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Technology for rehabilitation:�From 50.000 to 0 €�Angelo Basteris��Guest Lecture at UHasselt - REVAL

07/02/2020

07/02/2020

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6th March 2020

07/02/2020

SDU Health Informatics and Technology

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Where I come from

2

07/02/2020

Odense

Odense: the world's leading robot city

07/02/2020

Angelo Basteris

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6th March 2020

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Don’t be shy, please!��I will need your help for demos on:

  • Hand and upper limb movement
  • Full body movement
  • Head movement

​

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Angelo Basteris anba@mmmi.sdu.dk

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Angelo Basteris anba@mmmi.sdu.dk

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Rehabilitation robotics

Basteris, A., Nijenhuis, S.,Stienen, A., A., Buurke, J., Prange, G., & Amirabdollahian, F. (2014). Training modalities in robot-mediated upper limb rehabilitation in stroke: a frameworkfor classification based on a systematic review. Journal of NeuroEngineering and Rehabilitation, 11(1), 111

Angelo Basteris

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Adaptive training for the upper limb

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Manipulation of virtual tools to treat upper limb impairment in people with Multiple Sclerosis

Resistance for training �against muscular weakness

Mass-spring object to promote learning and contrast cerebellar impairment

�

Basteris A., De Luca A., Boehmker M., Bertoni R., Cattaneo D., Carpinella I.,Ferrarin M., Solaro C., Sanguineti V., (2011) A tailored exercise program of manipulation of virtual tools to treat upper limb impairment in Multiple Sclerosis in International Conference on Rehabilitation Robotics (ICORR2011),June 29 – July 1, 2011, Zurich, Switzerland

Angelo Basteris

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Adaptive behaviour

​

​

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Increasing�difficulty�

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Increasing �score

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Randomized control trial

Solaro, Claudio, Davide Cattaneo, Angelo Basteris, Ilaria Carpinella, Alice De Luca, Margit Mueller, Rita Bertoni, Maurizio Ferrarin, and Vittorio Sanguineti. 2020.� “Haptic vs Sensorimotor Training in the Treatment of Upper Limb Dysfunction in Multiple Sclerosis: A Multi-Center, Randomised Controlled Trial.” �Journal of the Neurological Sciences, February, 116743. https://doi.org/10.1016/j.jns.2020.116743.

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Small improvement in 9HPT

​

  • Both groups improved in 9HPT
  • Higher change in Haptic training group�
  • Improvement was not retained after three months
  • No significant change in ARAT score

�

11

Solaro, Claudio, Davide Cattaneo, Angelo Basteris, Ilaria Carpinella, Alice De Luca, Margit Mueller, Rita Bertoni, Maurizio Ferrarin, and Vittorio Sanguineti. 2020.� “Haptic vs Sensorimotor Training in the Treatment of Upper Limb Dysfunction in Multiple Sclerosis: A Multi-Center, Randomised Controlled Trial.” �Journal of the Neurological Sciences, February, 116743. https://doi.org/10.1016/j.jns.2020.116743.

​

Treated arm Non-treated arm

07/02/2020

Angelo Basteris

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SCRIPT �Supervised Care and Rehabilitation Involving Personal Telerobotics

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07/02/2020

  • User centred design of a robotic glove and games to motivate people with stroke to do rehabilitation at home

Amirabdollahian, F., Ates, S., Basteris, A., Cesario, A., Buurke, J. H., Hermens, H., Hofs, D., Johansson, E., Mountain, G., Nasr, N., Nijenhuis, S. M., Prange, G. B., Rahman, N., Sale, P., Schatzlein, F., van Schooten, B. & Stienen, A. Design, development and deployment of a hand/wrist exoskeleton for home-based rehabilitation after stroke - SCRIPT project Dec 2014 In : Robotica. 32, Special issue 08, p. 1331-1346

07/02/2020

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SCRIPT – playing games for rehabilitation with a robotic glove

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07/02/2020

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SCRIPT – Methods and participants

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07/02/2020

  • Six weeks

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  • Games for wrist and hand movements

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  • Instructed to practice at least 3 hours/week, but free to choose if and when

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  • Assessments:
    • Before training
    • After training
    • Two months follow-up

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07/02/2020

Angelo Basteris

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Clinical outcome of 6 weeks of use of robotic glove

  • Upper extremity function and quality of life improved after training, although dexterity did not

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07/02/2020

Nijenhuis SM, Prange GB, Amirabdollahian F, Sale P, Infarinato F, Nasr N, et al. Feasibility study into self-administered training at home using an arm and hand device with motivational gaming environment in chronic stroke. J Neuroeng Rehabil. 2015;12:89

07/02/2020

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Usability and motivation

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07/02/2020

Nijenhuis SM, Prange GB, Amirabdollahian F, Sale P, Infarinato F, Nasr N, et al. Feasibility study into self-administered training at home using an arm and hand device with motivational gaming environment in chronic stroke. J Neuroeng Rehabil. 2015;12:89

Training duration per week: �105 (SD 66) minutes

System Usability Scale: 69 % (SD 17 %)

Intrinsic Motivation Inventory : �5.2 (SD 0.9)

07/02/2020

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Angelo Basteris anba@mmmi.sdu.dk

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Blobo

It is(was) 50 €

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Accelerometer, gyroscope

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07/02/2020

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MakeyMakey

Allows making tangible interfaces

​

Approx 15 €

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07/02/2020

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Full body movements

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Adaptive training with full-body movements�

  • Using Kinect

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  • People with Parkinson’s Disease

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  • Reaching while standing

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  • 9 targets in peri-personal space

Angelo Basteris anba@mmmi.sdu.dk

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07/02/2020

Summa, S., Basteris A., Betti E., and Sanguineti V. “Adaptive Training with Full-Body Movements to Reduce Bradykinesia in Persons with Parkinson’s Disease: A Pilot Study.” Journal of NeuroEngineering and Rehabilitation 12, no. 1 (2015): 16

07/02/2020

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Adaptive training with full-body movements

  • Successful adaptation of target score and increased distance

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  • Improvement in movement duration (score) for the same target

​

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07/02/2020

Summa, S., Basteris A., Betti E., and Sanguineti V. “Adaptive Training with Full-Body Movements to Reduce Bradykinesia in Persons with Parkinson’s Disease: A Pilot Study.” Journal of NeuroEngineering and Rehabilitation 12, no. 1 (2015): 16

07/02/2020

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Using Artificial Intelligence for skeleton tracking

  • The webcam acquires an image
  • The image is processed by a model (which is AI, trained on thousands/millions of pictures)
  • The model identifies poses and the coordinates of the skeleton

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  • All this on the web
  • Based on Google TensorFlow (AI platform)

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07/02/2020

https://ml5js.org/reference/api-PoseNet/

07/02/2020

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PoseNet applications

This slide has been intentionally left empty

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Posturography

​

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Bolbecker AR et al., Postural control in bipolar disorder: increased sway area and decreased dynamical complexity , PLoS One. 2011

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Head movements

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����Let’s do an experiment!�

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Methods

Test subject

Examiner/Observer

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  • Look at the other person
  • Hold your head steady
  • On my cue, close your eyes (still holding your head steady)

Observe the other person

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Results?

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Did people move more with the eyes closed or with the eyes open?

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​

Was the movement ��lateral �or �upward/downward?

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Our methods

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15 seconds

15 seconds

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  • 22 participants
  • Spatial and temporal indicators of movement
  • One-way ANOVAs

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Head tracking software xlabsgaze.com

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Head “sway”

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Eyes open vs closed

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  • Larger movements with closed eyes (in the mediolateral direction)�
  • Faster movements with closed eyes (in the anteroposterior direction)�

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Neck joint proprioception

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We shake our head when we close our eyes!

  • Test is easy to setup and deliver (<1 minute)
  • We can run the experiment with
  • larger cohort of control subjects (for normative values)
  • people with neurodegenerative conditions and musculoskeletal injuries

​

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Neck joint position sense

This slide has been intentionally left empty

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Evaluating the joint position sense in the neck

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Basteris A, Pedler A, Sterling M. Evaluating the neck joint position sense error with a standard computer and a webcam, Man Ther. 2016 Dec;26:231-234. doi: 10.1016/j.math.2016.04.008

  • 22 healthy subjects

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  • Errors in all directions were aligned with (most of the studies in) literature

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What is affective computing?

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Measuring emotions with a webcam

https://www.auduno.com/clmtrackr/examples/clm_emotiondetection.html

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  • No picture is stored or uploaded, anywhere

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1. There is a solution out there!��2. It should be�Simple�Affordable�Adaptive

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https://www.ebay.com/itm/10Pcs-For-Cell-Mobile-Phone-Octopus-Ball-Sucker-Holder-Stand-Sucker-Random-Color/113829008126?hash=item1a80bcd2fe:m:mLq7DeafNUnZaNSzFjR-uAQ

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Horizontal transfer of technology:

movement of technologies from one area to another.

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Thank you!��Anything I can help with: angelobasteris@gmail.com�Slides:

https://cutt.ly/technology

Acknowledgment:

Prof. Peter Feys & his team, REVAL for hospitality and collaboration�UHasselt, Flemish government for funding research stay (Bijzonder Onderzoeksfonds, BOF)

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