A portable telerehabilitation system for remote evaluations of impaired elbows in neurological disorders

Abstract

A portable teleassessment system was designed for remote evaluation of elbow impairments in patients with neurological disorders. A master device and a slave device were used to drive a mannequin arm and the patient's arm, respectively. The elbow flexion angle and torque were measured at both the master and slave devices, and sent to each other for teleoperation. To evaluate spasticity/contracture of the patient's elbow remotely, the clinician asked the patient to relax the elbow, moved the mannequin arm at a selected velocity, and haptically felt the resistance from the patient's elbow. In other tasks, the patient moved his/her elbow voluntarily and the clinician observed the corresponding mannequin arm movement and determined the active range of motion (ROM). The clinician could also remotely resist the patient's movement and evaluate the muscle strength. To minimize the effect of network latency, two different teleoperation schemes were used depending on the speed of the tasks. For slow movement tasks, real-time teleoperations were performed using control architectures that considered causality of the tasks, with performance similar to that during an in-person examination. For tasks involving fast movements, a teach-and-replay teleoperation scheme was used which provided the examiner with transparent and stable haptic feeling. Overall, the teleassessment system allowed the clinician to remotely evaluate the impaired elbow of stroke survivors, including assessment of the passive ROM, active ROM, muscle strength, velocity-dependent spasticity, and catch angle.