Special Sessions at ICNR2024 are 90-minute sessions dedicated to a specific topic. The structure of the Special Session comprise of oral presentations and discussions. Contributors to Special Sessions will have to submit Extended Abstracts (2 pages) which will be published in the Proceedings as a book upon acceptance.
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Rehabilitation Wearable Robotics
Wearable robotics revolves around robotic solutions which can be worn, both as an aid for the disabled and to empower non-disabled users. On top of accomplishing the tasks they are conceived for, wearable robots must enforce additional stringent constraints: interaction safety (both physical and cognitive), bio-compatibility, light weight, low power consumption, acceptability. The study of wearable robotics is tightly interwoven with human-machine interaction, psychology, medicine, material science, design.
WR01. Advances in amputation surgeries and technologies for bionic hand reconstruction
Marta Gherardini (Sant’Anna, Italy)
Christian Cipriani (Sant’Anna, Italy)
Abstract. In the last 20 years we have witnessed tremendous advancements in the field of bionic hand reconstruction, aimed at restoring motor and sensory function in people who have lost their limb. Advanced upper limb surgical procedures merged with complex prosthetic technologies have opened unprecedented possibilities for people living with upper limb amputation, who are seeking better solutions both in terms of comfort and functionality. In this context, experts in different fields are seeking solutions to address the desire for a more intuitive and biomimetic control of the artificial limb, mimicking the natural hand, as well as the possibility of “feeling” the artificial limb, through the restoration of both proprioceptive and exteroceptive sensations. The path towards the development and clinical translation of these solutions is filled with several challenges, and requires a skilled and, most of all, multidisciplinary approach, combining the expertise of upper-limb surgeon, prosthetists, skilled occupational therapists, and engineers developing dexterous terminal devices and, most importantly, cutting-edge technologies required for interface with users. Within this context, this special session will explore the latest groundbreaking advancements in bionic reconstruction, delving into the fusion of technology and surgery/therapy interventions aimed at restoring dexterous motor functions and multimodal sensing equivalent to the human hand. Pioneering leaders in the medical and bioengineering fields from different countries will share their recent work aimed at enhancing the quality of life for amputee patients.
WR02. Emerging technologies for the next generation of overground rehabilitation robotic devices
Anselmo Frizera, PhD (Universidade Federal do Espiritu Santo, Brazil)
Ricardo Carminati de Mello (Federal University of Espirito Santo, Brazil)
Mario F. Jimenez (Universidad del Rosario, Colombia)
Abstract. Functional locomotion is a fundamental and essential skill to guarantee the independence, quality of life and well-being of people. The integration of robotics with conventional mobility assistance and rehabilitation devices has brought a new range of functionalities to such devices. In this way, new strategies to support health and assistance were developed based on solutions that offer physical support, sensory and cognitive assistance and advanced human-robot interaction strategies for human locomotion. Robotic devices such as smart walkers, robotic canes, and exoskeletons have been developed and applied in different clinical scenarios in recent years. In this area, it is important to recognize that overground gait training has the potential for higher therapeutic results due to its associated biomechanics being very close to natural gait.
This Special Session aims at gathering emerging technologies that can provide important advances in restoring motor and cognitive function in overground gait and locomotion rehabilitation. The topics of interest include (but are not limited to):
- Innovative system architectures to integrate cloud robotics and artificial intelligence into locomotion-oriented rehabilitation programs
- Novel technologies in sensing, actuation and control strategies applied to rehabilitation and assistive robotics
- Mixed reality and serious games
WR04. Enhancing and evaluating impact of wearable robots by user involvement: practical guidance
Gerdienke Prange (Roessingh Research and Development & University of Twente)
Abstract. Advances in (soft) robot technology are bringing applications of wearable robots ever closer to clinical practice and daily life of its users. Knowing who those users are, what they need and how use of a wearable robot fits into daily life is essential to move from research to clinical practice. This means involving users in research and development processes, which is easier said than done (properly). And involving users in your project, and keeping them engaged, is not the end of it. Knowing how to measure the impact of a wearable robot on its users is crucial, in order to gather the information that manufacturers need to bring their device to the market. What to measure, exactly? And what about other stakeholders in the ecosystem beyond the primary end-user? How to integrate their perspective? Co-creation with end-users and stakeholders is key to ensure that the innovation meets user needs and fits the healthcare context, but it’s not easy to do that properly. In this session we will show practical approaches based on user-centred design and citizen science to enhance impact of technology with user input, and present the societal return on investment (SROI) method as a way to assess impact of technology among all stakeholders, including aspects that are not directly expressed in monetary value. This will ultimately help to develop technology that is actually and optimally used and contributes to sustainable healthcare. We will illustrate this with several practical examples of how we applied such approaches to enhance and evaluate impact of wearable robots in daily practice, looking into a robotic hand exoskeleton being developed for spinal cord injury patients (GRIP) and soft robotic exoskeletons for motion assistance of grip (Carbonhand) and gait (SWAG) in patients with functional limitations.
WR05. Neural-machine interfaces for closed-loop control of lower-limb powered robotic systems – Cancelled
WR06. Artificial sensory feedback in prosthetics: Clinical translation
Strahinja Dosen (Aalborg University)
Jakob Lund Dideriksen (Aalborg University)
Abstract. Many methods and technologies to provide feedback to the users of upper and lower-limb prostheses have been presented in recent years. This includes sensory substitution approaches based on tactile stimulation of the skin, but also invasive techniques that employ electrical stimulation of the peripheral nerves. The impact of feedback was also assessed, and the results are encouraging, as there are indications that well-designed interfaces can improve prosthesis performance and user experience. However, most of the evaluations were conducted short-term and within a controlled environment of the research labs. There are also contrary results, where feedback was not beneficial in some tasks and/or users (naïve vs. experienced). Therefore, artificial feedback in prosthetics has shown to be an elusive phenomenon, and the translation of these developments into clinical use is still missing. The mainstream commercial prostheses do not provide explicit feedback to their users. In this special session, we will invite contributions that focus on addressing this point. We are particularly interested in methods and technologies that are integrated in sockets, convenient for out-of-the-lab testing as well as studies investigating the benefits of feedback in realistic conditions and/or daily life, potentially over a longer period. We also welcome the perspectives of the researchers, based on their own experience and/or user viewpoints, regarding the factors that are critical to bridge the gap between the lab and daily life. The session will contribute to understanding the challenges in the clinical translation and showing how far are we from the development of feedback that is impactful in the daily use of a robotic prosthesis. The organizers have contacted four leading groups, with expertise in both invasive and non-invasive feedback methods, who have agreed to participate in the special session, therefore, ensuring a balanced and comprehensive coverage of the topic.
WR07. Robotic lower limb prostheses: from design to evaluation
Ming Liu (North Carolina State University, University of North Carolina Chapel Hill, USA)
Helen Huang, PhD (North Carolina State University, University of North Carolina Chapel Hill, USA)
Abstract. Innovative technologies and advanced algorithms are launched continuously to boost performance and functionalities of robotic lower limb prostheses. At the same time, biomechanical evaluations of these advanced devices still lead to mixed results. We hope that a thoughtful discussion between the designers and evaluators can bridge knowledge gaps, trigger new ideas, and lead to multidisciplinary cooperation.
WR08. Predictive control for bio-protective robotic exoskeletons: closed-loop control of internal body forces
Massimo Sartori, PhD (U. of Twente, The Netherlands)
Mahdi Nabipour (U. of Twente)
Abstract. Developing wearable exosuits and exoskeleton technologies capable of providing closed-loop control over musculotendon loads, especially during dynamic activities like walking, presents a significant ongoing challenge. Addressing this challenge holds immense potential to facilitate more tailored and effective rehabilitation protocols, improve sports performance by reducing the risk of injuries associated with repetitive or high-impact activities, support healthy aging, and enhance occupational safety by providing ergonomic support and reducing strain on muscles and tendons. The efficacy of personalized wearable robotic systems heavily relies on how torque and forces are exerted on the user, and how these exertions impact the neuromusculoskeletal system. The musculotendon unit (MTU) experiences a variety of loading conditions during activities of different intensities, such as walking and running at different speeds. To have a real-time task independent close-loop control of the MTU force, the controller should be fast enough to account for the rapidly changing force profile throughout the gait. Researchers have previously employed a range of control techniques based on heuristics, joint torque proportionate support using electromyography (EMG), optimization for energy expenditure using human in the loop, chemical energy used by the muscle, walking speed, or user preference. Some other controllers, were designed to assist the user by mimicking the human ankle joint torque or the positive power profile. Current state-of-the-art lower limb exoskeleton controllers lack direct control over biological tissue parameters, such as muscle force. In this 90-minutes special session, we aim to discuss the challenges in using prediction-based controllers for closed-loop control MTU forces or joint torques during dynamic tasks such as hopping and locomotion. This session will include four oral talks (12-minute presentation and 3-minute Q&A) and a 30-minute panel discussion, which focuses on the gaps in this area, will be held at the end of the special session.
WR09. Quantifying, Understanding and Improving Human-Exoskeleton Interaction in neurorehabilitation
Nevio Luigi Tagliamonte, PhD (Università Campus Bio-Medico di Roma, Rome, Italy)
Diego Torricelli (CAR-CSIC)
Philipp Beckerle (FAU)
Abstract. Exoskeletons are becoming increasingly relevant to train or supplement motor functions in several application scenarios and especially in neurorehabilitation (therapy and assistance).
Anyhow, using exoskeletons to provide appropriate physical support while preserving natural, intuitive, smooth, and harmonious motion is still a great challenge from design and control perspectives. Moreover, the impact on rehabilitation aspects, especially in terms of effective treatment, recovery, and also independence, is a key aspect to be investigated. Biomechatronic and user-centered design and control solutions are continuously evolving to improve wearability and ergonomics, functionality, and effectiveness, as well as acceptability and usability. Moreover, novel assessment methods and protocols are currently being developed to analyze human-exoskeleton interaction from robotic, biomechanical, and physiological perspectives. This Special Session aims to collect current developments in the field of exoskeleton-assisted interaction, including any aspects related to design, control, interfacing, and assessment of exoskeletons, putting emphasis on the impact and effects on therapy in clinical setting and personal assistance during daily life. Contributions from different application areas are encouraged. Abstracts from the human-centered robotics, biomechatronics, biomechanics and bioengineering, rehabilitation, neuroscience, and other related fields will be considered.
WR10. Upper limb robot-assisted rehabilitation: from clinic to home
Olivier Lambercy (ETH Zurich)
Giada Devittori (ETH Zurich)
Abstract. Neurorehabilitation faces many open challenges due to the increasing number of neurological patients, the limited number of healthcare professionals, and the rising healthcare costs, which ultimately impact access to quality therapy. Technology-based solutions, such as robotics, bear high potential to enable a paradigm shift in neurorehabilitation models currently heavily relying on hospital stays/visits. In this session, we will review recent developments and clinical evaluation of technology-based solutions to support upper limb neurorehabilitation along the continuum of care, from the hospital bedside to their home. Specifically, we will focus on technologies that can promote home-based rehabilitation, motivate patients to self-engage in quality therapy, provide, and ultimately help increase, the therapy dose patients can receive after a neurological injury. Building on the expertise of technology developers and clinicians, we will discuss key enablers and challenges in view of the development and acceptance (from clinicians, patients, and policymakers) of such technologies for neurorehabilitation.
WR11. Cancelled.
WR12. Intent detection in practice
Claudio Castellini (Friedrich-Alexander-Universität Erlangen-Nürnberg, Germany)
Abstract. In a nutshell, Intent Detection (ID) consists of turning biological signals related to a patient’s muscle activity into control commands for an assistive device. Despite decades of research, however, dexterous, natural, and reliable ID has not yet fully penetrated in the clinics and on commercial devices. In this session we accept contributions related to practical applications of ID, close to market and with provable reliability and usability, or innovative solutions with high potential to mark a breakthrough.
WR13. Multi-human interactions in neurorehabilitation
Jim Patton (Shirley Ryan AbilityLab, University of Illinois at Chicago, USA)
Lorenzo Vianello (Shirley Ryan AbilityLab, USA)
Matthew Short (Shirley Ryan AbilityLab, Northwestern University, USA)
Abstract. Humans often interact in pairs or groups while performing motor tasks, either to enhance their performance by working as team or to share information and learn from one another. Certain motor tasks can be completed by a single individual, like a patient training to rehabilitate their impaired limb; however, the outcomes of these tasks change significantly when an additional individual (e.g., a physical therapist) is present. Other tasks, like moving a piece of heavy furniture, require multiple individuals to coordinate their efforts to accomplish something that would otherwise be very difficult. In each of these scenarios, human-human interaction can take the form of audiovisual communication and/or physical interaction, existing as discrete or continuous exchanges between individuals. In the context of rehabilitation, human-human interaction is achieved through direct physical contact. For example, in physical therapy, a therapist can interact with their patient by guiding their impaired limb through a movement. In some cases, however, it may be beneficial to customize the physical interface between the therapist and the patient. One way to achieve this is to connect each individual to a machine. A network of machines can then be controlled to implement desired interaction dynamics between the humans, and to display a virtual external environment. The simplest scenario involves two humans interacting through two machines, but other interaction network topologies, with groups of interacting humans, are possible. Studies on machine-mediated interaction between humans have demonstrated improved task performance and motor learning as a result of haptic training with a partner; these positive outcomes have been attributed to (1) increased motivation and interest; (2) the ability to estimate and infer strategies from a partner’s movement; and (3) the summing of physical effort, or the ability of partners to communicate and adopt specialized roles in performing a physical task. In this exclusive special session, we will explore the mechanisms that allow multiple humans to interact and how this interaction can be leveraged in the field of physical rehabilitation. In particular, we will discuss the practical implementation of machine-mediated interaction by providing examples ranging from single to multi-degree of freedom interaction for both the upper and lower extremities.
Clinical Motor Control
CMC01. Cycling limb movements in neurorehabilitation
Jozsef Laczko (Pazmany Peter Catholic University, Shirley Ryan AbilityLab)
An important motor task that helps to modulate neural activity after neurologic movement impairment, or prevent progression of neural based movement disorders or secondary diseases, is limb cycling and cranking. Cycling may be performed with upper limbs, with lower limbs or with four limbs simultaneously. This type of training is beneficial in rehabilitation for patients with spinal cord injury, and also for stroke survivors and patients with Parkinson Disease or Multiplex Sclerosis. Cycling training could reduce spasticity in limb muscles. It may also affect the patient’s performance in other motor tasks. Cycling exercises can be applied in clinics and in the home of the patient. This special session aims to present the latest results related to the control of arm and leg cycling movements and their potential application in rehabilitation protocols.
CMC02. The role of kinematically constrained limb movements in neurorehabilitation
Jozsef Laczko (Pazmany Peter Catholic University, Shirley Ryan AbilityLab)
There are many studies about unconstrained reaching arm movements of patients with various neurological diseases. At the same time, kinematically constrained limb movements are also important for rehabilitation of patients with neural based motor impairment. For instance, trajectory tracking, drawing movements, hand movements constrained to a linear or curved path, object avoiding movements or multi-joint movements restricted to horizontal or vertical planes, may be considered and have implications for rehabilitation. Body position respect to gravity may also influence neural control of limb movements. The special session will discuss how to consider these tasks when planning trial- or rehabilitation protocols.
CMC03. Motor control principles applied to robot mediated stretch reflex modulation and Functional Electrical Stimulation in individuals with CNS injuries
Jozsef Laczko (Pazmany Peter Catholic University, Shirley Ryan AbilityLab)
Functional electrical stimulation may be controlled by current advanced technologies as brain-machine interface or body-machine interface. These technologies are using various dimensional reduction methods, mapping redundant number of sensory signals into control variables. Machine learning methods and artificial intelligence may also provide opportunities to control functional electrical stimulation. How such approaches and methods can be used for identifying FES parameters? Neural networks were also suggested to build FES controllers. Closed-loop feedback FES controllers are applied in rehabilitation of SCI patients. In this session we would like to give insight into theoretical approaches, both deterministic and statistical, that might be translated to clinical application in treatment of spinal cord injured patients. We aim to discuss that what are possibilities and obstacles in application of these control principles.
CMC04. Enhancing Postural Control: Rehabilitation Interventions for Neurological Diseases
Guang H Yue (Kessler Foundation)
Shijun Yan, PhD (Shirley Ryan AbilityLab)
Postural control plays a significant role in motor functions in humans. Impairments in postural control affect essential activities such as reaching, sitting, standing, and walking. Traumatic Brain Injury (TBI) is one of the leading causes of sensorimotor deficits in adults and often results in balance impairments. TBI damages brain white matter network and weakens the ability of the brain to regulate balance function. In addition, TBI compromises the central nervous system’s capability to integrate sensory feedback during the motor control process, further exacerbating postural control deficits and balance dysfunction. Moreover, in younger individuals, deficits in trunk control restrict activities such as sitting, walking, and overall mobility in children with cerebral palsy (CP). These children often demonstrate impairments in the second level of postural control. In particular, they show incomplete adaptation to the EMG amplitude to task-specific constraints, excessive degree of antagonistic co-activation, and a top-down recruitment order of postural muscle activation. These impairments should be the target of intervention for improving trunk postural control in children with CP. In this session, we will cover innovative rehabilitation interventions aimed at enhancing postural control in individuals with TBI and children with CP.
CMC05. Evaluation of the paralysis level through Intervention and Rehabilitation for children with disability
Sayako Ueda (Japan Women’s University)
Ken Kikuchi (University of Tokyo)
Arito Yozu (University of Tokyo)
Eriko Kitahara (Juntendo University)
In recent years, there has been a significant increase in awareness and diagnosis of children with various conditions that impair cognitive and motor functions. These conditions include autism spectrum disorders, developmental coordination disorder (DCD), cerebral palsy, and several other neurological and developmental disorders. These impairments can have profound effects on a child’s daily life, affecting their ability to communicate, interact socially, perform basic motor functions, and achieve milestones in their developmental process. The importance of providing tailored rehabilitation intervention for such children cannot be overstated. Rehabilitation interventions must be carefully designed and implemented to address the unique symptoms and developmental stages of each child. This approach ensures that the interventions are not only effective but also supportive of the child’s overall growth and well-being. In this special session, we would like to delve into the neuroscientific mechanisms underlying these disorders. Understanding the brain’s structure, how it develops, and how these conditions affect its normal functioning is crucial for developing effective rehabilitation strategies. By examining the latest research and advancements in neuroscience, we can begin to unravel the complex interactions between brain development, neuroplasticity, and the manifestation of cognitive and motor impairments in children. Furthermore, we will explore rehabilitation interventions that are grounded in our understanding of these neuroscientific mechanisms. These interventions may include, but are not limited to, physical therapy, occupational therapy, speech and language therapy, and behavioral interventions. Each of these therapies plays a critical role in supporting the child’s development by improving motor skills, enhancing communication abilities, and fostering social interactions. By integrating these therapies into a comprehensive rehabilitation program, we can offer children with these conditions the best possible support to overcome their challenges and reach their full potential.
CMC06. Technical innovations for functional assistance of the paralyzed upper limbs
Christine Azevedo-Coste (INRIA, Montpellier)
Assisting the upper limbs movements in daily life for people suffering from arm paralysis remains a challenge. Existing solutions are generally limited to use in rehabilitation centres during the acute rehabilitation phase. New technological solutions are emerging to assist upper limb movements in ecological contexts. This functional assistance, used on a daily basis, could improve quality of life by allowing greater autonomy and, in some cases, functional recovery through repeated training. In this special session we welcome submission of articles related to the development and deployment of technological solutions dedicated to upper limb assistance with an emphasize on realistic and usable approaches in ecological situations.
CMC07. Diagnosis and rehabilitation for people with Parkinson’s disease
Qi An (University of Tokyo)
Shingo Shimoda (Nagoya University)
Kohei Kaminishi (University of Tokyo); Arito Yozu (University of Tokyo)
Tadamitsu Matsuda (Juntendo University)
Parkinson’s Disease (PD) is a progressive neurological disorder that significantly affects motor functions, necessitating ongoing adjustments in medication and targeted rehabilitation interventions to manage the evolving nature of its symptoms effectively. As PD progresses, patients often experience a range of symptoms including tremors, stiffness, and slowing of movement, which can severely impact their quality of life. Addressing these challenges requires a multidisciplinary approach, integrating medical treatment with physical and occupational therapy tailored to the individual’s current condition. This special session aims to explore the potential of leveraging Information and Communication Technology (ICT) devices for the remote diagnosis, detection of disease level, effect of medicine, and monitoring of Parkinson’s Disease. Through the use of advanced ICT devices, healthcare providers can continuously assess the condition of patients in real-time, enabling timely adjustments to treatment plans and rehabilitation strategies without the need for frequent in-person visits. Additionally, these approaches delves into the application of neuro-musculoskeletal models as a sophisticated tool to gain deeper insights into the patient’s physical condition. These models can simulate the complex interactions between neural and musculoskeletal systems, offering a comprehensive understanding of how PD affects movement and posture. In this special session, we would like to discuss theses approaches to develop a more nuanced and effective approach to rehabilitation intervention. This innovative methodology not only promises to enhance the precision of symptom assessment but also to tailor rehabilitation efforts more closely to the patient’s specific needs, thereby improving outcomes and potentially slowing the progression of the disease.
CMC08. Elucidating the Roles of Corticospinal and Reticulospinal Tracts in Motor Impairment and Recovery in Chronic Stroke: A Multifaceted Approach – Cancelled
CMC09. Smart use of mechtronics and signal analysis to improve movement coordination in hemiparetic stroke
Julius P.A. Dewald (Northwestern University)
Mike Ellis (Northwestern University)
The main goal of this session is to show how using engineering approaches allows for the study of neural mechanisms underlying the loss of independent joint control or synergies and flexor hypertonia in the paretic arm/hand following a unilateral brain injury. Novel interventions using a combination of neurophysiological and engineering techniques to reduce the effects of especially the flexor synergy will also be discussed. Evidence for the loss of independent joint control in the paretic limb of individuals with adult-onset stroke will be presented during movements in haptic environments generated by admittance-controlled robots. Furthermore, the relationship between the loss of independent joint control and cortical reorganization using high-resolution EEG and EMG combined with peripheral mechatronic quantitative measures of losses of independent joint control will be shown.
CMC10. Biofeedback for Neurorehabilitation
Erika G Spaich (Aalborg University, Denmark)
Biofeedback is a technique used to measure physiological processes in a person and inform them of selected characteristics of these processes to create awareness and facilitate regulating or changing bodily functions. With current technologies, a large diversity of biomechanical and electrophysiological signals can be easily monitored and processed to extract information on e.g., body posture, muscle activity, and fatigue. Feedback is then provided using different sensory modalities, e.g. touch, vision, and audition or combinations of these. In neurorehabilitation, biofeedback provides a tool to support motor (re)learning by using neuroplastic principles. Providing timely and relevant feedback, and in a manner that is understandable for the user, is key to achieving positive outcomes of neurorehabilitation. In this session, an introduction to biofeedback for neurorehabilitation and a broad spectrum of applications will be presented. Talks will address the neurorehabilitation of various target groups (people with stroke, spinal cord injury, and cerebral palsy), different functions or body segments (upper limb, lower limb, gait, cycling), and different feedback modalities (visual, auditory, vibrotactile, and virtual reality). This constellation of talks will provide a good insight into the current research in the field, and it will be presented by researchers at various levels in their academic careers.
CMC11. Altered descending motor pathways after stroke and spinal cord injury: implications for motor recovery
Ronan A. Mooney (Shirley Ryan AbilityLab)
Monica A Perez (Shirley Ryan AbilityLab)
The corticospinal tract is the primary descending motor pathway involved in making dexterous voluntary movements. Damage to the corticospinal tract, following stroke or spinal cord injury, typically leads to significant motor impairments (e.g., weakness, poor control, abnormal synergies, spasticity). These motor deficits are thought to arise from a loss of corticospinal input, as well as upregulation of alternate motor pathways such as the reticulospinal tract. In this session, we will discuss how altered activity in these descending motor pathways may underlie motor impairment and the potential for motor recovery follow stroke and spinal cord injury. First, Dr. Ronan Mooney will discuss how the functional integrity of the corticospinal and reticulospinal tracts can be assessed in humans, as well as evidence of heightened reticulospinal output in the presence of severe corticospinal tract damage after stroke. Second, Dr. Jules Dewald will discuss the behavioral signatures of corticospinal tract damage and upregulated reticulospinal output in people with stroke. Third, Dr. Monica Perez will present evidence indicating contributions of the reticulospinal tract for residual movement and motor recovery after spinal cord injury. Finally, Dr. Maria Germann will present evidence of plasticity induction within subcortical motor circuits following the application of novel non-invasive stimulation protocols in healthy individuals and people with spinal cord injury. Together, these key insights into the behavioral and physiological consequences of altered descending motor pathways after stroke and spinal cord injury has important implications for designing interventions aimed at improving motor recovery in these individuals.
CMC12. Neurophysical and sensorimotor techniques to enhance learning and adaptation – Cancelled
CMC13. Children are not small adults: solutions targeting neuropediatrics
Francesca Lunardini (Hospital Los Madroños/INNTEGRA, Spain)
Linda Greta Dui (Politecnico di Milano, Italy)
Children represent our future. Optimizing their health outcome should be a goal for their clinical pathway, from the screening of neurological or motor pathologies, to rehabilitation. However, they are often underrepresented in neurorehabilitation research. When designing neurorehabilitation solutions, they should be specifically tailored to children’s needs, and involve them as key stakeholders during the design process. This special session aims to fill this gap by targeting technologies and solutions for the assessment, diagnosis, training, and rehabilitation specifically designed for neuropediatrics. This means that children’s needs should have driven the choice of components, interfaces, interaction modalities, strategies for engagement. For example, solutions may be non-invasive or child-friendly, potentially incorporating gamification or other innovative techniques to maximize effectiveness, promote adherence and support children’s participation. The special session seeks to foster collaboration between researchers, clinicians, educators, and technology developers to devise innovative solutions that address the unique needs of pediatric patients and enhance their quality of life. In particular, the focus will be on solutions with practical application, aiming to become soon a standard for clinical practice.
Rehabilitation Robotics
RR01. Advanced and Hybrid solutions for wearable assistive technologies
Federico Masiero (Heidelberg University, Germany)
Leonardo Cappello Scuola Superiore Sant’Anna, Italy)
Enrica Tricomi (Heidelberg University, Germany)
Lorenzo Masia (Heidelberg University, Germany)
In the ever-evolving landscape of assistive technologies, “Advanced and Hybrid solutions for Wearable Assistive Technologies” is a groundbreaking special session that explores the cutting-edge developments in the field. Wearable technologies and prostheses have made remarkable strides in enhancing the quality of life for individuals with motor impairments and disabilities. Among all the developments brought by one century of modern research in the field, the search for intuitive and naturally perceived human-machine interfaces still remains a hot research topic. “Advanced and Hybrid solutions for wearable assistive technologies” promises to be an invaluable opportunity for researchers and practitioners in the field. This special session delves into innovative strategies that empower users and improve the functionality of these devices. In particular, it will feature a collection of research articles and case studies that shed light on the latest advancements on novel control methods, including sensorimotor integration in assistive wearable technologies. The selected line of speakers will share their expertise in the mentioned relevant topics: we will span from latest advances in context-awareness applied to soft robotic suits to invasive technologies aiming at restoring lost motor functions in amputees. Finally, after the speech of the invited speakers, attendees will engage in an open discussion centered around shaping the future of assistive technology with a human-in-the-loop approach.
RR02. Frontiers in bioengineering to improve motor coordination in stroke rehabilitation
Jinsook Roh (University of Houston)
Benjamin J. Fregly (Rice University)
Stroke is one of the major causes of adult disability worldwide. According to the World Stroke Organization, one in four people will experience stroke in their lifetime, and over 50% of the survivors will live with chronic disability. Stroke often leads to motor impairment, such as spasticity, muscle weakness, and abnormal motor coordination. Impaired, stereotypical motor coordination patterns emerge during stroke recovery and can be quantified as abnormal intermuscular coordination patterns. This multi-muscle coordination is a key contributor to motor impairment and suggests an underlying neural reorganization within the motor control system. Abnormal intermuscular coordination does not entirely resolve after spontaneous recovery or after conventional physical or occupational therapy. Thus, there is an important gap in our ability to effectively assess the recovery process of the motor impairment and reduce it after a stroke. This Special Session will provide examples of how muscle coordination in stroke can be modified and improved using bioengineering interventions, i.e., myoelectric interfacing and robotics, and muscle synergy analysis to improve the motor function of stroke survivors. In particular, we will present how assistive and resistive forces provided by a robot, robotic task settings, and robotic-aided training can impact upper limb muscle synergies in chronic and subacute stroke patients. Also, a personalized neuromusculoskeletal model will be introduced to identify the most “broken” muscle synergy in the paretic leg of an individual post-stroke and performs a walking simulation using the subject’s personalized model to predict how walking speed and bilateral symmetry would improve if this one “broken” synergy activation could be “fixed.” Furthermore, we will demonstrate how targeted brain stimulation can alter cortical activity and motor impairment after stroke. A panel discussion on the current challenges in the field will follow.
RR03. Advances in hand and wrist rehabilitation devices
Denny Oetomo, PhD (University of Melbourne, Australia)
The development of upper limb rehabilitation robotics have arguably been dominated by arm assistive robots that account for the gross reaching movements. The design of wrist and hand robotic devices for rehabilitation purposes is no less studied but relatively less developed in the translational sense, primarily due to the complexity of the human hand as well as the engineering and clinical requirements for the application. However, the need for the assistive and rehabilitation devices for the distal end of the upper limb is as important, if not more, as it completes the purpose of the gross reaching movements (ie. we reach out our arm usually to grasp and manipulate an object), thus it provides functional context for the reaching movement therapy. In this session, we would explore the latest in the development of concepts and devices for the rehabilitation of the distal end of the upper limb with a view to integrate and provide a more complete functional context to the upper limb movement therapies.
RR04. Combined use of robotics and immersive VR in neurorehabilitation
Jan Veneman, PhD, (Hocoma, Switzerland)
Robotics for functional movement therapy are used in neurorehabilitation to (re-)train gait, balance, as well as arm and hand functions, since over two decades. Immersive Virtual Reality systems are also increasingly used in clinical contexts over the recent years and show promise for use in combination with robotic devices for functional movement therapy. In this Special Session, current research and first learnings about the combined use of robotics and immersive VR systems in the context of movement rehabilitation will be discussed. Specific attention will be given to following topics: a) applications either specifically in gait and balance training, or specifically in arm and hand training, focusing on the specifics of such a context, b) direct coupling between the physical and virtual environment, for example first person representation of ego-movement, or using haptic feedback to support virtual illusions, c) observations from usability and feasibility studies with patients, d) Additional presentations of treatment approaches, novel technical solutions, as well as studies on feasibility, acceptance or clinical relevance of such combined use will be accepted.
RR05. Integrating Human Factors, Intensity Training Requirements, and Emerging Technologies: An Interdisciplinary Approach to Digital Health and Rehabilitation Technologies
Liliana Paredes (ETH Zurich)
In this session, we will integrate knowledge from various fields in neurological rehabilitation. Sarah will present the concept of digital twins of traumatic spinal cord injury patients as an in silico version of an individual, allowing for the simulation of expected recovery achieved through standard rehabilitation protocols. Sarah will also present a comprehensive overview of the concept of data-driven (AI) methods to generate recovery predictions and showcase their application for personalized predictions, and synthetic controls in clinical trials. Daniel’s presentation will examine the evolution of rehabilitation and devices in the context of robotics and digitalization. While acknowledging the field’s high potential in areas such as intensity, measurability, and home training, Daniel will highlight challenges such as human factors, limited financing models, market constraints, and susceptibility to errors. He will bring hope for future advancements, particularly with the integration of AI technologies? Jose’s talk will challenge conventional beliefs surrounding gait recovery in chronic stroke patients. His systematic review will reveal promising findings that challenge the notion of limited improvement post six months. By identifying factors influencing improvement, Jose will shed light on effective interventions for motor and functional rehabilitation beyond perceived recovery limits. Liliana will close the session focusing on the usability and feasibility of Myosuit-based gait training for ambulatory neurological patients with gait disorders. Through an interventional study, Liliana and colleagues assess the safety, feasibility, acceptability, and motivation of patients and therapists using the Myosuit in clinical and home settings. In summary, these presentations underscore the importance of innovative technologies and interdisciplinary approaches in advancing digital health and rehabilitation. We will highlight challenges, opportunities, and promising avenues for improving patient outcomes in neurological rehabilitation.
RR06. The future of neurorehabilitation: collaborative robotics to support the continuum of care – Cancelled
RR07. Toward optimal use of engineering tools in neurorehabilitation
Hyung-Soon Park, PhD (KAIST, South Korea)
Thomas Bulea (National Institutes of Health, USA)
Neurorehabilitation aims at recovery of neural control of physically impaired body parts. Engineering tools including wearable robots (or exoskeletons) and functional electric stimulation (FES) have been implemented by expert clinicians to create a variety of therapeutic training methods. These strategies can leverage devices in multiple ways, including augmentation of motor function through amplification and assistance of movement and enhancement of volitional motor output through on-demand therapeutic training by manipulation of efferent and/or afferent pathways. Thus, the same engineering tools can be deployed in a variety of ways to address specific symptoms in specific patient groups. In this special session, we will discuss methods for tailoring neurorehabilitation strategies to meet the individual needs of specific patient groups, with a focus on role the ability to accurately and reliably detect movement intent plays in the effective delivery of personalized rehabilitation approaches. Further, we will share clinical experiences of how these strategies are used in the context of multiple, distinct patient groups and the corresponding outcomes that were observed. Finally, we will integrate these findings from specific applications into a discussion of future directions for optimal use of engineering tools such as wearable robotics and FES to facilitate effective neurorehabilitation and functional recovery in individuals with neurological disorders.
RR08. Robotic Wheelchairs and Assistive Mobility Devices – Cancelled
RR09. Locomotor Balance Rehabilitation in Individuals Post-stroke
Hao-Yuan Hsiao, PhD (University of Texas at Austin)
Individuals post-stroke commonly show deficits in balance and walking function. In this session, novel evidence that advance our understanding of the motor recovery mechanisms will be presented. The ability to release effective balance responses after a slip or trip is critical to prevent a fall. An understanding of the neural mechanisms that underlie these responses is important to the development of evidence based and targeted interventions. Dr. Bhatt will present her work from functional neuroimaging on imagined and observed slipping and how they related with reactive stability during treadmill gait-slips. She will also present data from training-induced changes in brain activations during imagined slipping. Dr. Bhatt will present results from their randomized controlled study that examined long-term retention of gait-slip perturbation training and if degree of motor impairment affected it. Recent studies have shown that lateral movements of standing/walking surface triggered reactive responses that increased lower extremity muscle activities, likely related to spinal and supraspinal mediated neuromuscular mechanisms. By applying small and predictable lateral walking surface oscillations, leg muscle activity could be enhanced through both triggered reactions and anticipatory proactive control mechanisms and therefore improve limb loading without disrupting gait progression. Dr. Hsiao will present their recent findings on the immediate and short-term effect of a Treadmill Oscillation Walking intervention on balance and functional mobility outcomes. A stroke induces a cascade of neurophysiologic changes in cortical and spinal circuits that result in biomechanical gait impairments and gait dysfunction. In this presentation, Dr. Kesar will summarize their recent and ongoing research probing neurobiological and biomechanics mechanisms underlying post-stroke gait rehabilitation. She will present data elucidating neural mechanisms of treadmill training interventions combined with functional electrical stimulation, probed using non-invasive brain and peripheral nerve stimulation techniques. The presentation will also discuss their recent work on real-time gait biofeedback, including game-based biofeedback interfaces for stroke gait retraining.
RR10. Assistive and Rehabilitation Robots for Geriatric Users
Katja Mombaur (Karlsruhe institute of Technology & University of Waterloo)
Marko Ackermann (Karlsruhe institute of Technology & Heidelberg University)
In an aging society, assistive and rehabilitation technologies are essential to preserve and improve mobility of older adults in daily living activities such as walking, climbing stairs or standing up from a chair. Particularly the frail population can benefit from robotic devices that provide assistance during these activities. This session focuses on assistive and rehabilitation robots targeted to the special needs of elderly frail users, ranging from mobile and stationary exoskeletons to robotic rollators and wheeled devices. The aim is to bring together interdisciplinary researchers and clinicians interested in improving geriatric mobility. Talks in this session can present new hardware and design approaches, novel control concepts and user interfaces, modeling and simulation studies or clinical tests and user studies.
RR11. Cancelled.
RR12. Advances in Lower and Upper Extremity Rehabilitation Robotics for Persons with Mobility Disability
Ghaith J. Androwis, Ph.D. (Kessler Foundation)
Persons with disability due to stroke, spinal cord injury (SCI), multiple sclerosis (MS), or other neurological disorders face severe mobility deficits in their upper extremity (UE) and lower extremity (LE), even after rehabilitation. These mobility problems negatively affect patients’ ability to perform activities of daily life (e.g., impaired standing, balancing, walking, eating, drinking, dressing). In cases of lost mobility for LE or UE, recovery of function is based on neural adaptation through repetitive, task-oriented training, such as extended periods of walking [6]. Robotic exoskeletons orthotic devices have a potential application in this field due to the ability to 1) provide a regulated and controlled method of assistance to the user for long periods of time; 2) reduce burden on patient and clinical staff; 3) quantitatively measure torques and interaction forces; 4) be a highly repeatable method of controlled training. Objectives of this session are as follows:
- To provide an overview with clinical/engineering outcomes on the utilization of recently developed, FDA and commercially available robotic exoskeleton and orthotic devices for persons with SCI, stroke and MS.
- To provide detailed and objective biomechanical outcomes resulting from utilizing robotic exoskeleton for gait training, including quantification of the dynamics of exoskeletal-assisted walking (EAW) in FDA-approved devices to quantify:
- Human-robot dynamics (joint kinematics and kinetics)
- Hip, knee, and ankle joint forces from persons with SCI during EAW in FDA-approved robots.
- To provide an overview of a newly developed robotic exoskeleton controller for lower limb rehabilitation exoskeletons (LLRE) based on a neural network control policy. Using such pioneering approach based on deep reinforcement learning (DRL) for LLRE control, the controlled robotic device will assist users with diverse neuromuscular conditions during various activities such as squatting, sit-to-stand, and walking.
- To provide scientific evidence and outcomes showing the importance of early implementation of UE orthotics in persons with SCI in the acute phase.
- To discuss the benefits of continued utilization in clinic/community of light-weight FDA approved orthotics for persons with neurological disability in the chronic phase.
RR13. Functional Electrical Stimulation and robotics for neurorehabilitation
Alessandra Pedrocchi (Polytechnic University of Milan, Italy)
Emilia Ambrosini (Polytechnic University of Milan, Italy)
Abstract. The combination of functional electrical stimulation and robotic assistance during neurorehab training has been proposed some years ago, technical solutions and clinical validations are ongoing. More recently, solutions have been implemented to merge the multiple contributions and to manage fatigue and promote the maximal available user effort. Recently, also Transcutaneous spinal cord electrical stimulation and vagus nerve electrical stimulation have been proposed to promote recovery in neurorehabilitation, during exercises and eventually combined with robotics. In this special session we would like to discuss the current technical challenges on these emerging topics, the available clinical evidence and the neuroscientific bases of these combinations.
AI and Computational Methods in Rehabilitation
AICM01. Clinical and Biomechanical applications of shape and markerless systems – Cancelled.
AICM02. Revolutionizing Migraine Care: telerehabilitation and Digital Transformation
Tomokazu Shimazu (Saitama Neuropsychiatric Institute)
Masahito Katsuki (Suwa Red Cross Hospital)
Yutaro Fuse (Nagoya University)
Shingo Shimoda (Nagoya University)
In recent years, advancements in migraine treatment methods, including yoga, headache exercises, new drug and cognitive-behavioral therapy, have demonstrated significant potential in reducing the severity and frequency of migraine symptoms. These approaches prioritize the holistic health of patients, addressing not only the physical discomfort associated with migraines but also the psychological elements that may trigger or intensify episodes. Simultaneously, the concept of telerehabilitation has emerged as an important approach in migraine management, leveraging digital communication technologies to provide rehabilitation services from a distance. This method offers more than mere convenience; it represents a pivotal move towards integrating digital transformation (DX) in healthcare, specifically designed to meet the unique requirements of individuals suffering from migraines. Through the adoption of telerehabilitation in migraine care, medical professionals can utilize technological advancements to devise a nuanced and all-encompassing treatment strategy that surpasses the limitations of conventional medical approaches. Additionally, telerehabilitation introduces the distinct benefit of ongoing monitoring and support. Digital platforms enable the tracking of a patient’s progress, the frequency of symptoms, and the effectiveness of treatments in real-time. This enables healthcare providers to modify treatment plans promptly based on the patient’s current needs. This adaptive model of migraine management guarantees that patients receive the optimal care customized to their changing conditions. In this special session, we aim to encourage the discussions on migraine treatment, including innovative methods such as AI analysis, metaverse communication and a deeper exploration into the origins of migraines. This discussion will highlight the forefront of migraine treatment advancements, underscoring the transformative impact of technology in enhancing patient care.
AICM03. AI in rehabilitation monitoring and progress tracking
Diego Paez-Granados (ETH Zurich)
Jorge Peña Queralta (ETH Zurich)
This proposal aims to address the critical gap in precision rehabilitation by focusing on the advancement of methods for tracking performance and gathering daily life experiences of patients undergoing rehabilitation. The workshop will convene experts in artificial intelligence (AI) and rehabilitation to explore innovative avenues for enhancing rehabilitation practices in both inpatient and outpatient settings. Central to the session objectives is the integration of applied AI techniques, monitoring technologies, and intervention quantification within multi-dimensional rehabilitation environments. By harnessing the power of AI-driven solutions, attendees will delve into the potential for more precise and personalized rehabilitation strategies that optimize patient outcomes. Key topics to be discussed include the utilization of AI algorithms for real-time performance tracking, the development of wearable monitoring devices for continuous data collection, and the quantification of interventions to tailor rehabilitation programs to individual needs effectively. Through interactive discussions, presentations, and hands-on demonstrations, participants will gain insights into cutting-edge approaches and emerging technologies shaping the future of precision rehabilitation. Ultimately, this workshop aims to foster collaboration and innovation among interdisciplinary experts to drive advancements in rehabilitation practices and improve patient care.
AICM04. Moving outside the lab: Integrating mobile sensing, AI, and biomechanics for precision rehabilitation
Scott Uhlrich (University of Utah, USA)
Antoine Falisse (Uniservity of Stanford, USA)
Measuring human movement and the underlying neuro-musculoskeletal dynamics is an essential tool in biomechanics and rehabilitation research, yet traditional lab-based methods are costly and scale poorly. Consequently, simple measures of function, like the time to rise from a chair, are used to quantify movement health in the clinic, in the community, and in clinical trials. Recent advances in mobile sensing (e.g., smartphone videos and wearable sensors) enable detailed movement analysis outside of the lab. This approach, combined with neuro-musculoskeletal simulation and machine learning, offers deeper understanding of movement deficiencies and supports the development of precise rehabilitation methods. This Special Session will introduce novel tools for evaluating human movement biomechanics outside the lab, focusing on the intersection of computer vision, artificial intelligence, and biomechanical simulation. We will introduce how OpenCap, open-source software for measuring movement from smartphone videos, facilitates the development of more sensitive movement biomarkers for neuromuscular diseases and personalized rehabilitation interventions. Furthermore, we will discuss how neuro-musculoskeletal simulations enable the study of the neural and muscular causes of impaired mobility in conditions like cerebral palsy. Attendees will be introduced to state-of-the-art techniques in computational biomechanics and also be given practical guidance on tools that can immediately be integrated into their research or clinical programs.
AICM05. Precision Stroke Rehabilitation with Personalized Neuromuscular Electrical Stimulation
Vincent Cheung, PhD (Chinese University of Hong Kong, Hong Kong)
Prof. Xiaoling Hu, PhD (The Hong Kong Polytechnic University, Hong Kong)
Stroke rehabilitation is challenging partly because of the immense heterogeneity of post-stroke clinical presentations. Following recent efforts in implementing precision medicine in almost all medical disciplines, several investigators have proposed “precision rehabilitation” as a direction that should further increase the efficacy of interventions. One rehabilitative modality that may be particularly amenable to delivering personalized intervention may be neuromuscular electrical stimulation (NMES). Conceivably, the NMES stimulation parameters may be rationally designed to address any subject-specific pattern of motor impairment. As such, it has been proposed that the muscle synergy theory, the idea from motor neuroscience that the motor system generates movement through a modular controller, may provide a framework for constructing personalized NMES stimulation waveforms in a neuroscientifically grounded manner. Muscle synergies are neuromotor activation units that co-activate fixed groups of muscles according to certain spatiotemporal balance profiles, and hypothesized to be encoded in the motor system as basic building blocks of movement construction. Muscle synergies may be identified from behavioral multi-muscle electromyographic signals (EMG) using factorization and other methods. In NMES, the stimulation waveform delivered during rehab training, for example, can be based on the normative muscle synergies found to be impaired in the stroke survivor being trained. In this session, we will discuss current ideas on personalizing NMES for stroke rehabilitation, with a special interest in synergy-based NMES. We will present strategies of validating the neuroscientific and rehabilitative relevance of muscle synergies, present results of synergy-based and other personalized NMES trials for both the upper and lower limb, explore the neuroscientific mechanisms behind personalized NMES, and discuss future directions for improving this rehabilitative approachIn this special session, we will present results from recent attempts of synergy-based NMES, explore possible neuroscientific mechanisms behind synergy-based NMES, and discuss some future directions for improving this rehabilitative approach.
AICM06. Wearable technology and intelligent algorithms for precision medicine in stroke
Francesco Lanotte (Northwestern University, Shirley Ryan AbilityLab, USA)
Arun Jayaraman (Shirley Ryan AbilityLab, USA)
Rehabilitation medicine in stroke is seeking innovative approaches to optimize neural and functional recovery, facilitating patients’ reintegration into the community. However, the variability in individuals’ recovery potential challenges the conventional one-size-fits-all approaches. Stroke rehabilitation is experiencing a significant transformation shift due to the growing digitization of medicine and the widespread availability of portable technology. This shift has resulted in an unprecedented amount of data that offers insights into the time course of post-stroke impairments and recovery trajectories across diverse patient cases. Intelligent algorithms, capable of mining and synthesizing complex datasets, have emerged as powerful tools to identify biomarkers specific to patients or populations, relating to disability, disease, and injury. The convergence of recent developments in wearable technologies, intelligent algorithms, and cloud databases holds the promise of advancing precision medicine in stroke rehabilitation. Cutting-edge wearable devices (such as body-worn sensors or rehabilitation exoskeletons), coupled with intelligent algorithms, can capture detailed and actionable information. This revolutionizes the assessment of stroke patients, both in clinical settings and the community, enhancing patient engagement and proving cost-effective for an overall improved quality of care. Through this Special Session, we seek to emphasize recent accomplishments and challenges encountered to leverage wearable technologies and intelligent algorithms for precision medicine in stroke rehabilitation. Our goal is to deepen the understanding of this dynamic field, facilitating a faster deployment of these advancements in real-world scenarios.
AICM07. Quantitative assessment and model-based intervention for stroke rehabilitation
Minos Niu, PhD (Ruijin Hospital, Shanghai Jiao Tong University, China)
Stroke is a leading cause of long-term disability worldwide, which necessitates effective rehabilitation strategies to optimize motor recovery. Electrophysiological assessment methods, coupled with model-based interventions, offer promising avenues for enhancing stroke rehabilitation outcomes. This session provides a state-of-art overview of our studies based on quantitative assessment techniques and model-based interventions in stroke rehabilitation. The quantitative assessments based on functional near-infrared spectroscopy leveraged on hemodynamic responses as markers of neural activity. We aim to quantify the neural responses to progressive resistance in both normal individuals and stroke patients, preliminarily investigated the neural mechanisms of upper limb progressive resistance therapy. HD-EMG complements fNIRS assessments by providing details on muscle activation patterns during motor tasks. HD-EMG with post-stroke spasticity enables comprehensive evaluations of peripheral motor system function, aiding in the development of targeted rehabilitation interventions. This session will also cover computational models of neural activity during the design of personalized therapy. We will introduce a neuromorphic model to reanimate the neuro-dynamics with spiking neuronal activity, which provides a generative model to mimic human-like reflexes and elicit velocity-dependent EMG. This simulation study suggests that spasticity caused by different origins may be discernable by the progression of severity. Intervention strategies such as transcranial magnetic stimulation leverage insights from electrophysiological assessments and computational modeling to modulate cortical excitability and promote motor recovery. By targeting specific cortical regions implicated in motor impairment, TMS interventions can facilitate neural plasticity and enhance the effects of rehabilitation therapy.
Neural Interfaces and Stimulation
NIS01. Empowering balance control through non-invasive neuroenhancement approaches – Cancelled
NIS02. Personalized Realtime Biofeedback during Neurorehabilitation
Aileen Naef (ETH Zurich, Switzerland)
Chris Awai (DART, Lake Lucerne Institute, Switzerland)
Over 10 million patients are newly diagnosed with Stroke and Parkinson’s disease each year, leading to substantial functional impairments in this population and an increased healthcare burden. Specifically, the functional impairment experienced by these individuals primarily results in gait deficits, which, in turn, impact daily life and reduce individuals’ quality of life. The standard rehabilitation for such deficits has historically been face-to-face training, whereby a therapist provides the individual with feedback regarding their gait. However, the type, quality, and means of communicating such feedback can vary substantially and has an influence on the efficacy of the feedback. For these reasons a large body of research suggests that augmented biofeedback, defined as feedback about a biological process given in real-time from an outside source, may be advantageous over traditional feedback. When considering gait rehabilitation, augmented biofeedback can be provided via different modalities including visual, auditory, and haptic, with all aimed at providing the user with additional information about their movement success. Yet, despite evidence suggesting that biofeedback could be a promising tool for gait rehabilitation, there has been a lack of clinical translation. The challenges in clinical implementation are manifold and include cost, complex implementation, and lack of solid evidence supporting its effectiveness. However, with continuously improving technology and accessibility, augmented biofeedback retains a high potential for being used to improve gait rehabilitation in and outside the clinical setting. This type of feedback also has the advantage that it can be customized, much like traditional therapy, to the needs of the individual. Due to the role of personalization within motor learning, the argument for furthering research within the field of augmented biofeedback is easily made. As such, this Special Session aims to provide an overview of the development and implementation of personalized real-time biofeedback for neurorehabilitation and insight into what results from studies in this field can tell us. The goal of the Special Session is also to promote a discussion about the current use and future applications of such biofeedback in research and the clinic.
NIS03. Lighting Up The Black Box Of Alpha Motorneuron Plasticity By Decomposition Of Hdsemg Signals
Francesco Negro (Università degli Studi di Brescia)
The generation of voluntary movement relies on a sequence of integrated processes that culminate in the production and modulation of muscle force. The alpha motor neuron plays a pivotal role in these complex processes by integrating different synaptic inputs into their output spike trains transmitted to the muscle. Recent advancements in the decomposition of high-density surface electromyograms using blind source separation techniques have opened the possibility of non-invasively estimating the weights of these synaptic projections to the motor neuron pools. These improvements have enabled significant progress in assessing the excitatory or inhibitory activity of synaptic projections to multiple motor neurons and how this activity can be modulated to induce plasticity in neural connectivity. This special session will describe these recent advances in the analysis of the discharge patterns from populations of motor units. It aims to provide insights into motor neuron plasticity and unravel important features of motor control during voluntary contractions in humans.
NIS04. Brain-Computer Interfaces as Neurorehabilitation and Assistive Technologies
Víctor Martínez-Cagigal (University of Valladolid, Spain)
Ricardo Ron-Angevin (Grupo DIANA, University of Malaga, Spain)
Ivan Volosyak (Rhine-Waal University of Applied Sciences, Spain)
Roberto Hornero, PhD (Universidad Politécnica de Valladolid, Spain)
Brain-computer interfaces (BCIs) have emerged as technologies designed to establish a communicative interface between the human brain and the surrounding environment. This enables users to control applications or external devices through their own neural signals. Recent advances in neurotechnology and signal processing have gradually positioned BCIs as assistive technologies for individuals facing severe impairments, encompassing applications such as communication aids and domotic control, among others. Furthermore, they have proven to be valuable neurorehabilitation tools, fostering neuroplasticity and serving to replace or enhance compromised neural functions in contexts such as stroke rehabilitation and cognitive training. This special session is focused on reporting cutting-edge research in this field and discussing the upcoming challenges to be faced. Consequently, this session is intended to provide participants a multidisciplinary forum for presenting, sharing and discussing current and future research trends on the latest advancements in BCIs designed for application in neurorehabilitation and/or as assistive technologies for those with severe disabilities.
NIS05. IEEE/ICNR Symposium on Advanced Technologies in Neurological Rehabilitation: Bridging Innovations for Improved Patient Outcomes – Cancelled
NIS06. Non invasive brain stimulation: a tool for studying and promoting plasticity in neurorehabilitation
Sven Bestmann (University College of London, UK)
Vanesa Soto León (Hospital de Parapléjicos de Toledo, Spain)
Brain stimulation techniques have opened unprecedented avenues for understanding and modulating brain function in health and disease. Both invasive and non-invasive brain stimulation approaches can assess and probe neuroplasticity. This session focusses on the mechanisms underlying brain stimulation, and its applications in health and clinical populations. The session will showcase four novel and emerging stimulation approaches and their potential for therapy and rehabilitation: transcranial static magnetic stimulation (tSMS), deep brain stimulation (DBS), paired associative stimulation (PAS) and spinal cord stimulation (SCS). One attraction of these approaches is that they can elicit, modulate and promote neuroplasticity. By manipulating and promoting neuroplastic mechanisms, brain stimulation interventions have been used to enhance motor performance, restore function following neurological injury, and alleviating symptoms of neuropsychiatric disorders. Transcranial static magnetic stimulation (tSMS), a novel non-invasive technique, represents a promising avenue for modulating cortical excitability and investigating neuroplasticity mechanisms. By applying static magnetic fields to the brain, tSMS exerts neuromodulatory effects, offering potential applications in motor rehabilitation, cognitive enhancement, and psychiatric treatment. Paired associative stimulation (PAS) combines peripheral nerve stimulation with transcranial magnetic or electrical stimulation, and offers insights into the principles of synaptic plasticity. This session will discuss its potential as a therapeutic tool in motor rehabilitation and cognitive enhancement. DBS, characterized by the targeted delivery of electrical pulses to specific brain regions, has emerged as a transformative intervention for movement disorders, epilepsy, and psychiatric conditions. Similarly, SCS, involving the application of electrical impulses to the spinal cord, offers relief from chronic pain and neurological dysfunction by modulating ascending nociceptive pathways. By highlighting recent advances, challenges and limitations of these approaches, this special session will promote interdisciplinary dialogue and collaboration among researchers, clinicians, and technologists to unravel the complexities of brain stimulation and harness its therapeutic potential.
NIS07. Electrical Stimulation of the Peripheral Nervous System
Filipe André Oliveira Barroso (Cajal Institute, CSIC)
Cristina Montero Pardo (Cajal Institute, CSIC)
In the past few years, the potential of electrical stimulation of the peripheral nervous system has been increasingly explored in different kinds of medical conditions (e.g., spinal cord injury, stroke, spasticity, pathological tremor, Parkinson’s disease, dystonia, among others). This Special Session will present new advances in the field and promote a discussion on its potential applications.
NIS08. Cancelled.
NIS09. Modeling and modulating the motor and autonomous nervous system in movement disorders
Jaime Ibáñez Pereda (Universidad de Zaragoza, Spain)
Eduardo Rocon (CAR-UPM, CSIC, Spain)
Alejandro Pascual Valdunciel (Imperial College London, UK)
Movement disorders represent a significant burden on global disability, with conditions like Essential Tremor, Parkinson’s disease, and dystonia among the most prevalent neurological disorders or syndromes. Despite the diverse etiology, the underlying mechanisms driving abnormal motor control remain incompletely characterized. Key structures implicated in these disorders include the basal ganglia, cerebello-thalamo-cortical loops, and spinal cord, particularly in the context of tremor symptoms. Gaining insight into the physiological information about the interplay between the different structures involved in the generation transmission of the pathological neural signals plays is a crucial step to deep the understanding of the disorders. Also, it is important to further our understanding about the role of the autonomic nervous system in the expression of tremors. To do this, novel techniques modelling the autonomous and motor nervous system based on simulated and simulated data have to be used to elucidate these mechanisms. Meanwhile, the absence of effective pharmacological treatments for movement disorders without significant adverse effects underscores the need for alternative therapeutic strategies. Neuromodulation techniques such as peripheral nerve stimulation, transcutaneous spinal cord stimulation or vibration emerge as promising tools to manage the motor symptoms. However, the development of effective modulation strategies hinges on a comprehensive understanding of the pathophysiology. Targeted interventions informed by neurophysiological models hold the potential to restore aberrant neural circuits and pathological symptoms.
NIS10. Advances in Stimulation to Enhance Recovery and Improve Motor Function in Persons with Mobility Impairments
Ghaith Androwis (Kessler Foundation)
Persons with disability due to brain injury (BI), spinal cord injury (SCI), or other neurological disorders face severe mobility deficits in their upper extremity (UE) and lower extremity (LE). When mobility and function are lost in LE or UE, activities of daily living are severely impacted. These impairments can cause significant disability and dependence for functional activities[1, 2]. Such movement limitations significantly reduce a patient’s quality of life (QOL) and level of independence [3]. While there are rehabilitation techniques to provide strengthening and to help compensate for impairments to assist in function and activity of daily living (ADL), few effective techniques, including non-invasive stimulation systems, are available specifically for increasing the upper and lower extremity neurological strength and functional capability. The objectives of this session are as follows: a) To provide evidence on the effects of utilizing a combined spinal cord transcutaneous stimulation with activity-based training to improve upper extremity function in persons with SCI. b) To discuss the effects of a foot-drop stimulator on walking performance after brain injury. c) To provide detailed and objective biomechanical outcomes resulting from utilizing mobile simulators for gait training. d) To provide an overview with clinical/engineering outcomes on the utilization electromagnetic stimulation for persons with SCI.
NIS11. Novel VR assisted rehabilitation and evaluation of the upper limb in Stroke survivors – Cancelled
NIS12. Exploring the origin, function and modulation of cortical rhythms using non-invasive methods
Jaime Ibáñez Pereda (Universidad de Zaragoza); Sven Bestmann (University College London); James Bonaiuto (CNRS Institut des Sciences Cognitives); Alejandro Pascual Valdunciel (Imperial College London)
This conference session reviews and discusses advances in understanding the intricate interplay between motor-related neural rhythms in the cortex and other regions of the central and peripheral nervous system. We present novel methods to gain insight about the origin and function of motor cortical rhythms based on advanced neuroimaging techniques or on alternative ways to record this activity from the periphery. The session will encompass the latest advancements in neuroscience, neuroimaging, neurophysiology and biomechanics, shedding light on the synchronized patterns that govern communication between the central nervous system and the muscular system. Speakers will discuss different methods to modulate and read oscillatory activity directly from the brain or using muscles as an indirect measurement of brain activity. The session will also include results from motor paradigms aimed at promoting changes in neural activity in the motor cortex and their association with modulations in different frequency bands in brain and muscle signals. Ultimately, this conference session will provide a platform for multidisciplinary dialogue, encouraging a deeper understanding of neural rhythms in both the brain and muscles and their synergistic role in shaping human movement and cognition in health and disease.
Integrative Stakeholder Support to Innovation and Continuum of Care Models
ICCM01. Coffee with the Leaders: Investors and Industry Insights
Zen Koh (MotusAcademy, IISART, Fourier Intelligence)
This exclusive panel session brings together prominent investors from diverse backgrounds to share their perspectives, experiences, and insights into investment and entrepreneurship. Featuring representatives from renowned firms with substantial investments in rehabilitation technologies, this session promises a comprehensive exploration of the investment landscape within this specialised field. The invited speakers are representatives of BigBang Angels, Saudi Aramco, Softbank, Sequoia Capital, Active Venture Partners, Venture Kick, and Bpifrance. The discussion dives into various aspects crucial for both investors and entrepreneurs alike. From identifying promising opportunities to navigating challenges, the panellists offer valuable guidance from their extensive experience and diverse portfolios. Each investor brings a unique perspective shaped by their organisation’s focus areas, investment strategies, and expansive global reach. Attendees can expect to gain valuable insights into navigating the complexities of the investment landscape, understanding investor expectations, and positioning their ventures for success. The panel serves as a unique opportunity for entrepreneurs to gain firsthand knowledge from leading investors and to forge meaningful connections within the global investment community. With a specific focus on investments in rehabilitation technologies, attendees can expect tailored discussions shedding light on the unique opportunities, challenges, and emerging trends within this niche sector. Insights may include discussions on technological advancements, market dynamics, regulatory considerations, and the societal impact of innovations in rehabilitation technologies. In essence, this panel session is a pivotal forum for entrepreneurs and investors alike to engage in a collaborative exchange of ideas, insights, and experiences, fostering mutual learning and synergies within the dynamic realm of rehabilitation technology investments.
ICCM02. Campfire Session: Connecting Industry, Clinicians, and Academia
Zen Koh (MotusAcademy, IISART, Fourier Intelligence)
Denny Oetomo (University of Melbourne)
Milos R. Popovic (KITE University Health Network)
The special campfire session offers a unique podium for dialogue and collaboration among industry, clinical practice, and academia stakeholders in rehabilitation. This special session is dedicated to fostering interdisciplinary partnerships, advancing patient-centred outcomes, and exploring the latest developments in neurorehabilitation technology. With a distinguished lineup of guest panellists from diverse geographical locations, attendees can anticipate a rich exchange of insights and experiences from around the globe. The discussion will emphasise the importance of bridging the gap between industry, clinicians, and academia to drive innovation and improve patient care. Panellists will share their perspectives on successful collaboration models, highlighting best practices and lessons learned from their respective regions. By bringing together expertise from different sectors, the session aims to catalyse developing and implementing cutting-edge solutions that address the evolving needs of patients undergoing neurorehabilitation. Furthermore, the panel will explore the significance of patient-centred approaches in designing and evaluating neurorehabilitation interventions. Through sharing experiences and real-world examples, attendees will gain valuable insights into how industry, clinicians and academia come together to tailor treatments to individual patient needs, optimise outcomes, and enhance the quality of life post-injury or illness. In addition to interdisciplinary collaboration and patient-centric care, the session will spotlight recent advancements in neurorehabilitation technology. From virtual reality and robotics to brain-computer interfaces and neuromodulation techniques, panellists will explore emerging trends and discuss the potential impact of these innovations on clinical practice and patient outcomes. Overall, the campfire session promises to be an enlightening and inspiring discussion that transcends geographical boundaries. By fostering collaboration, promoting patient-centred approaches, and showcasing the latest technological developments, the session aims to accelerate progress in neurorehabilitation to improve the lives of individuals affected by neurological conditions.
ICCM03. Advanced Rehab Technologies & Exoskeletons in Rehab – Perspectives of Key Leaders
Zen Koh (MotusAcademy, IISART, Fourier Intelligence)
Arun Jayaraman (Shirley Ryan AbilityLab)
Francesco Lanotte (Shirley Ryan AbilityLab)
The panel discussion brings together industry leaders to explore the integration, innovations, challenges, and future trends surrounding exoskeleton technology in rehabilitation. Featuring representatives from prominent companies such as Cyberdyne, ExoAtlet, Ekso Bionics, Wandercraft, TWIICE, Keeogo, AbleHuman Motion, and Fourier Intelligence, this session promises a comprehensive exploration of the subject. The discussion aims to assess the current landscape of exoskeleton technology in rehabilitation, highlighting recent advancements and their applications in clinical practice. Panellists will share insights into integrating exoskeletons into rehabilitation programmes, emphasising the potential benefits for patients and healthcare providers. Moreover, the session will address implementation challenges, including regulatory hurdles, cost considerations, and user acceptance, providing practical strategies for overcoming these obstacles. The panel will discuss future trends in exoskeleton technology, exploring emerging innovations and their implications for the field of rehabilitation. Topics may include advancements in wearable robotics, artificial intelligence, personalised rehabilitation protocols, and remote monitoring capabilities. By examining these developments, attendees will gain valuable insights into the evolving landscape of rehab technologies and the potential impact on patient care and outcomes. The session format includes a panel discussion followed by a Q&A session, allowing attendees to engage directly with industry leaders and experts. This interactive format facilitates knowledge sharing, networking, and collaboration, fostering a deeper understanding of exoskeleton technology and its role in advancing rehabilitation practice.
ICCM04. Stroke Care Models and the Impact of Technology in Clinical Practice: a Global perspective
Arun Jayaraman (Shirley Ryan AbilityLab, USA)
José L. Pons (Shirley Ryan AbilityLab, USA)
Megan O’Brien (Shirley Ryan AbilityLab, USA)
This Special Session aims to provide a comprehensive overview of how different regions around the world approach stroke management and the transformative role technology plays in these models. Stroke remains a leading cause of disability worldwide, necessitating innovative care strategies that can be adapted across diverse healthcare systems. This SS will bring together healthcare professionals, researchers, technologists, and policymakers to share insights into effective stroke care practices and explore the integration of emerging technologies in diagnosis, treatment, and rehabilitation. The focus will be on comparing international stroke care frameworks, understanding the barriers to implementing technology in clinical settings, and discussing future directions for enhancing global stroke management through technological advancements.
ICCM05. SCI Care Models and the Impact of Technology in Clinical Practice: a Global perspective
Arun Jayaraman (Shirley Ryan AbilityLab, USA)
José L. Pons (Shirley Ryan AbilityLab, USA)
This Special Session aims to focus on the latest developments in spinal cord injury (SCI) management, emphasizing the role of innovative technologies in enhancing patient care and rehabilitation. Spinal cord injuries present complex challenges that require multidisciplinary approaches to treatment, recovery, and patient support. We aim to bring together leading experts in neurology, rehabilitation, biomedical engineering, and patient advocacy to share cutting-edge research, clinical advancements, and technological innovations in SCI care. Participants will explore the current state of SCI treatment, discuss the integration of emerging technologies in therapeutic strategies, and highlight the importance of personalized care plans. The goal is to foster a collaborative environment that encourages the exchange of ideas and strategies to improve outcomes for individuals with spinal cord injuries.
ICCM06. To be announced
Arun Jayaraman (Shirley Ryan AbilityLab)
José L. Pons (Shirley Ryan AbilityLab)
ICCM07. Care Models in Neurodegenerative conditions and the Impact of Technology in Clinical Practice: a Global perspective
Arun Jayaraman (Shirley Ryan AbilityLab)
José L. Pons (Shirley Ryan AbilityLab)
This Special Session aims to explore the diverse approaches to managing neurodegenerative diseases across different healthcare systems worldwide, with a special focus on the integration of technology. Neurodegenerative diseases, such as Alzheimer’s, Parkinson’s, and ALS, pose significant challenges to patients, caregivers, and healthcare providers due to their progressive nature and complex care needs. This session will convene experts in neurology, geriatrics, rehabilitation, and healthcare technology to discuss innovative care strategies, share advancements in technological interventions, and highlight best practices in improving the quality of life for affected individuals.
ICCM08. Understanding the Value of Co-Creating Technology with Patients
Katie Poggensee (TU Delft)
Laura Marchal-Crespo (TU Delft)
Salvatore Luca Cucinella (TU Delft)
Irene L.Y. Beck (Erasmus MC)
Incorporating end-user feedback is a critical step in the design process for any new technology. This is especially important for rehabilitation technology, as end users include not only the clinicians or caregivers operating the devices, but also the patients undergoing treatment. Despite the widespread agreement that these voices should guide the design and implementation of rehabilitation technologies, they are often not included until later stages of development, such as in usability tests on a final prototype. While this is certainly influenced by factors outside of developers’ control, such as the considerable costs associated with conducting research with vulnerable populations, some of these challenges could be alleviated by inviting stakeholders to the same table early on in the development process. Their involvement is vital to efficiently and effectively develop technology that addresses the actual needs and experiences of end-users. This special session aims to highlight patient perspectives and to provide an overview of methodologies to empathize with patients and their caregivers to promote their involvement and participation in the co-creation of rehabilitation technology. We will line up experts from different disciplines, who have interacted – or still interact- with patients to different extents and reasons. We will promote a dialogue about their perspectives on the importance of listening to (and involving) patients to develop technologies that can ensure the understanding of the complexities of their needs, which sometimes are not met with the development of too complex and high-cost technological solutions.
ICCM09. Boosting neurorehabilitation: drug, devices, funding and more
Antonio Oliviero, MD, PhD (Hospital de Parapléjicos de Toledo & Hospital Los Madroños, Spain)
Neurorehabilitation represents a dynamic and evolving field at the intersection of neuroscience and rehabilitation, focusing on the recovery of individuals with neurological disorders. This workshop aims to explore and integrate innovative treatment modalities that hold promise for optimizing outcomes in neurorehabilitation. The special session will commence with an example of clinical trials in neurorehabilitation, highlighting the challenges and opportunities in treating a diverse range of neurological conditions. A significant portion of the workshop will be dedicated to exploring novel therapeutic interventions. Different treatments have shown remarkable potential in promoting recovery and adaptation. The workshop will also address the importance of personalized medicine in neurorehabilitation. A number of treatments will be discussed, offering a glimpse into the era of tailored rehabilitation plans. Furthermore, emerging pharmacological interventions, including neuroenhancers, will be explored for their potential in complementing traditional rehabilitation strategies. Attendees will have the opportunity to learn from experts in the field through examples and discussion. Real-world stories and challenges encountered in the application of innovative treatments will be shared, fostering a collaborative learning environment. To enhance participant skills in outcome measurement and data analysis, a dedicated session will cover the utilization of technologies to facilitate evaluation for clinical trials. This segment aims to empower healthcare professionals with the tools necessary to objectively assess and track patient progress, thereby refining treatment strategies based on empirical evidence. In conclusion, this special session aspires to be a catalyst for the integration of cutting-edge treatment and evaluation modalities into neurorehabilitation practices. By fostering collaboration, sharing experiences, and providing practical insights, participants will be equipped to navigate the evolving landscape of neurorehabilitation and contribute to the advancement of clinical trial design of patient-centered care in this rapidly evolving field.