Exploration of a novel soft robotic assistive device for arm and hand function for people living with Motor Neuron Disease.

这个博士项目是两个领先机构的合作项目，由布里斯托尔大学软机器人实验室的Rossiter教授负责一级工程指导，谢菲尔德大学谢菲尔德翻译神经科学研究所(SITraN)的Shaw爵士教授负责二级临床和神经科学指导。其核心目标是开发一种现实世界中工作的软机器人设备，可以用来改善患有运动神经元疾病并表现为上肢无力的人的上肢功能。运动神经元疾病(MND)是一组无法治愈的疾病的总称，会导致运动神经元的退化和最终死亡，并导致自愿肌肉萎缩、部分或完全瘫痪，甚至最终死亡。MND患者残疾和痛苦的一个主要方面是双侧上肢无力的发展。可供MND患者使用的上肢矫形器价格高得令人望而却步，而且与复杂的用户需求匹配不佳，导致接受率较低。对于患有MND和其他退行性疾病的用户来说，它们的应用通常是次要的，而不是作为康复设备的作用，例如对中风患者。治疗上肢无力的有效设备可以减轻亲属和照顾者的护理负担，保持关节的灵活性，并减少疼痛。矫形器设计正处于一个新时代的门槛，与传统机器人相关的僵硬、无生命、限制性的机制将被生物现实系统取代，这是通过肌肉模拟执行器技术的发展实现的。受生物力学启发并与之匹配的软机器人技术有可能应用于具有自适应形态的模块化设备，这些设备可以应对肌肉退化。使能技术的发展是将现有和正在兴起的学术努力转化为临床有用设备的关键，特别是在致动器尺寸、致动器效率、寿命和控制接口方面。此外，软机器人技术的更全面的协同混合可能有助于克服它们各自的缺点。通过“撕毁规则手册”并直接致力于开创性的软机器人技术，该项目旨在生产一种可用于临床的设备，该设备将打破为MND患者提供的中风幸存者康复设备的标准。这个项目可能会导致未来的合作项目，以满足患有一系列神经肌肉疾病的人的矫形器需求。该项目已经获得了布里斯托尔大学研究伦理委员会的伦理批准，进行了一个富有同情心的联合设计过程(即将开始)。使用基于功能的设计流程来生产矫形器，导致了一个由现有解决方案的迭代主导的市场，这些解决方案继承了前人的缺点。该项目将采用富有同情心、以人为本的联合设计过程，有意考虑到用户的赋权、尊严和安全。将在项目的所有阶段与医疗保健专业人员和MND患者进行协商，以输入和评价项目输出以及测试原型。联合设计会议将是与小团体或个人虚拟和面对面举行的半结构化会议。联合设计过程由SITraN NIHR资助。该项目还得到了日本科学促进会(JSPS)2022年暑期奖学金的资助，将在东京工业大学铃森-远藤实验室开发一款最初的MND专用手套。该项目属于EPSRC辅助技术、康复和肌肉骨骼生物力学研究领域，以及人工智能和机器人主题。

This PhD project is collaborative across two leading institutions, with primary engineering supervision from Professor Rossiter at the University of Bristol Soft Robotics Lab and secondary clinical and neuroscience supervision from Dame Professor Shaw at the Sheffield Institute for Translational Neuroscience (SITraN) at the University of Sheffield. The core goal is to develop a real-world, working soft robotic device that could be used to improve the upper limb function of people living with motor neurone disease and presenting with upper limb weakness.Motor neurone disease (MND) is an umbrella term for a group of incurable diseases leading to the degeneration and eventual death of motor neurones and resulting in voluntary muscle wasting, partial or total paralysis, and eventual death. A major aspect of disability and distress in MND is the development of bilateral upper limb weakness. Available upper limb orthoses for people living with MND are prohibitively expensive and poorly matched to complex user needs, leading to low uptake. Their application for users with MND and other degenerative conditions is usually secondary to their role as rehabilitation devices e.g.for stroke victims. Effective devices for upper limb weakness could reduce the care burden on relatives and carers, preserve joint mobility, and decrease pain.Orthosis design is at a threshold of a new age where rigid, lifeless, restrictive mechanisms associated with traditional robotics will be replaced by biologically realistic systems enabled by the development of muscle mimetic actuator technologies. Soft robotics inspired by, and matched to, biomechanics have the potential to be applied to modular devices with adaptive morphology that can cope with muscle degeneration. Development of enabling technologies is key to translating the existing and arising academic effort into clinically useful devices particularly in terms of actuator size, actuating efficiency, life, and control interface. Additionally, a more holistic synergistic hybridisation of soft robotic technologies may help to overcome their respective disadvantages. By 'tearing up the rule book' and working directly on pioneering soft robotic technology this project aims to produce a clinically ready device that will disrupt the standard of stroke survivor rehabilitation devices being giving to people living with MND. This project could lead to future collaborative projects to tackle the orthoses needs of people living with a range of neuromuscular disorders.The project has secured ethical approval from the University of Bristol Research Ethics Committee for a compassionate co-design process (starting imminently). The use of function-based design processes to produce orthoses has led to a market dominated by iterations of existing solutions which inherit the failings of their predecessors. The project will use a compassionate, human-centred, co-design process with intentional consideration of the user's empowerment, dignity, and security. Consultations with healthcare professionals and people living with MND as 'co-designers' will be established at all project phases to input and critique project outputs as well as test prototypes. Co-design sessions will be semi-structured sessions held virtually and in person with small groups or individuals. The co-design process is being funded by the SITraN NIHR.The project has also received funding from the Japanese Society for the Promotion of Science (JSPS) 2022 Summer Scholarship to work on an initial MND specific glove at the Suzumori-Endo Lab at the Tokyo Institute of Technology.This project falls within the EPSRC Assistive technology, rehabilitation and musculoskeletal biomechanics research area as well as Artificial intelligence and robotics theme.