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kinea design website

portfolio: KineAssist Walking & Balance retraining

client: The Rehabilitation Institute of Chicago

kinea Design developed the KineAssist™ technology to help physical therapists provide better patient care, increase patient and therapist safety, and improve clinic economics. The KineAssist™ allows physical therapists to safely challenge patients in functional environments with reduced concern about falls, to record objective measures, and to do so within existing practice settings. Unlike equipment that requires significant set up time and additional staff, KineAssist™ tools require only one therapist, minimal set up time and can be used during transition, standing balance, ambulation and dynamic balance therapy.

to learn more about KineAssist™, click here to download a flyer about the technology.

see the Discover Channel's (The Daily Planet) segment on the KineAssist, (.flv 16MB, .wmv 32MB)

our approach

the KineAssist™ is a physical therapist’s tool, not a machine that itself provides physical therapy. KineAssist™ maintains the therapist’s connection with the patient in all its important aspects: physical, sensory and psychological. Our approach was guided by practicing physical therapists, with the help of IDEO, the world’s leading product development firm and practitioner of user/observation/design research. By understanding real users, in real tasks, set in real contexts, we developed a thorough understanding of the way clinicians provide physical therapy. Our clinician-centered approach, backed by a team of human-machine design engineers, clinical researchers, and experienced commercial experts, helped Kinea Design bring this technology into practice.

device description

Printable version

the KineAssist™ device is indicated for use by physical and/or occupational therapists in a rehabilitation setting for assisting/enabling therapeutic exercises, neuromuscular re-education and gait and balance training.

walking exercise modes

walking:

this mode allows the therapist to put a patient in the device and allow him to exercise by walking overground (i.e. in a hallway) or over a treadmill.

challenge:

this feature allows the therapist to challenge the patient balance as he is walking by loosening or widening the prescribed zone of safety, such that the patient can explore the limits of his/her stability while maintaining safety.  For example, the therapist might place obstacles in the patient's path so that the patient has to walk over them or around them.

strength training:

in this mode the device applies resistance in the direction of walking for strength training specific muscle groups.  This is achieved by adjusting the maximum speed the device can move.

stabilization:

in this mode the trunk and pelvis support mechanism applies forces to compliantly support the patient’s upper body.  The stiffness of the support is adjustable by the therapist from fully rigid down to zero.  For example, in some situations the physical therapist might want to focus on the patient's lower extremity by stabilizing the patient’s upper body.

postural:

in this mode the patient’s trunk and pelvis is placed in a certain posture by the therapist and actively maintained by the device by applying therapist adjustable bias forces. As the patient proceeds to perform walking exercises the machine will maintain the patients prescribed posture while allowing his/her normal gait motions; much like a therapist would do today by holding a patients upper body in a desired posture as they walk together.

body weight support:

in this mode the therapist is able to unload a desired amount of body weight off of the patient’s legs by lifting him.  The pelvis is rigidly held and the trunk is able to move within the zone of safety.

balance exercise mode

perturbation:

while the patient is performing either a static or dynamic activity the device allows for the therapist to throw the patient off balance by pushing the patient at different parts of the body.

challenge:

this feature allows the therapist to challenge the patient as he is performing balance exercises, such as reaching or sit-to-stand, by widening the prescribed zone of safety such that the patient can explore the limits of his/her stability while maintaining safety.

stabilization:

in this mode the patient is to maintain the position, in which he or she is placed by the therapist, via feedback by the machine while performing balance exercises.  For example, when reaching for pegs if the patient is unable to appropriately control his/her balance and falls outside of his prescribed stability range of motion, the machine would then signal this to the patient prompting him/her to start trying to recover.

intended use

Figure 1 – (left) Loading from wheelchair. (right) Harness attachment.

figure 1 illustrates one example of how a patient might be loaded onto the device.  The device is brought to close proximity of the patient after which the physical therapist will assist the patient in moving from a wheel chair (or other surface, e.g. mat, bed) onto the seat that is supplied by the device.  Once the patient is seated on the KineAssist™ (Figure 1 - right) the physical therapist proceeds to secure the harnessing straps/belts around the patient.  The harness chest straps are not illustrated.

set-up will take no longer than 5 to 10 minutes. Trunk control, comfort and therapist body mechanics will be optimized so that only  one therapist is required to setup a patient.

the degree of support is determined by the therapist and can be programmed independently for the trunk and the pelvis. These will be controlled either electronically or by passive mechanical devices that are under the therapist’s control.

examples:
  1. A patient with unilateral hemiplegia may require more trunk support on the right vs. left side of the torso.  The therapist would determine the amount and adjust accordingly.
  2. A patient with poor balance may just need a device to catch him when he falls and needs no support within the zone of safety.
  3. A patient with a spinal injury might have to be unloaded (un-weighed) by 50% of his body weight due to muscle weakness in his legs.

Figure 2 - Walking.

the pelvis and trunk move independently to encourage reciprocation or allow the patient to learn his own patterns for compensation.  The device also allows the therapist to control the direction and speed during walking exercises (Figure 2). These motions will be executed via the wheels, and/or the smart brace.

examples:
  1. A therapist wants the patient to be stabilized at his/her trunk and wants to move on a stool beside the patient in order to help advance his/her leg.  In this case the therapist would want to program the speed of the device to be slow and steady in order to maximize the patient's endurance.  Additionally, the therapist would not want the wheels on the machine to deviate  to the right or left.  She/he can program the wheels and the smart brace to support the patient in this way. (As if the patient were walking in parallel bars.)
  2. A therapist wants to practice advanced balance training with a patient who falls while distracted in the community.  This time she would increase the zone of safety so that it would only “catch” the person if they were about to fall (much as a therapist does today via a gait belt).  The therapist would allow the wheels to follow the patient in all directions, having them only come to a stop if the person is about to fall or hit an object. She would set the speed so the patient could modulate it to his or her normal walking speed.  In other words the device will simply follow the patient.  The patient can now practice head turning while walking, catching a ball, stepping over obstacles, etc

Figure 3 – (left) Perturbing. (right) Resting

either over a treadmill or over ground the therapist can introduce manual perturbations (Figure 3 - left).  A seat allows the patient to rest when they are fatigued. The feet would be in contact with either the ground or a foot stool.

gallery

press:
videos:

functional activities with a stroke survivor. Video files are large, please wait for them to load.

photos:

different views of the KineAssist™

front view
user Interface
user Interface
user Interface
       

setup

opening KA side arms for side transfer closing side arms adjusting waist strap positioning torso harness
       
adjusting torso harness adjusting under-the-leg straps harnessing is complete person transitions from sit-to-stand

person performing walking exercises

person walking sideways patient walking patient walking sideways PT assisting patient in walking
 

person losing his balance and recovering

person being caught by the KineAssist side view front view person recovering from a fall
       

person performing dynamic balance exercises

patient taking a vertical step patient kicking a ball reaching high ball reaching high ball
       
reaching for a low ball reaching for a side ball    
 

person performing balance exercises

opening a cabinet door reaching on tip-toes
(side view)
reaching on tip-toes
(back view)
reaching on tip-toes
(close-up)
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