The story of Hubotics -- A DIY physiotherapy kit

Last October, during the Makerfaire in Rome, the opencare WeMake team was exhibiting in front of project Hubotics!   A DIY solution that provides customized physiotherapy at home.  Composed of 3D printed parts, and a simple mobile app, the solution works in a way that makes it easy to stimulate muscles and nerves of the patient who needs therapy, with customized motion and power.

A wonderful family was in the Hubotics booth.  I had a chance to interview Luca, the project co-founder, who was demonstrating the project and openly shared the story of his solution below.

The project is still in development and is in need of testers, read the story and see if you can take part in the project in its current status.

1.  How did you start the project? What were your motivations?

The Hubotics project started in late 2013. At that point I was about to finish my Master’s studies and I wanted to add a practical side to my technical skills as an engineer and as a passionate DIYer by developing accessible technologies and aids which could have helped improving independence for people suffering from motor disabilities. Actually, the reason why I decided to study engineering and became a builder and hacker stemmed from my personal experience with my sister Chiara, who suffers from a motor disability.

I remember, as a child, my parents used to buy plenty of super expensive devices, as computer headsets, mice, keyboards or having to travel back and forth between clinics and private medical studios to have access to the “latest” rehabilitation techniques. After having hacked wheelchairs, remote controls for doors and televisions inside our house and having realized several other robotic contraptions, I realized that achievement of independence through the use of one’s own body is one of the most gratifying experiences everyone could hope for, that’s how the idea of creating an exoskeleton to be used in everyday’s life was born.

2. Did you start alone? How long did it take to develop the initial prototype? How was it funded?

Around that time, I started speaking about these ideas with Roberto, a friend with whom I had studied between Torino and Milano. Together, we started brainstorming and discussing and we finally converged on the idea of developing a low-cost, 3D printed exoskeleton for rehabilitation and assistance of upper-limbs, directly at people’s homes.

The idea was proposed at the Telecom Italia WCAP accelerator in Catania that believed in the project and decided to fund us. This allowed us to buy the 3D printers and the components to build and iterate on our ideas and prototypes. The first reliable prototype of the device, finalized in one year, consisted of a wearable, smartphone-controlled, elbow exoskeleton.

After showing the device at the MakerFaire 2015 in Rome and gathering plenty of positive feedback, we understood that the project had plenty of potential and decided to keep working on it.

What is your current status now?

Today, together with Roberto and Chiara, we keep on improving our devices and iterate on the designs in order to achieve a concept as usable and useful as possible while maximizing customizability and accessibility. Our latest device consists of an exoskeleton with 3 active degrees of freedom for controlling the shoulder abduction/adduction, shoulder flexion/extension and elbow flexion/extension of its wearer.

The device can be controlled by means of a smartphone app or by a program with predefined motions/tasks.

5. How do you see it moving forward? What kind of help/expertise/data that is missing for moving to a next phase?

Our main objective in the near future is running experiments with potential users of the exoskeleton and their relatives, in order to gather further feedback and improve our devices based on this.

Additionally, we are brainstorming on possible models that would allow the project to keep its philosophy of openness and accessibility while making it economically sustainable. For example, how to fund the project in order to promote further development? How to enable open/low-cost and customizable solutions capable of reaching end-users? How to ensure that these devices would work (and keep working) at users’ houses (services?), all these are open questions that we will be working on for the next phase.

Very interesting. I had a complicated above elbow fracture resulting in 70% muscle wastage, reduced movement of elbow joint and fingers, and removal of the funny bone nerve. I found using plastic bottles filled with water as weights very useful. Easy to change the weight and squeezing the bottle as I lifted was effective at getting the work to where it’s needed (and free). In what ways do you think the product in the picture would work better than a plastic bottle? Strenghtening multi-directional movement?

Telemetry

@Bernard , I pinged @hubotics on twitter, hopefully they can respond. I had a quick look at a presentation of theirs (in Italian). It seems it allows more control and a clearer view on the progress you’re making. And then, the smartness of it - how it captures data and at need can send it to your human therapist for monitoring purposes. I can imagine self-treatment being empowering and all, but authority in medicine seems pretty big still, as others explained so well in this other conversation.

Thanks, @Noemi. Yes, the telemetry would be interesting, and the other conversation is very. Yoga gave me massive authority, I can do things with my left arm that I never thought I’d be able to:) And I’ll always be grateful to my surgeon and physioterapists.

Use-case scenarios

Hello @Bernard, thanks for the inputs! :slight_smile:

The device has been designed to allow (and/or complement) simple shoulder and elbow movements (namely: shoulder abduction/adduction, shoulder flexion/extension, elbow flexion/extension). The main idea behind its development is that of enabling its use directly at people’s homes, in order to allow intensive sessions directly in activities of daily living. As such, it could be used in several scenarios, from rehab to assistance. The main differentiator wrt such scenarios would/could (mainly) be the user-interface.

In the simplest case, the device could be programmed (by a physician, physiotherapist etc.) in order to mimic/repeat a predefined set of motions over and over again in order, for example, to avoid the undesired consequences of limbs immobilization (contractures, poor blood circulation etc).

In a rehab setting, for example post-stroke, the exoskeleton’s motions could be derived by decoding user’s intention via physiological signals (mainly EEG, EMG). In this case the basic idea would be to allow the user to complement or slowly re-gain control over his flaccid/weak arm and discontinue its use once the user does not need it any longer.

In an assistive setting, for example post spinal cord injury or in myopathies, the exoskeleton’s motions could be derived as before or chosen from a simple interface (e.g. smartphone, joysticks etc.) in order to provide assistance-as-needed, whenever the user wears the device.

In a case like the one you’ve mentioned the device could indeed be used, not to help but rather to (selectively) resist the movements. By customizing some parameters to the user’s needs/residual abilities, one could enable specific trainings in order to work on specific ranges of motions, torques, joints/muscles combinations etc. Such parameters/programs could be also updated by a physician, or dynamically (by the device itself) by inferring correlates of muscle-fatigue, achievable range of motions etc.

In all the previous scenarios, as specified by @Noemi, data related to the user’s progress could be collected and analyzed, for the sake of monitoring and improving the therapy itself.

Thanks @luca_randazzo

I now see the wide range of applications for the device. Avoiding undesired consequences of limbs immobilization, post-stroke, torque and mechanics, uses for spinal cord injury and myopathies are all bits of info that show the huge potential value of what you’re doing. I wish you luck with it and will follow with interest:)

How complex is it

Hi, @luca_randazzo, it looks like a nice project. Is it open-source? How do you see it beeing constructed? Do you have any links to clinical works?

@Alexander_Shumsky, could it be something for WeHandU?

Hello @Rune,

Thanks :slight_smile:

The project is not yet open-source, we are indeed brainstorming on the type of licenses under which to release it. This will definitely affect the way it is going to be constructed/built/distributed, so unfortunately we have no answers yet on this regard.

We have not run any complete clinical assessment but we are planning to start some pilot studies on single users in the near future in order to assess the usability and functionality of the device.

Moving Forward

Hubotics was presented at the OpenCare Deep Games event at CERN earlier this year. As it’s early in the development stage, modifications of design are being achieved to maximize customizability and accessibility to a large community in need.  For the full article here:  here: https://goo.gl/vFqiY3

Thanks so much for sharing your experience with us. It’s always so inspiring and encouraging to learn about projects that start from a personal experience / situation.

I really hope that you can achieve your goals and spread these tools to other places and contexts.

Looking forward to learning more about this!