback of the patient’s biological signals (“biofeedback”), can contribute in a significant way to the rehabilitation process, from the patient’s point of view, by letting them to be motivated and to participate more actively in the process; as well as from the physiotherapist’s point of view, since they can focus their activity on the medical aspects of the rehabilitation and, at the same time, evaluate the progress of the patient’s rehabilitation.

In order to work on this project and execute tests with disabled people, a multidisciplinary group has been formed, made up of engineers and physiotherapists.