Antropomotoryka nr 57 [2012]. - Akademia Wychowania Fizycznego ...

Emilia Mikołajewska, Dariusz Mikołajewskiing its capabilities) but also as a rehabilitation deviceinteracting with the user all day long in the course of thestandard exploitation of the device. Therefore, the importantelement is the analysis of the exoskeleton andthe interaction between a human being and a machineboth on the bio-cybernetic and biomechanical levels,which overlap here. It seems particularly significantalso from the viewpoint of introducing the steering ofexoskeletons with brain-computer interface (BCI). Oneof the research projects conducted nowadays in thisarea is MindWalker [2, 3]. In the market, there are alreadyfirst two commercial medical exoskeletons: HAL5and ReWalk (versions B1/B2); and the consecutive one– eLegs – is to be available in the middle of 2012 [4, 5].In the course of clinical trials and the development ofknowledge on the exoskeletons, the dynamic growth oftheir clinical applications is predicted.Two main basic groups of the applications of theexoskeletons are being under consideration here:• r e h a b i l i t a t i v e m o d e – the use of the exoskeletonin case of severely ill people, the disabled andthe aged as an ultra modern equivalent of a combinationof today’s wheelchair with a rehabilitationrobot, and the tele-medical system (for instance,tele-supervision); the aim of using the exoskeletonmay be here of a dualistic nature: providing the constantsupport of everyday life activities and mobilityby replacing, strengthening and supplementingthe particular functions’ parameter or else – whenthe exoskeleton is used temporarily – training theabove-mentioned functions (e.g. while gradually reducingthe support), so that – when the using of theexoskeleton has been completed – those functionsare performed by a patient in an improved way;• a s s i s t i v e m o d e – the use of the exoskeletonas a supporting device for medical personnel andcaregivers of the severely ill people, the disabledand the aged, particularly in case of the activitiesrequiring a great physical effort: the change of a position,moving over, assuming the upright position orreeducation of walking, bathing etc. [6, 7, 8, 9, 10].Scientific research on exoskeletons focuses primarilyon the understanding of biomechanics, nervous control,and energetic cost of the movement of a humanbeing in the exoskeleton and without it. It may supple­The Alternative for a Wheelchair:The two-limb alternative (the exoskeletons only for lower limbs)The four-limb alternative (the exoskeletons for both lower andupper limbs)Supporting manyeveryday life activitiesNecessity to develop safetyand emergency systemsReducing energy costof a movement(e.g. in case of enfeeblement)Complex procedure of theuser’s adaptationand trainingPossibility of compensation(also temporary)of the OUN deficitsAdvantagesDisadvantagesIndividualchoiceAdjusting the steeringto the kind and levelof a deficitThe possibility of steeringwith the help of the brain-computerinterface (e.g. the MindWalker project)Exoskeleton is amobile rehabilitationdevice anda platform for telemedicalequipmentFigure 1. Advantages and disadvantages of using exoskeletons in rehabilitationNot fully examinedlong-term effectsof the exploitation– 116 –