2014 — 2016 |
Durfee, William K (co-PI) [⬀] Gillespie, Richard Brent [⬀] Krishnan, Chandramouli Remy, Christian David |
R01Activity Code Description: To support a discrete, specified, circumscribed project to be performed by the named investigator(s) in an area representing his or her specific interest and competencies. |
Nri: Wearable Embots to Induce Recovery of Function
DESCRIPTION (provided by applicant): More than 750,000 new or recurrent strokes occur each year in the United States. A large proportion of these Stroke survivors exhibit loss of arm function, which significantly affects thei ability to independently carry out activities of daily living. Recovering lost limb function after stroke requires therapy-often extensive amounts of supervised rehabilitation therapy that starts in the clinic but ideally extends into the home. Robotics offers a promising means to deliver such therapy, but new approaches in human-machine interface, mechanical design, and robot-facilitated interventions are needed. A sufficiently comfortable, lightweight, and portable device is required that facilitates active limb use in everyday tasks and puts the patient in control. Thee are considerable design challenges for a wearable device because motors powerful enough to replace lost muscle function are too heavy to be wearable. In this application, the PIs propose to develop a new class of safe wearable exoskeleton (called eMbots) based on transmissions rather than motors and test its feasibility in restoring arm function in stroke survivors. They see to achieve this overall goal by pursuing the following Specific Aims: (Aim 1) To design and fabricate an Elbow Wrist OrthotiK with Shoulder drive (EWOKS) hydraulic device and establish its mechanical performance. (Aim 2) To establish the physiological effects of eMbots on their wearers by performing a series of biomechanical tests. The physiological evaluations will involve both healthy subjects and motor impaired stroke subjects. All human participant experiments will be conducted in parallel with ongoing device development and designs will be continually improved based on experiment results. (Aim 3) To investigate the efficacy of eMbots to induce recovery of function after stroke by performing a 6-week intervention training in 15 stroke survivors (10 chronic and 5 sub-acute). A series of pre-, post-, and follow-up tests (3 months) of customary clinical measures will be performed to evaluate device efficacy. The proposed application has the potential to transform robotic rehabilitation by providing a new class of wearable robot that may not only benefit stroke survivors, but also individuals suffering from other neurological injuries.
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2017 — 2018 |
Krishnan, Chandramouli Palmieri-Smith, Riann Marie (co-PI) [⬀] |
R21Activity Code Description: To encourage the development of new research activities in categorical program areas. (Support generally is restricted in level of support and in time.) |
Functional Resistance Training During Gait: a Novel Intervention to Improve Knee Function After Acl Reconstruction
Abstract Quadriceps weakness develops rapidly after anterior cruciate ligament (ACL) injury and surgery. Despite aggressive rehabilitation, most people have noteworthy quadriceps weakness when they return to activity. This persistent quadriceps weakness has been associated with altered gait patterns, reduced functional performance, and poor long-term knee health-related quality of life. Emerging evidence also indicates that quadriceps weakness plays a crucial role in the development of post-traumatic osteoarthritis ? a negative outcome that is inevitable in almost 50% of this population. Thus, there is a pressing need for new, clinically- feasible intervention strategies to improve quadriceps function after ACL injury and surgery. We hypothesize that a lack of task-specific training elements in current rehabilitation approaches is the underlying reason for the inability to optimally address persistent asymmetry in knee strength and gait after ACL surgery. Accordingly, the current proposal aims to improve quadriceps function in individuals with anterior cruciate ligament (ACL) reconstruction via a novel paradigm, termed as functional resistance training. Progressive functional resistance training will be performed during walking for 8-weeks using a low-cost wearable robotic brace that is capable of providing scalable resistive torques. Various knee-related biomechanical, neuromuscular, and clinical outcomes will be evaluated both before and after the intervention, and will be compared with a dose-matched control group. The effects of progressive functional resistance training during gait on cortical and spinal reflex excitability will also be evaluated to understand the mechanistic underpinnings of improvements mediated by the intervention. The results of the proposed studies will establish the feasibility of functional resistance training to normalize biomechanical and neuromuscular profiles in individuals with ACL reconstruction. More importantly, the proposed application, if successful, may serve as a foundation for a novel paradigm to target quadriceps dysfunction in individuals with a wide range of knee injuries.
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