35374 - Rehabilitation Bioengineering M

Learning outcomes

To give the student a framework on disability issues, aids and techniques used for the functional evaluation with particular reference to neurorehabilitation and neuroprostheses in the control of posture and movements, prosthetics and orthotics for upper and lower limbs, and remote monitoring, home automation applications and virtual reality.

Course contents

1. Introduction to the course
• Historical Background
• Technologies for rehabilitation and their impact on health and society: the disabled and the elderly

2. Anatomical and physiological bases
• Anatomy and physiology of the musculoskeletal system
• Organization of the central and peripheral nervous system
• Functions of the central nervous system more often affected by traumatic/vascular events or neurodegenerative diseases

3. Biomechanics
• Biomechanics: definition, objectives, methodologies
• Statics, kinematics and dynamics of rigid bodies and multilink/multijoint systems
• Biomechanics of human movement: general purpose, history
• Kinematics and dynamics of human movement
• Motion analysis laboratory: stereo-photogrammetry, dinamometry, wearable sensors

4. Control of posture and movements 
• Postural control
• Balance disorders and their clinical evaluation
• Assessment of postural control by static and dynamic posturography
• Mathematical models of postural control
• The posturographic signal: parameters derived from the trajectory of the center of pressure
• Falls in the elderly and disabled subjects: stability analysis, determinants, dynamics, classification, prediction, assistance and rehabilitation.
• Exercises and projects

5. Elements of functional assessment
• Definition of function
• Functional evaluation scales
• Functional evaluation techniques
• Basics of pattern recognition and classification techniques
• Assessment of cognitive function
• Applications

6. Rehabilitation techniques based on biofeedback and virtual reality
• Biofeedback: basic principles and applications
• Postural biofeedback, gait biofeedback and neurofeedback
• Basic operation of a system based on Virtual Reality
• Applications

7. Aids and systems to support mobility, communication, and independence
• Introduction to Disability
• ICIDH and ICF classifications
• Definition of Aid. Supporting independence. Design for All
• Prostheses and orthoses. Stages of prosthetic treatment. Construction techniques
• Lower limb prostheses. Classification and coding. Exoskeletal and endoskeletal prostheses
• Upper limb prostheses. Classification and coding. Aesthetic prostheses and functional prostheses. Orthosis
• Mobility aids
• Robotic systems for rehabilitation

8. Human-machine-environment interfaces
• Sensors for motor disabilities
• Assistive technology. Customizing a device or a system
• Communication aids. Computer access solutions. Assistive keyboards and mouse emulators. Assistive software for computer access
• Home automation technology and operating standards
• Domotics and disability
• Virtual reality-based interfaces
• Brain-computer interface (BCI)

Readings/Bibliography

Teacher's notes and Power Point presentations.

1. Cappello A., Cappozzo A., di Prampero P.E. (Eds.). (2003). Bioingegneria della Postura e del Movimento, Patron Editore.
2. Winter D.A. (2009), Biomechanics and Motor Control of Human Movement, John Wiley & Sons,
3. Ozkaya N., Nordin M., Goldsheyder D., Leger D. (Eds. Angelo Cappello, Lorenzo Chiari) (2021) Fondamenti di Biomeccanica. Equilibrio, movimento e deformazione, Piccin Editore.
4. Farina, D., Jensen, W., & Akay, M. (Eds.). (2013). Introduction to neural engineering for motor rehabilitation (Vol. 40). John Wiley & Sons.
5. Salisbury, D. B., Dahdah, M., Driver, S., Parsons, T. D., & Richter, K. M. (2016, April). Virtual reality and brain computer interface in neurorehabilitation. In Baylor university medical center proceedings (Vol. 29, No. 2, pp. 124-127). Taylor & Francis.
6. Reinkensmeyer, D. J., & Dietz, V. (Eds.). (2016). Neurorehabilitation technology. New York: Springer.
7. Dimitrousis, C., Almpani, S., Stefaneas, P., Veneman, J., Nizamis, K., & Astaras, A. (2020). Neurorobotics: Review of Underlying Technologies, Current Developments and Future Directions. Neurotechnology: Methods, advances and applications.
8. Chen, S. C., Bodine, C., & Lew, H. L. (2021). Assistive Technology and Environmental Control Devices. In Braddom's Physical Medicine and Rehabilitation (pp. 374-388). Elsevier.
9. Gupta, D., Sharma, M., Chaudhary, V., & Khanna, A. (Eds.). (2021). Robotic Technologies in Biomedical and Healthcare Engineering. CRC Press.
10. Chui, K. K., Jorge, M., Yen, S. C., & Lusardi, M. M. (2020). Orthotics and prosthetics in rehabilitation.

Teaching methods

During the lectures the general issues related to the design and development of systems for the sensory-motor rehabilitation will be discussed. The course includes laboratory practicals and visits to medical centers. Numerical analysis will help design and simulate experiments in a realistic way. These will be later performed in the laboratory of Biomedical Engineering. Short theses will allow groups of students to investigate aspects of the course through the analysis of clinical cases.

Assessment methods

The assessment will take place:
• in the classroom during exercise solving
• in the laboratory during practicals
• project
• final examination, written and oral

The exam consists of:
• multiple choice questionnaire
• two exercises, one for each module
• oral presentation of the project

Teaching tools

• Power Point presentations
• Stereo-photogrammetric system
• Force platforms
• Wireless multi-channel electromyograph
• Wearable sensors and actuators

Office hours

See the website of Silvia Orlandi

See the website of Angelo Cappello