Workshops at ICNR2024 are either half-day or full day sessions dedicated to a specific topic. They are interactive in nature, potentially combining oral presentations, hands-on or demonstration activities, mini-poster sessions, panel discussions, etc. Contributors to the Workshops are invited and encouraged to submit Extended Abstracts (2 pages) which will be published in the Proceedings as a book upon acceptance.
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Hospital Los Madroños (HLM) – Site Visit and Associated Workshops
HLM Half-day Workshops – Morning session
WS02. EMG-based control of peripheral electrical stimulation – A new alternative to reduce pathological tremor
Filipe Oliveira Barroso (Cajal Institute, CSIC)
Cristina Montero Pardo (Cajal Institute, CSIC)
Recently, we have witnessed the emergence of peripheral electrical stimulation (PES) as an alternative to reduce pathological tremor. This hands-on workshop will shed light on the mechanisms responsible for tremor generation and reduction, as well as the principles behind the application of phase-locked PES. Attendees will be able to practice some techniques currently used to deliver customized PES, as well as to assess its neuromodulation effects.
Max capacity: 20PAX.
Vanesa Soto León (SESCAM. Hospital Nacional de Parapléjicos. Grupo FENNSI)
The workshop titled “Non-Invasive Brain Stimulation” aims to provide a comprehensive overview of cutting-edge techniques that facilitate the modulation of brain activity without the need for surgical intervention. With a focus on transcranial static magnetic stimulation (tSMS), transcranial magnetic stimulation (TMS), brain-computer interfaces (BCI), transcranial direct current stimulation (tDCS), and paired associative stimulation (PAS), this workshop seeks to elucidate the principles, applications, and therapeutic implications of non-invasive brain stimulation modalities. Transcranial static magnetic stimulation (tSMS) represents a novel approach to modulating cortical excitability by applying static magnetic fields to the brain. With its potential to induce lasting neuroplastic changes, tSMS holds promise as a tool for cognitive enhancement, motor rehabilitation, and psychiatric intervention. Transcranial magnetic stimulation (TMS) has emerged as a versatile technique for modulating neural circuits through the application of magnetic pulses to specific cortical regions. With applications spanning from neuropsychiatric disorders to motor rehabilitation, TMS offers insights into the functional organization of the human brain and holds therapeutic potential in diverse clinical contexts. Transcranial direct current stimulation (tDCS) involves the application of low-amplitude electrical currents to modulate cortical excitability. With its simplicity, affordability, and portability, tDCS has garnered attention as a potential intervention for cognitive enhancement, motor rehabilitation, and mood regulation, underscoring its versatility across diverse clinical and non-clinical domains. Paired associative stimulation (PAS) represents a paradigm that combines peripheral nerve stimulation with transcranial magnetic or electrical stimulation to induce neuroplastic changes in the brain. By harnessing the principles of synaptic plasticity, PAS offers insights into the mechanisms underlying motor learning, rehabilitation, and cognitive enhancement, with implications for personalized interventions and therapeutic strategies.
Max capacity: 20PAX.
Francesca Lunardini (Hospital Los Madroños / INNTEGRA)
Iris Jakob (TYROMOTION)
Stroke-induced spasticity originates from plastic rearrangement in the central nervous system, and it seriously affects patients’ quality of life. Typical features of post-stroke spasticity, such as hypertonia, paresis, and muscle spasms, are attributed to the underlying neural mechanisms. However, spasticity cannot be regarded as the sole consequence of the neural mechanism or central neural system injury. Non-neural mechanisms can also have secondary effects that contribute to the clinical symptoms of increased muscle stiffness and muscle fatigue.
Spasticity is simple to observe clinically but at the same time it is complex to quantify because of the involvement of multiple elements that contribute to spasticity. Commonly used tools are subjective clinical scales, including the Modified Ashworth Scale (MAS) and the Tardieu Scale. The first one was designed to measure muscle tone by rotating a joint and estimating the resistance, while the second one velocity is incorporated into the assessment. Most of these scales are prone to reliability and inter-operator reproducibility issues.
Researchers have been trying to obtain objective data for the quantitative measurement and study of spasticity. For instance, electrophysiological measurements, such as the ones of the reflex activities of the H-reflex and F-waves, can be used for objective evaluation of post-stroke spasticity. Another noninvasive technique is represented by surface electromyography (sEMG). In combination with joint angle measurements, sEMG can also be employed to study the tonic stretch reflex threshold (TSRT). Spasticity assessment can be conducted also through robots specifically designed for hand rehabilitation, as in the case of the Amadeo (Tyromotion, Austria).
This workshop will illustrate spasticity from a clinical perspective and will guide the audience through different quantitative assessment methods for spasticity, with hands-on examples on patients.
Max capacity: 20PAX.
HLM Half-day Workshops – Afternoon session
Francesca Lunardini (Hospital Los Madroños/INNTEGRA)
Parkinson’s disease (PD) is the second most common neurodegenerative disorder worldwide. PD is generally associated with slow movements, tremors, rigidity, and postural instability. However, the clinical spectrum of PD is wider, with patients presenting other fine motor complications including voice and speech impairments, or changes in oculomotor function. In addition, there is an increasing awareness that symptoms encompass also many non-motor domains like cognition and autonomic function. The clinical heterogeneity of PD is a significant challenge, both for diagnosis and treatment. We witness a strong variability among patients, who present varying combinations of symptoms, with pathological impairments advancing at different rates. Response to treatment varies from patient to patient, requiring optimal treatment plans tailored to each subject. Such between-subject variability may underlie biological and pathophysiological differences. This highlights the need for the identification of subtypes of PD based on symptomatology as homogeneous groups may reflect a common clinical, pathological, and genetic coherence. This may in turn facilitate the diagnosis process, and lead to tailored treatment strategies. Clinical scales are still the clinical gold-standard assessment. Due to their inherent limitations, such as low granularity and low responsiveness to change, it is unlikely that they can capture the complexity of PD. Against this background, technology-based assessment could represent a solution. It provides objective, fine-grained measurements capable of detecting small changes in motor and non-motor functions. In addition, the combination of multiple assessment techniques fits well the multi-domain spectrum of PD. This workshop aims to provide participants with an overarching view of multi-modal technology-based assessment of PD patients, with the goal of facilitating the discrimination of data-driven patient subtypes, and the quantification of treatment effects.
Max capacity: 20PAX.
Patrick Sagastegui (Imperial College London)
In this workshop, we will introduce techniques for surface EMG recordings to estimate the neural signal sent to muscles from the output layer of the spinal cord circuitries. Specifically, we will present methods for multi-channel EMG acquisition and their applications in neurorehabilitation, such as in prosthetics and neurofeedback. Students will be engaged in recording and processing EMG signals using instruments and tools provided by the organizers. They will learn to extract features from the EMG signals and train an algorithm to control a virtual cursor on the screen or a prosthetic hand.
Max capacity: 20PAX.
Irene L Y Beck (Erasmus Medical Center and Delft University of Technology)
To effectively design rehabilitative technology, it is crucial for stakeholders to understand the difficulties that patients experience and empathize with them. Active participation of patients in the development of rehabilitation technology can ensure the understanding of the complexities of their needs. Yet their involvement is often limited to the end of the process, such as usability testing. Stakeholders involved in the design process, including professionals from hospitals, universities, and industries, often underestimate the insights patients gain during their recovery journey in the interactions with different experts and technologies. These are multidisciplinary experiences where patients not only learn about treatments and their own health but also develop opinions and expertise that go beyond the technical considerations and knowledge of their caregivers. Hence, their participation in each stage of the development process may significantly enhance transdisciplinary collaboration, leading to more inclusive and user-centered technology. To address this issue, we – an international team of designers, engineers, and clinical personnel – propose to conduct a Participatory design workshop to consider the patient as an expert who is involved at each stage of a co-creative design process. We will invite participants to work in groups with former patients who suffered from a stroke and relatives to address their specific needs. We will provide a design challenge related to patients’ functioning in daily life (e.g., grasping issues during grocery shopping), allow them to reflect on the experienced difficulties and prototype rehabilitative technology that could help train the motor issue. We will share methods (e.g., personas, MoSCoW prioritization, rapid prototyping) for co-creating with patients, illustrating the benefits of this design approach. We expect to stimulate participants to embrace more Participatory design approaches in their future endeavors.
Max capacity: 20PAX.
Workshops at ICNR2024 conference venue
Venue Half-day Workshops – Morning session
Eduardo Iáñez Martínez (Miguel Hernández University of Elche, UMH)
This workshop presents cutting-edge research focused on advancing rehabilitation methods for individuals with incomplete spinal cord injuries (iSCI), specifically targeting improvements in locomotion. By combining various methodologies, we aim to revolutionize current approaches. Firstly, we propose the development of a novel type of Brain-Machine Interface (BMI) that can intuitively interpret users’ intentions, enabling natural control of lower-limb powered robotic systems. Secondly, we intend to introduce new metrics derived from sophisticated biomechanical analysis techniques. These metrics will provide objective insights into gait patterns and the underlying biomechanical and physiological mechanisms involved in the recovery process. Lastly, we aim to explore innovative transcutaneous spinal current stimulation (tSCS) strategies designed to enhance locomotion by inducing neuroplasticity. The development of this innovative rehabilitation strategy is being carried out under the national ReGait project involving three institutions: National Hospital for Paraplegics (HNP), Institut Guttmann (IG), and Miguel Hernández University of Elche (UMH). The structure of the Workshop during the presentation of the project is:
- Initial talk introducing the general concepts and current challenges of the ReGait project (~½ hour).
- Presentation by each institution of the individual work (BMI, biomechanical analysis, stimulation) and the current results obtained in each research (~2 hours).
- Brain-computer interface + questions/discussion.
- Transcutaneous spinal stimulation + questions/discussion.
- Biomechanical analysis and general metrics + questions/discussion.
- Experimental demo of the biomechanical analysis using the software developed by HNP (~1 hour).
- Round table: Discussion about applicability of the protocol in patients in terms of instrumentation, duration of the trials, fatigue, and other limitations (~½ hour).
Max capacity: 35PAX.
WS09. Challenges and future directions for reliable assessment in neurorehabilitation
Marianna Semprini (IIT)
Florencia Garro (IIT)
Indya Ceroni (IIT)
In the field of neurorehabilitation, accurately tracking limb movements, motor commands, and neural activity is crucial for understanding and monitoring sensorimotor recovery. The use of kinematics, electromyography (EMG), and brain activity analysis provides clinicians and researchers with precise, objective measurements of a patient’s abilities. These measurements not only allow for the objective monitoring of progress but also facilitate the evaluation of treatment effects and the customization of interventions based on individual patient needs. Notwithstanding, they are crucial for quantifying the technical performance of the device and its physical impact on the user. Several initiatives have been proposed to create global benchmarking that is based on such measurements to facilitate the transition of these devices from labs to real-world applications. Objectives are:
- Address the key challenges in using biomarkers (kinematics, EMG, brain activity) for assessing rehabilitative devices, including clinical, technological, and methodological perspectives.
- Evaluate how biomarkers are currently integrated into device assessments, highlighting strengths, limitations, and areas for improvement.
- Discuss use cases aiming to translate lab technologies to real clinical applications and how they utilize biomarkers for assessment.
Fabio Egle (Friedrich-Alexander Universitat Erlangen-Nurnberg; FAU)
Despite continuous progress in myocontrol based on pattern recognition, issues remain due to intra- and inter-session inconsistencies of electromyography signals. These include electrode shifts, limb position effects, or the inability to replicate training activations. In recent years, more and more research has been conducted on the topic of (co-)adaptive myocontrol, which tackles the problem of temporal signal inconsistencies through regular updates of the prediction model. On the one hand, interactive supervised methods, which can be updated on a specific trigger, have been investigated. This could be a subjective decision by the user or based on more objective reasons (e.g., declining prediction confidence). On the other hand, unsupervised methods like non-negative matrix factorization or autoencoders have been employed to find and update muscle synergies incrementally. The latter allows training even though the user is not able to elicit accurate labels for their muscle activity. Both (supervised and unsupervised) methods can be used in a co-adaptive fashion over an extended period, meaning that while the user learns to control the system, the system improves its understanding of the user’s signals further and further. Our workshop focuses on (co-)adaptive myocontrol methods, which can be incrementally updated, and their application for upper limb prosthetic control. The speakers give presentations (1) on innovative developments and applications in user and clinical studies of this promising technological path. Afterward, participants can discuss developments, limitations, and implications of this technology with all speakers in the workshop’s discussion slot (2). Finally, in the demonstration slot (3), participants will be able to come into direct contact with the developed technologies and experience them hands-on. The workshop aims to sensibilize the scientific community to the topic and works as an interdisciplinary conversation, bringing together the expertise of engineers and clinicians.
Ana de los Reyes Guzmán (Hospital Nacional de Parapléjicos, Spain)
Neurological diseases of the central nervous system are becoming increasingly common in the world’s population. These include stroke, multiple sclerosis and spinal cord injury, with stroke being the most common. All of them have very important motor sequelae in the people who suffer from them, which greatly affect the patient’s level of independence in activities of daily living and condition his or her social participation. This is where technology plays a very important role in the rehabilitation of neurological patients. A concrete example is the virtual reality-based therapies that are being developed to complement the conventional therapy that patients receive. These rehabilitative technological solutions are being created and developed with the active participation of multidisciplinary teams that bring together clinical and engineering profiles to create devices that reach patients and adapt virtual applications to their needs. In addition, a very important aspect is to take advantage of the use of technology to evaluate the possible improvement of patients in the motor aspect in an objective way, defining functional assessment metrics and comparing the movement patterns performed during the execution of motor tasks in virtual environments and in real physical environments. Therefore, we present this proposal in a workshop format, where we intend to present the contributions of technology to neurorehabilitation, specifying the solutions based on Virtual Reality; the clinical needs of neurological patients; systems and technologies of Virtual and Augmented Reality; and biomechanics and kinematic metrics to assess motion quality; and finally, the realization of practical activities, proposing workstations with real equipment that the participants can try out. Some of these systems are the result of the speakers’ research projects such as RehabHand or RehabImmersive software based on Leap Motion Controller and Oculus Quest 2, and virtual reality cycling platform.
Clara Beatriz Sanz Morère (Cajal Institute)
Anne Marie Laudanski (University of Waterloo)
Stefano Mazzoleni (Department of Electrical and Information Engineering, Polytechnic University of Bari)
Acquired neurological disorders often lead to mobility deficits resulting in slow, fatiguing, and unstable walking that reduces the quality of life of millions of people worldwide. Rehabilitation robots offer cutting-edge features that can provide high-dosage and task-oriented training with personalized assistance. Considering that there is growing evidence that neuroplasticity can be enhanced by developing patient-specific rehabilitation programs, these characteristics make wearable robots great candidates to enhance neuroplasticity during rehabilitation programs. Neuroplasticity occurs at all stages of life, wherein the central nervous system adapts by reinnervating denervated regions or creating new pathways or circuits through which information flow from the brain to specific areas of the body can be restored in response to internal and external stimuli. Despite its crucial role in recovery, investigation of neuroplasticity has proved challenging and remains poorly explored in the literature to date. The workshop aims at:
- Answering several questions that arise from the literature, including: is it possible to correlate functional recovery with neuroplasticity adaptations or model neuroplasticity from functional outcomes? Is it feasible to include neuroplasticity measuring techniques in current rehabilitation robots? Could novel technologies be an asset for boosting neuroplasticity? Where could researchers help in advancing current practices?
- Fostering an open dialogue between researchers, clinicians and even patients to discuss the benefits and limitations of fostering neuroplasticity in the context of neurorehabilitation. The discussion will focus on the potential role of technology towards enhancing neuroplasticity.
The workshop will be divided into three sections: 1. Introduction of relevant scientific questions from 6 well-known international researchers (2h) 2. Round table discussion (1h) 3. Hands-on experience (1h)
Arun Jayaraman (Shirley Ryan AbilityLab)
Many children experience motor deficits that profoundly affect their mobility, development, and quality of life. Early intervention, such as targeted therapies and rehabilitation, can reduce the severity of these deficits by harnessing the higher levels of neuroplasticity that occur during infancy. However, there are two critical gaps in our ability to maximize outcomes for these children. First, persistent motor deficits are often detected late (i.e., two years of age or older), since symptoms at younger ages can be subtle and easily overlooked by standard clinical assessments. Second, though there a wide variety of therapeutic programs have been investigated, the most effective interventions for these children is still largely unknown. To address these gaps, researchers are turning to technologies – such as sensors, video recordings, and neuromodulation – to evaluate and engage various facets of infant motor development. Data from these technologies are high-resolution, objective, and can be analyzed automatically using advanced signal processing and machine learning. Crucially, many of these technologies are feasible to implement across the clinic, home, and community settings. As such, technology-driven solutions may offer a more precise and accessible approach to identify and intervene for at-risk infants. This Special Session will explore the expanding intersection of technology and pediatric rehabilitation, showcasing the latest advancements to facilitate infant motor development. Through expert presentations, live demonstrations, and group discussions, attendees will gain valuable insights into the opportunities, challenges, and future directions of technology to improve early detection and enhance pediatric outcomes. We believe this workshop will provide a unique opportunity for interdisciplinary collaboration and knowledge exchange, ultimately contributing to the advancement of pediatric rehabilitation practices.
Venue Half-day Workshops – Afternoon session
Silvana Mercante (Hospital José Néstor Lencinas)
People with disabilities experience significant health inequalities compared to people without disabilities. Access to rehabilitation technologies is limited in Rehabilitation Services in low- and middle-income countries. In this context, it is also important to consider that the already high need will inevitably increase further due to demographic and epidemiological transitions. People with neurological injuries would benefit from assistive technologies by maintaining or improving autonomy, functioning, well-being, and social participation, allowing them to lead a productive, independent, and dignified life. To promote their development and use, coordinated work is required between clinical centers, research centers, universities, and companies. The adequate provision of technology in the Rehabilitation Services of hospitals in the public network is not an easy task, taking into account that it cannot depend on the distribution of the annual economic budgets of the Ministry of Health. There are barriers to its adoption, including high costs, resistance from professionals, lack of training, among others. In this sense, any healthcare organization that offers quality services must ensure that patients access new technologies safely and effectively. Other quality attributes that should be considered are access to technologies, patient satisfaction, and perception of professionals. This workshop aims to facilitate the cooperation and knowledge exchange among participants working in rehabilitation and assistance to people with neurological injuries. Special attention will be given to the management, advances, and clinical application of technologies in neurorehabilitation in Latin America. Aim: Bring together researchers from Latin America in disability and neurological rehabilitation technologies, both engineers and clinicians, promoting coordinated and teamwork.
Simona Ferrante (Politecnico di Milano)
In the digital transformation era, we are overwhelmed by technology (e.g., wearables, smartphones, mobile apps) that are meant to simplify our quality of life. How can these tools become reliable medical devices, well-managed in the context of neurorehabilitation? The new generation of patients and caregivers are more and more empowered and active participants of their care. How can they play a role in making the process of care more efficient? In this workshop different topics will be presented such as: i) Digital medicine to optimize care/rehabilitation pathways inside and outside the hospital; ii) Digital medicine to continuously monitor individuals, allow personalized and efficient follow-up delivered at the point of need; iii) Engaging digital medicine for prevention of age-related diseases and screening learning weaknesses in children; iv) The role of AI in digital medicine. Hands-on demos and a round table with experts will be organized to discuss the challenges, the barriers and the new frontiers.
Marek Sierotowicz (Friedrich-Alexander Universität Erlangen-Nürnberg, FAU)
Monitoring human kinematics is fundamental in both rehabilitation sciences and assistive applications. For assistance, automated kinematics tracking is crucial in facilitating the functional assessment of a patient’s motion capabilities and discerning their specific needs. In rehabilitation, achieving a real-time, precise, and accurate estimation of the user’s musculoskeletal configuration is paramount for numerous wearable robotics applications to optimize assistive forces. Beyond these examples, the utility of human kinematics tracking extends to broader fields such as teleoperation, ergonomics, biomechanics, and more. Each application presents diverse requirements regarding precision and accuracy, adding a layer of complexity to the challenge of finding the optimal implementation. Human posture tracking is a complex problem subject to numerous trade-offs, both due to the limitations of the available technologies and to the characteristics of the human body itself. For one, any wearable measurement system designed for skeletal kinematics monitoring is susceptible to errors due to soft tissue artifacts. Secondly, the human skeleton features numerous redundant, hard to observe degrees of freedom. On the technology front, various measurement techniques and sensors were developed over the years, often within the scope of a particular field, and sometimes remained relegated there. Thus, finding the optimal technology for a given application is not trivial. This workshop aims to provide participants with a comprehensive view of the current state of posture tracking, incorporating diverse perspectives from experts in sensor technologies and end applications across academia, clinics, and industry. The goal is to offer a transversal overview of the technology across different fields and foster the networking of researchers active in human kinematics tracking.
Sarah Lim (Fourier Intelligence/MotusAcademy)
Part 1, A Case-study Centered on Clinical Patient Data: This interactive workshop presents a patient case study from a Spanish clinic. The aim is to challenge the attendees to identify rehabilitation technologies that are suitable to solve the patient’s issues and goals. Attendees will be introduced to the case, which has been carefully selected to illustrate the complexities and opportunities within the field of rehabilitative care. The workshop will feature hands-on presentations from more than five leading rehabilitation technology companies, each showcasing their unique technological contributions to the field. These companies represent the pinnacle of innovation in rehabilitation, offering attendees a glimpse into the future of patient care. Following the case study presentation, participants will be divided into three groups, fostering a dynamic environment for collaborative problem-solving. Each group will engage in a guided discussion on how the different technologies presented could be applied to the identified problem or goal within the case study. The aim is to encourage multidisciplinary dialogue and brainstorming, providing a platform for attendees to conceptualise how various technological approaches can be integrated to create a comprehensive rehabilitation solution. This workshop is designed for healthcare professionals, engineers, researchers, and students passionate about enhancing rehabilitation practices through technology. It promises to be a fertile ground for innovation, networking, and exchanging ideas that will shape the future of rehabilitative medicine.
Part 2, From Concept to Clinics – Technology Innovation Workshop: This interactive workshop presents a patient case study from a Spanish hospital. The aim is to challenge the attendees to identify the patient’s challenges and create an idea to solve the patient’s issues. The workshop begins with a detailed presentation of a real-life case study, carefully selected for its relevance and potential for technological application. The case has been selected to illustrate the complexities and opportunities within the field of rehabilitative care. Following the case presentation, participants will be divided into three groups, each tasked with a singular mission: conceptualising and designing technological solutions tailored to the specific challenges presented in the case study. We hope to have an equal mix of those with clinical, research and engineering backgrounds within the groups. The hands-on, collaborative session will challenge attendees to think creatively and apply their multidisciplinary knowledge to design innovative technologies that address real-world problems. Emphasising commercial potential, the groups are given a tight deadline of three minutes to pitch their design concepts to a panel representing successful companies in the field. This format simulates real-world tech development and commercialisation pressures and considerations. This exercise will hone participants’ abilities to rapidly develop and communicate ideas that align with business strategies, market demands, and investor expectations. It provides a rare opportunity to think critically about the pathway from problem identification to marketable products, ensuring that proposed solutions are technically feasible and commercially viable. This workshop is essential for those who aspire to impact the rehabilitation sector with technologies that succeed both in clinical efficacy and the competitive marketplace. It offers a space where the fusion of innovative thought and business acumen can lead to real-world applications that enhance patient care and achieve commercial success.
Andrea Marinelli (IIT)
In recent years, the integration of feedback solutions into rehabilitative and bionics devices has garnered increasing attention due to its potential to revolutionize the functionality and user experience of these devices. This workshop aims to delve into the pivotal reasons for introducing feedback solutions, emphasizing their significance in improving the overall performance and adaptability of rehabilitation procedures. The workshop will address the crucial information required for effective feedback mechanisms, exploring the sensory input essential for users to seamlessly interact with the device. Participants will gain insights into identifying and prioritizing the most crucial information, laying the foundation for advanced bionics designs. Two distinct approaches will be discussed in the workshop: invasive and non-invasive solutions. The invasive solutions session will explore cutting-edge technologies that involve direct integration with the user’s nervous system, offering insights into novel feedback. In contrast, the non-invasive solutions session will focus on innovations that leverage external sensors and interfaces to restore essential information without direct neural connections. The session will end up with a round table to involve the audience in a discussion about the presented topics. The discussion will provide a platform for participants to collectively explore the reasons behind the limited availability of such advanced technologies in the market. Participants will engage in an open dialogue to uncover challenges, ethical considerations, and potential avenues for overcoming barriers to widespread adoption. To enhance the workshop’s interactive nature, speakers are encouraged to bring their own devices for live demonstrations, fostering a hands-on learning environment. Join us in this collaborative exploration of the future of feedback solutions and contribute to the advancement of technology that directly impacts the lives of individuals.
B.J. Fregly (Rice University)
This hands-on workshop will introduce the European research community to the Neuromusculoskeletal Modeling (NMSM) Pipeline (https://nmsm.rice.edu), which is open source Matlab-based software that adds Model Personalization and Treatment Optimization toolsets to the OpenSim musculoskeletal modeling software. Attendees will learn how to use the four tools available in the Model Personalization toolset and the three tools available in the Treatment Optimization toolset. Starting with a scaled generic OpenSim model and experimental motion capture, ground reaction, and EMG data, the Model Personalization toolset allows users to personalize 1) joint functional axes, 2) muscle-tendon model properties, 3) neural control model properties using muscle synergies, and 4) foot-ground contact model properties. Next, starting with this personalized model and the same experimental data, the Treatment Optimization toolset allows users to perform:
- a Tracking Optimization that closely reproduces experimental joint motion, ground reaction, joint moment, and EMG data simultaneously using muscle synergy controls,
- a Verification Optimization that verifies the muscle synergy controls found by Tracking Optimization can reproduce all available experimental data without tracking it, and finally
- a Design Optimization that performs predictive simulations to design a clinical intervention.
The workshop will also introduce the European research community to the Stroke Grand Challenge Competition to be held for the next four years at the American Society of Biomechanics annual conference. For each competition, we will provide an extensive walking data set, a personalized neuromusculoskeletal model, and an NMSM Pipeline Tracking Optimization for a new individual post-stroke and will challenge the neuromusculoskeletal modeling research community to use the NMSM Pipeline (or the software of choice) to design a personalized intervention that will improve walking speed and bilateral symmetry.
Robert Riener, ETH, Zurich, Switzerland
Technologies lack acceptance because requirements by clinicians and patients are not sufficiently considered by the developers. One possible reason for this is that there is a lack of communication and interaction between the different disciplines (e.g., engineers and clinicians) and professions (e.g., care persons, therapists, physicians). This workshop serves to bring together engineers, therapists, and physicians, and other health care experts in order to bridge the gap in the field and improve the applicability and acceptance of robotic technologies in rehabilitation. We will invite our clinical members of ICORR (Int. Consortium of Rehabilitation Robotics) to give ICNR participants and ICORR members a greater outreach and visibility.
Robots can be very useful to restore movement abilities of upper and lower limbs. First, they can promote neurorehabilitation as training devices after neurological injuries such as spinal cord injury (SCI), traumatic brain injury and stroke. Second, they can be used as assistive devices to support patients or elders with gait impairments in daily life situations. However, current mechatronic solutions are still too bulky, and their sensory technologies and control strategies are still too primitive to support the correct motion and motion intention. Furthermore, they still require a lot of effort, labor and/or surveillance by a human therapist and they are expensive and often not covered by health insurances. Consequently, the use of robots is less intensive than it could be, and they are not yet broadly accepted by the patients and medical staff. Therefore, we need to better connect engineers with clinicians and scientists with practitioners, health care administrators and insurance companies to better define the needs and preferences of the patients, find the responders of future robot-aided therapy and enhance the distribution and acceptance of the technologies. Usability and function of the rehabilitation robots must change not only to increase acceptability but also to improve the effectiveness and, eventually, the therapy outcome and quality of life of the patients who require physiotherapy or occupational therapy.
Shingo Shimoda (University of Nagoya, Japan)
This is a continuation of a global workshop series exploring AI applications in the medical industry. The 1st edition of the worldwide network of AI Labs in hospitals (WNAH2023) highlighted the significance of establishing a network of AI Labs in hospitals across five countries (United State, Japan, Australia, UAE, Spain) to standardize knowledge and methods, enabling collaboration between engineers and medical professionals. This initiative aimed to enhance medical research and practice using recent advances in robotics and AI. Building upon this foundational work, the 2nd edition of WNAH2024 further explores the transformative capabilities of AI within the healthcare sector, with a particular emphasis on rehabilitation and data management. This progression highlights the evolving recognition of AI’s potential to revolutionize both patient care and operational efficiencies, transitioning from basic applications to sophisticated decision-making processes that personalize care and optimize data utilization. WNAH2024 aims to provide a deeper exploration into AI’s current state, challenges, and future possibilities in healthcare. It seeks to offer comprehensive insights into AI’s role in rehabilitation, showcasing innovative solutions for personalized therapy and patient monitoring and in data management, where AI tools are vital in handling vast amounts of healthcare data for improved decision-making and patient outcomes. By highlighting successful case studies, addressing ethical and regulatory challenges, and forecasting future trends, the workshop intends to enable a rich discussion among healthcare professionals, technologists, and researchers. The overarching goal is to leverage AI’s power to meet global healthcare challenges, promoting a collaborative approach to develop more effective, efficient, and personalized healthcare solutions through AI. This initiative is crucial for the future of healthcare, emphasizing the need for a collaborative network that spans borders and disciplines. Through WNAH2024, participants will not only gain insights into the practical applications of AI in healthcare but also understand the complexities of integrating AI technologies in clinical settings, and envision the future of a technologically empowered healthcare system. This workshop represents a pivotal step towards realizing the full potential of AI in the healthcare sector, making it an essential gathering for those at the forefront of medical innovation and technology.
Venue Full-day Workshops
Juan Moreno (Cajal Institute)
This workshop aims to provide an overview of the State-Of-The-Art on the fusion of ES and WR technologies, -theoretical and hands-on experiences- highlighting the role of new emerging techniques and technologies in overcoming the traditional drawbacks of ES-WR fusion.The workshop invites contributions related to the fusion of robotic technologies and electrical stimulation (ES), in particular to cover:
- development of new applications of neurorehabilitation therapies based on the fusion of electrical stimulation and wearable robots, incorporating biomechanical models for personalization, intelligent control and hybrid control strategies, using AI-based techniques and new biomarkers that objectively quantify and monitor pathological movement,
- investigation of the ability of ES+wearable robots fusion to induce modulation of spinal and supraspinal centers involved in the underlying mechanisms of movement control disorders in different patient groups, including various multimodal markers and the applicability of AI algorithms to adaptive control of systems,
- development of consensus on a) the experimental design of pilot clinical studies involving ES+robotics fusion and b) the usability evaluation methodologies of new neurorehabilitation systems based on ES+wearable robots and their customization to individual users. This topic includes the exploration/analysis of application scenarios.
Max capacity: 20PAX.
Andres Ubeda (University of Alicante)
Alessandro Del Vecchio (Friedrich-Alexander Universität Erlangen-Nürnberg, FAU)
Leonardo Elias (University of Campinas)
Carina Germer (University of Campinas / Federal University of Pernambuco)
Jose C. Rangel (Technological University of Panama)
“Monitoring and delivering personalized hand neurorehabilitation through virtual activities controlled by the neural drive” is an international consortium of European and Latin-American Universities funded within the 4th EU-LAC Joint Call in STI 2022. The aim is to establish a research network between the research groups from Spain, Germany, Brazil, and Panama, with focus on addressing how motor rehabilitation could take advantage of cutting-edge technologies, such as high-density electromyography (HD EMG), virtual reality, and machine learning algorithms in a personalized way and considering the variability of motor diseases and specific geographical conditions. The full day workshop will serve as the second annual meeting of the MYOREHAB project. The decision of making the workshop within ICNR 2024 is to disseminate technical aspects of the project (not only the scientific discoveries) to a broader and qualified audience. Program will include talks on core topics of the project and technical hands-on sessions to train attendees in using and designing new technologies through the methods employed by the MYOREHAB team.
Rudi Gombauld (Kurage)
Part 1, Neuroskin: an complete solution for Neurorehabilitation: Transcutaneous spinal cord stimulation (tSCS) has been gaining momentum as a non-invasive rehabilitation approach to restore movement to paralyzed muscles after spinal cord injury (SCI). However, its low selectivity limits the types of movements that can be enabled and, thus, its potential applications in rehabilitation. Discover how NeuroSkin solve that trough combination of neurostimulation of FES lower part and spinal cord.
Part 2, Neuroskin: an AI-powered neuroprosthesis for gait rehabilitation after stroke: The purpose of Kurage is to support in the acute and sub-acute phase the gait rehabilitation of post stroke patients. Our NeuroSkin Solution was designed to help increase mobility for patient living with a variety of neurological disease, including stroke, cerebral palsy and multiple sclerosis. Our Neuroskin Solution is a neuroprosthesis that we like to name a second skin (legging for the lower body), equipped with IMU and GRF sensors as well as FES dry electrodes, driven by artificial intelligence capable of reproducing functional movements in a personalized way to overcome the deficiencies of the sensory-motor loop of the user. Our ambition is to spread the awareness and application of multi-channel FES for gait by solving at least two of its major barriers: a) complexity of donning and positioning: because of the large number of electrodes and cables in multi-channel FES applications, b) complexity of setting personalized parameters: for each patient to obtain optimal effects.
Part 3, Neuroskin: a complete embedded Gait Lab: In order to democratize gait analysis and ensure positive patient engagement, it’s crucial to focus on training physiotherapists effectively and providing ongoing support. Here are some recommendations: 1. Comprehensive Training Programs: Develop comprehensive training programs for physiotherapists to enhance their skills in conducting gait analysis and interpreting the results. Include both theoretical knowledge and practical, hands-on training with the equipment used in gait analysis. 2. Hands-on Workshops: Conduct regular hands-on workshops or training sessions where physiotherapists can practice gait analysis under the supervision of experienced professionals. Provide opportunities for physiotherapists to work with real patients to gain practical experience. NeuroSkin propose a Complete, Simple and useful Gait Analysis system using a variety of techniques including static examination, kinematic, kinetic and video analysis, muscle activity using interface electromyography (EMG), in shoe pressure measurement.
Eduardo Rocón (Biorobotics Group, CAR, UPM-CSIC, Spain)
This workshop will delve into recent advancements and innovative treatments in the realm of monitoring and rehabilitating paediatric patients. It will showcase cutting-edge technological developments and interfaces designed to facilitate interaction between paediatric populations with various pathologies and novel treatments. These treatments encompass rehab robotics, Virtual Reality, rTMS, TDCs therapies, and their applications in enhancing motor skills, managing pain, and ecologically monitoring patients during their daily activities. Such devices serve as the cornerstone for pioneering rehabilitation techniques. Participants will gain insight into the unique characteristics and potential of this burgeoning field. Throughout the full-day workshop, attendees will engage in discussions addressing challenging issues that have captivated the scientific community. Additionally, ongoing research endeavors aimed at developing new assessment techniques and treatments for paediatric populations will be highlighted. At the conclusion of the workshop, the chairs will summarize the key topics discussed and provide a glimpse into future developments. They will foster a dialogue among presenters and the audience, aiming to chart future research avenues.