Design strategies to improve patient motivation during robot-aided rehabilitation

Abstract

Background: Motivation is an important factor in rehabilitation and frequently used as a determinant of rehabilitation outcome. Several factors can influence patient motivation and so improve exercise adherence. This paper presents the design of two robot devices for use in the rehabilitation of upper limb movements, that can motivate patients during the execution of the assigned motor tasks by enhancing the gaming aspects of rehabilitation. In addition, a regular review of the obtained performance can reinforce in patients' minds the importance of exercising and encourage them to continue, so improving their motivation and consequently adherence to the program. In view of this, we also developed an evaluation metric that could characterize the rate of improvement and quantify the changes in the obtained performance.

Advances in upper limb stroke rehabilitation: a technology push

“…Initial clinical results suggest that forearm and wrist therapies leads to decreased chronic stroke wrist impairment as depicted by the FMA wrist and forearm sub-score results [16]. Similar FMA improvements were reported by the developers of the MEMOS system (Table 1) with a simpler wrist flexion-extension mechanism with eight chronic stroke subjects [17]. A hand rehabilitation system based on the Rutgers Master II force feedback glove-exoskeleton (Table 2) has shown promising results with exercises designed to increase the range of motion, maximum force and velocity of the fingers and thumb [77].…”

“…Via the system, stroke patients were able to play custom or commercial tasks and games during therapy sessions. Other developments examples for teletherapy include Colombo and colleagues' one degree of freedom wrist and 2-DOF shoulder/elbow robots packaged with simple motivational tasks and feedback metrics to increase patient intrinsic motivation and enjoyment during therapy [17] and the simulated piano that presents visual, auditory and tactile feedback to enable bilateral arm and hand therapy using cyberglove [1].…”

A design framework for a home-based stroke rehabilitation system: Identifying the key components

“…Colombo et al's robotic arm is not suitable for real homes as it is large, expensive and requires a clinician to set up [9]. Their simplistic on-screen tasks may lack appeal in the long term (their trial lasted only 3 weeks).…”

“…They have been found to lead to large improvements of recovery of upper limb function including strength gains, reach extent, movement quality and patient motivation and [9,24,29]. The three main robotic devices used in randomised control trials are the ARM Guide [22].…”

SOPHIA: Soft Orthotic Physiotherapy Hand Interactive Aid

“…Robotic rehabilitation can guide the patient's motions during exercise and ensure that the full movement has been performed. Robotic systems can also display the patient's progress and, using interactive games or virtual reality, encourage participation (Colombo et al, 2007).…”