FREEHAB: accessible, comfortable and adaptable wearable rehabilitation and assist devices

There are over 10.8 million disabled people living in the UK today. Nearly 6.5 million have mobility impairments. These numbers are growing as the median population age increases and age-related mobility issues due to musculoskeletal and neurological conditions such as arthritis and stroke, become more prevalent. Rehabilitation helps people improve and maintain their abilities in everyday life, but currently patient outcomes are hampered in two ways: Firstly, there is a lack of easy to use dynamic tools to help therapists to accurately analyse their patients' gait and mobility performance and devise the most effective personalised training and rehabilitation programmes. Secondly, as more and more rehabilitation occurs at home and requires patients to practice in the absence of a therapist, better ways to support in-home mobility and training are needed, to enable patients to achieve their potential in everyday mobility tasks.

The FREEHAB Healthcare Impact Partnership will develop soft wearable rehabilitative devices to directly address these needs. FREEHAB will build on discoveries from our previous EPSRC Right Trousers project in which we discovered new soft materials that can be used like artificial muscles. These include 3D printable electroactive gel materials and soft, but strong, pneumatic chains that change they shape when inflated and can exert considerable forces. These materials will be used to develop devices to help people to walk, stand and to move from sitting to standing. Together with integrated sensing technology we will make devices that physiotherapists can use to accurately pinpoint limitations in their patients' movements, thus enabling them to plan personalised training programmes. We will also make simpler devices that the patient can use to enhance their mobility activities and exercises with confidence when a therapist is not with them.

To do this we will work in partnership with physiotherapists in NHS services and in private practice, with people who have personally experienced physiotherapy for their mobility problems, and with business partners who are experienced in bringing rehabilitation and assistive technology devices through from concept to market. We will initially determine what patient and clinical considerations we need to take into account to design and develop the devices. We will continually consult with partners for their ideas and opinions as the devices are developed. We will plan how FREEHAB technologies will progress from research and development through translation into clinical trials, and to bring the devices into the supply chain after the project is over. This will be undertaken with advice from our clinical and business partners and with regard to regulation of devices for use in the NHS and intellectual property for commercialisation.

When we have designed and manufactured our prototype devices we will test them to determine how physiotherapists find them useful for assessment and how patients find them comfortable and useful for carrying out their physiotherapy training and rehabilitation. We will collect their views alongside formal measurements of patients' performance when they are wearing the devices compared to their performance when using a conventional orthotic brace. We will ensure we have the right regulatory and ethical approval for this early proof of concept testing. The results of our evaluations will help us to prepare for the next stages in product development and clinical testing needed to bring the devices into use in the NHS.

The FREEHAB Healthcare Impact Partnership is a multi-disciplinary endeavour to meet the critical needs of mobility-restricted patients and clinical specialists. It combines a programme of world-leading research and development with patient, clinical and business partners. It will have deep impact in the healthcare domain and wider impact on national and international research, the public and the UK economy. We define a programme of impact generation that extends across the following domains (see Pathways to Impact document for more details and our impact plan):

People: Through the training of professional researchers operating at the interface of robotics and healthcare, a growing and much needed field, and through training of clinicians in the adoption and use of advanced robotic technologies.

Science: Through the development of state-of-the-art soft actuators and sensors. These include dielectrophoretic zipping actuators, smart materials, plastic electroactive gels and lightweight pneumatic actuator fibres. These will enable the fabrication and testing of three FREEHAB ART devices for walking, standing and sit-to-stand transfer. Dissemination of research with be through leading journals (e.g. Science Robotics, Soft Robotics), international conferences (e.g. ICRA, IROS) and dedicated workshops at robotics and clinical therapy conferences.

Clinicians: Impact on clinical sciences includes understanding of patient and clinical uses of ART technologies and the advancement of these through FREEHAB devices. Our clinical partners (NBT, CNSS, DN) and wider physiotherapy clinicians will benefit from better in-clinic and at-home assessment devices and prescribable healthcare solutions.

Patients: The target group of patients with mobility difficulties due to age and stroke will benefit from new FREEHAB devices that are more effective in assistance and rehabilitation, and more comfortable. These devices will be more accepted and adopted by patients, thereby spreading healthcare benefits to a larger patient population.

Economy: FREEHAB is a partnership which brings together clinicians, researchers and technology businesses and charities (Open Bionics and Designability) to generate significant long-term healthcare and economic benefit. This includes primary commercial development of devices in the UK for use in NHS and private clinics, for home use and for global marketing. Significant secondary impact will be generated through greater patient independence and higher quality of life, leading to a reduction in care events, lower health and social care costs and a reduction in burden on UK Government budgets.

Public: FREEHAB will raise awareness of this important healthcare research and disseminate its outputs to the public through engagement events including a large exhibition (Royal Society Summer Science Festival, Cheltenham Science Festival, British Science Press conference) where we will show core actuator technologies in hands-on demonstrators, and complete FREEHAB soft robotic ART devices.