Robotics, mechatronics, and digital technologies are advancing significantly in sports, exercise, and healthcare, and offer innovative solutions that shape the future of these fields. In Part 2 of this special issue, we examine independent research and cutting-edge developments that address new challenges and provide unique contributions to these domains. Technological advancements in assistive devices and rehabilitation offer new solutions for improving the quality of life of individuals with physical challenges. Researchers of wearable assistive devices and prosthetics continue to devise methods to enhance mobility and support physical functions, thereby benefiting both users and healthcare providers. Sports and motion analysis remains a key focus area, where innovative technologies are employed to analyze and improve athletic performance. By capturing and evaluating detailed movement data, these technologies can help athletes refine their techniques and achieve greater precision in their sports, thus ultimately resulting in enhanced performance and injury prevention. As in Part 1, the studies presented in this issue demonstrate the practical applications of cutting-edge technologies and offer insights into their future potential. We hope that these contributions will inspire researchers and practitioners alike and provide a foundation for continued advancements in these exciting and impactful fields.

Robotics, mechatronics, and digital technologies are rapidly advancing in the fields of sports, exercise, and healthcare, and their applications are expanding daily. In part 1 of our special issue, we focus on the innovative contributions of cutting-edge technologies in various domains. Robotics technology is crucial in sports and exercise training as it monitors individual movements and forms, provides user feedback, and enables effective training. The development of robots to enhance the accuracy and reproducibility of sports techniques is a key element directly linked to performance improvements. Robotics and mechatronics provide new possibilities for treatment and rehabilitation in healthcare. Developing beneficial systems for medical professionals and patients contributes to increased precision in surgery and productive support in rehabilitation. Power assistance and motion augmentation are witnessing advancements that prolong individual capabilities and achieve better performance. These studies may reduce the physical burden of daily activities and specific tasks, thereby enhancing efficiency. Therefore, studies on haptics and sensory feedback are important. Efforts to improve user interfaces through virtual haptic experiences represent a promising new application of digital technology. The studies included in part 1 of this special issue present recent technological trends and practical examples of sports, exercise, and healthcare and aim to provide valuable information and inspire the readers. We hope that these studies will serve as significant steps toward future technological advancement and social implementation.

The authors proposed a new surgical instrument that can cut a target region of the liver from the surface into a cylindrical shape and remove a tumor with less loss of liver tissue. The instrument has a unique mechanism that drives the four blades three-dimensionally, alternating between cutting and coagulation. In order to confirm the effectiveness of the proposed mechanism, a desktop experimental prototype was manufactured. Through an experiment on a pig liver using a prototype, it was shown that the target portion can be excised into a cylindrical shape as expected by the proposed mechanism.

A system to easily quantify the vestibulo-ocular reflex (VOR) function has been prototyped. VOR is a reflex action of eyeballs caused by functions of vestibular system at the rapid head rotation to stabilize gaze. VOR measurement is often used for assessment of brain growth of young children and diagnosis of vertigo. There are research reports that VOR is affected by alcohol intake and fatigue. Therefore, VOR measurement is considered to be effective in assessing conditions of parts of the brain. However, VOR measurement is not easily available for anyone because it usually requires passive head rotations manually given by a well-trained medical doctor. The goal of our study is to realize an easy method to evaluate VOR without medical doctors. An evaluation system including a head-mounted device and a PC software has been prototyped. Results of test measurements are reported.

Authors have prototyped a head-mounted interface that detects user's various lower jaw movements in addition to the head rotation angles for operating robotic laparoscope holder. The jaw movements are distinguished based on deformation of the skin surface around a mandible joint. The skin deformation is measured by using a photoreflector array. Two experiments have been conducted to evaluate the prototype. One is for evaluating accuracy of lower jaw movements identification and the other is for evaluating temporal accuracy of its signal generation. The experiments have shown that the interface could be effective as a means for operating robotic laparoscope holders.

Authors have been developing a robotic laparoscope holder operated by using a head-mounted interface. Pan-tilt operations of a flexible endoscope are available through surgeon's head rotations in pitch and yaw directions and zoom in/out operations are available through the head rotation in roll direction with this system. In addition to the head rotations, jaw movements are used as control commands. Endoscope operations are available only under the surgeon's gentle chewing effort. Surgeon can anytime stops and restarts camera operation by stop/restart of chewing efforts during the surgery. Therefore no footswitch which is often used in commercialized robotic laparoscope system are needed for this system. Two evaluation tests have been conducted to see the performance of the proposed system. In the first test, the operability of the two control methods, one under chewing efforts which is proposed in this study and the other under footswitch operations, has been compared. It has been shown that the control methods using chewing efforts allow users to have a camera work of the equivalent operability as that under footswitch operation through the test. In the second evaluation test, the efficiency of a forceps task under the surgeon's camera work by using the proposed system has been evaluated. The time for completing a forceps task was compared between the case of surgeon's camera work by using the proposed system and the case of under scope operations of a human assistant. It was shown that the forceps task under scope operations using the proposed system always takes more time than that under scope operation of camera assistant because the surgeon needs to play a double role, a surgeon and a camera assistant during the surgery. The increase rates of the time for completing the task of general adult subjects and surgeon subjects from that of the task under camera work given by a camera assistant were 40[%] and 70[%], respectively.

Study objective: To test the hypothesis that the jaw closure using a pneumatic actuator device affect airway collapsibility and resistance during propofol anesthesia.Design: Prospective, randomized study.Setting: University-affiliated hospital.Patients: Six male subjects were included in the present study.Intervention: We used pressure-flow relationships to evaluate critical closing pressure (Paul-) and upper airway resistance in different conditions of body and head position. Anesthesia was induced and maintained with a propofol infusion, targeting a constant blood concentration of 1.5 to 2.0 mu g/mL to establish an adequate depth of anesthesia, with patients breathing spontaneously through a nasal mask. An air-inflatable pneumatic actuator was used to achieve jaw closure. Nasal mask pressure was intermittently reduced to evaluate upper airway collapsibility (passive P-CRIT) and upstream resistance under 4 different conditions: (1) neutral occlusion at 0-cm head elevation (baseline), (2) jaw closure at 0-cm head elevation, (3) neutral occlusion at 6-cm head elevation, and (4) jaw closure at 6-cm head elevation. Pour and upstream resistance under each condition were compared using 1-way analysis of variance. P < .05 was considered significant.Measurements: The pressure and inspiratory flow at the subjects' nose mask were recorded. Polysomonographic parameters (electroencephalograms, electrooculograms, submental electromyograms, and plethysmogram) were also recorded.Main results: The combination of 6-cm head elevation with jaw closure using the pneumatic actuator decreased upper airway collapsibility (P-CRIT approximate to -3.0 cm H2O) compared to the baseline position (P-CRIT approximate to -1.2 cm H2O; P = .0003).Conclusion: We demonstrated that jaw closure using an air-inflatable pneumatic actuator device can produce substantial decreases in upper airway collapsibility and maintain upper airway patency during propofol anesthesia. (C) 2016 Elsevier Inc. All rights reserved.

A robotic device that allows a surgeon to operate a laparoscope by itself through commands based on the head and the jaw movements has been prototyped. This robotic device has a unique head-mounted interface to measure surgeon’s head inclination angles in horizontal and vertical directions and detects the degree of contraction of temporal muscles that always acts under jaw movements by using sensors. Surgeons can easily operate the robotic device and control the area of scope view inside of the abdominal cavity through the head inclination angle and the voluntary effort of bite with back teeth during the surgical operations with both hands. The excellent operability of a prototype has been presented through an evaluation test under a simulated surgery task inside a training box. In addition, the high potential of the proposed system to make the surgeons possible to perform an extirpative surgery of cancer on gallbladder or liver under its own laparoscope operation through a test of an animal model.

An innovative electric-powered glove system has been prototyped to support finger rehabilitation for people with motor impairment on their fingers after a stroke. This glove system is composed of a leather glove which has a unique actuation mechanism called an exotendon system, a muscle activity sensor is fixed on the upper forearm to detect user's efforts during finger exercises and a controller including a microcomputer and a drive unit. An evaluation has been conducted based on A-B design of a single subject study and it has been observed that finger exercises carried out using the prototyped glove system has effectively improved the finger functionality of a stroke patient.

Robotic Unicycle in stable driving This paper introduces the first successful development of a robotic unicycle imitating a human rider. The robot consists of a body supported on a single wheel, a closed linkage on each side of the body to drive the wheel, and a rotor on the top. The effects of the closed link, gyro effect, centrifugal force, and reaction torque of the rotor on the robot’s stability and direction were investigated in simulations and experiments. Stability and drive principles of the robotic unicycle were proposed. The unicycle accelerated or decelerated because of the location of the compound center of gravity. Direction control was proposed based on the proposed acceleration control rule and a specified yaw angular velocity. Using that rule, drive simulations of tracing a circle and a “number 8” were conducted. The computer simulations demonstrated stable driving of the robotic unicycle. The experimental evaluation, velocity, and direction control of the robot were also studied. The principles of postural stability and driving of the robotic unicycle were clarified.

Continuous maintenance of an appropriate position of the mandible and head purely by manual manipulation is difficult, although the maneuver can restore airway patency during sleep and anesthesia. The aim of this paper was to examine the effect of head elevation with jaw closure using a remote-controlled airbag device, such as the airbag system, on passive upper airway collapsibility during propofol anesthesia. Seven male subjects were studied. Propofol infusion was used for anesthesia induction and maintenance, with a target blood propofol concentration of 1.5-2 μg/ml. Nasal mask pressure (PN) was intermittently reduced to evaluate upper airway collapsibility (passive PCRIT) and upstream resistance (RUS) at three different head and jaw positions, jaw opening position in the supine position, jaw opening position in the sniffing position with 6-cm head elevation, and jaw closure at a 6-cm height sniffing position. The 6-cm height sniffing position with jaw closure was achieved by an airbag device that was attached to the subject's head-like headgear. Patient demographics, PCRIT and RUS in each condition were compared using one-way ANOVA with a post hoc Tukey test. P <; 0.05 was considered significant. We also confirmed the effects of our airbag device on improvement of upper airway collapsibility in three obstructive sleep apnea patients in a clinical study. The combination of 6-cm head elevation with jaw closure using the air-inflatable robotic airbag system decreased upper airway collapsibility (PCRIT ~ -3.4-cm H2O) compared with the baseline position (PCRIT ~ -0.8-cm H2O, P = 0.0001). In the clinical study, there was improvement of upper airway obstruction in sleep apnea patients, including decreased apnea and hypopnea duration and increased the lowest level of oxygen saturation. We demonstrated that establishment of head elevation with jaw closure achieved by a remote-controlled airbag device using an inflatable airbag system can produce substantial decreases in upper airway collapsibility and maintain upper airway patency during propofol anesthesia and sleep.

Persons suffering from intractable disease like ALS (Amyotrophic Lateral Sclerosis) and spinal cord injury often show deterioration in muscular function. Some of these patients are obliged to use artificial respirators and cannot have verbal communication with others. In order to support their communication, there exist various input devices like touch sensor input devices, capacitance sensor input devices and also vision input devices. In addition, computer controlled environment is helpful for such patients. By developing proper computer controlled environment which is controlled by the proper input device, even the patient with serious disability can live sound life. Due to the infrared network system, the computer controlled environment could be well organized.

A prehension orthosis with a pneumatic actuator has been developed to compensate for the disability of cervical cord injury patients and support their daily activities. One major feature of this orthosis is that the user can continually pinch or hold a target object using a finely adjusted finger force. The movement and force applied to the fingers can be controlled by continuous instructional signals fromthe user through the activity of a command muscle, which is selected from among the muscles without functional impairment in the user’s body. The level of muscle activity can be obtained by using an original sensor that detects the hardness of the target muscle through contact with the skin. The level of muscle activity can be estimated by the hardness information of the muscle. This sensor is easily fixed to a user’s body by using an elastic belt and even works over clothing. Therefore, the user can wear the system very easily. This feature allows the system to be very user friendly. Users can handle fragile objects such as an egg or sculpted-glass by using this prehension orthosis because of its finger force control function. Excellent dexterity in the finger force control has been demonstrated through evaluation tests conducted with various subjects, including a spinal cord injury patient.

In this paper, Environmental Control System for spinal cord injured to support their living is proposed. A distinguished feature of this system is that an original image processing technique is introduced as a smart input device. In addition, infrared signal emitter and receiver system are developed to reduce the cables and devices around the bed. These two features established the well-organized nursing environment.

For elderly patients, dosing is crucial for their healthy life. Many of theme are requested to take medicine regularly without any mistake. To assist their daily drug dosing, a medication calendar to guide them is proposed. The calendar has 28 pockets, with reed switches attached on the back. With the use of a microprocesor the reed switch signal is read and used to guide the users with their drug dose with a voice command.

Persons suffering from intractable disease like ALS (Amyotrophic Lateral Sclerosis) and spinal cord injured present symptoms of muscular deteriorations. These patients are often obliged to use artificial respirators in the case the breathing action becomes impossible. It should be noticed that using the artificial respirator means that uttering voice is impossible. In order to support their daily lives, computerized environment is proposed, where various home electric appliances can be controlled by computer. Furthermore, the computer has original vision input device. A distinct advantage of this computerized environment is that the most of the home electric appliances needs no to be connected by the cables.