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

该博士项目由两家领先的机构合作完成，主要由布里斯托尔大学软机器人实验室的Rossiter教授负责工程监督，谢菲尔德大学谢菲尔德转化神经科学研究所（SITraN）的Dame教授负责临床和神经科学监督。核心目标是开发一种真实的、可工作的软体机器人设备，可用于改善患有运动神经元疾病和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，这些疾病导致运动神经元的退化和最终死亡，导致随意肌萎缩，部分或全部瘫痪，最终死亡。MND中残疾和痛苦的一个主要方面是双侧上肢无力的发展。可用于MND患者的上肢矫形器价格昂贵且与复杂的用户需求不匹配，导致使用率低。对于患有MND和其他退行性疾病的用户，它们的应用通常次于它们作为康复设备（例如中风患者）的作用。有效的上肢无力治疗装置可以减轻家属和护理人员的护理负担，保持关节活动，减轻疼痛。矫形器设计正处于一个新时代的门槛，在这个时代，与传统机器人相关的僵硬、无生命、限制性机制将被仿生肌肉致动器技术的发展所支持的生物逼真系统所取代。软体机器人受到生物力学的启发，并与之相匹配，具有应用于具有自适应形态的模块化设备的潜力，可以应对肌肉退化。使能技术的发展是将现有的和正在兴起的学术成果转化为临床有用设备的关键，特别是在执行器尺寸、执行效率、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各自的缺点。通过“打破常规”，直接致力于开创性的软机器人技术，该项目旨在生产一种临床就绪的设备，这将颠覆目前给MND患者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，以解决患有一系列神经肌肉疾病的人对矫形器的需求。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，这是一个富有同情心的共同设计过程（即将开始）。使用基于功能的设计过程来生产矫形器，导致了一个由现有解决方案的迭代所主导的市场，这些解决方案继承了其前辈的失败。该项目将采用富有同情心的、以人为本的协同设计过程，并有意考虑用户的授权、尊严和安全。将在项目的所有阶段与医疗保健专业人员和痴呆症患者作为“共同设计师”进行磋商，以输入和评论项目产出以及测试原型。共同设计会议将是半结构化的会议，以虚拟或面对面的方式与小团体或个人举行。共同设计过程由SITraN NIHR资助。该项目还获得了日本科学促进协会（JSPS） 2022年夏季奖学金的资助，在东京工业大学的Suzumori-Endo实验室研究最初的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.