Digital Theses Archive


Tesi etd-09272018-165018

Type of thesis
Development and validation of innovative assessment metrics and biomechanical model for upper limb robot-assisted rehabilitation
Scientific disciplinary sector
INGEGNERIA - Biorobotics
relatore DARIO, PAOLO
  • biomechanical model
  • evaluation
  • rehabilitation
  • upper limb
Exam session start date
Upper limb disability following stroke may affect activities of daily living and can drastically change the stroke survivors’ life. To enhance the quality of life for stroke survivors, rehabilitation plays a key role for the patient to regain motor function. Robot-assisted training has been demonstrated to provide safe, effective and cost-effective approach for upper limb rehabilitation. In addition, robotic systems provide objective measures about patient motor performance, which can be used for patient evaluation. Following rehabilitation training, recovery assessment is essential to adapt training intensity and frequency according to patient ability. The motor recovery evaluation using clinical outcome measures is usually performed before and after the training, but performing evaluation during training is difficult because of time and resources limitation. Using kinematic parameters in addition to clinical scales for evaluation has been applied, but the most appropriate clinical outcome measures and kinematic parameters to be used as an integrated assessment method remain unclear.<br>This research aims to investigate the feasibility of an integrated evaluation approach which combines clinical outcome measures, kinematic parameters, physiological variables for upper limb motor recovery following robot-assisted training. The proposed evaluation method is expected to provide a comprehensive and detailed evaluation for the recovery of the patient, not only before-after but session by session training. This research starts with a systematic literature review on the kinematic parameter used for evaluation following upper limb robot-assisted therapy and their correlation with clinical scales. In this review the kinematic parameters, which was recorded by robot devices for evaluating motor recovery after intervention, was identified and classified into the International Classification of Functioning, Disability and Health (ICF) domains. The appropriate clinical outcome measures and kinematic parameters to be used as an integrated assessment method is presented.<br>In next two chapters of this dissertation, the combined evaluation approach based on clinical scales and kinematic parameters was validated by mean of two clinical trials. The results from two trials showed that the kinematic parameters provide objective measures about patient motor performance. Finally, a biomechanical model of the upper limb with acromioclavicular joint dislocation for assessment of upper limb movements with different types of Rockwood acromioclavicular dislocation was developed. This model is used to help the evaluation of the recovery of the patient following shoulder motor impairment.