ABSTRACT
The coronavirus disease (COVID-19) outbreak requires rapid reshaping of rehabilitation services to include patients recovering from severe COVID-19 with post-intensive care syndromes, which results in physical deconditioning and cognitive impairments, patients with comorbid conditions, and other patients requiring physical therapy during the outbreak with no or limited access to hospital and rehabilitation centers. Considering the access barriers to quality rehabilitation settings and services imposed by social distancing and stay-at-home orders, these patients can be benefited from providing access to affordable and good quality care through home-based rehabilitation. The success of such treatment will depend highly on the intensity of the therapy and effort invested by the patient. Monitoring patients' compliance and designing a home-based rehabilitation that can mentally engage them are the critical elements in home-based therapy's success. Hence, we study the state-of-the-art telerehabilitation frameworks and robotic devices, and comment about a hybrid model that can use existing telerehabilitation framework and home-based robotic devices for treatment and simultaneously assess patient's progress remotely. Second, we comment on the patients' social support and engagement, which is critical for the success of telerehabilitation service. As the therapists are not physically present to guide the patients, we also discuss the adaptability requirement of home-based telerehabilitation. Finally, we suggest that the reformed rehabilitation services should consider both home-based solutions for enhancing the activities of daily living and an on-demand ambulatory rehabilitation unit for extensive training where we can monitor both cognitive and motor performance of the patients remotely.
ABSTRACT
In a robotic rehabilitation setup, patient's safety and interaction stability are critical throughout the therapy. This paper addresses the stability aspect by proposing a method to vary the endpoint stiffness using a variable impedance mechanism. The proposed device consists of permanent magnets in an antagonistic configuration that acts as springs and the variation in stiffness is achieved by modifying the separation between those magnets. This device is mounted on the end-effector of an admittance controlled robotic arm and tested with the help of healthy humans on a virtual maze traversal experiment consisting of both fine and gross motor regions. Moreover, the subjects are tested both in normal and simulated tremor conditions to verify the effectiveness of the device. The experimental results show that the VSM can not only suppress the high-frequency forces but can also reduce the interference of human endpoint stiffness in the stability of the robot.
