Biomechanics and Technical Aids
Principal investigator: Antonio José del Ama Espinosa
The R & D Unit of the Biomechanics and Technical Aids department was founded in 2005 to address growing needs for new knowledge and approach in the treatment of spinal cord injured (SCI) patients that would complement an already established rehabilitation and physical therapy program at the National Hospital for Paraplegics. The main goal of our work is to improve lives of SCI patients by creating conditions for applying the latest advances in the field of Biomechanics to their specific needs. To accomplish with this goal, the Biomechanics Unit has a multidisciplinary team, comprised by researchers from clinical and engineering fields, focusing its activity, closely linked to the analysis of human movement, around three well differentiated areas.
The first one is clinical assessment, providing the services of gait assessment, sitting pressure and positioning in wheelchair to the hospital’s clinical staff. The second is research in the areas of analysis of human movement applied to disability, evaluation of technical aids, development and evaluation of robots for rehabilitation, virtual reality applied to rehabilitation and development of metrics for functional evaluation of disability and function of the upper extremity, and advanced systems for the monitoring and management of the sitting pressure among others. This activity is deployed and financed through competitive regional, national, European or private calls, either autonomously, leading research consortia or as a consortium partner. As a result of this research activity, the Biomechanics Unit is since 2015 Associated Unit with the Neural Engineering Group of the Insitituto Cajal at CSIC. The third is the provision of services related to the functional evaluation of products for rehabilitation and assistive technology (wheelchairs, cushions, etc.) to companies.
- del-Ama AJ, Gil-Agudo A, Pons JL, Moreno JC. Hybrid FES-robot cooperative control of ambulatory gait rehabilitation exoskeleton. Journal of NeuroEngineering and Rehabilitation 2014;11(27)
- del Ama AJ; Moreno, JC; Gil-Agudo, A; de-los-Reyes, A; Pons, JL.. Online Assessment of Human-Robot Interaction for Hybrid Control of Walking. Sensors 2012;12(1):215-225.
- del Ama AJ, Koutsou AD, Moreno JC, de-los-Reyes A, Gil-Agudo A, Pons JL. Review of hybrid exoskeletons to restore gait following spinal cord injury. J Rehabil Res Dev 2012; 49(4):497-514.
- Crespo-Ruiz B, del-Ama AJ, Jimenez FJ, de-la-Peña A, Morgan J, Gil-Agudo A. Physical Activity and Transcutaneous Oxygen Pressure in Individuals with Spinal Cord Injury. J Rehabil Res Dev 2012;49(6):913-24.
- Gil-Agudo A, Pérez-Nombela S, Forner-Cordero A, Pérez-Rizo E, Crespo-Ruiz B, del-Ama AJ. Gait kinematic analysis in patients with a mild form of Central Cord Syndrome. Journal of Neuroeng Rehab 2011, 8:7.
- Moreno JC, del-Ama AJ, de los Reyes-Guzmán A, Gil-Agudo A, Ceres R, Pons JL. Neurorobotic and hybrid management of motor disorders: a review. Medical & Biological Engineering & Computing. 2011; 49 (10): 1119-30. DOI: 10.1007/s11517-011-0821-4.
- de-los-Reyes A. Gil-Agudo A, Peñasco-Martín B, Solís-Mozos M, del-Ama AJ, Pérez-Rizo E. Kinematic analysis of the daily activity of drinking from a glass in a population with cervical spinal cord injury. Journal of neuroengineering and rehabilitation 2010;7(1)
- Gil-Agudo A, del-Ama AJ, Pérez-Rizo E, Pérez-Nombela S, Rodríguez-Rodríguez LP. Upper limb joint kinetics during manual wheelchair propulsion in patients with different levels of spinal cord injury. Journal of Biomechanics 2010;43(13):2508-15.
Antonio José del Ama Espinosa: Group Leader. MsC. PhD. Ing.
Angel Gil Agudo: Scientific consultant. Head of Rehabilitation. PhD, MD.
Ana de los Reyes Guzmán: Researcher. MsC. PhD. Ing.
Vicente Lozano Berrio: Researcher. MsC. OT.
Enrique Pérez Rizo: Researcher. MsC. Ing.
Biomechanical analysis of movement during key activities in patients with spinal injuries
While the characteristics of normal human gait are well studied and documented, the similar knowledge in patients with spinal cord injuries is scarce. Therefore, this line of research has a goal to provide the knowledge and methodology for gait analysis in patients whose locomotor capacity is compromised due to various neurological disorders and/or spinal cord injury. Nevertheless, being aware of the facts that the major portion of SCI patients (80%) realizes their daily activities using a wheelchair made us also focus on biomechanical analysis of the manual wheelchar propulsion. By doing so, we joined a small number of international groups involved in this innovative research. Corollary to the main research line, we also perform the analysis of arm movements during various daily activities as well as during walking with sticks.
Virtual reality for rehabilitation of the upper extremity.
Due to the advances in the computation capacity and graphical representation, as well as the affordability of peripherals for interaction and immersion in virtual environments, the therapeutic possibilities of these technologies have been multiplied at accessible cost. Aware of this great potential, the Biomechanics Unit leads and participates in research projects related to the development of virtual reality systems as tools for treatment and evaluation of the upper limb function, crystallizing in the development of the ToyRa system together with Indra Sanidad and the Rafael del Pino Foundation, a system that integrates both the treatment and the objective assessment of the upper limb function as key factors. This research line continues with the exploration of different systems such as Kinect or LeapMotion amongst others, as well as the development of new virtual reality environments for current systems (Armeo). This line is completed through the development and validation of metrics for the objective assessment of upper limb function based on these technologies.
Definition and implementation of protocols for functional assessment of technical aids
Presently the data on this subject are scarce and thus, the process of prescribing and adjusting the equipment in question usually turns into a trial-and-error process where a scientific knowledge and quantification are virtually missing i.e. it is largely unknown if the prescribed equipment fulfills the expectations for which it was prescribed. Our opinion is that the functional evaluation of a prescribed assistive technical device (e.g. wheelchair) should be complementary to its technical evaluation and of equal importance. Therefore, we tend to use two approximations in this analysis: 1) first, producing the most realistic simulations by the specialized personnel during which we assess possible problems that may surge during a routine use of the equipment/device as well as documenting other positive and/or negative aspects of its design; and 2) applying various instrumentation techniques to the analysis and recording variable sof interest (related to the device, to the user and to the analyst) to evaluate its function. Although the second approximation tends to be much more complex than the first one, it also offers much more objective device evaluation than the first one. Our final goal is to create synergies with institutions currently conducting such technical evaluation, in order to offer joint services to the corresponding administrations, professionals and companies related to the sector.
Robotic exoskeletons for walking assistance.
Significant advances have been made in recent years in the field of robotics to treat the impact of spinal cord injury on gait ability with the recent outbreak of robotic exoskeletons for functional compensation. The research lines are based on a close collaboration with the Neural Engineering Group of the CSIC Institute Cajal at CSIC, participating in several projects that deal with the development of new techniques and robotic and electrophysiological technologies, as well as technical and clinical evaluation procedures, with the objective of improving the performance of exoskeleton technology. The objective of the Biomechanics Unit is to investigate the short- and medium-term impact of the use of these technologies, generating knowledge about possible applications and indications, by actively participating in the development and partial validation phases of the projects.
Pressure relief systems for sitting and positioning in a wheelchair.
Closely linked to the healthcare activity, this line of research aims to increase the knowledge of the physiological and functional impact of using these devices, as well as in the quality of life of the users, both commercial and prototype. For this, the Biomechanics Unit leads and / or participates in research projects, applying the extensive knowledge gathered in clinical assessment.
- Evaluación de la terapia robótica con exoesqueletos en la rehabilitación de la marcha en lesionados medulares incompletos. Convocatoria de ayudas de proyectos de investigación en salud del Instituto Carlos III, Ministerio de Economía y Competitividad. IP. Ángel Gil Agudo (2015-2018)
- Plataforma de Bajo Coste para Rehabilitación del Miembro Superior basado en Realidad Virtual: RehaHand. Programa Estatal de I+D+i Orientada a los Retos de la Sociedad 2016, Ministerio de Economía y Competitividad. IP. Ana de los Reyes Guzmán (2016-2019)
- Smart Wearable Robots with Bioinspired Sensory-Motor Skills: BioMot. 7º Programa Marco, FP7-ICT-2013-10 7th, Small or medium-scale focused research project (STREP). Coordinator: Juan C. Moreno (Neural Rehabilitaron Group, Cajal Institute, CSIC). IP at HNP: Antonio J. del-Ama (2013-2016)
- Dispositivos Híbridos Neuroprotésicos y Neurorobóticos para Compensación Funcional y Rehabilitación de Trastornos del Movimiento". Proyecto HYPER; Programa CONSOLIDER-INGENIO 2010 CSD2009-00067 Convocatoria 2009 del Ministerio de Ciencia e Innovación junto con otros 8 centros de investigación nacionales y bajo la coordinación del Instituto de Automática Industrial del CSIC. IP at HNP: Angel Gil Agudo. (2010-2014).
- Análisis biomecánico de las extremidades superiores al caminar con muletas. Estudio comparativo de dos patrones diferentes de marcha. Convocatoria de la Fundación para la Investigación Sanitaria en Castilla–La Mancha, por la que se convocan Ayudas para la realización de Proyectos de Investigación de fecha 31 de marzo de 2010 (D.O.C.M. nº 68 de 12 de abril de 2010). IP: Enrique Pérez Rizo. (2011-2013).
- Hybrid Technological Platform for Rehabilitation, Functional Compensation and Training of Gait of Gait in Spinal Cord Injury (SCI) Patients. Convocatoria 2011. Programa Nacional de Proyectos de Investigación Fundamental en el marco del VI Plan Nacional de Investigación Científica, Desarrollo e Innovación Tecnológica 2008-2011 (MICINN). DPI 2011-28160-C03-03. IP: Ana de los Reyes Guzmán. (2012-2014).
- Estudio ecográfico, biomecánico y clínico del hombro doloroso en el deportista en silla de ruedas. Convocatoria 2011. Programa Nacional de Proyectos de Investigación Fundamental en el marco del VI Plan Nacional de Investigación Científica, Desarrollo e Innovación Tecnológica 2008-2011 (MICINN). DEP 2011-29222-C02-02. IP: Angel Gil Agudo. (2012-2014).
- PUMA: Development of an integrated Multi Strategic System to prevent Pressure Ulcers in Risk Wheelchair Users. Convocatoria de Research for the benefit of SMEs 7th Framework Programe on Research. Technological Development and Demonstration. Research Executive Agency European Union. FP7-SME-2012 (ref: 315114). (Séptimo Programa Marco de la Comisión Europea). Coordinator: IBV. IP at HNP: Angel Gil Agudo (2013-2014).
- Sistema de Rehabilitación Integral. Convocatoria de ayudas: Acción Estratégica de Telecomunicaciones y Sociedad de la Información. Subprograma: Avanza Competitividad I+D+I. TSI-020302-2011-10. Ministerio de Industria, Turismo y Comercio. (2013-2014).