Although the use of robotic devices to address neuromuscular rehabilitative goals represents a promising technological advance in medical care, the large number of systems being developed and varying levels of clinical study of the devices make it difficult to follow and interpret the results in this new field. This article is a review of the current state-of-the-art in robotic applications in poststroke therapy for the upper extremity, written specifically to help clinicians determine the differences between various systems. We concentrate primarily on systems that have been tested clinically. Robotic systems are grouped by rehabilitation application (e.g., gross motor movement, bilateral training, etc.), and, where possible, the neurorehabilitation strategies employed by each system are described. We close with a discussion of the benefits and concerns of using robotics in rehabilitation and an indication of challenges that must be addressed for therapeutic robots to be applied practically in the clinic.

No abstract

We examined the effects of low-dose bromocriptine, a D2 dopamine receptor agonist, on processes thought to be subserved by the prefrontal cortex, including working memory and executive function, in individuals with traumatic brain injury. A group of 24 subjects was tested using a double-blind, placebo-controlled crossover trial, counterbalanced for order. Bromocriptine was found to improve performance on some tasks thought to be subserved by prefrontal function, but not others. Specifically, there was improvement in performance on clinical measures of executive function and in dual-task performance, but not measures that tap the ability to maintain information in working memory without significant executive demands. Also, on control tasks not thought to be dependent on the prefrontal cortex, no improvement on bromocriptine was noted. These results demonstrate a selective effect of bromocriptine on cognitive processes which involve executive control, and provide a foundation for potential therapies for patients with prefrontal damage causing dysexecutive syndromes.