There are numerous causes that can affect the functioning of the human locomotor system, leading to the appearance of joint disorders in the lower limb and generating atypical gait patterns. The importance of research and development in assistance technologies to compensate patho-logical gait have been recognised since the beginning of the twentieth century and numerous challenges still lie ahead to make their clinical application a reality. In this section, GAIT, the lower-limb Wearable exoskeleton is presented, conceived as a compensation and evaluation system of pathological gait, for application in real conditions as a combined assistance and assessment methodology of the problems affecting mobility in individuals with neuromotor disorders. The main technological challenges are discussed with respect to sensing, actuation and control subsystems. Special emphasis is placed on advances in robotic lower-limb orthoses, and biomechanical requirements, structural design considerations and the approaches existing to develop robust real-time controllers for portable solutions with a common aim, human motor control, are analysed.

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In 2003, 700,000 persons in the United States suffered a cerebral vascular accident (CVA), or stroke, with the total number of survivors estimated at 5.5 million. The total cost for rehabilitation and lost revenue in 2006 was 57.9 billion (Thom, Haase et al. 2006). Stroke common-ly causes significant residual physical, cognitive, and psychological impairment (Gresham 1990). As the geriatric population increases and more effective therapies for acute stroke management emerge, there will be more survivors living with disabilities. In addition to greater numbers of survivors, there has been an increase in the number of more moderately affected survivors (Wolf, D’Agostino et al. 1992), which has increased the demand for stroke rehabilitation in an era of health care cost containment. Efforts to pre-vent stroke must, therefore, be balanced with pragmatic efforts to prevent disability and maximize quality of life for stroke survivors. Persons with hemiparesis following stroke constitute the largest group of patients receiving rehabilitation services in this country. The current consensus regarding rehabilitation of patients with some voluntary control over movements of the paretic limb is that they be encouraged to use the limb in functional tasks and receive training directed toward improving strength and motor control, relearning sensorimotor relationships, and improving functional performance (Gresham, Alexander et al. 1997). Given such recommendations, the research community has responded with efforts to improve the effectiveness of rehabilitative treatment of motor disability resulting from stroke.

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The Movement Disorder Society defines tremor as an involuntary rythmi-cal oscillation of a body part (Deuschl et al. 1998). This definition excludes other movement disorders with a less cyclic character such as chorea or ataxia. Tremor is the most frequent movement disorder in clinical practice with an estimated prevalence between 3-4% of the population over 50 (Manto et al. 2004). Everybody has some tremor component, usually invisible for the naked eye, called physiological tremor. However, there are other forms of pathological tremor that can be very disabling, and often a cause of social exclusion (Rocon et al. 2004). There are many pathologies that can cause pathological tremor, among others Essential Tremor, Parkinson Disease, brain trauma or multiple sclerosis. Common treatments of tremor are pharmacological and surgical. Pharmacological treatments depend on the specific pathology that causes tremor. For instance Parkinson disease tremor is treated with L-dopa, and common treatments for Essential Tremor are blockers (Deuschl et al. 1998). Surgical classical treatment for tremor is thalamic thermocoagulation (Deuschl et al. 2000). However from mid 90’s Deep Brain Stimulation (DBS) is preferred to thermocoagulation (Deuschl et al. 2000). Despite these therapies, there are still an important number of people with pathological tremor resistant to the common treatments (Deuschl et al. 1998). Thus, other alternatives are of interest to help people suffering from different kinds of pathological tremor. Many of these alternatives focus on removing the consequences of tremor rather than its origins. Among others the following approaches can be mentioned: Removing the tremor from a tremorous signal (Riviere & Thakor, 1996; Gonzalez et al. 2000) Design of assistive devices based in dampers (such as the NeaterEater or the MouseTrap Design of robotics systems to suppress tremor. This chapter focuses the attention on the design of robotics systems to suppress tremor. First of all, we will introduce different strategies to suppress tremor using robotic approaches, then we will show the biomechanical and ergonomics issues to take into consideration in the design of these robotic systems, finally we will introduce a set of guidelines to take into account in the design of robotics systems for tremor suppression.

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There are numerous causes that can affect the functioning of the human locomotor system, leading to the appearance of joint disorders in the lower limb and generating atypical gait patterns. The importance of research and development in assistance technologies to compensate patholo-gical gait have been recognised since the beginning of the twentieth century and numerous challenges still lie ahead to make their clinical application a reality. In this section, GAIT, the lower-limb Wearable exoskeleton is presented, conceived as a compensation and evaluation system of pathological gait, for application in real conditions as a combined assistance and assessment methodology of the problems affecting mobility in individuals with neuromotor disorders.

(далее…)

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In recent years, robots have made substantial in-roads in the medical field and are gradually finding their way into clinical practice. Intuitive Surgical’s da Vinci surgical robot broke ground in 1998 by performing the first tele-robotic surgery to repair a heart valve. Accuray’s CyberKnife radiotherapy robot began treating head, neck and upper spine tumors in 1999 by combining image guidance with a robotically-directed radiation beam. In 2002, Interactive Motion Technology began therapy of stroke patients with the InMotion2 robot, also known as the MIT-Manus . These devices and many others under development have provided researchers and doctors alike with capabilities not previously available.

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