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BackgroundMobile health apps have emerged as useful tools for patients and clinicians alike, sharing health information or assisting in clinical decision-making. Prostate cancer (PCa) risk calculator mobile apps have been introduced to assess risks of PCa and high-grade PCa (Gleason score ≥7). The Rotterdam Prostate Cancer Risk Calculator and Coral–Prostate Cancer Nomogram Calculator apps were developed from the 2 most-studied PCa risk calculators, the European Randomized Study of Screening for Prostate Cancer (ERSPC) and the North American Prostate Cancer Prevention Trial (PCPT) risk calculators, respectively. A systematic review has indicated that the Rotterdam and Coral apps perform best during the prebiopsy stage. However, the epidemiology of PCa varies among different populations, and therefore, the applicability of these apps in a Taiwanese population needs to be evaluated. This study is the first to validate the PCa risk calculator apps with both biopsy and prostatectomy cohorts in Taiwan. ObjectiveThe study’s objective is to validate the PCa risk calculator apps using a Taiwanese cohort of patients. Additionally, we aim to utilize postprostatectomy pathology outcomes to assess the accuracy of both apps with regard to high-grade PCa. MethodsAll male patients who had undergone transrectal ultrasound prostate biopsies in a single Taiwanese tertiary medical center from 2012 to 2018 were identified retrospectively. The probabilities of PCa and high-grade PCa were calculated utilizing the Rotterdam and Coral apps, and compared with biopsy and prostatectomy results. Calibration was graphically evaluated with the Hosmer-Lemeshow goodness-of-fit test. Discrimination was analyzed utilizing the area under the receiver operating characteristic curve (AUC). Decision curve analysis was performed for clinical utility. ResultsOf 1134 patients, 246 (21.7%) were diagnosed with PCa; of these 246 patients, 155 (63%) had high-grade PCa, according to the biopsy results. After confirmation with prostatectomy pathological outcomes, 47.2% (25/53) of patients were upgraded to high-grade PCa, and 1.2% (1/84) of patients were downgraded to low-grade PCa. Only the Rotterdam app demonstrated good calibration for detecting high-grade PCa in the biopsy cohort. The discriminative ability for both PCa (AUC: 0.779 vs 0.687; DeLong’s method: P

Brachial Plexus injuries are complex in nature caused in large by high impact traffic accidents which can lead to additional complications such as Complex Regional Pain Syndrome and even lead to amputation or the need for further surgical intervention. Treatment options to help repair the brachial plexus initially involve surgical intervention and post-surgery rehabilitation with medication to help with ongoing pain. Pain treatments used for these types of injuries are limited and differ in effectiveness. Paradigms utilising multimodal systems such as the one described in this paper based on virtual reality and robotics could yield results that are non-invasive and provide better rehabilitation outcomes for the sufferers. In this paper we present a single case study exploring whether Virtual Reality plus Haptic feedback have any practical potential for reducing upper limb pain and improving function in patients with brachial plexus injuries. The case study is presented with long standing complex combination of phantom limb and neuropathic pain. A decrease in perceived levels of pain was reported which amounts to a 50% reduction in pain from baseline and an improved range of motion. An examination of the sensory phantom map on the stump seems to indicate an early establishment of the thumb representation on the stump close to the area being stimulated with potential implications for prosthesis use.

Prosthetic limbs (and orthotic devices) have been used as a paradigm for the treatment and rehabilitation of neuropathic pain, such as phantom limb pain. Long-term adoption of the devices for the continued use in rehabilitation remains low in part due to reduced embodiment and the high cognitive load associated with controlling the device. Previous research has shown that incorporating sensory feedback in prostheses can provide proprioceptive information, increase control and manipulation of objects, and improve embodiment. However, feedback experienced by the user varies daily and requires constant parameter adjustments to maintain accurate and intuitive sensory perception, further preventing long term adoption. Work therefore needs to be explored that correlate feedback modalities to perception of tactile information, such as texture and pressure. The work presented in this paper begins to explore this by utilizing a deep-learning algorithm to classify the dissipation of vibration artefacts found in the EMG signals of able-bodied individuals to specific texture patterns. Four texture patterns were applied to 7 participants using two vibration motors and repeated 3 times. In post processing, a RNN network identified the artefact features along equidistantly spaced EMG electrodes and correctly classified unseen data from each participant.

The main focus of spasticity treatment is to alleviate pain, improve function and reduce risk of additional complications. In this paper the design of a robotic system with enhanced focal vibro-tactile stimulation for the treatment of spasticity in the upper limbs is presented. Building on emerging evidence on the use of vibrations in the treatment of spasticity, we propose a new integrated approach. Our design combines the use of vibro-tactile stimulation of the high tone muscle with robotic movement assistance to augment rehabilitation outcomes in patients with spasticity in the upper limbs.

The system described in this paper combines virtual reality with haptic feedback to increase the level of immersion and invoke the sense of agency in patients with phantom limb pain with the aim of reducing perceived pain. This paper presents three case studies of an on-going clinical study. The initial results suggest an increased sense of embodiment of the virtual limb promotes a decrease in perceived levels of pain. The results strengthen the view that the cortical map does not fully "disappear" yet lays dormant.

This paper addresses the mechanical structure and control method of a redundant drive robot (RDR) to produce compliant motions, and show how the design parameters of the RDR can effect the produced motions and the mechanical and performance limitations of the actuators of the RDR. The structure and control method of the RDR can have been proper to produce compliant motions, but the effect of the design parameters of the RDR to the mechanical and performance limitations have not been clear. Therefore, the feasibility of producing compliant motions in the case of the prototype of the RDR is confirmed by conducting simulations and experiments, and then the design parameters of the RDR to the mechanical and performance limitations are verified by conducting simulations.

The guidelines for enhancing robot-assisted training for post-stroke survivors head towards increasing exercise realism and variability; in particular lower limb rehabilitation needs the patient to feel challenged to adapt his locomotion and dynamic balance capabilities to different virtual ground scenarios. This paper proposes a design for a robot whose end-effector acts as a footplate to be in permanent contact with the user's foot during practice: the structure is such that it enables the user's foot to rotate around three axis, differently from what is currently available in the research for gait training; the parallel kinematic structure and the dimensional synthesis allow a suitable range of motion and aim at limiting device mass, footprint and reaction forces on the actuators when rendering virtual ground. The employed methodology has been validated using ground reaction forces data relative to stroke survivors.

This paper examines a new form of interaction combining haptic and sonic exploration with static visual information from a real painting. Motivated by recent work in neurorehabilitation exploring group interactions with a robot, and by the educational and explorative value of artefacts, we investigate the feasibility of an interactive painting as a potential tool for the rehabilitation of brain injuries. The study consisted of a series of thirty-six single case studies with healthy individuals exploring a painting through haptic feedback with/without sonic interaction and assessed using a multidimensional measurement intended to evaluate the participants' subjective experience. The results showed that participants engaged with the interactive installation and executed more movements while exploring the painting in pairs. It appears that the haptic painting paradigm encourages development of analytical skills, imagination, promotes spatial skills realisation and enhances touch/hearing sensory channels. The results suggest that this approach might be of value to neurorehabilitation by exploring concepts of augmented artefact installations with technology (haptics + sound), promoting social integration and potential use in public spaces.

This paper presents the ROBIN (Rehabilitation Of Brain INjuries) multi-model system for whole-arm therapy retraining following a brain injury or a stroke. The design, control and integration of a new type of hybrid system based on a multi-robot implementation is described. The system is able to support multiple exercise design approaches, providing grasp and full upper limb movement over a large workspace whilst sitting or standing. When used in its largest configuration a total of 12 active and 9 passive degrees of freedom are available to provide active, active assist or passive grasp retraining in combination with reaching movements (and dynamic gravity compensation) in a reach-grasp-transfer-release sequence., (© 2011 IEEE)