Soft pneumatic actuator for lower limb rehabilitation: Development and its efficacy in reducing muscle stiffness and pain / Hanisah Bakeri
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Résumé
Lower limb injuries have been identified as a significant contributor to the occurrence of time lost during both physical training and daily activities. In recent years, pneumatic compression therapy has emerged as a viable alternative for managing patients who exhibit resistance to conventional compression methods. The conventional compression method exhibits limitations in consistent pressure distribution and adaptability. Recognizing these challenges, this study explores the integration of soft pneumatic actuators (SPAs) in compression therapy to enhance precision and dynamic adaptability, offering a promising alternative for improved treatment outcomes. The objective of this study is to investigate the potential application of soft pneumatic actuators (SPA) in the context of rehabilitation therapy for musculoskeletal ailments. The primary objective of this study is to analyze various aspects related to SPA including their design, material selection, fabrication, and design testing. Additionally, the research aims to experimentally validate the efficacy of lower limb rehabilitation compression therapy in reducing muscle stiffness among healthy individuals. Furthermore, ongoing investigations in the field of compression therapy predominantly focus on the advancement of soft pneumatic actuators tailored to various applications. However, there remains a dearth of definitive findings pertaining to the advantages of compression therapy in alleviating muscle fatigue. Therefore, a SPA chamber with two elastomeric layers was developed for this study, with single-side inflation using food-grade silicone. The 3D deformation profiles of the SPA chamber using three different elastomeric rubbers were analyzed using the finite element method (FEM). The best SPA-compliant behavior was displayed by food-grade silicone A10 Shore with a maximum deformation value of 25.34 mm. Next, the SPA chamber was fabricated using A10 Shore food-grade silicone and experimentally validated. A total of 30 healthy male subjects were recruited and underwent a fatigue induction exercise. Muscle stiffness was assessed at four distinct time points in both the intervention group, which received SPA, and the control group, which did not receive SPA. The compression pressure in respect to calf circumference was measured, and both the maximum and average values were recorded. The findings suggest that the SPA system demonstrates effective pressure transmission on the skin within the pressure range of 20-160 mmHg for healthy male subjects. A positive linear trend between pressure variation and calf circumference was found. The mean muscle stiffness for the intervention group exhibited a reduction from an initial value of 496.26 ± 24.70 Nm-2 to a subsequent value of 382.30 ± 19.72 Nm-2 immediately following the application of pneumatic compression. This decrement corresponds to a percentage reduction of 22.96%, with p-value of 0.0001. There was no statistically significant difference seen between the pre-treatment and post-treatment measurements in the control group, with a p-value of 0.3500. The results of the study showed that the short form McGill pain questionnaire (SF-MPG) of the intervention group had a statistically significant impact on the pain index following a 30-minute treatment with SPA. The study demonstrates that the proposed SPA system is capable of reducing muscle stiffness and delivering the desirable pressure for treating musculoskeletal injuries, thereby aiding in the acceleration of recovery.
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