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Project 10733: ROBIN



People involved:


Dr ir Erwin de Vlugt
Project function: Project Leader
Organisation: Technische Universiteit Delft

Stijn van Eesbeek
Project function: PhD candidate
Organisation: Technische Universiteit Delft

Karin de Gooijer- van de Groep
Project function: PhD candidate
Organisation: Leids Universitair Medisch Centrum

Lizeth Sloot
Project function: PhD candidate
Organisation: Vrije Universiteit Medisch Centrum

Prof.dr. Frans van der Helm
Project function: Co-applicant, Program Leader
Organisation: Technische Universiteit Delft

Dr.ir. Alfred Schouten
Project function: Co-applicant
Organisation: Technische Universiteit Delft

Dr. Carel Meskers
Project function: Co-applicant
Organisation: Leids Universitair Medisch Centrum

Dr.ir. Jaap Harlaar
Project function: Co-applicant
Organisation: Vrije Universiteit Medisch Centrum

Dr.ir. Jurriaan de Groot
Project function: Co-applicant
Organisation: Leids Universitair Medisch Centrum

Prof.dr. Hans Arendzen
Project function: Co-applicant
Organisation: Leids Universitair Medisch Centrum

Prof.dr. Gert Kwakkel
Project function: Co-applicant
Organisation: Vrije Universiteit Medisch Centrum

Prof.dr. Jules Becher
Project function: Co-applicant
Organisation: Vrije Universiteit Medisch Centrum


Newsletter (2) November 2012

As most movement disorders are manifest during execution of movements, we finished a new identification method that enabled estimation of muscle and reflex stiffness for a wide range of movement tasks. CP patients were separated from healthy controls and from each other based on intrinsic and reflexive properties. Most recent results showed accurate estimation of muscle, tendon and reflexive stiffness within just a single observation of less than one minute! From small changes in treadmill velocity we also achieved in estimation of ankle joint viscoelasticity during walking. Multicenter (LUMC/VUMC) ROBIN stroke/CP cohort study starts early 2013.
 



Newsletter (1) April 2012

Main technological challenge in the ROBIN project is the development of time variant identification techniques for physiological system analysis. Humans control muscle activation to change joint stiffness for stabilization and to produce force for movement. Stabilization and force production need to be timed precisely for adequate posture maintenance and movement. As muscular and reflexive contributions change constantly over time in daily tasks, the time variant identification technique must be able to quantify these contributions in time.

The ROBIN project is progressing to meet these goals and finished to following tasks:
• An existing time variant identification technique, called linear parameter varying (LPV) system identification as applied to windmill control, was adopted and tested on simulated and real human data of joint stiffness. Intrinsic muscle stiffness and reflexive feedback from muscle spindles were accurately tracked over time, even for relatively fast transitions. Contact Stijn van Eesbeek for more information about LPV identification.

• Achilles, a single axis manipulator, has been developed by MOOG The Netherlands for patient measurements, ready for applying static and dynamics measurements of the human ankle. The data will be analysed using the LPV methods. Different virtual dynamics have been implemented to simulate various loading conditions. For more information about the Achilles, contact Piet Lammertse (MOOG The Netherlands).

• A three stage ABC-protocol has been defined, comprising A) passive, B) active (isometric) and C) active movement tests to be performed on the Achilles. The A part has been tested on stroke and CP patients at the Leiden University Medical Center (LUMC) in the Laboratory for Neuromechanics and Kinematics. Patients were clearly separated by intrinsic and reflexive properties underlying ankle joint stiffness. For more information about the protocol and Achilles measurements, contact Karin de Gooijer-van de Groep.

• Y-Mill, an instrumented dual band treadmill has been installed and tested at the Rijnlands Rehabilitation Center (RRC) in Leiden. A new calibration method is under development to calibrate the force plates for different loading conditions. The Y-Mill will be used to apply small perturbations by fast changes of the band velocity to identify the ankle stiffness during walking. The role of ankle joint stiffness in gait stability and velocity will be determined. For more information about the role of ankle stiffness in walking contact Lizeth Sloot. For more information about the Y-Mill, contact Peter Martens (ForceLink BV).

First patient measurements will start in April 2012. The clinical aims are twofold:
1. Quantification of the effect of different ankle interventions (e.g. BOTOX) on neuromuscular properties (treatment-effect).
2. Prediction of ankle interventions on ankle stiffness and gait patterns (treatment-function).
The clinical trials within the ROBIN project are supervised by Dr. Carel Meskers (LUMC). For general questions contact Dr. Erwin de Vlugt (TU Delft).


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Introduction
 

ROBot aided system Identification: novel tools for diagnosis and assessment in Neurological rehabilitation (acronym ROBIN) is a multidisciplinary project aiming to identify the underlying neuromuscular mechanisms causing abnormal stiffness of the ankle joint in stroke and cerebral palsy patients.

ROBIN comprises three PhD-student positions, one technical for development of a nonlinear identification technique (already fulfilled), one for evaluation of the technique on patients (technical/clinical oriented student) and one for comparison to ankle stiffness during walking (technical/clinical orented). Rehabilitation practice is increasingly confronted with neurological patients who suffer from autonomy threatening movement disorders that require treatment. These movement disorders are characterized by improper control of joint impedance. Intervention is focused on either neural or non-neural causes, or both. However, current clinical assessment of joint impedance is incapable of discriminating neural and non-neural components. ROBIN aims to distinguish the impedance of the human ankle joint into neural and non-neural components under active and passive conditions using precise quantitative measures. ROBIN takes a combined biomechanical and control engineering approach using time variant nonlinear System Identification and Parameter Estimation techniques (SIPE) using haptic robotic manipulators to perturb (rotate) the ankle joint. From the reaction to the perturbations clinically relevant neural and non-neural parameters are to be estimated using neuromuscular modeling. The single joint neuromuscular parameters of the ankle joint will be related to gait parameters, i.e. energy consumption, performance and stability. An attempt to compare single joint SIPE to SIPE of the ankle joint during walking will be a part of the project. ROBIN SIPE technology will be integrated in daily clinical practice from the start of the project to validate the proposed SIPE technology on a large cohort of stroke and Cerebral Palsy patients (n=250). ROBIN sets out to ultimately improve treatment (e.g. botulinum toxin, splinting) for movement disorders in neurological patients.


Three PhD-student positions are comprised by this project:
  1. technical profile for development of the SIPE techniques (at TU Delft),
  2. technical/clinical profile for evaluation of the SIPE technology (at LUMC)
  3. technical/clinical profile for SIPE during walking (at VUMC).

Partners

MOOG (Medical Robotics), ForceLink (High-end Treadmills), TMSi (EMG recording), Noppe-OIM (splints), Allergan (pharmaceuticals).

For more information and job application (motivation and CV) contact to dr. E. de Vlugt, e.devlugt@tudelft.nl