gms | German Medical Science

Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2022)

25. - 28.10.2022, Berlin

An Robotic Exoskeleton for CRPS Rehabilitaion

Meeting Abstract

  • presenting/speaker Nikolas Wilhelm - Klinik für Orthopädie und Sportorthopädie, Klinikum rechts der Isar, Technische Universität München, München, Germany
  • Thomas Dickmann - Klinik für Orthopädie und Sportorthopädie, Klinikum rechts der Isar, Technische Universität München, München, Germany
  • Carina Micheler - Klinik für Orthopädie und Sportorthopädie, Klinikum rechts der Isar, Technische Universität München, München, Germany
  • Jan Lang - Klinik für Orthopädie und Sportorthopädie, Klinik für Unfallchirurgie, Technische Universität München, München, Germany
  • Sami Haddadin - Lehrstuhl für Robotik und Systemintelligenz, Munich School of Robotics and Machine Intelligence, Technische Universität München, München, Germany
  • Rainer Burgkart - Klinik für Orthopädie und Sportorthopädie, Klinikum rechts der Isar, Technische Universität München, München, Germany
  • Claudio Glowalla - Klinik für Orthopädie und Sportorthopädie, Klinikum rechts der Isar, Technische Universität München, München, Germany

Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2022). Berlin, 25.-28.10.2022. Düsseldorf: German Medical Science GMS Publishing House; 2022. DocAB72-701

doi: 10.3205/22dkou580, urn:nbn:de:0183-22dkou5800

Veröffentlicht: 25. Oktober 2022

© 2022 Wilhelm et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Objectives: Complex regional pain syndrome (CRPS) is a chronic neuropathic pain secondary to soft tissue or bone injury that is typically longer and more severe than the original injury. There is usually a high degree of hand function impairment and patient distress.

Treatment involves a multimodal therapy approach with an focus on physical therapy and ergotherapy and is typically time-consuming and costly.

In addition, there is currently a lack of objective collection of patient-specific data that would allow a more accurate evaluation of the different therapeutic approaches.

For this reason, the development of the robot-assisted rehabilitation system took the approach of "theragnostics" in order to be able to carry out independent physiotherapeutic training on the one hand, and at the same time to record valuable data such as joint mobility and joint stiffness.

Methods: An exoskeleton for the index finger was developed for robotic therapy support, which enables objective recording of individual patient data and simple therapy support. The exoskeleton is operated by a single linear motor and records the entire state of the finger by means of a force sensor and three potentiometers for angle measurement. Through an additionally developed app and the communication of app and exoskeleton via Bluetooth, simple therapeutic games can also be realized with the exoskeleton.

The developed system was tested on three CRPS patients over a period of six weeks and is shown in Figure 1 [Fig. 1].

The study protocol recorded Budapest diagnostic criteria, QuickDASH score, skin temperature, finger blood flow, and noninvasive skin conductance.

Results and conclusion: The developed system was able to be applied to all patients without complications and enabled a smooth recording of individual patient data. In addition, all developed games could be successfully implemented on patients. Table 1 [Tab. 1] displays the Budapest duagnostic criteria as well as the QuickDASH score before and after therapy:

The study showed that the technical application of the exoskeleton and the accompanying measurements can be performed safely in CRPS patients. In addition, a positive trend for the patients' recovery during the entire therapy including the exoskeleton treatment could be demonstrated. The data to be collected during the test sessions could be safely documented and evaluated with the specially developed app, so that further development of the exoskeleton to include the other long fingers and the thumb is now planned.