Kostas Nizamis

• PhD
• Professor (Assistant) at University of Twente

The human hand is important for the performance of activities of daily living which are directly related to quality of life. Various conditions, such as Duchenne muscular dystrophy (DMD) can affect the function of the human hand and wrist. The ability to assess the impairment in the hand and the wrist by measuring the range of motion (ROM), is esse...

Upper extremity function is affected by a variety of neurological conditions. Robotic exoskeletons offer a potential solution for motor restoration. However, their systematic adoption is limited by challenges relative to human intention detection and device control. This position paper offers a focused perspective on this topic. That is, on how kno...

The hand is a very complex and versatile tool, which allows humans to interact with their immediate environment, engage in daily life activities and socialize. Individuals with Duchenne muscular dystrophy (DMD), experience years of deteriorated hand function, leading to severe dependence on caregivers. Robotic exoskeletons can provide a feasible so...

With recent improvements in healthcare, individuals with Duchenne muscular dystrophy (DMD) have prolonged life expectancy, and it is therefore vital to preserve their independence. Hand function plays a central role in maintaining independence in daily living. This requires sufficient grip force and the ability to modulate it with no substantially...

Recent advances in the field of neural rehabilitation, facilitated through technological innovation and improved neurophysiological knowledge of impaired motor control, have opened up new research directions. Such advances increase the relevance of existing interventions, as well as allow novel methodologies and technological synergies. New approac...

This study outlines a comprehensive approach to the kinematic and dynamic analysis of lower limb movement, with the express purpose of designing an efficient wearable rehabilitation assistant device for the lower body. The approach begins by conducting a kinematic analysis of the lower limbs, presenting the degrees of freedom and each joint’s range...

The importance of managing complexity in innovation has been highlighted both in research and practice, however the question remains : how can this be accomplished? Although there have been answers to this question, the practical alignment of process (project management) and system (technical management) viewpoints remains understudied. We responde...

Systems Engineering (SE) research with Industry as a laboratory (IaL) has multiple benefits: it safeguards relevance, facilitates co-design, and allows researchers to gain practical insights. However, it faces a challenge in aligning traditional academic research with fast-paced industrial processes. The Spiral Approach for Systems Engineering Rese...

The concept of Industry 4.0, as a means to move forward in the industrial ecosystem, has reached an important turning point. Where do we stand now in terms of industrial innovation and transition? This opinion paper provides an overview of the situation in the Netherlands, a reflection on what has been achieved by the Industry 4.0 paradigm, and the...

There exists a grey area between market‐pull and technology‐push markets, in which stakeholders are aware of an issue they want solved, yet do not have clear expectations on a solution. This paper presents a method to meaningfully include these stakeholders in a design process, especially if they come from a non‐technical background. A combination...

Home hand rehabilitation for stroke is becoming increasingly important due to logistic and financial challenges. Developing Daily-life Integrated Hand-rehabilitation Products (DIHP) aims to enable the application of at-home rehabilitation. The materials of these products are essential for their success, however, selecting materials for DIHP has not...

Introduction: Duchenne muscular dystrophy (DMD) is a genetic disorder that induces progressive muscular degeneration. Currently, the increase in DMD individuals' life expectancy is not being matched by an increase in quality of life. The functioning of the hand and wrist is central for performing daily activities and for providing a higher degree o...

Complexity is often regarded as a “problem” to solve. Instead of attempting to solve complexity, we follow systems engineering practices and switch back to the problem domain, where a major obstacle is the impossibility to universally define complexity. As a workaround, we explored complexity characterization and its existing shortcomings, includin...

Hand rehabilitation aims to improve patients' hand and arm skills, improve adherence to training and increase their participation in activities of daily living (ADLs). A novel way of achieving this is to employ ADL-based interactive rehabilitation tools and show patients how their improved skills can be transferable to daily tasks. Hence, in this p...

Surface electromyography (sEMG) is used to determine muscle activity by picking up the associated bio-potentials using skin-mounted electrodes. In this paper, we study how the electrode and skin impedance of 3D printed sEMG electrodes can be improved by comparing traces made of either silver ink or carbon black loaded thermoplastic polyurethane (TP...

Complexity is often regarded as a “problem” to solve. Instead of yet again attempting to solve complexity, we follow systems engineering practices and switch back to the problem domain. A major obstacle in the problem domain is the impossibility to universally define complexity. As a workaround, we explored complexity characterization and identifie...

Background: Spinal Cord Injury (SCI) constitutes a major sociomedical problem, affecting approximately 0.32-0.64 million people each year worldwide, affecting young individuals and causing long-term, often irreversible disability. While effective rehabilitation of SCI patients remains a significant challenge, novel neural engineering technologies h...

italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">Contribution: This study provides evidence for the benefit of short online courses for the transdisciplinary competence development of graduate students. It shows the significant challenges students face while learning, and provides instructional recom...

There is a growing recognition that the world’s emerging complex problems require perspectives from multiple disciplines to be properly addressed. For higher education, it is imperative to develop well-rounded graduates with both a depth and breadth of knowledge and skills to integrate perspectives across disciplines. A mixed-methods study was cond...

Ethical, legal and societal implications (ELSI) in the development of wearable robots (WRs) are currently not explicitly addressed in most guidelines for WR developers. Previous work has identified ELSI related to WRs, e.g., impacts on body and identity, ableism, data protection, control and responsibilities, but translation of these concerns into...

Policymakers need to consider the impacts that robots and artificial intelligence (AI) technologies have on humans beyond physical safety. Traditionally, the definition of safety has been interpreted to exclusively apply to risks that have a physical impact on persons' safety, such as, among others, mechanical or chemical risks. However, the curren...

Background: Neural rehabilitation and rehabilitation robotics explore their predominant focus on restoration of sensorimotor function, attempting to recruit and promote adaptive neural plasticity while inhibiting maladaptive plasticity. Although the role of emotions and affective states are considered crucial to the learning process, their implicat...

In response to the industrial world becoming more complex and the recent social distancing caused by the COVID-19 outbreak, emerging technologies such as Virtual Reality (VR) are gaining importance for industrial training. The novelty, however, does not lie in the sole use of VR-based technology but rather in its adaptive and flexible nature. This...

Recently, several research projects in the Nether-lands have focused on the development of wearable robotic exoskeletons (WREs) for individuals with Duchenne muscular dystrophy (DMD). Such research on WREs is often treated solely within the disciplines of biomedical and mechanical engineering, overlooking insights from disability studies and philos...

Duchenne muscular dystrophy (DMD) is a genetic disorder that results in progressive muscular degeneration. Although medical advances increased their life expectancy, DMD individuals are still highly dependent on caregivers. Hand/wrist function is central for providing independence, and robotic exoskeletons are good candidates for effectively compen...

Duchenne muscular Dystrophy (DMD) is a progressive degenerative muscle disease, affecting, among others, the upper extremities. Effective hand rehabilitation can improve the hand function of people with DMD. To reach this goal, we first need to gain more insight into the hand cognitive-motor performance of people with DMD. This is the first study e...

For the first time, a person with Duchenne muscular dystrophy is controlling an active hand orthosis. In this case study, we decoded the hand motor intention of the participant, using direct sEMG, for the control of an underactuated hand orthosis we developed (SymbiHand). Link: https://www.youtube.com/watch?v=jpHjlFM0t3Y&feature=youtu.be

People with Duchenne muscular dystrophy are currently in need of assistive robotics to improve their hand function and have a better quality of life. However, none of the available active hand orthoses is able to address to their specific needs. In this study, the use of hydraulic technology is proposed in the design of an active hand orthosis. Com...

Background Adults with Duchenne muscular dystrophy (DMD) can benefit from devices that actively support their arm function. A critical component of such devices is the control interface as it is responsible for the human-machine interaction. Our previous work indicated that surface electromyography (sEMG) and force-based control with active gravity...

The development of dynamic hand orthoses is a fast-growing field of research and has resulted in many different devices. A large and diverse solution space is formed by the various mechatronic components which are used in these devices. They are the result of making complex design choices within the constraints imposed by the application, the envir...

Duchenne muscular dystrophy (DMD) is a disease resulting in progressive muscle degeneration. Active arm supports can improve the quality of life for people with DMD by augmenting the residual motor capabilities of their arm. As an extension of our previous study, this research aims at developing a EMG-based control interface to detect the user's mo...