Title:
Development and Evaluation of Tongue Operated Robotic Rehabilitation Paradigm for Stroke Survivors with Upper Limb Paralysis
Development and Evaluation of Tongue Operated Robotic Rehabilitation Paradigm for Stroke Survivors with Upper Limb Paralysis
Author(s)
Zhang, Zhenxuan
Advisor(s)
Prilutsky, Boris I.
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Abstract
Stroke is a devastating condition that may cause upper limb paralysis. Robotic rehabilitation with self-initiated and assisted movements is a promising technology that could help restore upper limb function. The objective of this research is to develop and evaluate a tongue-operated exoskeleton that will harness the intention of stroke survivors with upper limb paralysis via tongue motion to control robotic exoskeleton during rehabilitation to achieve functional restoration and improve quality of life. Specifically, a tongue operated assistive technology called the Tongue Drive System is used to harness the tongue gesture to generate commands. And, the generated command is used to control rehabilitation robot such as wrist-based exoskeleton Hand Mentor ProTM (HM) and upper limb-based exoskeleton KINARMTM. Through a pilot experiment with 3 healthy participants, we have demonstrated the functionality of an enhanced TDS-HM with pressure-sensing capability. The system can add a programmable load force to increase the exercise intensity in isotonic mode. Through experiments with healthy and stroke subjects, we have demonstrated that the TDS-KINARM system could accurately translate tongue commands to exoskeleton arm movements, quantify function of the upper limb and perform rehabilitation training. Specifically, all healthy subjects and stroke survivors successfully performed target reaching and tracking tasks in all control modes. One of the stroke patients showed clinically significant improvement. We also analyzed the arm reaching kinematics of healthy subjects in 4 modes (active, active viscous, discrete tongue, and proportional tongue) of TDS-KINARM operation. The results indicated that the proportional tongue mode was a better candidate than the discrete tongue mode for the tongue assisted rehabilitation. This study also provided initial insights into possible kinematic similarities between tongue-operated and voluntary arm movements. Furthermore, the results showed that the viscous resistance to arm motion did not affect kinematics of arm reaching movements significantly. Finally, through a 6 healthy subject experiment, we observed a tendency of a facilitatory effect of adding tongue movement to limb movement on event-related desynchronization in EEG, implying enhanced brain excitability. This effect may contribute to enhanced rehabilitation outcome in stroke survivors using TDS with motor rehabilitation.
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Date Issued
2020-07-27
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Dissertation