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A team of researchers at the Hong Kong Polytechnic University (PolyU) achieved a significant step in the development of rehabilitation devices by introducing a groundbreaking technology-driven solution. The Mobile Ankle-foot Exoneuromusculoskeleton, a robot for ankle-foot rehabilitation designed specifically for stroke patients with hemiplegia, utilises the Internet of Things (IoT) technology to revolutionise the way stroke patients regain their lower limb function and walking ability.
This device facilitates tele-rehabilitation, allowing remote monitoring and self-help rehabilitation exercises at home, thereby addressing the challenge of limited access to in-person rehabilitation services in Hong Kong.
In recent years, Hong Kong has experienced a high number of new stroke cases annually, with a large portion of patients suffering from varying degrees of physical mobility impairments. Regular and intensive rehabilitation training is crucial for these patients to regain their physical mobility and alleviate post-stroke disabilities.
However, due to the overwhelming demand for daytime outpatient rehabilitation services, stroke patients often struggle to receive timely and consistent rehabilitation. Common issues among stroke patients, such as foot drop and inversion, significantly disrupt their daily lives.
The Mobile Ankle-foot Exoneuromusculoskeleton, developed by a research team led by Dr. Hu Xiaoling, Associate Professor of the Department of Biomedical Engineering at PolyU, is a groundbreaking wearable robot for ankle-foot rehabilitation.
This multifaceted device combines exoskeleton technology, soft pneumatic muscles, tactile sensory feedback, and neuromuscular electrical stimulation to effectively correct foot drop, foot inversion, and improve the walking gait of stroke patients. It also aids in balance improvement and contributes to long-term rehabilitative neuroplasticity.
Stroke patients with hemiplegia often suffer from weakened muscle strength and coordination in their affected lower limbs, especially in the foot and ankle. The Mobile Ankle-foot Exoneuromusculoskeleton can automatically detect various gait events, including standing, heel strike, heel off, and toe-off. With mechanical support from the exoskeleton, soft pneumatic muscles, vibration tactile feedback, and neuromuscular electrical stimulation, the device helps patients stand securely on their affected foot, balance plantar pressure, and exert propelling force when walking, ultimately enhancing their foot drop condition.
The device is characterised by its lightweight design, weighing approximately 400 grams, which allows hemiplegic patients to wear it independently. It also boasts energy efficiency, providing up to four hours of continuous use with a 9V rechargeable battery, enabling patients to engage in rehabilitation exercises at their convenience, whether at home or outdoors.
In contrast, other lower-limb exoskeleton robots on the market primarily depend on external forces and have limited capabilities in improving ankle joint and muscle coordination for stroke patients. They are typically constrained to hospital and rehabilitation clinic settings. Conventional ankle-foot orthoses may result in muscle atrophy and disrupt patients’ ability to regain voluntary motor control over the affected ankle.
The device not only offers stroke patients a more flexible and effective approach to lower limb rehabilitation but also enables therapists to remotely supervise multiple patients’ rehabilitation progress. It aims to complement traditional outpatient rehabilitation services and help stroke patients achieve more efficient rehabilitation results.
The PolyU team is collaborating with local and Mainland hospitals and rehabilitation clinics to conduct clinical studies on the Mobile Ankle-foot Exoneuromusculoskeleton. The results have shown that this device significantly enhances stroke rehabilitation, surpassing the efficacy of using external mechanical forces alone. Patients participating in the clinical studies demonstrated notable improvements in ankle dorsiflexion and successfully corrected foot inversion.
The team has harnessed IoT technology to record patients’ rehabilitation progress through a mobile app. This approach offers real-time monitoring, progressive evaluation, personalised guidance, and reminders. It empowers patients to engage in rehabilitation independently, improving patient engagement and treatment outcomes.
The app fosters mutual support and companionship among patients throughout their training journey, allowing therapists to provide remote monitoring and supervision for multiple patients, ensuring a smooth rehabilitation process.