A Novel Framework for Upper Limb Rehabilitation Using Automated and Robotic Systems [Online]
Sobresaliente "Cum Laude" con Mención Internacional
This thesis has been submitted in the format as a collection of publications

This thesis proposes a conceptual framework of rehabilitation under an innovative paradigm of integration of robotic and automated systems into a holistic health strategy. This framework considers the traditional rehabilitation cycle as a reference of design, analysing its components and current issues in order to develop automated alternative systems that keep the clinical meaningful.

The research work primarily focused on developing one of the core components of the framework, that is, the automated assessment systems (AAS). The assessment stage is strongly influenced by "one-on-one'' patient-therapist interactions, difficult management of patient's results, and time-consuming and labour-intensive procedures due to the nature of manual administration. Therefore, the AAS aims to face these limitations and to augment the clinicians' capabilities by providing them with automated tools. In this regard, this thesis presents the process of automation of a traditional and well-known clinical test for the assessment of upper extremity (UE) motor function. The Box and Blocks Test (BBT) of manual dexterity was the primary outcome measure taken as a case of study. The automation process considered different approaches (computer vision, proximity sensors, VR) in order to provide the clinicians with an objective, reliable, and automatic tool denoted as the automated box and blocks test (ABBT).

Additionally, this thesis reviewed the limitations of current robot-based interventions focusing on devices for UE treatment. Thus, this analysis resulted in the identification of a need for systems for complementing the task-oriented training performed for rehabilitation robotics. In this line, this work also explored the use of virtual reality for the rehabilitation of UE motor function. As a result, a set of video games were implemented. These video game served as an intervention tool for a treatment protocol in hospital in order to improve UE functioning and, concurrently, evaluate the feasibility of the ABBT.

Finally, the nature of hospital-oriented perspective requires testing the developed systems in clinical environments. Hence, part of the research consisted of piloting of the ABBT in a hospital facility and correlating the metrics obtained from the manual and automatic procedures. Besides, a treatment focused on improving the UE functioning using the serious games developed in this thesis was conducted in clinical settings. This way, this research work also provides a methodology for the validation of systems with the ultimate purpose of hospital applicability.

Universidad Carlos III de Madrid