Assistive and Rehabilitation Robotics

With increasing demands on physical therapy services worldwide due to aging populations and improved survival rates from conditions such as stroke, the role of technology within healthcare is becoming ever more significant. Robotic systems are increasingly seen as a means by which to address the challenge of unmet need, alleviating the burden on physiotherapy staff and budgetary resources while improving patient outcome and quality of life. This may be through the provision of additional therapeutic exercise by means of robotic intervention; creating intelligent prosthetics to improve patient ability and comfort; assistive technologies to enhance patient independence; or improved diagnostic and assessment tools to help evaluate motor impairment or identify developmental conditions.

At Leeds we are at the forefront of developing such technologies, taking a user-centered design approach we engage with clinicians, physiotherapists, patients and their carers to create innovative robotic systems that can have a real impact on people’s lives. With a track record in producing devices and taking them through to clinical trial, enhanced by our state-of-the-art manufacturing facilities, we foster a collaborative research environment with links to Leeds NHS Primary Care Trust.

The main research topics in assistive and rehabilitative robotics at Leeds are (1) Assistive Robotics (2) Rehabilitation Robotics (3) Intelligent Prosthetics and (4) Robotics for Clinics and Schools

Assistive Robotics

A significant number of people currently suffer from disabilities or chronic conditions, which limit their physical capability. There are three particular groups of individuals whose physical capabilities are limited: People with some form of congenital disability from birth. Individuals whose physical capabilities have been affected by illness, disease or accident. Older people who have gradually lost capability as a result of the natural ageing process. Additionally there are individuals, who are engaged in tasks that are arduous and repetitive who could also benefit from some enhancement of their capabilities. Modular assistive and enhancive robotic systems could be used to help these groups by offering solutions to protect health and improve and prolong independence.

At Leeds our research engineers are working with doctors, scientists, designers and industry to generate novel robotic systems to address these issues. Examples of our work include:

• Assistive modular robotic exoskeletons;
• Enhancive modular robotic exoskeletons; and
• Wearable soft robotics for independent living.

Rehabilitation Robotics

Stroke is the largest cause of adult disability in the UK. It impacts a patient’s mobility, independence and well-being. Recovery is largely dependent on the frequency and intensity of therapeutic intervention which, due to limited physiotherapy resources, is often unable to meet the National Institute for Health and Care Excellence’s (NICE) recommended intervention of 45 minutes exercise per day. Robotic systems are seen as a way to provide increased access to therapeutic exercise not just in the acute stages within a hospital setting but also longer term in community stroke units and in the home. They are capable of undertaking the repetitive exercise tasks needed to fulfil the patient’s potential for recovery while at the same time gathering quantitative data about patient performance and improvement. While stroke is often the focus of such interventions due to prevalence and cost to the NHS and social care, the application of this technology extends beyond stoke, helping children with Cerebral Palsy and Development Coordination Disorders along with other neuromuscular conditions.

At Leeds we have developed a suite of systems to address these problems. These include iPAM, a dual robotic system for providing assistive therapeutic exercise to the upper-limb, mimicking the way in which a physiotherapist guides a patients arm. iPAM is designed for use in acute stroke services within a hospital setting to provide additional upper-limb exercise during inpatient care. MyPAM is planar joystick system designed to provide targeted assistive exercise for children with Cerebral Palsy and adults with stroke. Designed to be used in a community setting, they can be installed in schools, community stroke units and in a patient’s home to provide improved access and engagement with therapeutic intervention.

A user-centered design process has been key to the development of these systems, involving patient groups, physiotherapists and clinicians throughout the development through strong links with Leeds NHS Primary Care Trust.

Intelligent Prosthetics

Many people around the world need to go through amputation due to circulatory and vascular problems, complications associated with diabetes or cancer, or Trauma. In order to provide these amputees with more intelligent prosthetics, human locomotion should be thoroughly studied. A key feature of human locomotion is its adaptability and robustness to changing situations. For the cases of standing, walking, turning, ascending and descending steps/ramps, and sitting, the lower limb segments and body centre of mass require a sophisticated intelligent sensory-motor-control system to ensure adaptability.

At Leeds our research aims to provide a novel concept of a lower limb prosthetic system working in synergy with its user by considering the effects of dynamic coupling of body segments and estimation of user intent though various means including body posture monitoring. Our current research include design and development of a smart biomimetic, self-tuning, fully adaptable lower limb prosthetics with energy recovery (Smart BioLeg).

Robotics for Clinics and Schools

We are using robotic systems to help support children with motor difficulties. Children with poor movement skills have lower levels of exercise, poor fitness and reduced participation in social and sports activities. Poor movement skills affect children’s educational progress and they are more likely to become dangerously overweight. Eighty per cent of children with unaddressed movement difficulties have serious ongoing health and social problems in adulthood, but health service teams are overwhelmed by large numbers of referrals. The Chief Medical Officer has argued that helping children at an early stage can prevent ongoing physical and mental health problems, and suggested that schools provide the ideal setting for this help.

Advances in computational neuroscience have allowed the development of models predicting human learning. These models highlight the importance of feedback and feed-forward mechanisms in the acquisition of skills – and help explain why many children struggle to attain critical motor skills such as handwriting. Meanwhile, theories of embodied cognition suggest that motor activity and perception underpin the development of more abstract cognitive skills, thus influencing overall attainment.

The computational models that explain human learning suggest that decreasing the noise associated with feedback signals, and increasing the amount of useful information they contain, can accelerate learning processes. This explains why adults’ and children’s fine motor skills can benefit from robotic therapies which enhance feedback.

Our project is exploring the efficacy of a robotic intervention designed to enhance feedback and we contrast this with a teacher-led ‘pen-and-paper’ programme based on the same neuroscientific principles of motor learning . The project bridges a gap by determining the extent to which well-established functional benefits from motor training (e.g. improvement in manual control) translate into improvements in key academic activities - activities which are reliant on such underpinning functions (e.g. handwriting). We are investigating whether haptic robotic intervention (using the PHANTOM Omni and our own bespoke robotic systems) facilitates additional benefits in related areas of attainment, as predicted by embodied cognition theory.

Our team utilizes a range of standardized computer based tools to measure children’s fine and gross motor skills before and after intervention. These tools are currently being used to track the motor development of 13,500+ children who are part of the ‘Born in Bradford’ longitudinal birth cohort study. This work has been featured in the national media (including BBC television).