A Review of Robot-Assisted Lower-Limb Stroke Therapy: Unexplored Paths and Future Directions in Gait Rehabilitation

Abstract

Stroke affects one out of every six people on Earth. Approximately 90% of stroke survivors have some functional disability with mobility being a major impairment, which not only affects important daily activities but also increases the likelihood of falling. Originally intended to supplement traditional post-stroke gait rehabilitation, robotic systems have gained remarkable attention in recent years as a tool to decrease the strain on physical therapists while increasing the precision and repeatability of the therapy. While some of the current methods for robot-assisted rehabilitation have had many positive and promising outcomes, there is moderate evidence of improvement in walking and motor recovery using robotic devices compared to traditional practice. In order to better understand how and where robot-assisted rehabilitation has been effective, it is imperative to identify the main schools of thought that have prevailed. This review intends to observe those perspectives through three different lenses: the goal and type of interaction, the physical implementation, and the sensorimotor pathways targeted by robotic devices. The ways that researchers approach the problem of restoring gait function are grouped together in an intuitive way. Seeing robot-assisted rehabilitation in this unique light can naturally provoke the development of new directions to potentially fill the current research gaps and eventually discover more effective ways to provide therapy. In particular, the idea of utilizing the human inter-limb coordination mechanisms is brought up as an especially promising area for rehabilitation and is extensively discussed.

Analysis of Human Gait Using Hybrid EEG-fNIRS-Based BCI System: A Review

“…Due to portability and excellent temporal and spatial resolution of both EEG and fNIRS helping patients during gait rehabilitation in terms of wearable lower limb exoskeletons, orthosis, prosthesis, and other assistive robotic devices (Belda-Lois et al, 2011 ; Chéron et al, 2012 ; Castermans et al, 2013 ; Tariq et al, 2018 ; Hobbs and Artemiadis, 2020 ). Belda-Lois et al ( 2011 ) reviewed gait therapies used in gait rehabilitation comprise classical gait rehabilitation techniques, FES, BCI systems, and assistive robotic devices.…”

Sensors and Systems for Physical Rehabilitation and Health Monitoring—A Review

“…The use of robot-assisted gait training has been one of the most current studies in the field of rehabilitation, showing itself as a promising area [94][95][96][97]. In [98], the authors reported an initial study to analyze the emotion of patients, offering a therapist a better interpretation of the psychological state of the patient and their transition from each emotional state.…”

The Rehabilitation and the Robotics: Are They Going Together Well?

“…Some of these directions that more directly relate with motion rehabilitation [ 4 , 10 , 11 ] are: To assess the effects of using robots at different phases of recovery. To develop wearable robots easy and practical to wear and remove.…”