ARMin III – arm therapy exoskeleton with an ergonomic shoulder actuation

Rehabilitation robots have become important tools in stroke rehabilitation. Compared to manual arm training, robot-supported training can be more intensive, of longer duration and more repetitive. Therefore, robots have the potential to improve the rehabilitation process in stroke patients. Whereas a majority of previous work in upper limb rehabilitation robotics has focused on end-effector-based robots, a shift towards exoskeleton robots is taking place because they offer a better guidance of the human arm, especially for movements with a large range of motion. However, the implementation of an exoskeleton device introduces the challenge of reproducing the motion of the human shoulder, which is one of the most complex joints of the body. Thus, this paper starts with describing a simplified model of the human shoulder. On the basis of that model, a new ergonomic shoulder actuation principle that provides motion of the humerus head is proposed, and its implementation in the ARMin III arm therapy robot is described. The focus lies on the mechanics and actuation principle. The ARMin III robot provides three actuated degrees of freedom for the shoulder and one for the elbow joint. An additional module provides actuated lower arm pro/supination and wrist flexion/extension. Five ARMin III devices have been manufactured and they are currently undergoing clinical evaluation in hospitals in Switzerland and in the United States.

Effects of arm training with the robotic device ARMin I in chronic stroke: three single cases

BACKGROUND: Several clinical studies on chronic stroke conducted with end-effector-based robots showed improvement of the motor function in the affected arm. Compared to end-effector-based robots, exoskeleton robots provide improved guidance of the human limb and are better suited to train task-oriented movements with a large range of motions. OBJECTIVE: To test whether intensive arm training with the arm exoskeleton ARMin I is feasible with chronic-stroke patients and whether it improves motor function in the paretic arm. METHODS: Three single cases with chronic hemiparesis resulting from unilateral stroke (at least 14 months after stroke). A-B design with 2 weeks of multiple baseline measurements (A), 8 weeks of training (B) with repetitive measurements and a follow-up measurement 8 weeks after training. The training included shoulder and elbow movements with the robotic rehabilitation device ARMin I. Two subjects had three 1-hour sessions per week and 1 subject received five 1-hour sessions per week. The main outcome measurement was the upper-limb part of the Fugl-Meyer Assessment (FMA). RESULTS: The ARMin training was well tolerated by the patients, and the FMA showed moderate, but significant improvements for all 3 subjects (p < 0.05). Most improvements were maintained 8 weeks after discharge. CONCLUSIONS: This study indicates that intensive training with an arm exoskeleton is feasible with chronic-stroke patients. Moderate improvements were found in all 3 subjects, thus further clinical investigations are justified.

Effects of intensive arm training with the rehabilitation robot ARMin II in chronic stroke patients: four single-cases

BACKGROUND: Robot-assisted therapy offers a promising approach to neurorehabilitation, particularly for severely to moderately impaired stroke patients. The objective of this study was to investigate the effects of intensive arm training on motor performance in four chronic stroke patients using the robot ARMin II. METHODS: ARMin II is an exoskeleton robot with six degrees of freedom (DOF) moving shoulder, elbow and wrist joints. Four volunteers with chronic (>or= 12 months post-stroke) left side hemi-paresis and different levels of motor severity were enrolled in the study. They received robot-assisted therapy over a period of eight weeks, three to four therapy sessions per week, each session of one hour.Patients 1 and 4 had four one-hour training sessions per week and patients 2 and 3 had three one-hour training sessions per week. Primary outcome variable was the Fugl-Meyer Score of the upper extremity Assessment (FMA), secondary outcomes were the Wolf Motor Function Test (WMFT), the Catherine Bergego Scale (CBS), the Maximal Voluntary Torques (MVTs) and a questionnaire about ADL-tasks, progress, changes, motivation etc. RESULTS: Three out of four patients showed significant improvements (p < 0.05) in the main outcome. The improvements in the FMA scores were aligned with the objective results of MVTs. Most improvements were maintained or even increased from discharge to the six-month follow-up. CONCLUSION: Data clearly indicate that intensive arm therapy with the robot ARMin II can significantly improve motor function of the paretic arm in some stroke patients, even those in a chronic state. The findings of the study provide a basis for a subsequent controlled randomized clinical trial.

ARMin: a robot for patient-cooperative arm therapy

Task-oriented, repetitive and intensive arm training can enhance arm rehabilitation in patients with paralyzed upper extremities due to lesions of the central nervous system. There is evidence that the training duration is a key factor for the therapy progress. Robot-supported therapy can improve the rehabilitation allowing more intensive training. This paper presents the kinematics, the control and the therapy modes of the arm therapy robot ARMin. It is a haptic display with semi-exoskeleton kinematics with four active and two passive degrees of freedom. Equipped with position, force and torque sensors the device can deliver patient-cooperative arm therapy taking into account the activity of the patient and supporting him/her only as much as needed. The haptic display is combined with an audiovisual display that is used to present the movement and the movement task to the patient. It is assumed that the patient-cooperative therapy approach combined with a multimodal display can increase the patient's motivation and activity and, therefore, the therapeutic progress.

ARMin - robot for rehabilitation of the upper extremities

Task-oriented repetitive movements can improve motor recovery in patients with neurological or orthopaedic lesions. The application of robotics can serve to assist, enhance, evaluate, and document neurological and orthopaedic rehabilitation. ARMin is a new robot for arm therapy applicable to the training of activities of daily living in clinics. ARMin has a semiexoskeletal structure with six degrees of freedom, and is equipped with position and force sensors. The mechanical structure, the actuators and the sensors of the robot are optimized for patient-cooperative control strategies based on impedance and admittance architectures. This paper describes the mechanical structure, the control system, the sensors and actuators, safety aspects and results of a first pilot study with hemiplegic and spinal cord injured subjects.

Jesus, Ufos, Aliens - Eine Rezension: Kreiner, Armin (2011): Jesus - UFOs - Aliens. Außerirdische Intelligenz als Herausforderung für den christlichen Glauben. Freiburg im Breisgau: Herder

Hinter dem vielleicht etwas zu stark auf ein weiteres Publikum zielenden Titel verbirgt sich ein durch und durch seriöses Buch über das "faszinierendste Projekt“, mit dem der Autor sich je befasst habe (S. 7). Wenn es überhaupt Menschheitsfragen gebe, zähle die Frage, ob wir "allein" im Universum sind, mit Sicherheit dazu. Da damit die erste deutschsprachige Monographie seit mehreren Jahrzehnten zum Thema vorliegt, ist sie hier sicher einer Besprechung wert.

Why do we yawn?

Yawning is a phylogenetically old behaviour that can be observed in most vertebrate species from foetal stages to old age. The origin and function of this conspicuous phenomenon have been subject to speculations for centuries. Here, we review the experimental evidence for each of these hypotheses. It is found that theories ascribing a physiological role to yawning (such as the respiratory, arousal, or thermoregulation hypotheses) lack evidence. Conversely, the notion that yawning has a communicative function involved in the transmission of drowsiness, boredom, or mild psychological stress receives increasing support from research in different fields. In humans and some other mammals, yawning is part of the action repertoire of advanced empathic and social skills.

Bilateral impairment of concurrent saccade programming in hemispatial neglect

When healthy observers make a saccade that is erroneously directed toward a distracter stimulus, they often produce a corrective saccade within 100ms after the end of the primary saccade. Such short inter-saccadic intervals indicate that programming of the secondary saccade has been initiated prior to the execution of the primary saccade and hence that the two saccades have been programmed concurrently. Here we show that concurrent saccade programming is bilaterally impaired in left spatial neglect, a strongly lateralized disorder of visual attention resulting from extensive right cerebral damage. Neglect patients were asked to make saccades to targets presented left or right of fixation while disregarding a distracter presented in the opposite hemifield. We examined those experimental trials on which participants first made a saccade to the distracter, followed by a secondary (corrective) saccade to the target. Compared to healthy and right-hemisphere damaged control participants the proportion of secondary saccades directing gaze to the target instead of bringing it even closer to the distracter was bilaterally reduced in neglect patients. In addition, the characteristic reduction of secondary saccade latency observed in both control groups was absent in neglect patients, whether the secondary saccade was directed to the left or right hemifield. This pattern is consistent with a severe, bilateral impairment of concurrent saccade programming in left spatial neglect.

Die Zeit der Pädagogik. Zeitperspektiven im erziehungswissenschaftlichen Diskurs. Festschrift für Walter Herzog

Zeit ist in der öffentlichen Diskussion über Erziehung eine konstitu tive Bestimmung. Dabei wird sie sehr unterschiedlich gefasst: Erziehung wird verstanden als ein Prozess, der zeitlich konsekutiv geordnet werden muss. Es wird aber auch von einer Erziehungszeit der Eltern gesprochen und von der Schulzeit im Lebenslauf. Unterricht und Didaktik verlangen von den Lehrpersonen ein Zeitmanagement. Über Schulanfang, Schul ende und Dauer der Schulzeit wird politisch debattiert. Aber weit dar über hinaus werden Erziehung und Bildung selbst zum Instrument, mit dem in der Gegenwart die Zukunft, die Zeit des einzelnen Menschen und sogar der ganzen Gesellschaft berechenbar werden sollen. Trotz dieser Zentralität der Dimension «Zeit» ist die theoretische Diskussion darüber wenig entwickelt. Der vorliegende Band diskutiert aus soziologischen, pädagogisch-psychologischen und historischen Perspektiven die Zeit dimensionen von Erziehung.

[Examination results and autopsy findings in assaults on elderly people]

As the percentage of elderly people in the population grows, violence against persons of advanced age constitutes an increasing social problem. The findings of the clinical forensic examinations (CE group) and autopsies performed on elderly violence victims (> or = 60 years) between 1999 and 2008 at the Institute of Legal Medicine of the Hanover Medical School were retrospectively analysed. In all, the study material comprised 55 victims of the CE group (35 females and 20 males, median age 73.5 years) and 55 autopsies (33 females and 22 males, median age 72.7 years). In most of the autopsy cases, the suspect was a family member or partner. In contrast, the alleged perpetrator was a stranger in most cases of the CE group. Blunt force injuries were most often found in the CE group victims (63.6%). Altogether, 38.2% (CE group) and 20.0% (autopsy cases) of the violent assaults were associated with robbery. In the majority of the CE cases, the victims suffered potentially or acute life-threatening injuries. In summary, the analysis shows that elderly people frequently become victims of robbery and blunt force injury. In most homicides of old people, the perpetrator is familiar to the victim. In surviving elderly violence victims, the assault is more likely to be reported to the police if the suspect is a stranger.

Why do we yawn? The importance of evidence for specific yawn-induced effects

Gallup (this issue) believes that our recent review on the function of yawning (Guggisberg et al., 2010) is unbalanced and that it ignores evidence for his thermoregulation hypothesis. Here we address these criticisms and show them to be untenable. While we never claimed that the social hypothesis of yawning has "definite experimental support", we emphasize the importance of experimental evidence for specific effects of yawns when considering why we yawn. The only specific effect of yawning that could be demonstrated so far is its contagiousness in humans, some non-human primates, and possibly dogs, whereas all studies investigating physiological consequences of yawns were unable to observe specific yawn-induced effects in the individual of any species. The argument that from an evolutionary perspective, yawns must have a "primitive" physiological function arises from imprecise reasoning.