Design, implementation and analysis of a cost-effective rehabilitation robot for children with cerebral palsy

Abstract

Background: Cerebral palsy is neurological damage that results in severe physical disability in children. It often affects the motor control of the upper limb, leading to difficulties in performing activities of daily living. The core mechanisms of rehabilitation interventions to promote upper limb function involve targeted and highly intensive practice of functional tasks, which drives neural plasticity to improve motor skills. However, majority of rehabilitation robots are designed for clinical settings where it has challenge of motivation for children to engage with high intensity frequent therapy due to the need to travel to and from the clinic. Aim: Design, develop and evaluate a low-cost home-based rehabilitation robotic system integrating hand grasping, elbow flexion/extension and forearm pronation/supination movement assistance for children with cerebral palsy. Methods: Literature review and User Centred Design (UCD) were conducted to identify and understand the requirements of a home-based upper limb rehabilitation robot. Mechanical structure was optimised through topology optimisation. Arduino is used to test the force sensors that will be used in this robot. Basic cost-effectiveness of home-based rehabilitation robot were summarised through literature research. Conclusions: This research provided a detailed research identifying what a home-based rehabilitation robot should do and providing a reasonable, effective and cost-effectiveness solution for home-based upper limb rehabilitation for children with cerebral palsy. It is helpful for increasing users’ motivation and efficiency of post-stroke rehabilitation and reducing the stress on clinical and therapists. After structure optimisation, the final mass of the whole device is estimated about 8300g, reduced the 6.95% mass of original design. In the cost analysis, the ideal rehabilitation robot should have 5 DOF’s, weight less than 10kg and cost under £5,000. The cost comparison between clinical intensive treatment, clinical rehabilitation robot-assisted therapy and home-based rehabilitation robot-assisted therapy proves the cost-effectiveness of home-based rehabilitation robot-assisted therapy. A three month trail indicated that robotic-assisted therapy had a lower total cost (£9,265.50) relative to the usual care (£13,956.34) when there is no significant difference of upper limb functional improvement between them. Contribution: Developed a journal paper involving 4 themes and 63 design requirements from therapists and patients for a home-based rehabilitation robot (has been submitted to the journal topics of stroke rehabilitation and under reviewing). The first analysis of human upper limb joint usage in 21 high frequency ADLs to inform what a home-based upper limb rehabilitation robot should do. Designed and manufactured a prototype of a novel low-cost home-based rehabilitation robot with 5 DOF’s. Designed the first force sensing handgrip for a home-based rehabilitation robot which can measure real-time grip strength and promote useful exercise.  

Date of Award	31 Dec 2021
Original language	English
Awarding Institution	The University of Manchester
Supervisor	Parthasarathi Mandal (Supervisor), Sarah Tyson (Supervisor) & Andrew Weightman (Supervisor)