Regaining upper extremity function is the primary concern of persons with tetraplegia caused by spinal cord injury (SCI). Robotic rehabilitation has been inadequately tested and underutilized in rehabilitation of the upper extremity in the SCI population. Given the acceptance of robotic training in stroke rehabilitation and SCI gait training, coupled with recent evidence that the spinal cord, like the brain, demonstrates plasticity that can be enhanced by repetitive movement training such as that available with robotic devices, it is probable that robotic upper extremity training of persons with SCI could be clinically beneficial. The primary goal of this pilot study was to test the feasibility of using a novel robotic device –the RiceWrist Exoskeleton- for rehabilitation of the upper limbs (UL) of two tetraplegic persons with incomplete SCI. Two pilot experiments were conducted. Experiment 1was the first novel attempt to administer treatment with the RiceWrist. The left UL of a tetraplegic subject was treated during seven therapy sessions. The subject's feedback and the investigator's observations were used to enhance the robotic device and the corresponding graphical-interface. In Experiment 2, a second tetraplegic subject underwent 10 three-hour training sessions administered by a physical therapist. Smoothness factor (FS) –a new measure developed in Experiment 1- was used as the primary outcome to test the subject's performance before and after the training. The RiceWrist was modified according to the feedback obtained in Experiment 1. Thereafter, the device was successfully administered for upper limb training of the tetraplegic individual. Noticeable improvements in FS were observed for the stronger arm of the subject who completed 10 sessions of training. Improvements were also observed in the subject's hand according to the Jebsen-Taylor Hand Function Test. Results from this study suggest a potential application of the RiceWrist for rehabilitation of SCI individuals and offer valuable information regarding development of UL robotic devices for this population.

Cerebral palsy affects movement, muscle tone, and coordination as a result of an injury to, or lesion of, the immature brain. One of the most common manifestations of cerebral palsy is spastic hemiplegia, which limits arm and hand use on the involved side of the body [1]. Many treatment options are available but a major clinical problem is how to evaluate the success of these treatment plans. Currently, video analysis is the standard used for evaluating dexterity of cerebral palsy patients. This requires trained clinicians to spend hours watching video of patients performing specified tasks in order to evaluate baseline dexterity and improvements throughout treatment. VICON is the current state of the art device for motion capture. It captures motion using multiple video cameras around the room and outputs the position data of many points through time. VICON machines must be carefully calibrated and are too bulky to be used throughout a clinic. VICON can also not show the upper extremity dexterity necessary for tracking many cerebral palsy patients’ progress. As can be seen, no portable, efficient, and quantitative dexterity test for cerebral palsy patients currently exists.

Background: Upper limb weakness is the primary concern of tetraplegic individuals who have sustained incomplete spinal cord injury (SCI), to an extent that it is considered more important than standing abilities. Recent evidence of the plasticity of the brain and the spinal cord that can be enhanced by repeated practice- such as that available with robotic devices- suggest that robotic training of upper limbs can be beneficial to persons with SCI. The goal of this pilot study was to evaluate an innovative rehabilitation technique using the RiceWrist, a newly developed robotic device, for a person with tetraplegia. A 24-year-old male with incomplete SCI at the C4 level, 6.5 months post-injury participated in 10 sessions of robotic training over 2 weeks. Variability of movement trajectory (spatial) and the time to complete (temporal) simple point-to-point wrist and forearm movements were collected before and after training completion to determine skill acquisition. The participant successfully completed 10 sessions of robotic training. While there were minimal changes in variability of movement trajectory, great improvements were observed for the average movement time for the majority of wrist and forearm movements. Overall, results suggest that the RiceWrist robotic device could be used for upper-limb rehabilitation and can potentially serve as an assessment tool for the SCI population.

We present a tactile Respiratory Management System (tRMS) to manage and control breathing patterns of cancer patients undergoing radiation therapy. The system comprises of an array of small vibrating motors and a control box that supplies power to and provides a control interface for up to twelve motors through the parallel port of a standard personal computer. The vibrotactile array can be fastened along the forearm, arm, thigh, leg or abdomen in any configuration using Velcro and fabric wraps. All motors are operated in a binary fashion, i.e. on or off, with quick response time and perceivable vibration magnitudes. The tRMS system is inexpensive and portable, providing spatiotemporal variations in tactile cues to regulate respiratory motion during radiotherapy. The system will also be used in future psychophysical studies to determine effective use of tactile cues to control human motor actions.