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Fuzzy Logic-Based Risk Assessment of a Parallel Robot for Elbow and Wrist Rehabilitation.

ABSTRACT: A few decades ago, robotics started to be implemented in the medical field, especially in the rehabilitation of patients with different neurological diseases that have led to neuromuscular disorders. The main concern regarding medical robots is their safety assurance in the medical environment. The goal of this paper is to assess the risk of a medical robotic system for elbow and wrist rehabilitation in terms of robot and patient safety. The approached risk assessment follows the ISO12100:2010 risk management chart in order to determine, identify, estimate, and evaluate the possible risk that can occur during the use of the robotic system. The result of the risk assessment process is further analyzed using a fuzzy logic system in order to determine the safety degree conferred during the use of the robotic system. The innovative process concerning the risk assessment allows the achievement of a reliable medical robotic system both for the patient and the clinicians as well. The clinical trials performed on a group of 18 patients validated the functionality and the safe behavior of the robotic system.

SUBMITTER: Tucan P

PROVIDER: S-EPMC7013898 | biostudies-literature | 2020 Jan

REPOSITORIES: biostudies-literature

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Fuzzy Logic-Based Risk Assessment of a Parallel Robot for Elbow and Wrist Rehabilitation.

Tucan Paul P Gherman Bogdan B Major Kinga K Vaida Calin C Major Zoltan Z Plitea Nicolae N Carbone Giuseppe G Pisla Doina D

International journal of environmental research and public health 20200119 2

A few decades ago, robotics started to be implemented in the medical field, especially in the rehabilitation of patients with different neurological diseases that have led to neuromuscular disorders. The main concern regarding medical robots is their safety assurance in the medical environment. The goal of this paper is to assess the risk of a medical robotic system for elbow and wrist rehabilitation in terms of robot and patient safety. The approached risk assessment follows the ISO12100:2010 r ...[more]

PMID: 31963917

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Project description:BackgroundIn recent years, many studies focused on the use of robotic devices for both the assessment and the neuro-motor reeducation of upper limb in subjects after stroke, spinal cord injuries or affected by neurological disorders. Contrarily, it is still hard to find examples of robot-aided assessment and rehabilitation after traumatic injuries in the orthopedic field. However, those benefits related to the use of robotic devices are expected also in orthopedic functional reeducation.MethodsAfter a wrist injury occurred at their workplace, wrist functionality of twenty-three subjects was evaluated through a robot-based assessment and clinical measures (Patient Rated Wrist Evaluation, Jebsen-Taylor and Jamar Test), before and after a 3-week long rehabilitative treatment. Subjects were randomized in two groups: while the control group (n = 13) underwent a traditional rehabilitative protocol, the experimental group (n = 10) was treated replacing traditional exercises with robot-aided ones.ResultsFunctionality, assessed through the function subscale of PRWE scale, improved in both groups (experimental p = 0.016; control p < 0.001) and was comparable between groups, both pre (U = 45.5, p = 0.355) and post (U = 47, p = 0.597) treatment. Additionally, even though groups' performance during the robotic assessment was comparable before the treatment (U = 36, p = 0.077), after rehabilitation the experimental group presented better results than the control one (U = 26, p = 0.015).ConclusionsThis work can be considered a starting point for introducing the use of robotic devices in the orthopedic field. The robot-aided rehabilitative treatment was effective and comparable to the traditional one. Preserving efficacy and safety conditions, a systematic use of these devices could lead to decrease human therapists' effort, increase repeatability and accuracy of assessments, and promote subject's engagement and voluntary participation. Trial Registration ClinicalTrial.gov ID: NCT04739644. Registered on February 4, 2021-Retrospectively registered, https://www.clinicaltrials.gov/ct2/show/study/NCT04739644 .

Project description:BackgroundElbow and wrist chronic conditions are very common among musculoskeletal problems. These painful conditions affect muscle function, which ultimately leads to a decrease in the joint's Range Of Motion (ROM). Due to their portability and ease of use, goniometers are still the most widespread tool for measuring ROM. Inertial sensors are emerging as a digital, low-cost and accurate alternative. However, whereas inertial sensors are commonly used in research studies, due to the lack of information about their validity and reliability, they are not widely used in the clinical practice. The goal of this study is to assess the validity and intra-inter-rater reliability of inertial sensors for measuring active ROM of the elbow and wrist.Materials and methodsMeasures were taken simultaneously with inertial sensors (Werium™ system) and a universal goniometer. The process involved two physiotherapists ("rater A" and "rater B") and an engineer responsible for the technical issues. Twenty-nine asymptomatic subjects were assessed individually in two sessions separated by 48 h. The procedure was repeated by rater A followed by rater B with random order. Three repetitions of each active movement (elbow flexion, pronation, and supination; and wrist flexion, extension, radial deviation and ulnar deviation) were executed starting from the neutral position until the ROM end-feel; that is, until ROM reached its maximum due to be stopped by the anatomy. The coefficient of determination (r 2) and the Intraclass Correlation Coefficient (ICC) were calculated to assess the intra-rater and inter-rater reliability. The Standard Error of the Measurement and the Minimum Detectable Change and a Bland-Altman plots were also calculated.ResultsSimilar ROM values when measured with both instruments were obtained for the elbow (maximum difference of 3° for all the movements) and wrist (maximum difference of 1° for all the movements). These values were within the normal range when compared to literature studies. The concurrent validity analysis for all the movements yielded ICC values ≥0.78 for the elbow and ≥0.95 for the wrist. Concerning reliability, the ICC values denoted a high reliability of inertial sensors for all the different movements. In the case of the elbow, intra-rater and inter-rater reliability ICC values range from 0.83 to 0.96 and from 0.94 to 0.97, respectively. Intra-rater analysis of the wrist yielded ICC values between 0.81 and 0.93, while the ICC values for the inter-rater analysis range from 0.93 to 0.99.ConclusionsInertial sensors are a valid and reliable tool for measuring elbow and wrist active ROM. Particularly noteworthy is their high inter-rater reliability, often questioned in measurement tools. The lowest reliability is observed in elbow prono-supination, probably due to skin artifacts. Based on these results and their advantages, inertial sensors can be considered a valid assessment tool for wrist and elbow ROM.

Project description:Similarity measure, also called information measure, is a concept used to distinguish different objects. It has been studied from different contexts by employing mathematical, psychological, and fuzzy approaches. Image steganography is the art of hiding secret data into an image in such a way that it cannot be detected by an intruder. In image steganography, hiding secret data in the plain or non-edge regions of the image is significant due to the high similarity and redundancy of the pixels in their neighborhood. However, the similarity measure of the neighboring pixels, i.e., their proximity in color space, is perceptual rather than mathematical. Thus, this paper proposes an interval type-2 fuzzy logic system (IT2 FLS) to determine the similarity between the neighboring pixels by involving an instinctive human perception through a rule-based approach. The pixels of the image having high similarity values, calculated using the proposed IT2 FLS similarity measure, are selected for embedding via the least significant bit (LSB) method. We term the proposed procedure of steganography as 'IT2 FLS-LSB method'. Moreover, we have developed two more methods, namely, type-1 fuzzy logic system based least significant bits (T1FLS-LSB) and Euclidean distance based similarity measures for least significant bit (SM-LSB) steganographic methods. Experimental simulations were conducted for a collection of images and quality index metrics, such as PSNR (peak signal-to-noise ratio), UQI (universal quality index), and SSIM (structural similarity measure) are used. All the three steganographic methods are applied on dataset and the quality metrics are calculated. The obtained stego images and results are shown and thoroughly compared to determine the efficacy of the IT2 FLS-LSB method. We have also demonstrated the high payload capacity of our proposed method. Finally, we have done a comparative analysis of the proposed approach with the existing well-known steganographic methods to show the effectiveness of our proposed steganographic method.

Dataset Information

Fuzzy Logic-Based Risk Assessment of a Parallel Robot for Elbow and Wrist Rehabilitation.

Publications

Fuzzy Logic-Based Risk Assessment of a Parallel Robot for Elbow and Wrist Rehabilitation.

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