Effectiveness of robo-assisted lower limb rehabilitation for spastic patients: A systematic review

Shakti, Divya; Mathew, Lini; Kumar, Neelesh; Kataria, Chitra

doi:10.1016/j.bios.2018.06.027

Cited by 26 publications

(12 citation statements)

References 75 publications

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“…Gait performance can be also analyzed through the other joints of both paretic and non-paretic sides [35]. Usually, this assessment includes at least the knee and ankle joints, where the results commonly exhibit kinematics improvement [32].…”

Section: Discussionmentioning

confidence: 99%

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Actuation system of the ankle exoskeleton T-FLEX: first use experimental validation in people with stroke

Gomez-Vargas

Ballén-Moreno

Barria³

et al. 2020

Preprint

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Abstract Background: Robotic devices can provide physical assistance to people who have suffered neurological impairments such as stroke. Neurological disorders related to this condition induce abnormal gait patterns, which harm the independence to execute different Activities of Daily Living (ADL). From the fundamental role of the ankle in walking, Active Ankle-Foot Orthoses (AAFOs) have been developed to enhance the users' gait patterns, and hence, their quality of life.Methods: Ten patients who suffered stroke used the actuation system of the T-FLEX orthosis triggered by an inertial sensor on the foot tip. The VICON motion capture system recorded the users' kinematics for unassisted and assisted gait modalities. Biomechanical analysis and usability assessment measured the performance of the system actuation for the participants in overground walking. Results: The biomechanical assessment exhibited changes in the range of motion of the lower joints for $70\%$ of the subjects. Moreover, the ankle kinematics showed a correlation with the variation of other movements analyzed. This variation had positive effects on 70\% of the participants in at least one joint. The Gait Deviation Index (GDI) presented significant changes for 30\% of the paretic limbs, where one volunteer increased this index in 14\%. The spatiotemporal parameters did not show significant variations between modalities, although users' cadence had a decrease. Lastly, the satisfaction with the device was positive, being the comfort the most users-selected aspect.Conclusions: This article presented the assessment of the T-FLEX actuation system in people who suffered stroke. Biomechanical results showed improvement in the ankle kinematic and variation in the other joints. In general terms, GDI did not exhibit significant changes, and Movement Analysis Profile (MAP) registered the main movements altered by the device. Future works should focus on assessing the full T-FLEX orthosis in a larger sample of patients that includes a stage of training.Trial registration: This study was registered as Preliminary Biomechanical and Usability Study of an Active Ankle-Foot Orthosis for Stroke Survivors on 30 January 2020 in Clinical Trials with the identi er No NCT04249349 (available at https://clinicaltrials.gov/ct2/show/NCT04249349).

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Section: Discussionmentioning

confidence: 99%

“…Spatial-temporal parameters allow measuring the device's effects on the user [19,35]. Mainly, orthotic devices should improve the subjects' parameters to enhance their mobility in the execution of ADLs [36].…”

Section: Discussionmentioning

confidence: 99%

Actuation system of the ankle exoskeleton T-FLEX: first use experimental validation in people with stroke

Gomez-Vargas

Ballén-Moreno

Barria³

et al. 2020

Preprint

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“…All patients underwent the standard comprehensive neurological rehabilitation program commonly used in foot rehabilitation for patients in the early poststroke period [15].…”

Section: Methodsmentioning

confidence: 99%

The usefulness of isometric protocol for foot flexors and extensors in assessing the effects of 16-week rehabilitation regiment in poststroke patients

et al. 2019

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Background Ankle joint function in a paretic limb has a fundamental impact on mobility. Return of joint function is a measure of early poststroke physical rehabilitation. This study aims to assess the suitability of using the isometric protocol for objective evaluation of flexor and extensor muscle strength in the paretic limb of poststroke patients. Methods 34 patients (F: 9, M: 25) aged 51–79 years with hemiparesis following an acute ischemic stroke and 34 healthy controls were examined using the isometric protocol measured on the Biodex System ® . The following parameters were analyzed: peak torque [PT], average torque [AVGT], average torque/body weight [AVGT/BW] for flexors and extensors, and AVGT flexor/AVGT extensor [agonist/antagonist ratio] of the paretic foot, the nonparetic foot and foot of healthy controls using three foot–shank positions (15°, 0°, and − 15°) prior to rehabilitation commencement and at its completion 16 weeks later. Results Prior to rehabilitation commencement, nonparetic foot differed significantly ( p < 0.05) from healthy foot controls in all parameters and all positions for flexors and in all positions for foot–shank positions of 0° and − 15° for extensors. At rehabilitation program completion the following parameters increased significantly for the paretic foot: PT, AVGT, and AVGT/BW for foot extensors in all tested positions, and PT for foot flexors in foot–shank position of − 15°. The nonparetic foot however, showed no significant difference following rehabilitation regardless parameter or foot position tested for flexors and extensors alike. Prior to rehabilitation agonist/antagonist ratio in the paretic foot differed significantly from corresponding parameter in the control group for the foot–shank positions of 15° and 0°, whereas at rehabilitation completion, the two groups showed significant difference only in foot–shank position of 0°. Conclusions In the early period following stroke, there is a significant strengthening of the paretic limb, but no improvement in the strength of nonparetic limb.

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“…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.…”

Section: Systems and Sensors In Physical Rehabilitationmentioning

confidence: 99%

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

Nascimento

Bonfati

Freitas

et al. 2020

Sensors

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The use of wearable equipment and sensing devices to monitor physical activities, whether for well-being, sports monitoring, or medical rehabilitation, has expanded rapidly due to the evolution of sensing techniques, cheaper integrated circuits, and the development of connectivity technologies. In this scenario, this paper presents a state-of-the-art review of sensors and systems for rehabilitation and health monitoring. Although we know the increasing importance of data processing techniques, our focus was on analyzing the implementation of sensors and biomedical applications. Although many themes overlap, we organized this review based on three groups: Sensors in Healthcare, Home Medical Assistance, and Continuous Health Monitoring; Systems and Sensors in Physical Rehabilitation; and Assistive Systems.

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Effectiveness of robo-assisted lower limb rehabilitation for spastic patients: A systematic review

Cited by 26 publications

References 75 publications

Actuation system of the ankle exoskeleton T-FLEX: first use experimental validation in people with stroke

Actuation system of the ankle exoskeleton T-FLEX: first use experimental validation in people with stroke

The usefulness of isometric protocol for foot flexors and extensors in assessing the effects of 16-week rehabilitation regiment in poststroke patients

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

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