ExoRehab is an IoT rehabilitation solution that combines robotics, gaming, and data analysis. Digitalizing physical therapy for muscle rehabilitation enables patients to acquire therapeutic training at home via wearable technology solutions with effective training. This smart device's wireless sensors provide personalized rehabilitation guidance using motion-recognition technology and automatically adjusts the therapy for effective support and training. Remote access gives physicians access to patient data, enabling them to implement efficient patient management and provide accurate medical decisions based on their progress. Combining neuromuscular electrical stimulation (NMES) with gamified rehab programs enhances motivation for rehab exercises with cutting-edge bio-signal sensing technology.

Fig. 1 - A knee patient can wear the exoRehab and activate the combined software to receive NMES and/or FES therapeutic treatment.

Effective recovery progress is possible when a patient receives physical therapy soon after suffering an injury. ExoRehab's technology provides immediate access to therapy by eliminating common human obstacles and employing inventive artificial intelligence (AI) platforms. Patients who undergo physiotherapy are often discouraged by a time-consuming process that involves traveling over long distances to complete daily or weekly therapy sessions. In addition to being inconvenient, travel can be especially uncomfortable for those who have suffered serious injuries that cause a great deal of pain during movement.

Traditional rehabilitation physiotherapy sessions are also tedious, dull, and exhausting, with repetitive movements that offer no mental stimulation or motivation to press on. Rehabilitation treatment sessions for injuries may also be in short supply in the patient's region, making it difficult for the patient to recover properly. The remote personalized rehabilitation guidance provided by the exoRehab model achieves the goals for efficient and rapid rehabilitation, which resolves the problems experienced by the average patient.

Injuries to the muscle caused by pulled, torn, or ruptured muscles can range from mild to severe, which reduces or stops function. Damage to muscle fibers prevents them from contracting, resulting in muscle spasticity that ultimately interferes with normal movement. The motor neurons that control muscle contractions via axon terminals to the muscle fibers can lose the vital signals from the nervous system because of injury. Re-establishing the patterns of nerve activity that connect the brain to the muscle activity via therapy is the standard methodology to regain lost function, maintain range of motion and manage spasticity. Neuro-muscular electrical stimulation (NMES) provides electric stimulation to the motor neurons and effectively reactivates the damaged muscle fibers.

Electricity as a Treatment

Applying electricity as a treatment for pain appears to date back to the times of Ancient Greece and Egypt, when people discovered that certain species of fish could deliver substantial electric shocks. Natural electrical production was eventually replaced by man-made devices, and in the 18th and 19th centuries, pain relief was administered through the application of static electrical currents. In today's modern age, the benefits of electrotherapy treatment have led to the development of transcutaneous electrical nerve stimulation (TENS), percutaneous electrical nerve stimulation (PENS), and NMES devices, which have all been proven extremely useful for therapy and recovery. NMES, and more specifically, functional electrical stimulation (FES), functions by stimulating muscle contraction through electrical impulses that are carried through surface electrodes applied to the skin. The electrical stimulation of intact peripheral motor nerves enables motor neurons to recognize a once-performing muscle and forces it to react with compensatory voluntary muscle motion, leading to the reactivation and development of motor neurons. The ultimate goal of this type of therapy is to restore the communication between the brain and the muscular system.

The current clinical prototype development for this all-in-one wearable device was designed for the knee joint and is constructed in a two-part wearable system on the thigh and below on the shin, capable of sensing specific target points. A knee patient can wear the exoRehab and activate the combined software to receive NMES and/or FES therapeutic treatment. There is no discomfort or pain in the NMES and/or FES treatment, but some users feel a mild tingling sensation. The ergonomically designed body cover contains the modules that connect the bio-signal sensors to the body's electrodes. Overall, the product design has a fine integration of systems that makes the device lightweight with a body-perfect design (see Figure 1).

The Next Phase

The next phase of exoRehab will be to recognize a patient's movement patterns and induce artificial body movements by using finely tuned stimulation technology based on pattern learning. Pinpointing the muscle's location and intensity will measure the target regardless of the patient's physical characteristics and movements. In terms of knee bracing, the wearable is free of temporal and spatial limitation, allowing its sensors to measure the angle between the user's thigh and shin while calculating the range of motion (ROM) and muscle strength in the movement of the area. This data will then be assessed using electromyography (EMG) recordings of the target muscles as they respond to nerve signals. Machine-learning-based NMES stimulation would consequently be administered to improve muscle strength while relieving fatigue. As a wearable robotic device, this treatment will recognize motion from the user and automatically adjust the amount of strength it applies for effective support and training.

Fig. 2 - The device's fully automated system will also connect the bio-data to a tablet, which will assess the data collected and then transmit the information directly to the patient's physician who will be able to provide further progress details.

Patients who use gamified integrated rehabilitation programs designed by medical professionals will be more motivated to perform active and focused rehabilitation. Furthermore, data-driven management programs will enable them to receive more efficient and accurate treatment while being provided with a clear indication of current status, goals, and progress. The program will consequently allow users to execute rehab training exercises based on their own body data, all while monitoring the rehabilitation progress of their affected body part. The device's fully automated system will also connect the bio-data to a tablet, which will assess the data collected and then transmit the information directly to the patient's physician who will be able to provide further progress details (see Figure 2).

The exoRehab is an advanced AI device designed by researchers in fields of software, robotics, and hardware engineering, and using expertise from industrial designers and clinical advisors, such as Exosystems’ rehabilitation specialists and other medical professionals. This device was created to collect joint movement information and integrate it with gamified therapy. The clinical prototypes are currently being developed to modulate the joints that are most commonly injured, such as those found in the shoulder, elbow, arm, wrist, and leg. Merging bio-signal sensing technology and electrical stimulation technology utilizes a principle widely proven in the medical field, which improves strength and relieves fatigue caused by injuries.

This article was submitted by Exosystems, Gyeonggi-do, Republic of Korea. For more information visit here.