Thanks to $1.2 million in funding from the National Institutes of Health, a team of engineers led by Panagiotis Artemiadis (left inset) in collaboration with co-investigators Fabrizio Sergi (right inset), Jill Higginson and Tom Buchanan—later improved upon Will work Stroke rehabilitation with the help of robotics
Photos by Ivan Krepp
December 19, 2022
UD engineers studying how robotic devices can guide personalized rehabilitation strategies for stroke patients
Each year in the United States, approximately 800,000 people have a stroke, and stroke survivors often experience reduced mobility and an increased risk of long-term disability. The recovery and rehabilitation process in this group of patients is challenging both physically and mentally and may take weeks or years to fully recover strength, control and sensation.
Now, a team of researchers from the University of Delaware College of Engineering will work toward improving post-stroke rehabilitation. With $1.2 million in funding from the National Institutes of Health, the project will use robotic exoskeleton devices and advanced modeling techniques to develop patient-specific exercises and interventions using a “therapeutic engineering” approach.
The work will be led by Associate Professor Panagiotis Artemiadis with joint appointments in the Departments of Mechanical Engineering and Biomedical Engineering. Associates and co-investigators, with those joint appointments, include Fabrizio Sergi, an associate professor, Jill Higginson, professor and associate dean for undergraduate and graduate education and director of the Engineering Inspired Health Institute, and Tom Buchanan, George W. Laird Professor of Mechanical Engineering.
post-stroke rehabilitation research
Previous and ongoing research projects at UD have focused on many aspects of the post-stroke rehabilitation process, including how the body perceives its location and movements (proprioception) in order to correct loss of language and speech abilities (aphasia) .
Doctoral student Gilhwan Kim (right) demonstrates the robotic device and adaptive treadmill set-up, a unique approach that more closely mimics how patients would respond in a real-world setting.
This newly-funded project, led by Artemiadis, builds on previous research on exoskeletons, which was conducted as part of an NIH-funded project involving Buchanan, Higginson and Sunil Agarwal (now at Columbia University), and involves “a different outlook and set”. tools “toward improving post-stroke rehabilitation,” Buchanan said.
Buchanan continued, “In some ways it continues a theme that we started several years ago, but it’s using an entirely new toolkit, and that’s what makes it really exciting.”
Higginson said this work also builds on his and Sergi’s research program through the GOALL project, which involves focusing on small “nudges” in movement with the help of robotic systems and adaptive treadmills. Higginson said, “Since then, Panos has come to campus, and he brings a completely different flair that takes this work a step further.” “Overall, this new project is a really innovative way to manipulate the way someone walks.”
Purity and Personalization
One of the main objectives of this research is to develop a mathematical model of human gait and how the brain controls the movement of the legs during walking, Artemiadis said. These models will be developed from data collected on a unique device, a variable-stiffness treadmill, which also allows for a more dynamic assessment of a patient’s gait. The variable stiffness treadmill has been developed in Artemiadis’s lab and is used in a variety of projects with human and robotic walkers.
Artemiadis said, “Once we have a representative model, a patient who needs gait rehabilitation can come into the clinic, and after specific things are evaluated, such as which joints, which muscles needs to be reactivated, an individualized type of therapy can be proposed”. “Our goal is to create a model for the person that allows us to tailor exactly what the robot will do during treatment which can lead to better outcomes.”
Sergi said a major advantage of this study design is the robotic device’s ability to perform very precise interventions that help patients perform specific, repetitive motions that patients need to perform during the rehabilitation process.
Doctoral student Gilhwan Kim (right) using the adaptive treadmill device in the Human Robotics Laboratory on UD’s Science, Technology and Advanced Research (STAR) campus.
“In the context of running, it is important to deliver mechanical stimuli in a way that is synchronized to the moment where it generates maximum propulsion. If you apply a force in a window of 150 milliseconds (ms), for example, You can use the model to ask what will happen 200 ms later if you apply that force,” Sergi said. “But to do that, you need to collect data that correlates exactly with human walking.” be coordinated with, and you can only do that with an automated system.”
“When you have a stroke, the connections between the brain and nerve cells die in a specific area, and only practicing specific motions will rebuild those connections you’ve lost,” Artemiadis said. “The more you practice specific motions, the more the limb and brain can re-learn to control that motion. This is why robot-assisted gait rehabilitation is so promising.”
And relying on an adaptive treadmill that simulates how patients move outside the clinic may also improve retention, or what patients have done in therapy and are able to apply it to their daily lives, he said. Higginson. “Being able to see those changes in real time, so the user experiences it and learns what it feels like to go faster because of the help they’ve got can be beneficial,” she said.
advance the field
The researchers involved in this project will bring together a unique range of expertise towards addressing this research challenge – wearables during walking, with Artemisias’ knowledge of human-robot interactions, interlimb coordination and the study of gait in dynamic environments Sergi’s research on exoskeletons and propulsion, and Higginson and Buchanan’s expertise in anatomy, biomechanics and neuromuscular control.
Jill Higginson (left), professor and associate dean for undergraduate and graduate education and director of the Institute for Engineering Driven Health, and Tom Buchanan, the George W. Laird Professor of Mechanical Engineering, are also co-investigators on this grant.
“This project is a novel use of applied robotics to study human walking, but the real strength of this work is the team we have and the diverse faculty members approach this problem,” Buchanan said. “It’s really exciting to be a part of this project.”
Artemiadis said that along with improving the mobility of post-stroke patients, this work could also help researchers better understand human gait, which could lead to the development of more accurate models and new applications for robotics in health care. is important.
“For robotic-assisted interventions, we need to know exactly what to do to engage the brain in this motion – it’s not just driving your legs to walk, it’s interacting with the legs.” and is having a tremendous interaction with the feet which makes it more efficient in terms of rehabilitation,” Artemiadis said.
One of the biggest challenges for both the field as well as this particular project, Sergi said, is coming up with a personalized treatment model, a challenge that “is also its main advantage”. “One of the main needs of this population is to improve mobility and walking, and these methods go toward understanding how much we can optimize therapeutic programs and movement-based therapies that are part of stroke rehabilitation.”
Higginson said it’s fun to be part of a team that is bringing together different areas of expertise.
“I’m looking forward to being able to apply computational results based on all the experimental data, and to be able to identify differences between interventions,” Higginson said. “I think that can be helpful in furthering the field.”